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Menopausal Symptoms

I waited to announce the emerging research regarding the safety of post-menopausal hormone replacement therapy for breast cancer patients suffering from severe menopausal symptoms until the research finally supported my belief that women have the right to receive the treatment that they need if they accept the risks of that treatment.

The past year of research (2024-2025) has produced a significant amount of research demonstrating the health risks associated from not taking hormone replacement therapy, as well as the safety of using testosterone after breast cancer and the limited risks of hormone replacement therapy following breast cancer.

I have practiced women’s medicine for over 40 years, and I believe that female patients should have the right to receive post-menopausal hormone therapy if they understand and accept the associated risks and benefits, as long as it is administered safely.

Let me pause here to discuss how doctors ethically make decisions about treatment. First, the aim of medical treatment is to improve health and longevity while alleviating symptoms. It is a doctor’s responsibility to evaluate, treat, and advise patients on the best course of therapy based on their medical training, practical experience, and the latest research. However, the third factor is often overlooked when advising patients about hormone replacement therapy after breast cancer. Doctors determine the best course of treatment by using this information and weighing the benefits of a treatment against its risks. We are trained to provide this information to patients to facilitate informed decision-making with the patient, not for the patient. This process requires time that doctors no longer have. Ah, and therein lies the problem.

Doctors are trained to follow research related to the diseases and conditions they treat and to integrate that research into their practice. The basic decision-making process involves weighing the benefits of treatment (or no treatment) against the associated risks. When the benefits of a treatment outweigh its risks, it is recommended to the patient. “Recommended” means the doctor, based on current knowledge, believes it to be safer and more effective for the patient’s health to pursue a specific treatment. However, this does not imply that the patient must follow the doctor’s advice. A patient is autonomous and can assess the risks and benefits once informed, allowing them to refuse a treatment or request one that falls outside current medical guidelines. Doctors do not have to embark on a treatment they do not believe is beneficial or safe. Doctors have autonomy as well!

Doctors in mainstream medicine adhere to “medical guidelines” established by our specialties, which represent the minimum level of care expected from a physician. However, these guidelines are often decades behind current research, meaning that the risks and benefits communicated to a patient may be outdated. A legal requirement known as informed consent mandates that a doctor inform the patient or include this information in a consent form that the patient reads and signs, detailing the procedure or treatment. If the treatment is newer than the guidelines, it is categorized as “off-label.” It is essential for the doctor to inform the patient that the treatment does not conform to current guidelines, and the patient must acknowledge the known risks associated with the treatment.

At BioBalance Health®, we often find ourselves ahead of the guidelines, and my experience indicates it may take up to 20 years for the guidelines to catch up with us. Much of our treatment is considered off-label because it is current and ahead of the guidelines. It is superior to other treatments and remains safe, but risks are inherent in every treatment!

Now, let’s return to breast cancer and the roles of estradiol, testosterone, and progesterone replacement. Here are the facts about breast cancer:

Most breast cancer patients are post-menopausal, and have symptoms of menopause
Not all types of breast cancer are stimulated by estradiol or progesterone, and therefore for these cancers hormone replacement therapy is safe.
Breast Cancer patients with negative nodes who have had a bilateral mastectomy are candidates for hormone replacement therapy after their treatment.
The risks of estrogen replacement for ER+ breast cancer patients may promote the growth of cancer cells, while testosterone replacement lowers the risk of recurrence and alleviates certain menopausal symptoms.
When testosterone is combined with estradiol, the risk of developing breast cancer in all women is reduced.
Testosterone enhances the quantity and activity of cancer-fighting T-killer and T-helper white blood cells.
All breast cancer patients can manage menopause symptoms using testosterone pellet therapy and vaginal estrogen without an increased risk of recurrence.

Do you remember when I mentioned that the risks of treatment should be balanced with the benefits of that same treatment?

Recently, numerous research articles have outlined the benefits of estradiol treatment, which I included in my 2017 book, “The Secret Female Hormone: How Testosterone Replacement Can Change Your Life.” In early 2025, the safety of taking estradiol for menopausal women confirmed the less publicized research that had come before. The Journal of Endocrinology and Metabolism reported that women who underwent estradiol replacement after the age of 60 live 20% longer than those who do not take hormone replacement therapy. This challenges the guideline that advises OB-GYNs to discontinue hormone replacement therapy before the age of 60.

The Benefits of Estrogen replacement after menopause, based on multiple research studies over the last 20 years is as follows:

ERT alleviates symptoms such as dry vagina, painful intercourse, insomnia, hot flashes, and night sweats.
Estrogen replacement prevents and treats osteoporosis in women.
Testosterone replacement in women with osteoporosis can reverse the process of bone loss, bringing bone back to normal strength and decreasing fracture risk.
Non-oral Testosterone and Estradiol can prevent arteriosclerotic heart disease.
ERT and HRT decreases the risk of diabetes with aging.
Estradiol replacement during the first decade after menopause can delay the onset of Alzheimer’s disease and dementia by ten years. If you are genetically predisposed to developing Alzheimer’s or dementia by age 80, E2 replacement may postpone this onset until you turn 90.
Testosterone replacement in the first 10 years after menopause postpones the onset of Alzheimer’s disease and dementia for an additional ten years.
Testosterone boosts immune function in both sexes and diminishes the onset and severity of infectious diseases.
Aging causes cognitive decline, marked by challenges in memory and thinking, and menopause speeds up this process. Testosterone and estradiol replacement therapies may aid in reversing this decline.
Muscle mass decreases after menopause due to a decline in testosterone but replacing testosterone with bio-identical pellets restores muscle mass to premenopausal levels.

The latest medical article that inspired me to create this podcast was published in the journal Menopause, which discussed the challenges many women face after breast cancer treatment without hormone replacement for their severe menopausal symptoms. Here are the quotes I think you should hear: (MHT = Menopause Hormone Therapy)

“Among 226 breast cancer survivors.. the menopause symptom burden was high and

women’s experience of menopause-related breast cancer after-care was poor. Few women felt actively involved in menopause treatment decisions.

The NICE breast cancer guideline (NG101) states that women with a history of

breast cancer can be offered MHT in “exceptional” circumstances if other treatments have failed (off-label use). However, NICE does not define what “exceptional” circumstances are or who gets to decide.

Up to 50% of breast cancer survivors, especially those with debilitating menopausal symptoms, may choose to accept a small increase in risk in exchange for an

improved quality of life and/or to mitigate future health risks associated with chronic estrogen deficiency.“Allowing”. women to have MHT only in “exceptional” circumstance undermines patient autonomy and limits a clinician’s ability to integrate clinical knowledge and judgment with the best currently available evidence (which is decades behind clinical guidelines). Clinicians have a legal and ethical responsibility to patients to make informed treatment choices.

If you have had breast cancer and are experiencing symptoms you no longer want to endure, my advice is to find a doctor with whom you can make an informed decision based on the latest research. It’s important to understand and accept the risks and to sign a High-Risk Consent for HRT.

If you aren’t that brave, then seek a physician who will prescribe testosterone pellets along with vaginal estradiol to alleviate some of your post-menopausal symptoms. Life is too short to follow guidelines that are 20 years out of date when you are suffering.

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Last time we reviewed why interpreting your lab may lead you to the wrong diagnosis and treatment. Today we continue our review of each lab panel and why the reference ranges on your lab results may not be the “Healthy Normal Range” that you should compare your results to.

Lab reference ranges are established with a one-size-fits-all mentality, ignoring the numerous variables that influence blood results.

Have you ever tried on a “one-size-fits-all “ANYTHING? Those clothes may fit 20% of the population but for the rest of us, the garment doesn’t fit our width, weight or height! All one-size-fits-all lab reference ranges are much the same.

For example, the standardized “reference ranges” in the US serve as a one-size-fits-all “ideal range” applied to everyone, despite genetic differences, varying latitudes, and the diverse diets that characterize the American multiethnic population. This presents the first problem with using a single range for all people: variations among individuals based on differing genetic needs. The second issue is that the ranges on the lab report indicate the minimum levels necessary for survival, not necessarily the healthiest blood levels for most individuals. Another example of one size doesn’t fit all is the reference range for women’s hormones. A range is displayed for cycling women, but there is no healthy range for menopausal women. Does the range displayed refer to menopausal women with HRT, or menopausal women without HRT to treat their menopausal symptoms? Is the range based on what is healthy, or what is average? We aren’t sure.

Labs don’t ask patients questions that could help interpret lab values. Therefore, they cannot provide a truly diagnostic reference range for any illness. They only consider gender and age, as reference ranges are solely adjusted for these two factors. A doctor must interpret individual lab results alongside a patient’s medical and surgical history, including established diseases, medications, supplements, hormonal treatments, and past lab values. For instance, laboratory companies should offer reference ranges based on whether a patient is menopausal, a woman is undergoing ERT, a man is receiving testosterone, a patient is on thyroid medication, a person is being treated for diabetes, or the diabetic tests are performed to diagnose diabetes.

Some Reference Ranges are Based on comparing results to Misleading formulas

The best example of this issue is the Lipid Panel. Doctors use this panel to determine a person’s risk for heart attacks caused by atherosclerosis. Most doctors don’t know the formula for determining Total Cholesterol. This test doesn’t predict heart disease in most patients, as the formula used to arrive at that number is not indicative of the disease. However, doctors have been advised that when total cholesterol levels are high, a patient should start taking a statin, a drug that reduces blood cholesterol and sometimes lowers the rate of heart attacks in certain individuals, though it is rarely predictive in 50% of the population.

The problem with the lipid panel is twofold: the LDL level indicates future atherosclerosis in only about 50% of the population and is not a specific test for future heart disease risk.

Total cholesterol is even less predictive of heart disease because it stems from a flawed formula.

Doctors interpret a high Total Cholesterol level as an indication that a patient may be at increased risk for heart disease in the future. When I test patients with elevated Total Cholesterol or high levels of LDL using a Cardiac Calcium Scan to measure plaque, only half of them actually produce plaque, and consequently, are not at risk for atherosclerotic heart disease. I believe that the Total Cholesterol number is derived from an inaccurate formula for determining a person’s risk of future heart disease. The Total Cholesterol number is calculated using a flawed equation. The equation is as follows:

LDL + 1/5 Triglycerides+ HDL = Total Cholesterol

Total Cholesterol = LDL (bad cholesterol) + 1/5 Triglycerides (high risk factor) + HDL (good cholesterol)

Let’s examine this formula simply like this: Bad + Bad + Good does not equal Bad. Due to this incorrect formula, thousands, if not millions, of patients have been prescribed statin drugs for a lifetime without justification! Statins carry risks. The list of side effects is extensive and includes muscle deterioration and statin-associated dementia. Unfortunately, most people who experience statin side effects are women. Women tend to have higher HDL levels than men. Additionally, they typically do not have atherosclerotic plaque until menopause and usually do not develop it after menopause if they undergo estrogen replacement therapy!

This gender issue is just one of the problems with laboratory reference ranges that are not adjusted for sex. The total cholesterol values were developed solely from the blood levels of men, who typically have lower HDL levels. Women were excluded from the tests conducted to create this blood panel. For women, I dispel the myth that high total cholesterol predicts heart disease by recommending a Cardiac Calcium Scan to check for plaque. If a woman has no plaque by the age of 50 and is taking estrogen, she is unlikely to develop plaque in the future. I still test them every 2-3 years to ensure that no metabolic changes have altered their risk, but I don’t put much faith in the unreliable cholesterol blood panel.

There is another blood test that has deceptive reference ranges: IGF-1

How about the GH-IGF-1 test, the test for Growth Hormone? IGF-1 is a metabolite of GH that we can measure to determine how much the patient produces. This hormone aids in healing and replenishing aging cells in patients after their growth is complete. The healthy normal range with which I was trained, (150-350 MIU), has been changed to an age-adjusted normal that compares a person to others in her age category who had their blood drawn the previous year. What is wrong with this?

Growth hormone (GH) decreases with age and contributes to the declining health people experience as they grow older. Similarly, IGF-1 diminishes with age and illness, which means that the “reference range” essentially reflects that you are “average for the sick individuals who visit Quest to have their IGF-1 levels checked. ” IGF-1 levels can be enhanced through weight loss, testosterone replacement, and an increase in muscle mass.
The current reference range does not indicate health or illness; it merely shows whether you fall within the average for your age group.
This non-scientific method of determining “health” is widespread in contemporary medicine. By comparing aging individuals to others within the same age group, for hormones that decline with age, based on samples from sick patients who visit a specific lab in the past year, these labs label patients as “healthy” even when they are as ill as other individuals their age who go to that lab! This practice constitutes age discrimination! Regarding hormones, the levels we maintained during our fertile and youthful years correspond to the blood levels indicative of health in all individuals ages.

For example:

People who check their IGF-1 (Growth Hormone) levels and see a low “52 ng/ml” might feel satisfied that they are within the standard range (50-280 ng/ml). However, they may not realize that this range applies to older, unhealthy individuals, not to healthy young ones (150-350 ng/ml). This is just one example of the issues that arise when non-medical individuals, who do not monitor these tests regularly, draw conclusions from the numbers.

Some illnesses require more than one blood test for diagnosis

If you consider only one of the three tests for diabetes or prediabetes (Fasting Blood Sugar, HbA1c, and Insulin), you cannot self-diagnose as diabetic, prediabetic, insulin resistance or healthy. Diabetes is a disease that has coincided with the rising number of obese individuals. Both conditions affect nearly 50% of the American population. Blood tests cannot be interpreted accurately unless a patient has fasted for 12 hours; all three tests should be evaluated. When diagnosing diabetes and insulin resistance, we perform three tests to assess whether a patient has insulin resistance, prediabetes, or diabetes. These tests guide our diagnosis and inform the treatment we provide based on their results.

Fasting insulin is a highly misleading test. Over 15 years ago, a significant study was conducted that was believed to change the reference ranges for fasting insulin. The new range set for normal fasting insulin was less than 10 mIU/ml. By publishing the reference range less than 18 mIU/ml, they miss diagnosing many patients with insulin resistance

HBA1C is a test that gives a value of average blood sugar over three months.

The results are often used alone to determine prediabetes and diabetes; however, considering all three aspects makes the diagnosis and treatment plan more specific for the patient.

FBS (fasting blood sugar) is the third diabetes test. It is generally used as a screening test that prompts the ordering of the other two blood tests; however, some patients exhibit symptoms of diabetes and insulin resistance without having elevated fasting insulin levels.

Many medications can raise diabetic test values, causing a patient to seem diabetic when they are actually experiencing a side effect of the drug. One such medication is Atorvastatin. The solution is not treating diabetes but rather adjusting the medication.

Hormone tests are especially challenging to interpret, Especially when testing free Testosterone in women

Here are the problems with the free Testosterone test itself:

Women have extremely low levels of free testosterone and testosterone compared to men. I have been informed by Quest that women’s free testosterone levels are not reliable with current methods because they are not always reproducible when a test is conducted twice on the same day. This leads me to believe that hormone levels do not always reflect the actual blood levels of free testosterone and estradiol.
The levels of testosterone in women are based on menopausal levels of T. Women have long been thought to not produce testosterone, so the “normal” levels are quite low, and 0 used to be considered normal- until one day I managed to persuade a medical director at Quest to increase it to 0.2!
Women’s testosterone is influenced by their production of E2 and E1, which inactivate free T. Women vary in how their cells respond to testosterone and estradiol.
Receptor sites and their genetic acceptance of hormones can mean that the same blood level of testosterone in both sexes does not produce the same effects in all patients. Some women (and men) are resistant to E2 and T, or to one of the two. This indicates that the hormone-free T level may be optimal for one woman while being ineffective in alleviating any low T symptoms for another. The latter individual is T resistant, and we currently have no means outside of research labs to determine which women are sensitive and which are resistant. This requires that doctors and NPs look beyond typical reference ranges to effectively manage E2 and T replacement for women.
Lastly some labs use the total testosterone level through a formula determine the free T. This carries inherent risks of reporting the wrong active level of testosterone.

Total and free testosterone blood levels for men, are derived from results of older men, rather than from the blood levels that indicate health and the levels at which men experience no symptoms. This leads men to believe they are normal, even though they are symptomatic, and they can’t get treatment.

There is no time to discuss the reference ranges for LH, FSH, Estradiol, and Estrone; these topics will be addressed in a future blog. I hope I have encouraged you to review your blood work with your doctor or Nurse Practitioner, and not to act as your own doctor by interpreting your blood tests.

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There is a new federal rule for lab companies that requires them to report your blood tests to you as soon as they are finished, often even before your doctor has seen them. This rule, deemed unreasonable, was established by individuals without medical expertise (politicians), who know little about interpreting lab data or the workings of doctor’s offices. Sending your lab results to you before doctors can assess them is not a decision rooted in sound medical practice but rather in the notion of individual freedom. While this is important, it does not compare to having an expert interpret your results with you.

The law requiring that your lab results be sent to you as soon as they are completed does not consider the fact that these results are not designed for laymen to interpret. Additionally, lab results are meant to be analyzed alongside a patient’s medical history, age, gender, and medications. The results are not tailored to report information specific to your situation, which is how a doctor would interpret them.

Lab results often lack layperson-friendly explanations. This new protocol can cause anxiety, as patients may panic over results that appear abnormal, even if they are normal for their specific medical condition and treatment. Furthermore, lab companies only request your age and gender. The factors that doctors evaluate when interpreting your results are diverse and numerous, each influencing the overall interpretation.

What are the considerations that doctors add to their interpretation?

Menopausal status
Medical conditions
Healthy normal for young and healthy adults
The newest recommended ranges for health
Body weight
Other lab values seen on the same report

The problem with you getting your own lab and interpreting it as written is multifactorial:

The lab is sent to you digitally with very little explanation except for reference ranges.

There is no information about who you are being compared to. Other women, both men and women? Old women? Young women? Women with symptoms or women who are well without symptoms. The reporting of the lab results to a patient directly may hide problems that need action or create fears that are unnecessary.

Anxiety over your results will continue until your doctor’s appointment to discuss … so you may experience unnecessary worry in many circumstances.
Reference ranges make many assumptions, but labs don’t input vital information about you into their computer.
1. your age of menopause,
2. your weight
3. your height (or BMI)
4. previous illnesses and your medications.
5. if you are on hormones or testosterone

Here is a good example. The test for pituitary hormones FSH and LH.

When a woman aged 45 is menopausal, and has a very high FSH and LH, the lab says it is “normal” (in the reference range), yet the woman is having severe hot flashes, night sweats, anxiety, and insomnia. That is not healthy or “normal”.

The same two tests can be used to determine if a person is menopausal.

Let’s say a 42-year-old woman has elevated FSH and LH, but her estradiol is very high (200-300). To the layperson, this looks like menopause, but in reality, it is the picture of ovulation, not menopause. One has to look at another test, estradiol, to determine whether she is premenopausal and ovulating or menopausal (her estradiol would be very low, and FSH and LH would be high). See the problem?

Reference Ranges don’t tell you what the doctor is looking for.

The same two tests, FSH and LH, are used to diagnose polycystic ovaries (PCO) too. In women without PCO, the FSH is higher than the LH, but if the LH is greater than the FSH, the diagnosis of PCO should be considered! There is no information about this interpretation in the lab report.

Falling within the reference range doesn’t guarantee health or absence of symptoms. If patients are to interpret their own lab results, reference ranges should reflect health in every possible scenario.

FSH and LH are influenced by BCPs and menopausal HRT. Lab results should be interpreted considering the information regarding BCPs or ERT that the patient is taking. When women are on BCPs and HRT or ERT, their FSH and LH levels are suppressed to an extremely low point. If you are unaware that the patient is taking these hormones, it may appear that the diagnosis is pituitary failure affecting estrogen levels and ovulation. Only doctors can interpret this test. There should truly be a “normal” range for those undergoing hormone replacement therapy, along with a reference range that reflects overall health, rather than merely the average for your geographical area in the US or your age group.

Please make an appointment with your doctor to review your lab results so you can understand how they are interpreted. If you have questions about your lab results that are concerning you, schedule a time to discuss them with your doctor. Doctors don’t have the time to explain results over the phone or through email—that is what appointments are meant for. Phone calls to doctors’ offices are not intended for lab result interpretation. You or your insurance will not compensate the doctor or NP for this service over the phone.
The reference ranges for many tests and medical situations are actually wrong. If you aren’t trained as a doctor or Nurse practitioner who interprets metabolic lab results every day, you could get the wrong diagnosis!!!
1. For example, when evaluating a patient for insulin resistance, the reference range was officially changed almost two decades ago. Still, the lab companies have left the normal range very high (insulin> 18). In the revised range, fasting insulin diagnoses insulin resistance if the value is > 10. The resulting outcome is that many people are not diagnosed at a time when they can be easily treated without drugs and are told that they are “normal” when they are really experiencing insulin resistance. This is misleading and just wrong!
Lab values are not adjusted to your individual situation.
Many tests are adjusted for gender; however, some are specifically adjusted for women who are menstruating regarding H/H. In other words, men and women have different “normal” H/H levels in the reference range. Women who do not menstruate or who are menopausal should be compared to the same reference range as men, but that does not happen.
This leads to menopausal women, who are normal, often being told they have too many red blood cells when that is not the case. Conversely, menopausal women who are truly anemic are told they are normal, which means it takes longer to diagnose their anemia from colon cancer! The H/H should have a reference range that is considered “normal” for a woman’s stage in life, depending on whether she is experiencing menstrual periods or not.
Many reference ranges are averages for regions of the US and vary between lab companies; therefore, they are not reliable values for comparing patients.
For instance, the Homocysteine test has a normal range that is relatively high, and each lab has different reference ranges. This test serves as a screening tool for MTHFR genetic risk related to embolic stroke and heart disease. The suggested treatment involves methylated B vitamins; however, the interpretation on the lab printout advises taking B12 and folic acid, which, in my experience, tends to increase the number rather than decrease it.
Reference ranges for nutrients, vitamins, and minerals reflect the minimum levels needed for survival, not optimal health.
For example, B12 reference range levels for B12 blood levels are listed as 200-1100 pg/ml, yet I was trained to try to achieve 400 -1500 pg/ml. The lower range of the written reference range (200-400) is not healthy.
The desired blood levels for vitamins are often controversial, and various medical colleges issue new recommendations on Vitamin D levels each month. Consequently, doctors must determine which level of Vitamin D to recommend for their patients. These institutions not only provide changing reference ranges but also offer differing advice on how frequently to test Vitamin D. This inconsistency arises primarily from the ongoing debate about the minimum acceptable level of Vitamin D.

I have more information about your lab results next week that your doctor may not share with you. There is a lot of controversy surrounding the reference ranges on the lab sheet, and you should know the truth in case your doctor doesn’t.

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The newest miracle drug for weight loss is changing the lives of thousands of people who have battled obesity for extended periods of time….These GLP-1 medications are also treating or preventing the diseases that go with long term obesity: Diabetes, Heart Disease, Joint replacements, Arthritis, Sleep Apnea, and Alzheimer’s Disease. Researchers are finding more indications every day for patients to take these weight loss medications.

But like anything else there is no perfect answer to any problem. Among the few side effects of this drug, the most frequent side effect is reflux, also called acid indigestion, or GERD (gastroesophageal reflux disease). Often my patients don’t even know what their diagnosis is, they just tell me about their symptoms.

The symptoms of GERD include:

Asthma symptoms
A bad taste in the mouth
Difficulty swallowing
Dry, hacking, cough
Chest pain after meals

These symptoms are worse after a big meal, at bedtime, after spicy food, or dose related. Most of my patients don’t want to discontinue the GLP-1 inhibitors because they are finally losing weight! We manage the GLP-1 side effect of GERD by decreasing dose of the medication and slowly increase the dose back to an effective level. We also offer lifestyle and dietary treatments before we offer prescription medication.

Therefore, if reflux is not constant, and is not causing any lasting damage to the patient’s esophagus, we can treat it with lifestyle changes and over the counter medication, to lower the stomach acid that is refluxing into the esophagus.

The lifestyle changes patients can employ on their own are described below.

Lifestyle changes needed to avoid or treat Gastric Reflux caused by GLP-1 agonists. What can you do to prevent and treat this side effect:

Eat smaller meals: Large meals expand your stomach and put pressure on your lower esophageal sphincter (LES).
Don’t go to bed less than 2 hours after eating
Avoid trigger foods see below
Sleep on your left side
Elevate the head of your bed
Avoid tight clothing:
Chew your food well– chew each bite for 20 seconds.
Quit smoking: Smoking weakens your LES and makes your stomach more acidic.
Stop drinking alcohol
Chew (non-mint) sugar-free–gum

In addition to changing your active lifestyle, changing your diet is necessary as well.

There are trigger foods to avoid minimizing your reflux symptoms.

tomato sauce and other tomato-based products

high fat foods, such as fast food and greasy foods
fried foods
citrus fruit juices
soda-diet and regular
Caffeine
Garlic
onions
mint of any kind
milk based products

My patients ask me, “So what can I eat?” …I admit I did take away some of the most exciting foods, however my patients ask me what they can eat so the list of foods that help avoid and treat GERD are listed below.

High-fiber foods: vegetables, fruit, and whole grain bread.
Alkaline foods. Foods fall somewhere along the pH scale (turns litmus paper blue).
Drink alkalinized water (PH > 8)
Ginger—fresh sushi Ginger from Asian food stores.
Apple cider vinegar on salads and a Tablespoon in water every morning
Lemon water—just squeeze a slice of lemon in your water.
Coconut water
Honey.
Lean Protein including meat
Low-Fat and Nonfat Dairy Products.
Non-Citrus Fruits like apples, pears, bananas, and melons
Vegetables like broccoli, Carrots, Corn, Cucumbers, Green Beans, Green peppers, Potatoes and Sweet potatoes

For my patients who take herbal and other supplements, the following is a list of the supplements that may decrease your symptoms of GERD.

Chamomile Tea
Licorice
Marshmallow
Slippery Elm Tablets
Probiotics-Mega Brand
Prebiotics-Mega
Digestive Enzymes
Aloe Vera Juice
Baking Soda
Magnesium glycinate

What happens when you have made all the lifestyle changes you can and have lowered your GLP-1 dose or changed to a different type of GLP-1 Agonist, and you still have GERD?

As a physician I prescribe medications to help my patients treat their GERD, however most of the medications have been placed over the counter so I can recommend them to my patients, and they can buy the medication without a script.

The class of medication that treats GERD include Antacids, H2 Blocker, and Proton Pump Inhibitor.

Antacids neutralize stomach acid, but they typically only work for short periods. They are generally made of calcium. This type of medication is best used prn for symptom relief. Side effects of antacids may include constipation and diarrhea.

The second option for treatment of GERD is an H2 blocker. These drugs reduce the amount of acid the stomach releases. Eg. Pepcid, Tagamet, Gaviscon.

Proton pump inhibitors (PPIs): These drugs are available by prescription from a healthcare provider, and now some doses are over the counter. PPIs help reduce the amount of acid the stomach makes. They should be used for a two-week period only for severe attacks and then you should change to an H2 blocker or antacid.

WHY stop a PPI after 2 weeks? Omeprazole is an example of a PPI. Theses medication kill the good bacteria in your intestines, change your breath and can affect how you absorb your nutrients. If you must take them chronically to treat and prevent the progression of damage to the esophagus.

What if I did everything and GERD is still a problem:

If your condition is severe, your doctor may recommend a consultation with a GI doctor for an endoscope or other diagnostic procedure. In addition, you may have to hold your GLP-1 Agonist for a period of time while you treat your esophageal inflammation.

Just as in all medical issues there are many ways to treat side effects of drugs. Your provider will prescribe the medication that she or he is most comfortable with.

What next?

So if you have reflux and are on a GLP-1 inhibitor, you may be advised to decrease your dose or switch to Tirzepatide medication (Mounjaro, Zepbound).

There are many steps you can take before you need prescribed medication. Your doctor may even change your GLP-1 agonist prescription or refer you to a GI doctor, but before this is necessary you should try the lifestyle and dietary changes that I recommend in this Blog first.

This side effect of GLP-1 agonists doesn’t affect every patient and can be managed as you see above, however the lifestyle changes and dietary changes can only be done by you, so the ball is in your court!

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Almost every week I hear from my male patients that their PCP doctor has scared them by telling them to stop taking testosterone pellets because their Hematocrit is too high. Alternatively, their doctor recommended a lower dose of T. These two recommendations are those doctors who don’t understand all the good that the testosterone is doing for these men.

My male patients come to me for Testosterone pellets to treat their ED, lack of libido, loss of muscle, inability to think, weight gain, lack of motivation, anxiety attacks, poor stamina, arthritis, loss of balance, and basically everything that makes a man a man! The most amazing thing is that I can treat them with ONE hormone, Testosterone in pellet form, and cure all these problems! If a man stops taking Testosterone, they get these symptoms again and have to take a multitude of drugs to feel just a fraction better! The treatment for a high H/H is simple…it is a routine removal of blood, either a blood donation or a phlebotomy (removal of 500 cc of blood) in the office, every 2-6 months to keep their H/H under control.

The advice their doctors give them is going to cause them great pain and actually shorten their lives and there is little risk if any to removing blood every few months! In the event that a man demands that I lower their dose…..and I do it…the next inevitable phone call is to complain that their symptoms are coming back! They literally blame me for the advice of their PCP!

I would like to tell these men that the same doctors who could not help them with their low T are the same ones who are giving them the advice to lower or stop their testosterone therapy with T pellets. It is human nature and especially that of doctors to try to criticize the advice of the doctor who got better results with a patient than they did! So, if you develop a condition called erythrocytosis secondary to your testosterone replacement, then you can keep your T therapy, if you are compliant and follow your testosterone doctor’s directions and get your blood removed when it is scheduled. This should prevent any severe reaction from your doctor.

This is a typical response to my patient who has concerns. However, I have given my patients many sources of written and video information about every aspect of testosterone replacement, the risks and benefits including erythrocytosis. These include my book, Got Testosterone? was given to them on the first visit. We also have over 650 informational blogs and videos on You Tube, FAQs and a very extensive handout given to each of them on the first visit. They just have to read!

I have read your concern about erythrocytosis and testosterone replacement that was brought up by your PCP. It is true that T replacement increases the H/H in both sexes. It is useful if you are anemic, but if you have a genetic response to testosterone that elevates your H/H above what is considered normal, then we advise blood donation or phlebotomy every 2-6 months. It is true that the dose of T can affect the H/H, but men often need a high dose of T to feel normal. The removal of blood is low risk and effective.

I am a Specialist in Hormone Replacement Medical care with a 38-year history of replacing bioidentical hormones and 23 years of experience replacing bioidentical hormones with T and E2 pellets. You came to me because your doctors were not helping you with the symptoms of testosterone deficiency and because I have the most experience in the Midwest.

#1. The first issue that we must always consider while we treat anyone is the primary goals for treatment, the relief of low testosterone which is why you came to me. You made an appointment with me because you had un-addressed issues that your PCP (Primary Care Doctor) didn’t treat satisfactorily

Your symptoms were treated with testosterone pellets successfully at a dose that is individual to you. Your health as you get older is also dependent on your blood level of free Testosterone (the total T is not significant) by delaying the diseases of aging. The level that is required to treat your symptoms is the young healthy Free T blood level of a young and healthy man.

Most labs give a reference range for older men which reflects the fact that free testosterone levels drop with age. Old men don’t feel well BECAUSE they have low free T. The low free T level is why you don’t feel well. Our practice has found that everyone has an ideal free T level that we try to maintain, and these are young-healthy level but not old-man level. That is what we have been trying to achieve for our patients.

#2. The second issue is a side-effect that you, as an individual, have experienced with pellets and will experience with any T replacement that you receive that is a high enough dose to treat your symptoms.

Erythrocytosis is a side effect that some men experience on any form of testosterone, however its occurrence doesn’t mean you are on too much testosterone, it means you have a side effect of having a normal free T level. Erythrocytosis is genetic, and your free T blood level stimulates the production of too many red blood cells. We don’t stop the treatment that is making you better, to treat the side effects of it. We treat the side effects.

We treat this side effect with phlebotomies to keep your H/H within the safe range. Did your medical doctor/cardiologist tell you why this is important? We tell you: too many red blood cells can increase the work of the heart, however the Hematologists that we consult with give us the HCT% number we should stay below is 58%. We like to keep your HCT% below 52% but that requires you to be compliant with your regular blood donated or phlebotomized in our office (that takes an appointment). You must be compliant to keep your H/H normal.

These 2 issues are at odds with one another. I cannot give a man enough testosterone to treat his symptoms, without stimulating some production of RBCs. I have no other low T treatment that doesn’t stimulate your bone marrow to make red cells BUT I do have a simple treatment to remove your extra blood cells routinely to keep you from having too many blood cells circulating.

Only you can make the decision to choose health with T pellets and do phlebotomies regularly as recommended, or to stop T and allow your blood count to decrease., and your symptoms will come back.

I want you to read your post-pellet instructions, locate my book Got Testosterone? and read it especially the section on Erythrocytosis, and look at FAQs (frequently asked questions) on the www.biobalanacehealth website, read related episodes of my 677 blogs and or listen to my health casts for your answers. You can imagine how I feel when my patients don’t read what I provide to them in multiple forms to answer their questions.

In the future you should read the information I have given you or come in for an appointment to discuss these matters.

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I am not sure if you play THE “WHAT’S THE DISEASE THAT I DON’T WANT TO HAVE GAME with yourself, but since I am a doctor I have spent a lot of time thinking about what diseases I do not want! I started my list in medical school when I witnessed what certain diseases can do to your life. Medicine has many cures and treatments, yet some diseases that are treated still can negatively change your life forever.

Even though losing a limb and amputation were at the top of my list there is one disease that tops my list. Of course, I also have under stroke the usual scary situations like paralysis, or having an incapacitating heart attack that prevents an individual from taking care of himself or herself. However, my most feared diagnosis is having a STROKE!

You may not fully comprehend how a stroke can change your life, but it can affect your speech, your ability to move, to think, to go places, to have a sense of humor, to write and communicate, even to have a sexual relationship with your loved one. A stroke essentially can take away your ability to be the person you have always been, AND it requires that someone must become your caretaker. That helplessness is something I am most afraid of….We all have our personal fears, but whether you fear having a stroke or not, you should try your hardest to avoid having one!

DEFINITION: a stoke is a medical emergency that occurs when blood flow to the brain is blocked or a blood vessel bursts. This can damage or kill parts of the brain, which can lead to long-term disability, brain damage, or even death. This can cause s a loss of function, physical, mental, and emotional, and loss of one or more of the senses like sensation, speech, sight, hearing and taste and smell!

In my practice at BioBalance Health we always work with our patients to prevent them having a stroke and or heart attack. These two conditions are the biggest villains that steal the joy of our “golden years” from us. From the start of my BioBalance Health practice, I have incorporated healthy diet training, exercise options and encouragement, how and what to take to supplement my patients’ diet and how to outsmart their genetic makeup so they can be healthier than their parents. All of these lifestyle changes can decrease the risk of stroke and heart attack in a person.

So what is it like to have a stroke?

First let’s go over what symptoms are typical of someone having a stroke.

The symptoms of a stroke are multiple, and a person might not have all of them.

Weakness on one side of the body
Facial drooping on one side of the face
Dizziness
Numbness
Loss of balance
Sudden loss of vision.
Trouble making sense when speaking
Trouble talking, reading or understanding
Sudden nausea and vomiting
Brief loss of consciousness such as fainting, seizures, confusion, or coma.

When someone has one or more of these symptoms it is an emergency, and you should call 911, then start asking the patient to open their eyes, smile, raise both arms and hold them up. Ask them to talk to see if their speech is impaired. Your findings will be helpful to the EMTs who come to the scene.

An event is called a stroke, when there is a deficit in physical or mental function and that deficit continues and doesn’t go away. If it the symptoms completely resolve, it is called a TIA- a transient Ischemic attack. It is a warning to see a doctor and make sure you don’t have a stroke in the future and it is a wakeup call to stop all poor lifestyle choices.

PREVENTING A STROKE:

This last month, the American Heart and Stroke prevention Association released new Guidelines on how to prevent a stroke.

I think talking about the risk factors for stroke and discussing how to prevent having one, is worthy of discussion. Recently the medical guidelines for stroke prevention have been revised, and even though I think a few more things should have been included, the fact that they made the first change in the guidelines in 10 years is a first step. Here is what they advise all people who are aging should do.

#1 See your internal medicine or Family physician regularly, at least yearly

#2. Stop sedentary behavior—walk/exercise/ do Yoga, just get out of the chair for the majority of your day!

#3. If you are diabetic, they advocate going on Ozempic/Mounjaro to lose weight—that will lower your risk of a stroke, and heart attack..

#4 If you are hypertensive, take your BP medicine every day

#5 Follow these lifestyle changes called Life’s Essential 8: Your behavior and lifestyle put you at risk for having a stroke:

Healthy diet, low carb Mediterranean diet, no junk food!

Physical activity every day

Achieve a healthy weight,

Make sure your sleep is restful

Stop use of tobacco products, No smoking or vaping

Achieve healthy levels of blood glucose, and blood pressure.

Don’t drink more than one 4 oz glass of wine a day

I add these recommendations to theirs for the care of my patients:

Drink ½ your weight in water every day
Wat at least half your weight in grams of protein a day
Get a Cardiac calcium scan to see if you have arterial plaque. If you do have plaque (arteriosclerosis) then you are at risk for stroke as well. See a cardiologist to be treated preventatively and tested.
Option other than a cardiac calcium scan, get a carotid ultrasound to make sure you don’t have plaque in the neck vessels that lead to your brain..
Make sure your Homocysteine level is normal (

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If you are receiving testosterone or estradiol hormone pellet therapy, BioBalance Health wants to know if you have any of the following medical conditions that may require you to take antibiotics before any medical or dental procedure that breaks the skin, including pellet insertions and dental cleanings. BioBalance Health is dedicated to providing safe and effective hormone replacement with pellets for both men and women, and we want to ensure your health and safety throughout the process. We use sterile procedure guidelines, but certain conditions still require antibiotics to prevent local infections.

Conditions That May Require Pre-Procedure Antibiotics:

If You Have Had a Joint Replacement.Some orthopedic surgeons recommend that patients take antibiotics before dental procedures to prevent infection in the joint that was replaced, while others may not. It is important that you follow the advice of YOUR orthopedic surgeon regarding antibiotics before any procedure. If your orthopedic surgeon has advised you to take antibiotics, please let us know. We can provide you with an antibiotic injection or a prescription to take the day of your pellet insertion that will prevent infection.
If You Have Uncontrolled Type 1 or Type 2 Diabetes. If your blood sugar is not well-controlled, you may need antibiotics before your pellet insertion to prevent infection of the pellet insertion area. If you are treated and keep your sugars in good control you may not need antibiotics, however if your diabetes is in poor control, you are more likely to get an infection. It is important that you take antibiotics before your pellet insertion.

The following blood sugar levels are considered indicators of poor diabetes control:

HbA1c > 9.0
Fasting blood sugar > 150 mg/dL

If your blood sugar exceeds these levels, or if your primary care doctor has recommended that you take antibiotics before dental cleanings or procedures, you should also take antibiotics before your pellet insertion to reduce the risk of infection.

If You Have an Autoimmune Disease and are on Immunosuppressive Treatment. If you are receiving treatment for an autoimmune condition that suppresses your immune system, you may be at higher risk for infection at the insertion site. In this case, you will need to take antibiotics before each pellet insertion. If your Rheumatologist does not believe antibiotics are necessary for you, you may proceed without them.
If You Are Receiving Cancer Treatment. Certain cancer treatments, especially those that suppress white blood cell production, can compromise your immune system. If you are undergoing such treatment, you should take antibiotics before or with your pellet insertion to prevent infection.

In Summary: If a doctor has advised you to take antibiotics for procedures, such as dental cleanings, you should also take antibiotics before your pellet insertion. Please inform us of any conditions or treatments that may require this precaution, and we will ensure you are properly prepared for your procedure.

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If you feel ignored and unheard by your doctor or nurse practitioner, your feelings are correct! As a group women are not listened to and often dismissed as emotional and not smart enough to understand “complicated” medical information, by the Misogynistic American medical community, the US governmental agencies who make the rules for what women need. If you feel unheard and dismissed by your doctor, your impression is probably right, and you need to vote with your feet and leave that doctor for someone who listens to you and treats your symptoms and conditions that undermine you and your productivity.

The Myths that the majority of people believe are created by men and broadcast by premenopausal women and the media who have no first-hand knowledge of the problems that women contend with when they become pre-menopausal. Here are just a few of the lies and Myths that we must contend with.

Women love the freedom of being in menopause! No worry about pregnancy or bleeding. LIE
Women can’t become president’s companies or the President of the United States because we are going to hit the red button to destroy the world because we experience PMS before menopause, and after we just can’t think or make educated decisions. LIE
Symptomatic Menopausal Women are Over-reacting to a “normal” Phenomenon that “strong” women take in their stride. LIE
Women complain about menopausal symptoms to get attention. LIE
Women’s menopausal symptoms are really from psychiatric disease. LIE
Women who complain of bleeding all the time don’t need a hysterectomy! Just use medication (that doesn’t work). LIE
Women’s menopause symptoms are from behavior problems. They need counselling! LIE
Menopause should be a wonderful time of your life! Right! LIE

All these LIES are damaging to the women who need medical treatment. We don’t need name-calling, subtle dismissal of our symptoms by our doctors, one size fits all non-medical treatment like vitamins and herbs, or basically categorizing our physical symptoms as imaginary or mental which allows doctors to be excused from treating our hormone deficiencies.

No sex drive, painful sex, insomnia, fatigue, brain fog, weight gain, fatigue, hot flashes and sleep disturbances, migraines, loss of muscle weight gain and fatigue, depression and anxiety are physical symptoms of menopause and pre-menopause, that can all be treated with estradiol, testosterone and in some cases progesterone replacement. Menopause and the years leading up to it CAN BE TREATED safely and effectively but we aren’t offered treatment by the doctors who work for our insurance companies! Refusing to provide the hormones you need at menopause is denying you the treatment for literally losing the hormones that made you, YOU is not only disturbing but scary!

Medical care includes the replacement of waning hormones The only differences between menopause and testosterone loss and hypothyroidism, Cortisol deficiency (Addison’s disease), Parathyroid deficiency, Growth hormone deficiency in children are all paid for by insurance and doctors willingly treat these illnesses because they are not only paid to do so but they have taken a Hippocratic oath to treat the symptoms and diseases of the patients who come to them. However, in my office I hear the struggles that women have had getting treatment for their symptoms. Their doctors generally use the excuse, “I don’t believe in hormones.” So, they get out of treating half of their patients over 50. Hormonal treatment isn’t a religion, it is a condition that 50% of the population will have in their lifetimes. If your doctor is a PCP Primary Care Physician or OBGYN, then they have the training and the duty to treat you.

Sadly, these lies have sculpted how women are looked at in the American and English-speaking countries. Misogynistic beliefs are meant to keep women in a second-class status. The result is ignoring the simplest and the most affordable menopausal treatment -Estrogen and testosterone- and profit from our menopausal pain by serving up very expensive treatments for each of the many complaints secondary to menopause that no women can afford. eg: one drug for dry vagina, another for just hot flashes, a third for4 the mood changes that occur with menopause, and another for osteoporosis. All these symptoms can be treated with a combination of testosterone and estradiol, and you can get your sex drive back too! If you think that your government is going to help you , remember the leaders in US government are mostly men who buy-in to the destructive misogynist group think!

Lie #1: Women love the freedom of being in menopause! No worry about pregnancy or bleeding anymore.

Menopause might have been a relief from bleeding every month however, we no longer worry about childbearing before menopause since the birth control pill was created in the 1960s. In contrast the women of the first half of the 1900’s before Birth control, because menopause stopped women from having unwanted or unaffordable numbers of children. In reality, women living 100 years ago rarely lived past age 45 for women so most women didn’t live to experience menopause! Women suffered then but they were gagged by societal rules, and no one cared how they felt after childbearing years. Now we are very integral to society at any age, not just for childbearing, and menopause is not freedom or enjoyable! We need one all encompassing answer. The answer is long-acting estradiol and testosterone pellets that can resolve all these symptoms and make the years of a woman’s life after menopause like any other era.

Lie #2. Women can’t become presidents of companies or the President of the United States because we are too emotionally unstable. Women are portrayed as unreasonable, hysterical and unreliable. LIE!

The belief that women can’t be a CEO or president of an organization, or of the US, because we are too emotional before menopause, and after menopause we are not competent to make decisions, is based on uneducated beliefs and old wives tales (really old husband’s tales). We are more competent than men before menopause because we can think of more than one thing at a time, and act on the information, and because we have outstripped men in high school and college class status for decades. As for after menopause, we are at least as competent to lead if we have our menopause treated as men who are aging and becoming addled.

If we had the information that has been kept from us about the treatment for menopause, and if we were encouraged to get treatment instead of disparaged by our doctors of both sex in the US, and the US government, then we could hold any position we are qualified for, probably better than men. Even the “Societies” that say they are for women don’t seem to be when they publish articles like the one, I read last week from the Medical Journal called “Menopause” women need counselling not medical treatment for the symptoms that we “imagine”.

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During our interview I reviewed her path through recovering from years of no hormones and discussed how dramatic her recovery was. Her symptoms included no libido and no orgasms, Painful intercourse from a dry vagina, fatigue, depression, troubles with memory, Insomnia, lack of motivation, dry wrinkled skin, alopecia, osteopenia, weight gain, loss of muscle mass and weakness, fibromyalgia, migraines, hot flashes, insomnia and poor of quality of life. Her symptoms impaired her ability to have a quality life. During the years after her hysterectomy, she developed hypertension and Rheumatoid Arthritis. After she was treated with Estradiol and Testosterone pellets, her recovery was dramatic and fast! It amazed both of us, and she has continued to improve her health and now she is very healthy, without hypertension and she had almost a decade free of Rheumatoid Arthritis.

It turns out that the recovery of her energy, confidence and strength was well timed. She needed all the health and strength she could get to take care of her husband who finally succumbed to brain cancer in 2019. The same year she had the strength to become VP of Paramount bank as her employment. It seemed that the more life-disasters that she overcame, the stronger she got! As generally happens when people are overly stressed, even hormone replacement is overwhelmed. In 2018 had a recurrence of rheumatoid arthritis, and she developed Hypothyroidism and Insulin resistance. Grace, my NP at BioBalance Health, helped her treat her thyroid and weight gain and guide her to overcome these medical problems including losing the weight she gained with insulin resistance.

In 2022 she met, and married Mark Behlmann, who she served on the same charity boards with, but she had never met before. She got her second chance with Mark at finding love and fulfillment in her partnership with him. He encouraged her to compete in the. Ms. Missouri Senior, and she employed her energy, talent for singing, her own passion for success and service to become the 2024 Ms. Missouri Senior. In her role she encourages women to use their gifts to achieve everything that they can in life and to find a doctor to help them survive loss of hormones after menopause, so they can continue their service to family and society throughout their lives…she is the best example I can think of living your life to the fullest every day, no matter how old you are!

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Do you ache all over? Are you weaker every year? Shorter and more bent over? Are your clothes hanging off your shoulders? Do you walk slower and hold on to things as you walk? If you notice these signs in yourself or someone you love it means you, or they are becoming frail.

As a physician I had to become a people watcher…. or more accurately an observer of the people around me. Even if you aren’t medical people, I am sure many of you are as well…. but being very observant is a requirement for a physician because there are many signs of illness that can be observed just from observing a patient who we I am treating. I always pay attention to how the patient I am consulting with walks, shakes my hand (their strength), and how well they care for themselves, the quality of their speech, whether they look well nourished, over-nourished or frail. All of these individual observations and more, become automatic to me as a doctor. They help me diagnose and treat my patients without a stethoscope or even an x-ray… Today I want to talk about frailty, what it is, and what it means to your doctor and you as a patient.

Frailty can be defined as the visible qualities of loss of muscle mass, bone mass, energy, as and strength, as well as thinning of the skin, kyphosis of the spine (standing with your head looking down and your shoulders rounded), slow movements, weakness of strength and voice. Frailty is the visible sign of aging.

The opposite of Frailty is the Quality of being robust. When we are young we are strong, energetic, our muscles are visible, our skin is clear and taught, our posture is straight and we appear healthy and strong….when we are young we are Robust! Frailty is the quality of being old and weak, in a catabolic state (or a state of tissue breakdown and “shrinking”). You can equate Frailty with aging, or physically being old.

What does frailty mean to a doctor?

When we take care of a patient who comes to us for the first time in a frail state we rule in or out a list of diseases of aging and physical problems. These include:

Arthritis
Osteoporosis
Sarcopenia or severe loss of muscle mass and strength
Inflammatory diseases like arthritis
Heart disease
Diabetes
Dementia
Inability to be independent

Doctors must look for illness and decide on a treatment to remedy a disease, but frailty is not considered a disease that has a treatment. It is a sign that a patient is going through the last stage of life. Many studies have been done that equate frailty to a limited life span and a loss of quality of life, but no treatment has been employed by mainstream medicine to delay, avoid or treat frailty.

Up to now this is all very depressing, however it is my well founded belief that the loss of testosterone after age 45 in women and 55 in men is the first step toward frailty, however if adequate testosterone is replaced soon after the symptoms of T deficiency starts, then frailty can be avoided as we age, and the eventuality of loss of quality of life will be delayed or avoided all together.

It is a fact that nothing other than the hormone testosterone can reverse frailty and stop it from progressing. With T treatment my patients increase their muscle mass, create stronger muscles, and improved their mental and physical stamina.

To me this is such an easy one-hormone-answer to actually improve my patients lives, at any stage in the aging process, however the pharmaceutical companies that control American medicine much prefer to treat each symptom with a different drug. There are millions of aging folks in nursing homes who could have maintained their independence, and avoided the use of many drugs if they were treated with testosterone before their frailty reduced their mobility so they need help to perform daily activities of living independently.

Sadly, medicine in the US basically gives up on frail and aging patients and we doctors are taught to make frail patients “comfortable”, just treating their symptoms without hope of reversing frailty and the outcomes of that condition. Of course, it is much healthier to prevent frailty by replacing the essential hormone testosterone early on, however your doctor will have to think out of the box to arrive at the Testosterone treatment, rather than follow the medical protocols that involve just keeping aging patients “comfortable”.

Research studies and articles to be read by doctors like the recent one in the New England Journal of Medicine that draws a direct line between aging and frailty, but only concentrates on the fact that frailty portends early death and discussed the best ways to make patients comfortable dictated by the severity of frailty. There is no treatment other than high protein diet and vitamins with physical therapy which will not “treat” this disease.

I want to tell you about two very different patients in my practice. The first is a very successful man in his late 70s who came to me seeking weight loss because he had been an athlete and still enjoyed playing golf, but he was complaining of weakness and other symptoms of frailty, in addition to looking borderline frail when he first came to me. We did a body composition test, and he had a higher fat mass and a lower that ideal muscle mass which is the way frailty begins.

We discussed the fact that weight loss (fat loss) obtained by more exercise and less carbohydrate in his diet might improve his Pre-diabetes and inflammation, but would not make him stronger, or increase his physical and mental stamina, in other words reverse his beginning frailty. He chose to embark on an exercise-based weight loss program combined with a high protein low carb diet.

In the end he did not take my advice about the best way to lose weight without losing muscle which would have been to add Testosterone and Metformin to his treatment plan, however he wanted to be the one directing his own care (he was a business man and not a doctor) without a basic knowledge of physiology, or nutrition, or any training about aging and frailty. Let me note that if he was younger than 55, and he tried this weight loss program while he was making adequate Testosterone, he might have had a successful fat loss program and gained muscle density and strength while he lost fat, however, this gentleman is 78.

You can guess the end of the story. He did lose weight, however he lost as much muscle as fat and was even weaker after 6 months. This is sometimes what happens when very successful people in one area of life think that makes them brilliant in all disciplines.

Now, the flipside of the coin. I will tell you about an 82-year-old doctor who came to me almost too late. His much younger wife was already my patient, and she encouraged him to have a consult with me to see what I could do for him. He had the right attitude, but was already frail, and I could feel the humorous bone of his arm, when I ushered his into my office for his consultation. I explained what observing him and his lab told me more while he told me that he had almost every symptom of aging, and frailty. He told me that he was an athlete in college and that he always had a lot of muscle, and he watched every day as his muscles “melted away”, despite his exercise daily. He was frustrated and had trouble with his memory as well because he had lost his testosterone long ago and he had done well for as long as he had because he had eaten a nutritious diet, taken supplements and worked out daily. We discussed his other medical problems, and some treatments for them, additional supplements to assist in building muscle and bone strength.

He came back 5 months later after he had his T pellets inserted and he walked in with confidence, and the difference in his muscle mass was visible! He was no longer “frail looking”. He told me he was thinking better, not completely yet, but his mind was getting progressively better. He had lost fat and gained muscle. He had turned the clock back 15 or more years. Testosterone in the right dose and delivery system can erase frailty and give a quality of life back to my patients who had no help from other doctors.

Look around you if you aren’t yet at the age that carries with it frailty or if you are without Testosterone and are experiencing frailty…look at those around you in the doctor’s office or when you are waiting to board a plane…look at the pre-borders who can’t walk the length of the ramp to the airplane and see if they have the visible characteristics I am talking about. If you are over 45 and female or 55 and male and not on Testosterone maybe you should consider having your testosterone replaced so you can keep your muscle mass and independence as long as you live.

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In my Anti-Aging-Longevity practice, one of the complaints my new patients tell me about is the fact that their hair is thinning, falling out or changing to a brittle texture, as well as the fact that their hair is turning grey.

Hair DOES get thinner, coarser, and greyer as we age! That is a fact, and one I can’t fully explain to you, except that it happens to everyone! My philosophy is that each of us should work with what we have, and optimize it, as well as treat any condition that makes hair loss work instead of wishing and wishing we had the hair we did when we were 25! Accepting the fact that your hair gets thinner after 40 and working with the hair you have takes knowledge to determine what is normal and what is not. Some of the things that everyone should know before looking for the best path forward to healthy hair.

Aging and Slower Hair Growth

Low Growth Hormone
Lack of Estradiol and T in women and lack of T in men

Aging causes Growth Hormone (GH) to decrease, which slows the growth of hair, fingernails, bone. Your hair falls out at the same rate as it did when you were young, but the growth slows which results in losing more hair than you replace which thins your hair!

If you started your young life with fine, thin hair, then this difference between growth and loss of hair can make your hair very thin. To get to the root of the problem (I apologize) increasing GH will make your hair grow a bit faster. Testosterone replacement and Estradiol replacement both increase the growth of GH. Both hormone replacements increase hair thickness. Testosterone has a second benefit. Testosterone makes your scalp oiler, which in turn increases the longevity of your hair. At menopause the lack of these two hormones causes a big change in hair thickness.

Loss of hair in specific areas—Balding

Genetics
Scarring alopecia
Androgenic alopecia
Extensions
Dread-locks

Balding and alopecia both cause a person to lose hair follicles, not just slow the rate of hair growth. Balding usually is genetically determined, so look at the older members of your family to determine what is in your future. This type of hair loss is very difficult to treat. 50% of men have some balding by age 50, and 1/3 of women experience it sometime in their lives. Until recently there was nothing to stop this process or grow more hair in those areas, however both men and women can resurrect their hair follicles (if they haven’t been gone too long) and make them grow with the TED hair restoration painless ultrasound treatment by Alma.

Other options are Hans Weiman hair transplants or weaves, both of which are extremely expensive, don’t necessarily look natural (President Biden and his son) and must be redone every couple of years. Women can just cover over the problem with a wig, but even that answer has drawbacks—they are hot and itchy until you get used to it. Women can also get extensions to make their hair look thicker, but it ruins the quality of the hair you have which in the long run causes even more hair loss from scarring of the scalp.

Women of color have traditionally used tight braids, cornrowing or dreadlocks to control their hair. This cultural process causes them to break their hair off at the scalp and damage the hair follicle from tension, which results in hair no longer growing in multiple areas of the scalp.

Change in Hair Texture and Dryness

At menopause for women and when men’s testosterone gets very low, we notice a change in texture of our hair. The cuticle area that covers the hair shaft becomes fragile and stops protecting the hair shaft, so the texture becomes frizzy, and hair breaks causing a dull look similar to what my mother used to call a “birds nest”.

Our scalps become dry, and the oil glands dry up with age and loss of sex hormones, so hair is dry and frizzy, making us look like we just stuck our fingers in a light switch. You can read about many “natural remedies” but beyond taking collagen, Biotin and B vitamins most supplements don’t work in a dramatic way that would be noticeable.

The remedies for hair loss include all the following and you will have to do most of them to improve your aging hair!

Hormone replacement of Estradiol and Testosterone
Conditioners (which only work a little)
Hair color which covers the shaft with pigment and strengthens hair
Brazilian treatment that drives straightener into the hair shaft and seals it with heat.
Take supplements of Collagen every morning
Take methyl B12 and Biotin daily
Stop bleaching your hair
Eat a diet with healthy fats and protein
Wash your hair every 2-3 days
Take the fat soluble vitamins A.E.K,D
If you are anemic take iron supplements
Avoid statins if possible

Other medical causes of frizzy, broken hair can be found in low thyroid hormones which slows hair growth, decreases oil production, and results in brittle hair all over the head. Replacing your thyroid hormones and supplementing your iodine can overcome this obstacle. All medicine changes should be managed by your doctor.

Many drugs cause hair loss, and you can’t change some of them:

Metoprolol or any Beta blocker
Blood pressure medication
Prednisone and all steroids
Cancer treatments
Anything that inhibits your B vitamins like some autoimmune diseases

What can you do to fix what you can fix!

Nutrition:

Hair is protein; however hair requires oil (fat) to grow and be beautiful—a diet rich in protein, and healthy fats give you the building blocks to make healthy hair and skin.

Add Vitamins of A/E/K/D, vitamin C, Multi Methyl B vitamins with methyl folate and Biotin because our diets aren’t perfect!

Hair care:

Get hair products without sulfides. They break hair and make it weak! Wash your hair as little as possible. Decrease the use of hot hair tools like flat irons. Color your hair and or Brazilian it to make it stronger. Medications not to take are listed above. But the medications to take to help your hair are your sex hormones, Estradiol, Testosterone, and make sure your DHT doesn’t get too high which can cause hair loss in the male pattern. You may need Finasteride or Minoxidil if you have male pattern hair loss. Sun damage is important to maintain your hair in sunny areas. Wear a hat or scarf when outside and comb some conditioner through your hair at the pool to “cover your hair from sun damage”.

Summary:

Now that you know the possible causes and treatments for hair loss, you can do everything possible up to seeking medical care, and then medical care may be necessary. Hair thinning is often familial and also due to our estradiol and testosterone hormones decreasing after 35-40 years of age. You may need a scalp biopsy from a Dermatologist if your hair loss is in patches or severe over a short period of time, which implies an autoimmune disease. When you see a doctor be prepared with a list of your hair products, your diet, a list of medicines and a timeline for your hair loss. This preparation will get you the best treatment per doctor visit, and your doctor will appreciate not having to ask you all those questions!

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Are you menopausal and have any of the following symptoms?

- Hot Flashes
- Night Sweats
- Dry Vagina
- Painful intercourse
- Dry skin
Lack of sex drive
Lack of motivation
Fatigue
Depression and or anxiety
Change in body composition, with fat collection in the abdomen
Loss of Muscle Mass and strength
Irritability
Inability to remember names and places
Decreased ability to problem solve
Insomnia
Arthritis
Body pain

These are all symptoms we currently are aware of associated with menopause and low testosterone. These symptoms can be treated and reversed with bioidentical estradiol and testosterone pellets. Menopause should be treated like an illness that is universal but more severe in some women compared with others. If your symptoms affect your lifestyle, relationships and work then you should see a doctor who treats hormone deficiency and accept treatment!

However, if you allow yourself to be manipulated by a male-dominated medical system that teaches all doctors to believe that menopause is normal as women age and don’t seek out hormone replacement, then you just may be setting yourself up for years of symptoms that are treated with handfuls of medications, but never get you back to normal.

Just think about this for a minute: Men develop erectile dysfunction and experience muscle loss as they age, but medicine doesn’t consider ED or Sarcopenia a natural aging process for men, they advocate and endorse treatment with testosterone, ED medications, injections for ED and therapy for ED, and in most cases pay for it! If the male mentality would include women we would all be treated with estrogen and testosterone when we got to age 50 (or menopause).

It is not just about the symptoms that E-T replacement can cure, but the diseases that you can avoid by taking estrogen and testosterone after menopause. These avoidable diseases of aging include:

Osteoporosis leading to broken bones and spinal stenosis.
Heart disease and stroke
Diabetes
Alzheimer’s Dx and dementia
Obesity
Low muscle mass and inability to walk or move independently.
Autoimmune diseases
Loss of blood flow to Lower extremity, resulting in amputations and inhibiting walking and running
Severe arthritis
Gout
Worsening depression and anxiety
Frailty which is what causes most older people to be placed in a nursing home.

Just think it is not fate that gives you these conditions. It is genetics plus lifestyle plus whether you replace your sex hormones or not! This decision is in your control. If you really want a life free of debilitating disease and symptoms that are require constant medical care, then you must buck the system (that was designed to keep us from maintaining our mind and body) and look for a doctor to replace your testosterone and estradiol in a non-oral delivery system and maintain it for life.

By stopping ERT or Testosterone like the ACOG doctors tell you to, you will start the symptoms all over again. My job is to offer you the right type of help to reverse the effects of menopause…both symptoms and diseases. Your job is to decide whether you want to get help and become healthy by taking non-oral estrogen and testosterone for the rest of your life.

Think of menopause as a disease and you will be more prepared to fight for your right to be treated by the medical system.

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The second set of myths about weight loss involve what we have been told by our federal government through the FDA and surgeon general, that is believed by most of us, but the motivation of the government is not generally for your well-being.

Myth #7 Salt is bad for you, and you should limit your intake of salt to minimal amounts.

A large study found that eating less than 3 grams of salt a day increases one’s mortality by 25% when compared with moderate intake. It is a fact that salt is vital to life, this contradicts the AHA who preaches that a low salt diet is what is required for health.

Myth #8. Replacing hormones at menopause, estradiol and testosterone, will cause women to gain weight.

The advent of menopause changes a woman’s metabolism and makes every woman in industrialized nations insulin resistant which slows their metabolism and causes women to gain fat and lose muscle which lowers the metabolic rate even lower because muscle mass burns 90% of our calories, and as it shrinks the Basic metabolic rate drops.

The only way to counteract this cataclysmic change is to replace estradiol and testosterone in a bio-identical and non-oral delivery system (pellets, patches, topical applications and vaginal tabs. Even with sex hormone replacement, insulin resistance is

Still a factor in weight gain, so a low carb, high protein diet and medical treatment with Metformin, or Wegovy or Mounjaro may be necessary to regain ideal weight after menopause.

Myth #9 Milk products are bad for you, and you should take them out of your diet.

Milk is not metabolized in the same way and does not have the same metabolic effects as milk products like yogurt, cottage cheese, ricotta cheese, and all cheeses. The majority of Americans can tolerate, and even need milk products as a valuable source of protein. There is a small minority of people who cannot tolerate milk products, and even fewer who respond to milk products with inflammation. If you do not have GI symptoms, or joint aches when you eat milk products then you are not necessarily healthier to cut them out of your diet.

Not only is milk good for most Americans, but it has been proven to decrease oxidative stress and inflammation….the very things it is accused of increasing!

Myth #10 Skim milk is better for everyone than whole milk, and those people on a diet should opt for skim milk.

This myth is born from the myth that we should eat low fat diets to lose weight. It is a fact that Whole milk has more fat than skim milk, but skim milk is higher in carbohydrate, is generally consumed in larger amounts and is not as satisfying as whole milk.

Skim milk is 55% carbohydrate/43%protein/5% fat while whole milk is 50% fat/20% protein and 30% carbohydrate. Unfortunately, the processes we use to make milk safe to drink (Pasturization and Homogenation) remove the necessary enzymes (Lipases, and Lactase) that help humans tolerate lactose sugar in milk. The process of skimming milk removes the Vitamin D and A that are in unprocessed milk.

If you can drink milk, choose smaller volumes of whole milk, not skimmed, if you like milk products like listed above, then add them to your high protein diet. A 64 million person- year study recently revealed that whole milk drinkers, milk product eater had a significant decrease in all-cause mortality. Skim milk drinkers did not have a decrease in all cause mortality.

Myth #11 Cutting animal products in your diet will decrease your cholesterol and therefore prevent heart attacks.

So why do we follow fads? I believe it is because we are human and we look for the easiest path to a goal, and easy diets appeal to most of us who want to lose weight, however losing weight is complex and involves a good medical based plan and a change in your lifestyle. Your plan should start with seeking the right kind of medical advice that fits the diet to your blood work, medical history and in some cases your genetics.

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My medical practice, BioBalance® Health, allows me to hear all of the myths about how to lose weight, when I am in consultation with a new patient. All of my female patients and some of the men have at one time, or multiple times been fooled by the false promises of friends, doctors, and advertisers, about quick and easy ways to lose weight. If you have bounced around trying every diet out there on the internet and failed to lose weight, then I can help you stop the pointless trial and error process, and help you embrace the difficult and time-consuming process of truly losing body fat and keeping it off!

If you thought that all we do at BioBalance Health is replace women and men’s testosterone with long-acting bioidentical pellets, you are partly right! In addition to treating our patients’ hormone deficiencies we also have the goal of attempting to guide them toward a healthy long life! This involves treating “pre-diseases” like prediabetes that other doctors don’t treat until damage has been done and guiding our patients as to the right way to achieve their ideal weight. One of the important roles we have in assisting our patients with “fat-loss” is to disprove all the lies our patients have been told over the years by nearly everyone about how to lose weight. Some of these myths are actually believable (unless you are a doctor and understand the physiology of weight loss), but still never work. Other diet plans work for some people with specific genetic qualifications, but not for the majority of the population. Then, there are diet plans that are so bizarre and illogical, that they literally make me giggle when my patients describe the protocol (or advice) they have been following without results.

Why are these myths so prevalent? It is because we have been programed since childhood to eat in a way and in amounts that are inevitably going to cause us to be obese. It takes a lot of work to turn those lifestyles, habits and food choices around to lead my patients to lasting fat loss and long-lasting health. Hard work never “sells” and a time-consuming diet doesn’t either so businesses make a lot of money keeping you fat!

You may or may not have heard these! I will tell you why they

#1 Myth- If you eat fewer calories, you will lose weight, and all calories are the same.

This is one of the myths that is spoken by doctors every day because they learned it 30 years ago in medical school, and it just isn’t true! To begin with calories in food are metabolized differently depending on whether they are Protein, Fat or Carbohydrate. It takes more calories to metabolize Protein, and more than fat and the food that burns the least calories to be metabolized are carbohydrates. So, food calories are different depending on which food group they are from. Eg. There is a vast difference between the weight you might lose, or gain based on the food group your calories came from. For example: If you eat a steak with 500 calories verses a slice of birthday cake/icing that contains 500 calories, it takes more calories to breakdown protein so you USE calories to make it into blood sugar, while the birthday cake takes almost no energy to make BS and readily makes fat if it is not used in exercise.

Another factor that causes counting calories to be a losing proposition, is that every food stimulates insulin differently, and insulin that is over stimulated over time gives a person insulin resistance which causes them to be so efficient that they can go a day and not eat anything, and still fail to lose weight. If you have tried a low-calorie diet and that happened, then you are not alone. Going back to the steak and birthday cake example, steak does not stimulate insulin very much and birthday cake is likely to over stimulate your insulin making insulin resistance worse and doesn’t make energy but is stored as fat!

The third reason limiting calories cannot be the basis of a weight loss diet is that an individual human body has a vast number of factors that influence how you as a unique individual burns calories, therefore any one calorie limiting diet will not work for the majority of humans. We are all different with individual requirements for the types and amounts of food we need which is based on our genetics, our history of healthy or unhealthy diets, our daily exercise, and how obese we are when we start to lose weight.

What that means simply is that there is no easy way to attain your ideal weight and stay there but limiting your calories. Weight watchers tried this method for years and I never found a person who lost weight by eating a certain number of any type of calories (candy, dessert, or fruit and vegetables with the equivalent number of calories) in one day, who lost weight and kept it off. If you eat 1200 calories of fruit, veggies, eggs, fish and or meat throughout the day and have an active lifestyle, you will lose fat that day. If you eat 1200 calories you save up all day to eat one dessert you will probably gain weight because it will overstimulate your insulin and make your calories into fat and not energy. Weight Watchers changed their program several years ago when their clients realized their system didn’t work. Counting calories to lose weight is a myth you should avoid.

Myth #2: The promise: “If you just eat _________ (one food like grapefruit/cabbage soup/ salad/juice take your pick) for ____ weeks you will lose 20 lbs.

The cabbage soup diet is an example of this failed “theory” which invaded the US female population in the early 2000s and my patients embraced it completely believing that they would lose 20 pounds in 4 weeks. I objected and told them that eating only one food for 4 weeks was unhealthy, a baseless fad which was unlikely to work, but very few of them listened. It turns out that Cabbage is a food that slows the metabolism of people with A blood type, and the majority of citizens in my city, St. Louis, have A blood type! At their next GYN visit my patients were all moaning over the fact that they had GAINED 20 pounds on the cabbage soup diet! Not eating a variety of foods is unhealthy and this proves that even an unhealthy diet doesn’t promise weight loss for everyone.

So please don’t follow fads. they are baseless, and you might gain weight and not lose it!

Myth #3 You can exercise your way to fat loss, eat whatever you like and still lose weight.

I believe exercise should be part of every human’s healthy lifestyle, and exercise is necessary to speed up the metabolism while you eat a low carb, high protein diet and refrain from bad habits like alcohol consumption. However, eating like you normally do and exercising hours daily will not bring about weight loss for 90% of the population of the US. Lasting weight loss doesn’t occur unless you add eating a healthy diet, stopping bad habits and taking the required supplements necessary to decrease your fat mass, and exercise. Yes, you have to do it all! Increasing muscle increases our metabolic rate and exercising muscles increases the loss of fat, but both muscle building and muscle strength require high protein diets, with a moderate amount of fat, and without a lot of carbohydrate. Eating carbohydrates unchecked can cause the weight loss promised by exercise-based weight loss programs to fail, over and over again. After the age of 45 your muscle will not be preserved while you lose weight if you do not replace your low testosterone and exercise too. So it is not ONE factor that facilitates weight loss, it is complicated and there is a perfect fat-loss plan for everyone…you just have to find it!

Myth #4 Low fat diets are a good way to lose body fat and prevent heart disease!

Every study has failed to support this idea! Low fat diets don’t lower cholesterol, but low carb diets do! We were told by cardiologist for the past 30 years that low fat diets would lower the cholesterol and the atherosclerosis in your arteries…but they lied! It is now accepted by most doctors that low fat diets leave people hungry which causes them to eat too many carbs resulting in an increase in cholesterol and weight gain. Re-introducing fats into your diet should include healthy fats (fat from seafood, vegetables like olive oil, milk fat and other omega 3,6, and 9 ) are necessary for brain health and good body composition.

The advice by the US FDA and Medical specialists to eat a low-fat diet has contributed to over 50% obesity, dementia, and diabetes in America. If your cardiologist tells you that a low fat diet is going to prevent heart disease, then look for a more up to date cardiologist.

Myth #5 High protein diets are not effective for weight loss.

High Protein-Low Carb diets are the best diet for the majority of people in the US. This diet is the most effective type of eating plan for your weight loss. If you want to know what % of protein, fat and carbohydrates you should eat, then go to our website, BioBalancehealth.com and become a weight loss patient with genetic guidance and you will learn how to distribute your foods based on your unique genetic map. High protein diets keep you “full” longer after a meal or snack, so your calorie intake is naturally lower.

Reserve your intake of carbs to supply you with physical energy before and after exercise. Otherwise, your diet should consist of high protein and fat, and limited carbs, with plenty of fresh vegetables and fruit (these food are not considered carbohydrate).

Myth #6 Diet soda is a “free food” because there are no calories, so I can drink as much as I want to and lose weight!

Diet soda contains many chemicals, salt and includes a chemical sweetener called aspartame. Salt causes swelling, and all chemical sweeteners stimulate insulin and act to make you hungrier than if you drank unsweetened iced tea, water or anything sweetened with stevia. Stevia is a plant that does not contribute to insulin resistance and diabetes. The majority of diet sodas stimulate insulin just like carbohydrates do and contribute to weight loss failure. Every time you drink one you should consider it just like eating a carbohydrate!

Summary:

Following the advice above will prevent so much frustration with future weight loss attempts, and will help you achieve your ideal weight through avoiding these myths about weight loss.

Remember that weight loss fads have been around for a long time without a public refute of the obvious myths above. Fads should be ignored if you want effective weight loss. Remember that Instagram and Facebook posts are only motivated by profit, even though they spread crazy diets as based on fact. There is no one monitoring the “fads” validity.

Please don’t listen to fads of people who are not doctors or nurses trained in weight loss! More Myths about weight loss next week!

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Dave Glover, the most listened to talk radio voice in the Midwest, invited me on his show last week to talk about BioBalance Health Testosterone Pellets for men and women and BioBalance Skin my medical esthetic spa. His show is on KMOX, the voice of the St. Louis Cardinals. Dave Glover and I have worked together for 10 years, and he is unabashedly my patient who has experienced the superiority of our medical care that is unique, and preventive, in addition to being the best testosterone pellet therapy in the Midwest. We go far beyond to direct our patients to a healthier life.

Dr. Maupin Radio Interview with Dave GloverWhen patients have their first appointment our doctors have already reviewed their lab amd medical history, and the first appointment is chocked full of information about the meaning of their laboratories, diagnosing medical problems such as insulin resistance and prediabetes to finding diseases they were unaware of. At the same one-hour long appointment we work with our patients to develop an individualized diet and exercise program for their unique situations.

The secret to our success in bringing 95% of our patients back to health is the foundation of replacing testosterone in the most effective and safest method with replacement non-micronized testosterone estradiol pellets. We do much more in a short time to direct our patients to reversing the symptoms of aging (the symptoms of testosterone and estradiol loss) while we prevent future illnesses like diabetes and help our patients move to healthier lifestyles.

Dave asked me what is new about BioBalance Heath. We are always improving our knowledge, based on new medical research, and our newest offering is a simple genetic Diet and Metabolism Test called Nutrigen. This test is done by simply doing a self-cheek swab and never has to be repeated! Right now we are offering this test for $300 (a discount of $150). If you have tried many diets and still don’t know what type of food you should eat, our test is meant to be a ONE-TIME test to tell you everything you genetically need to lose weight. Or if health is your goal and not weight loss and you want to know how to eat for the rest of your life, this diet is a necessity! It comes with a 60-page report.

What % of your diet should be fat, carbohydrates or protein?
What times of day should you eat?
Should you eat snacks?
Does exercise help you lose weight or not?
Is a low carb diet the best one for you? a low-fat diet? A low-calorie diet?
Is a high fat diet the best for you to be healthy?
What supplements do you genetically need?
Everything you have ever asked about your individual path to ideal weight!

Everyone who elects to take this test will get a 60-page report about every genetic factor that affects their diet, metabolism, exercise and weight loss. It even includes what genetic factors are working against them and their ability to lose weight. When their test comes back, our Nurse Weight Loss Specialist, Sarah Hooper RN will be ready for them to make an appointment to go over the report and explain a healthy eating plan. We always have used the INBODY machine for following body composition and not just weight for ALL our patients, pellet, weight loss, and non-pellet patients.

Dave then asked about what was new in our BioBalance® Skin Office? We are always looking for ways for our patients to look younger, and healthier as they age. Dr. Maupin and Sullivan’s criteria to adding services is that they are TRULY EFFECTIVE, as well as painless, and the service is affordable compared to other pathways to the same outcome.

This year we have added a painless hair growing ultrasound treatment called TED. It can treat any form of hair loss, as long as there are some follicles left to stimulate. Women and men come in for 4 to 6 45-minute treatments, that feel like a scalp massage. There are no necessary serums or vitamins to buy. You just have to keep the areas treated out of the sunlight for the month following the treatment. This is a real breakthrough and compared to very costly hair transplants and painful PRP treatments this is a game anger!

For women who have lost weight and ask us every time they come in for weight loss or pellets what they can do about sagging and crepey skin, now we have a variety of treatment s to offer them: Opus treatments for the chin and jowls, Juvashape to tighten areas all over the body. EM Sculpt to build muscle, lose subcutaneous fat and tight skin, and EM Face to take the place of a Facelift! Our patients are encouraged to come in for a free consultation to help them decide what they can do to “SHAPE UP” after successful weight loss!

We offer episome treatments with our Aqua Gold treatments to rejuvenate tighten, smooth out and lift facial skin….It is a step up from microneedling for more mature skin.

We literally offer the MOST EFFECTIVE, MOST ECONOMICAL TREATMENTS with the least pain and best results anywhere! BioBalance Skin Staff will guide you to the appropriate choice of treatments so you can be assured you have the best esthetic treatment for your individual problem.

Our Goal is to help our patients look as good as they feel with their BioBalance Pellet treatments!

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2024 has been the hottest summer of the decade and it is causing many of you to go to the ER with heat related sickness. There are several risk factors that may put you at high risk for illness relating to the heat. I have been present several times when someone collapses from heat stroke which is the most severe heat related illness. The heat can kill you if it progresses this far. It is interesting, athletes who won’t back off from their outdoor activities, and will work out in the highest heat of the day.

Heat stroke can cause a person to collapse, drop their blood pressure, act out, or pass out, or even seize, all of which are signs to call 911, and start emergency procedures: elevate their legs, if possible, place ice packs under the arm pits, around the sides of the neck, and on their groin.

The highest risk patients:

Babies and toddlers
are over 65
On multiple medications
Taking a diuretic
Obese patients
People with anemia and other blood conditions
Patients with coronary heart disease
Patients with atrial fib
Those people who don’t drink water, just caffeinated drinks-dehydrated people
Who have just been flying (dehydrated)
Who are hung over (dehydrated)
Who have been nauseated and vomiting in the days before going out and working or playing in the heat.

Ask the heat stroke victim to drink fluids if possible. Of course, make sure they stop the activity they are engaged in outside in the heat. Move them to a cool place while you are waiting for emergency help to arrive. Heat stroke can cause a vascular stroke or death, so emergency treatment is necessary. If possible, offer the victim water with electrolytes in them (NUUN-Sport) and some sugar in case they are also hypoglycemic as well. If they can’t drink, which is a side effect of heat stroke, put a wet washcloth in your mouth to suck water from it slowly.

My husband and I went on a trip to Cinque Terra, Italy with another couple last fall to hike the trails between the 5 towns that line the cliffs over the shores of Liguria. The hike was supposed to start at 8 am so we could avoid the heat of the day….and it was in the 90s and humid…but as luck would have it the transportation we had arranged for wasn’t able to take us to the starting point and we didn’t get there until 10:30. We packed several water bottles and a few snacks but we were not prepared for the 4 ½ hour trek high above the mediterranean on a trail that was 3 feet wide and involved thousands of steps up and down…we had drunk most of our water in the first 2.5 hours and were very hot and sweaty the whole time….about 40 minutes from the town of Vernazza, my husband started stumbing, and talking nonsense…he had stopped sweating and couldn’t walk….There was no place to lay him down without blocking the path and we found a shady spot for him to recline and put his feet up. I had some Nuun-sport electrolytes which I had put in my water and had been drinking, so I put 2 electolye tablets in ½ bottle of water and tried to get him to drink it…..he was delirious and refused, and I had to force him to drink…he fell asleep and we received water and cold water bottles to put around his neck from passersby.

Ideally, we would have gotten ER help which he really needed, but there was no way to get emergency care to him and at 6-4 and 230 he was too heavy to carry/drag…and remember we were on the edge of a 200 ft cliff. When he had slept 20 minutes I kept my finger on his pulse and he was thready and fast…..Thankfully he rallied and we got to Vernazza and he walked into the ocean after drinking several glasses of water to cool off and fell asleep on the beach for an hour until he was ready to get on the train back to our hotel….This was one of the scariest times of my life because I knew what to do but didn’t have the IVs, or water or ice or anything to help him. Remember this and make sure you are always prepared for the worst scenario when you are active in the heat!

So how do you know when you are getting close to heat stroke?

You feel weak and out of breath. Your pulse rises, you stop urinating, and you STOP sweating. You are getting close to heatstroke when you start to feel cold even though the ambient temperature is high. When you feel dizzy and unstable on your feet…the next thing to happen is vascular collapse

See the stages of Heat Related Illnesses below, which we are all at risk for! This is from the NEJM.

Heat-Related Illness Description Treatment Severe illness Heat stroke A multisystem, life-threatening illness characterized by elevation of the core body temperature (to >40°C) and CNS dysfunction Classic heat stroke: most often occurs among older persons with compromised behavioral and physiological compensatory responses to heat exposure

Exertional heat stroke: most often occurs among healthy persons during extreme physical exertion, which results in excessive metabolic heat generation, often but not always with concomitant ambient heat exposure

Move patient to cool environment; manage airway, breathing, and circulation; administer rapid cooling with cold-water or ice-water immersion or other means; administer intravenous rehydration; and evacuate to emergency department after on-site cooling is performed. ICU admission is warranted for management of end-organ sequelae. Moderate illness Heat exhaustion Profound fatigue, weakness, nausea, headache, or dizziness (or a combination of these symptoms) resulting from a decrease in body water content or blood volume due to water or salt depletion from heat exposure; mild elevation (

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In general, I spend my time defending women and the fact that our problems and sexual physiology is ignored, by the governmental powers and physician organizations in the US, so I try to do my part to bring information to women about their hormones and the aging process. Today I am changing my focus to men and the way men’s normal sexual function is considered a “normal” and rarely discussed outside the men’s locker room and or porn sites. So here goes…The fact is that men’s sexuality isn’t just the act of sex, but men spend a lot of their sexual energy on fantasies and just thinking about having sex. Men’s ability to have an orgasm is not just a wham- bam—thank you…well you know the phrase…and there are many physiologic factors that must work, in the background to bring a man from thinking about sex or desire, to an orgasm.

Sadly, in the current environment couples don’t talk about sex….they don’t tell their partner what makes them excited or even what they want…. because none of us can read minds, too many of us don’t get what we want when it comes to sex.

With lack of communication between partners, leads couples to trial and error without a map. Neither sex knows how the other sex “works”. I decided to describe the normal series of what men go through on their way to orgasm to educate them and their partners. In addition, the process is not always the same in each person and as men age the time between the first sexual thought to completion gets longer and longer…sometimes these detours include episodes of losing an erection, sometimes getting it back and sometimes not which leads to frustration of both partners.

In youth when a man’s free testosterone is high and his arteries are free of plaque, between puberty and age 35, erections may occur often, and they last a long time if the man is stimulated for a long period of time. At this point sex is automatic and easy to complete to orgasm and ejaculation.

As time goes on, free Testosterone starts to decrease with age, as does the diameter of a man’s arteries…blood flow doesn’t rush to the pelvis to create an erection like it did in youth. The things that lower free testosterone. What happens with age that cause erections and ejaculation to be less and less automatic and easy?

T and free T drops after age 35 in most men and becomes critical by age 55, even in healthy men.
Ejaculate decreases due to lowering of free T
Vasectomies decrease the volume of ejaculate by 1/3
Stress causes free T to decrease.
Hypertension causes arteries to contract and deliver less blood to the pelvis for an erection.
High blood sugar and diabetes destroys the arteries in the pelvis making blood have a more difficult time getting to the penis.
Stress causes Cortisol to rise and free T decreases,
Obesity increases the estrogens in men and that decreases free T by binding it with sex hormone protein and inactivating it.
Any medication the constricts blood vessels (ADD medicine, Phentermine, speed, etc) decreases blood flow to the pelvis.
Some medications that lower blood pressure lower It in the pelvis too low so that men are impotent (e.g. Lisinopril).

For men who don’t know all these medical, aging changes that happen to most men, these changes cause fear and anxiety which of course makes it worse. Men who have this issue (most men) are even reticent to talk to me about it and they haven’t talked to their spouse either.

So here is what I tell them: You are aging like everyone else, and that fact can’t be changed, however, your lifestyle and your medical health, or poor health is affecting your orgasms and your ability to have sex. These factors CAN be changed. You can change your BP medicine to

one that doesn’t impair erections. You can get your diabetes or obesity under control, and you can improve your erections. However, to get it all back you will need testosterone replacement if your free T is under 129 ng/dl. The safest way to accomplish this is with my practice BioBalance® Health…we do it better and know all the tricks to making you healthy productive and potent!

What is in the ejaculate? mature sperm are mixed with whitish, protein-rich fluids with prostaglandins are produced by the prostate. These fluids nourish and support the sperm so they can live after ejaculation for a limited time to fertilize an egg. This mixture of fluid and sperm, known as semen, and is what is moves through the urethra in the form of ejaculate.

Sensory stimulation travels from the skin to the brain and stimulates dopamine and endorphins which are neurotransmitters that make a man fee happily ecstatic during and after an ejaculation. These neurotransmitters also stimulate the Hypothalamus to make oxytocin, a bonding hormone that binds couples together. Many nerves, vessels and the brain are involved in a successful sexual encounter.

The culmination of a sexual encounter is complex and involves the whole body. I find it interesting that the “medical view” of orgasm is still divided into 4 different steps when, if you are a male (or even a female who has had sex with a male) the divisions seem very arbitrary and is ALWAYS connected to ejaculation.

It is a fact that men and women can have sexual intercourse and orgasm without ejaculation.

The following is how the practice of medicine describes the male sexual act. In contrast I have educated my patients by comparing sex to a on the fact that men can have orgasms which occur in the brain when endorphins flood the neurons, even without ejaculation. So I will discuss, the male sexual experience to them, not with the “4 easy steps of male sexual response”, but as a “process” of achieving orgasm in men. It is more like a recipe, that requires each ingredient to be added in order, but sometimes you can stop in the middle and start again. It is not always a straight line from sexual desire to orgasm.

In general, all men need testosterone to have sexual desire, and sexual desire to have sex, however both men and women can be physically or visually stimulated to be aroused without true sexual desire. If the man has a long history of having sex often, then the habit of having a sexual response can be achieved without enough testosterone, however the erection will not necessarily last long enough. Continued physical stimulation can bypass desire, and therefore testosterone, and a man can be stimulated into having an erection of sorts and into having an orgasm with or without ejaculate

An erection requires testosterone to become fully erect, however there is a “work around” now and men without testosterone can have an erection with Viagra, Cialis pills, or prostaglandin injections into the penis itself. Men can also have a penile implant placed so they can have sex without testosterone or Viagra/Cialis. However, let’s talk about sex with testosterone in men who have good pelvic blood flow who don’t require medication to become erect.

The second necessary ingredient after testosterone is stimulation, which can be with touch, visual stimulation, auditory stimulation or even imagination that causes a man to be stimulated. The sexual response to any of these stimulations send messages through the nerves from the brain to the pelvis that dilates his veins and arteries. This sends blood to the penis from the arteries and blocks the veins from draining the blood out. This creates an erection. Testosterone’s role is to cause the arteries to dilate by stimulating the production of nitric oxide from the arterial walls. Remember the stimulation? The ongoing stimulation (mental, visual, auditory or imaginary) keeps the erection hard with vascular dilation.

At this point stimulation can be changed or paused and other stimulation can prolong this part of the process. Holding the base of the penis can keep it hard, or any tight encircling toy can keep the erection from proceeding to orgasm for some time or the erection can go away without continued stimulation.

The third step is the preparation for orgasm which can last from as long as 30 minutes and as short as 2 minutes. A clear “pre-ejaculate” is produced that lubricates the penis for intercourse, and if ejaculation is to take place there is a “loading of semen” that takes place from the seminal vesicles readying the man for ejaculation. At this point the penis contracts the muscles quickly in rapid repeating emissions that shoot the semen out of the urethra. This is the orgasm and ejaculation that occur together, which is typical of normal youthful ejaculation. As men get older the force at which they ejaculate decreases.

After ejaculation/orgasm the brain is flooded in endorphins, the feel-good neurotransmitters, that make a human feel happy and satisfied. This is solely the result of the orgasm after a sexual encounter. The feeling of ejaculation does relieve pelvic pressure but is not needed to experience orgasm in most men.

Medical science has been able supply an assist for desire (testosterone) and erectile function (vasodilation and release of nitric oxide but they have not discovered the “pill” to make ejaculations occur or to improve their volume. It is important for an aging man to accept that orgasm doesn’t require ejaculation since we don’t have an answer to recreating the youthful ejaculation. Besides age, vasectomy can also limit ejaculation. dehydration, vasoconstrictors, anti-hypertensive drugs and diuretics can limit the volume of the ejaculate as well.

After the “process of sexual orgasm” the penis loses tumescence, blood leaves the pelvis and overall relaxation occurs throughout the body. Then a period of time must pass before another erection can occur. Over time some “twice a day men” can turn into once every week…..this can be changed by practicing…..having sex more often.

The sexual response in both men and women is more like a symphony with several movements, than a recipe, but it is definitely not a series of steps that is followed in every human in every circumstance. It is the job of the physician to help patients both understand and live with any variations in the sexual process. Much of what I do is act as a teacher to my patients who need to understand their own bodies and any dysfunctions thereof. Understanding becomes treatment over time.

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The medically accepted belief that testosterone is bad for men has finally now been superseded by a huge study from Australia that proves that men with healthy levels of Testosterone live longer and healthier than men with low Testosterone! All you men who have been told that testosterone is bad for you or will cause prostate cancer by your doctor, you can tell you provider that he or she is out of date!

At BioBalance Health® we have been treating men with testosterone pellets for years and our patients are our evidence that testosterone not only keeps men’s sexuality healthy, but youthful testosterone blood levels keep men healthy in many ways, eg. strong muscles and bones, excellent immune systems, healthy heart and blood vessels, lean muscle mass and it prevents the diseases of aging too! I have been treating men and women with Testosterone for over 20 years and I concur with how this study plays out in real life, in my own practice. When my patients replace men’s low testosterone levels with testosterone pellets and they follow my recommendations for a low carbohydrate diet and weight training exercise, supplements and treatment of pre-diabetes and pre-cardiac disease, they live more productive, longer and more enjoyable lives.

My goal for my medical practice is to keep both men and women healthy as they age, and testosterone replacement is the most important necessary element to that end. My intent is to defeat the aging process with interventions that have the potential to delay the onset of age-related diseases and preserve your ability to live life to its fullest, no matter what age you are! We have based our treatment on hundreds of other studies that literally studied one symptom of testosterone deficiency or disease of aging at a time in relation to testosterone levels and found bioidentical testosterone to be beneficial to the health and longevity of men. However, we treat all the symptoms of aging and low T with testosterone pellets.

Australia’s Men’s Study found that men who continued to produce normal youthful levels of Testosterone or replace their Testosterone to achieve normal youthful levels lived longer, more active lives than men who let aging take its course and drain them of testosterone! We have known this for two decades and we have treated men and women with testosterone pellets, the most effective and safest way to prescribe T. Many smaller studies have been done that prove the same thing, but none so dramatic as the latest study we are referencing.

At this point I have two questions to answer for most of your inquiring minds: Why did all the experts tell you that testosterone replacement is dangerous? and, why are the experts in the field of men’s medicine, Urologists, still advising men not to replace their low testosterone as they age? Let me explain that why everyone is so negative about testosterone and why most medical doctors still believe that prescribing testosterone to men is evil. This all started in the 1950s based on the study of only 3 men, who had had prostate cancer. They said they were testing them to find out if testosterone caused prostate cancer recurrence in men after prostate cancer. During the study one of the men had a recurrence of prostate cancer when he was given testosterone injections. In the “olden days” that provided the basis for the belief that Testosterone CAUSED prostate cancer! The doctor even got a Nobel prize. Based on this minimal and falsely extrapolated information, 50 years of doctors have been taught that prostate cancer is caused by testosterone, when in reality testosterone is only dangerous if a man already has an aggressive cancer already, will testosterone replacement stimulate the growth of prostate cancer.

This misinterpretation of a faulty medical study has prevented generations of men from being treated with testosterone to prevent diabetes, heart disease, loss of muscle mass and the ability to walk and lift, as well as the inability to have sex throughout their lives. This has been a grave dis-service to American men, because the world follows us with all of our medical protocols, this misinterpretation and lack of preventive care with T has spread around the world.

The second question you should ask is: Why are the experts in the field of men’s medicine, Urologists, still advising men not to replace their low testosterone as they age? Well, this is not just your doctor’s fault. Other than being trained by generations of doctors who believed the inaccurate information about the danger of testosterone causing prostate cancer and passing it on, there is a problem with how we train the doctors who take care of men. Urologists are surgeons first and not particularly interested in anything that has to do with preventive medical care. Their training is based on surgery: they go through a general surgery residency after medical school for 5 years and then do a specialty in urologic surgery which doesn’t include treatment of anything medical or preventive. More than that, their College of Urologic Surgery and their journal has been blinded by supporting the surgical treatment of prostate cancer, so their motivation to prevent prostate cancer is generally opposite their type of practice of medicine. They can only operate on prostate cancer when a man has it.

Now if you have a penchant for conspiracy theories you may then jump to the conclusion that both the practice of medicine, the business of pharmaceuticals and the government have monetary benefit from keeping all of us sick, and limiting our longevity, since we are a drain on the system after we stop working and live off Social Security and Medicare. In other words, old Americans don’t provide value to the whole of society. I contend it is only because we don’t help aging Americans stay productive and healthy that they are a drain on the rest of the population…However, that conspiracy theory is just a theory I have heard from my patients.

This study is big news because it is the most important study that has been allowed through the blockade of powers, to the public! We at BioBalance Health® can now give you men what you need, and when other doctors criticize our treatment, we can defend our treatment plan with this Australian study and the other hundred studies that came before. You have your ability to ask for what you need from your doctor, based on sound evidence! The second study is below and was in the Journal of Internal Medicine about the same time as the Australian men’s study.

Study links low testosterone to increased mortality

A study published in the journal Annals of Internal Medicine found that men with low testosterone levels had a higher risk of all-cause mortality, and those with very low levels also faced an increased risk of cardiovascular mortality. The findings suggest potential links between testosterone concentrations and health outcomes, emphasizing the need for further investigation into underlying mechanisms and potential therapeutic implications.

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On the last Heath cast #662 we talked about the choice of doing nothing when faced with symptoms of hormone deficiency and symptoms of aging, versus the choice to actively live a healthy life. I believe that concentrating on yourself as you age can save your lifestyle and or your life! Preventing illness as you age is as important as paying your taxes!

An unhealthy living plan without replacing deficient hormones can lead you on a road to illness and early death. If that doesn’t motivate you, then consider yourself warned. Recently I saw a man in his late 70s who I had seen about 7 years before this. He and his wife entered my office, and I could see that some of my medical predictions had come true. This man had developed every disease I told him his blood work and physical self-predicted. Despite the treatment plan I gave him, he ignored me on diet, exercise, supplements, stopping smoking and drinking I gave him 7 years earlier. He admitted that everything I told him would happen, did happen and now he is in constant pain, he is morbidly obese, and has trouble even walking. He now has diabetes and has had a heart attack and 7 ER admissions for his heart since. He did not do one thing I told him, except just recently he stopped drinking alcohol. He now is ready to live a healthy lifestyle however since he has so many diseases, he spends an enormous amount of money on medications and medical care. The cost of care was his reason to ignore hormones, but he ignored my lifestyle advice as well. Even though now a lifestyle change and testosterone pellets will improve his life, he still has done damage to his blood vessels and heart not to mention his joints and back. These aging changes I cannot prevent, just stop the rapid progression.

When you become our patient, we ask you a variety of questions that help us design a treatment plan, more accurately named a “longevity plan”. Symptoms of Testosterone, Estradiol and Thyroid deficiency:

A combined list of symptoms of aging for men and women include:

Loss of Testosterone Symptoms:

· Loss of sex drive

· Loss of erections, and morning erections

· Loss of orgasms for women

· Fatigue

· Insomnia

· Depression/anxiety attacks

· Loss of strength and muscle mass

· Frailty

· Can’t think clearly or remember names of things

· Loss of motivation

· Loss of efficiency at work

· Weight gain

· Belly fat increase

· Sagging skin

· Arthritis

· Osteoporosis

Loss of estradiol (women):

· Hot flashes

· Night sweats

· Anxiety attacks

· Irritability

· Dry vagina

· Painful intercourse

· Sagging skin

· Frontal balding

· Urine loss

· Dry skin

· Shrinking vagina

· Osteoporosis

· Arthritis

Thyroid deficiency:

· Hair loss

· Fat gain

· Fatigue

· Depression

· Feels cold all the time

· Very dry skin

· All body swelling

· Constipation

· High cholesterol

· Low blood pressure and pulse

These symptoms above can be treated and in treating them you will experience not only a lack of symptoms, but a longer healthier life. However, if you also change your lifestyle you can avoid the diseases of aging too!

Through replacing your deficient hormones, add only individually chosen supplements and develop a healthy whole food eating plan, with 3-7 days a week of exercise (1 hour/ session).

What do I mean? What is a healthy Lifestyle?

· If you smoke STOP!

· If you Drink more than 15 alcoholic drinks a week, then stop, If you aren’t addicted to alcohol, you should decrease your drinking to < or = 7 drinks a week.

· Exercise 30-60 minutes a day (consecutively)

· Throw out all the simple carbs in your kitchen: all cereals and granola, use olive oil to cook and no vegetable oils, Processed dry food in boxes or cans should be donated to charity.

· Buy fresh fruit, fresh vegetables, cheese yogurt, fresh or frozen meat, fish chicken, turkey for meals at home.

· Sourdough bread is the best choice in breads—it has no gluten but still has carbohydrates, so small amounts are advised.

· Do something you love every day

· Look for opportunities to have fun

You CAN turn your bad genes off through a healthy lifestyle! Now we know even your genes can be combatted through healthy living. The diseases of aging can be adjusted or avoided. When thinking about what your risks might be, remember that Family history is a broad and faulty way to determine your risk, but genetic testing is a better way to determine your risk of disease that is found in in your chromosomes and genes. The combination of your genes are uniquely yours. Knowing what your genes are can guide you to an individual healthy lifestyle for avoiding disease and living a long life. We offer this service for our patients who want to know what the perfect diet and lifestyle plan is. It is called the

Nutrigen test is optional but a great idea if you are trying to renovate your life! This saliva test (no needles) can determine the genetics you inherited from your ancestors. We then share the information with you and develop a lifestyle plan that includes lifetime changes in eating to decrease carbohydrates from grains and sugar, increase protein, and remove as many processed foods as possible. The Nutrigen test tells you what genes you inherited that impacts your health, but it doesn’t tell me whether you have turn any of your bad genes off or your bad genes on!

We offer that test to our patients who are trying to lose fat or just reframe their life so they can live more productively and as much without disease as possible,

Now if you aren’t convinced that you need to replace your hormones with testosterone plus estradiol if you are a postmenopausal woman, or if you figure you will

Does a future of having Alzheimer’s disease strike your panic button enough to change what you eat and how much you exercise, and to replace your Testosterone with Pellets? Or is it losing a limb from diabetes? Being unable to talk from a Stroke? Would losing your ability to move around as you do today from a Stroke or heart attack make you scared enough to value your health and clean up your lifestyle? Or would the prospect of never having sex again be the trigger that causes you to be as careful with you own health, body, and mind, preserving it for the rest of your life?

Medical care is not just about fixing the sick through medications or surgery anymore, although that is the paradigm we have all grown up in. That dated belief may have dominated our belief about what medical care can do for us and how it works because until recently medical experts didn’t understand how diseases sprouted from a bad lifestyle, or because we were taught that our genes determine our health and there is nothing we can do about it…..but we now know that leading a healthy lifestyle, using food as fuel and not entertainment, and being moderate in everything from food, to alcohol to exercise is the key to a long healthy life. New information in the last 20 years has come to light revealing that an individual can turn off bad genes through a healthy lifestyle…. Your genetics do not dictate your fate, but it is your behavior that dictates the diseases you will suffer fromwith through the last half of your life and eventually die from.

Let’s talk about the most dangerous lifestyle choices that you can make. You must think about your body as a luxury car that requires a lot of maintenance, the best quality gas to fuel it, and loving care every day to maintain its value and performance. Our bodies are a thousand times more complicated than the highest- performance car, and I contend that the most beneficial maintenance you can do is to think about your health every day especially when you are presented with behavioral choices. For instance, when you wake up you should stretch and make sure your muscles are not spasmed. YThe you should think about the two most important choices you will make all day, “When will I work out for an hour?” and “What shall I eat today?”. . Exercise is key to managing your insulin sensitivity and blood sugar, protecting you from diabetes and heart disease. Why would you avoid this inexpensive protection from these deadly diseases? Planning what you will eat that day (or for the next week) should include healthy, non-processed foods and drinks with plenty of water and protein and limited carbohydrates from grains especially from wheat.

But you counter my suggestion ,” Wwhat should I do when everyone around me is overeating processed foods and drinking alcohol and sugared soda?”. My answer is, “Stop and think! Do you drive over a cliff because the guy in front of you does? No! Be brave and don’t make a scene., just choose to eat and drink in a healthy manner…if that is not available, leave and find the food and drink your body needs!” You are no longer a teenager when all the mistakes we make are “forgiven” by our bodies. That stops working after age 20!

I think you should look at taking care of yourself like being engaged in working toward a goal, whether it be in sports, climbing the corporate ladder, getting a raise or getting your degree. Health is a goal that will repay you throughout your life.

I no longer work in OBGYN not because I didn’t enjoy it, or it wasn’t profitable enough, I stopped running around with my hair on fire, stressed out and exhausted without adequate sleep or nutrition because it was bad for me! My medical practice literally made me sick! I gained weight, felt terrible, looked old, was crabby and depressed, so I made a choice to make my health a priority and a priority for my patients.

In terms of how my medical practice changed…from doing insurance paid medicine which is paid for the patient by someone else I was daily faced with patients who didn’t value my advice and didn’t follow it! I now have a medical practice where patients pay for their care themselves. There is something about paying for something that makes you value it more!

Instead of seeing patients yearly that I gave the same advice I give to my BioBalance patients today and repeating myself year after year without my patients making any progress, I now recommend lifestyle changes and treat my patients with replacement testosterone and estradiol pellets and they immediately feel better and follow my advice!

I am blessed to watch my patients achieve health by changing their hormones, diet, exercise, changing medications and taking supplements to round out the nutrition offered by their food choices.

The one most important health goal should be weight loss so you can achieve your ideal weight while you maintain your muscle mass. That change will take effort and sacrifice and if you are over 40 you will need testosterone to make this happen!

Here are the diseases that are caused by obesity:

· CANCER! All kinds!

· Diabetes-Type II

· Heart disease, Myocardial infarction and stroke

· Alzheimer’s disease

· Autoimmune diseases

· Endometriosis

· Arthritis and joint replacement

· Hypertension and kidney disease

· Immune deficiency

Are you afraid of getting any of these diseases? What is your most terrifying disease that keeps you awake at night? Any of these in the list above?

I have always been fearful of Alzheimer’s Disease and stroke because not being able to think and speak is my biggest fear! I have gone so far as to have genetic tests for Alzheimer’s Dx and I have 1 of the 2 genes that cause this devastating condition. However, because I have taken estradiol and Testosterone pellets since I was 47, my chance of getting this disease has been delayed 20 years. Other factors that increase my risk for stroke and dementia are inflammation from being overweight, eating a high carb diet, lack of exercise, hypertension, poor neurotransmitters from a poor diet and bad gut bacteria.

One by one I have changed my lifestyle to decrease these risk factors.

If I can do this, you can! You don’t have a harder work schedule than I have had or less time to choose foods to eat. I choose to turn down more than one alcoholic beverage, to take my own healthy snacks when I travel and at my office.

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My goal for BioBalance Health® is to guide my patients to live a healthier life by offering them the newest preventive treatments, and safest hormone treatment available. My patients make an appointment with me and Dr. Sullivan for help with their current symptoms of aging and hormonal treatment to replace their missing hormones. They also receive a plan for unique preventive lifestyle changes to assist them in continuing their lives in health.

But first, I believe that treating the symptoms of aging is the first thing on the agenda, and those symptoms are treated by replacing the hormones that disappear with age, testosterone, estradiol and often thyroid hormone. These symptoms are classic and appear within a short period of time, together: This is a combined list of symptoms of Testosterone and Estradiol loss for women after age 38, combined with loss of Testosterone in men after age 50.

Symptoms of loss of Testosterone and Estradiol · Loss of normal youthful body, muscle and shape

· Loss of sex drive

· Infrequent or absent orgasms · Fatigue · Depression or Anxiety · Insomnia · Memory loss/ Difficulty thinking · Loss of motivation · New migraine headaches · Decreased muscle mass · Joint aches/ arthritis · Dry eyes · Loss of balance

· ED in men (men)

· Poor or decreased ejaculation (men)

· Increased belly fat Loss of waistline · Weight gain · Cellulite

· Ringing in the ears · Dry vagina (women)

· Painful intercourse (women)

My patients frequently tell me that they feel so good after getting their first testosterone pellets that they wish they would have come to see me years before because they have been suffering and now their symptoms are improved or gone. They also comment on how great their sex life is, their improved stamina to walk, play golf or run and how much younger they look! That is the enjoyable part of my practice.

Replacing these hormones gives my patients their lives back and gives them their energy back so they can make changes in their lives to keep themselves healthy to avoid the diseases of aging.

The Diseases of Aging are these:

Cancer
Type II Diabetes
Arthritis
Heart Attack
Stroke
Dementia, Alzheimer’s Disease, Parkinson’s disease
Osteoporosis
Frailty, inability to walk or climb stairs
Immune deficiency
Autoimmune diseases
Depression and anxiety

We find that we get great results with one or two hormones, but because we are preventive medicine doctors and hormone replacement doctors we are not just interested in your current condition and symptoms, but we are concerned about the diseases you are at risk to get when you get “old”. We then go over your family history of diseases with you and use it to determine what you are at risk for. Let me say that family history is only ½ of your risk factor because each parent only carries 1/2 of the genes you own. This means that your risk is usually watered down by the relative who has the disease, and your risk usually goes up if two relatives on opposite sides of the family have the same disease. Even though we use family history as an estimate of your risk for diseases in the future it is not very specific or accurate. The information your family tells you about their history may not be accurate for the real diseases your parents and grandparents had. My family history is a good example of bad information in an individual’s medical history:

I thought I was at risk for Adult-Onset Diabetes because my grandfather on my father’s side and my grandmother on my mother’s side had Type II Diabetes. I was worried since medical school that I would eventually get AODM too. When I had my genetics done, I found that I had 4/5 genes that foretell obesity, but NO DIABETES genes! This changed my approach to my own health from avoiding carbs totally, to losing weight until I was at ideal weight.

In case you don’t know it, almost all obese people develop Type II Diabetes eventually. If they don’t change their lifestyle soon enough and lose weight as well as get the proper nutrition it is in their future. Diabetes is a disease that will follow them through their lives, putting them at risk for other diseases like cancer, heart disease, Alzheimer’s disease, dementia of all kinds, arthritis, and joint deterioration needing joint replacements. This list includes the most common causes of death. So the moral of the story is, my family history didn’t tell me what I was going to be at risk for!

You can plan your healthy living plan based on your family history, or you can get your own genetics done to tell you what you are at risk for based on your genes, OR you can just clean up your lifestyle, receive your hormone replacement using the safest delivery system

(pellets) and begin a healthy lifestyle as soon as possible. Get real information based on your individual situation now with blood work and add your genetics or family history to help motivate you to get healthier. Changing your lifestyle is the hardest thing you can do so getting expert advice from a physician, and then follow it. Look for a doctor who will help keep you motivated to follow your healthy living plan and do your half of the path to health and healthy aging without disease.

Please join me, Dr. Kathy Maupin, BioBalance Health® next time when we outline a plan for health and longevity to avoid the pain and disability of aging.

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I bet you have heard the idiom, “There is no free lunch”, or “There is no medication without a side effect”, but did you know that medications that are prescribed by your doctor can have negative effects on your health that are never even discussed with you….so you should protect yourself by replacing the nutrients that your medications remove from your body, and that must be replaced for you to be healthy.

Statins -→ COQ 10 DEFICIENCY= fatigue and depression

Beta Blockers -→ COQ-10 DEFICIENCY= fatigue and depression

Oral contraceptives and oral estrogen/progestins-→ COQ-10 DEFICIENCY= fatigue and depression

Antidepressants called SSRIs-→ COQ-10 DEFICIENCY= fatigue and depression

Dosage: If you take any of these medications you need to take COQ10 200-400 mg/day every day!

Thiazide Diuretics=HCTZ -→ Magnesium and Zinc Deficiency muscle spasms, prostate issues, constipation

Take 50 mg of Zinc and 400-600 mg of Magnesium Glycinate a day to replace what is lost.

NSAIDS (Motrin, Advil, Aleve, Ibuprofen, Meloxicam, Naproxen, Indomethecin, Daypro, Mefenamic acid, Voltaren)-→ malabsorption, depression, anxiety, and the vitamin and mineral deficiencies listed:

Folic Acid Deficiency- Take Methyl- Folate 500 mg
Iron Deficiency—Take Iron Bisglycinate (Ferrabsorb)
Vitamin C deficiency—Take Vitamin C 500-1000 mg/day
Amino acid deficiency—take Arginine +/- Ornithine.

OR change your medication to Celebrex 200-400 BID

PPIs=Proton Pump Inhibitors (Omeprazole, Prilosec, Pantoprazole, Lansoprazole, Protonix) are taken for stomach ulcers, H. Pylori infection and gastric reflux

PPIs Increase Homocysteine which increases your risk of stroke, MI, and Pulmonary embolism.

PPIs decrease the absorption of many nutrients. They actually cause malabsorption of essential nutrients.

Replace these nutrients with supplements, but much of what you take won’t be absorbed unless you take daily Probiotics:

B12 – take methyl B12 1000 mcg/day
Folate – take as methyl folate 5,000mcg/day
Vitamin D – take 5,000 IU/day

Note: PPIs can even cause the growth of dangerous gut bacteria causing chronic Hemophilus. If you have chronic vaginitis that smells fishy, it could be your PPIs!

If you have this stop the PPI, take Pepcid instead (histamine receptor blocker) or nothing and take probiotics to repair the damage the PPIs have caused. These nutrients need to be replaced to keep you healthy, however it is better for most patients to only take PPIs for 2 weeks at a time or substitute a histamine receptor blocker like: Pepcid, Zofran.

Surgery

It is not just the medications doctors prescribe for their patients; sometimes surgical procedures can cause chronic diseases through preventing nutritional nutrients to enter your body.

Removal of the gall bladder must be done, yet patients are not told what they can do to be healthy after the surgery.

The gall bladder provides enzymes that help you breakdown foods, primarily fats and absorb fatty vitamins from your food and supplements. If you have had your gallbladder removed you can become nutritionally deficient in A, D, E fat soluble vitamins, and you will promote the growth of abnormal gut bacteria and are at risk for leaky gut, Celiac disease, autoimmune diseases and malnutrition. Everyone who has their gallbladder removed should take digestive enzymes with every meal and take Probiotics daily.

Bariatric Surgery for Obesity

The last iatrogenic nutritional deficiency that I will discuss is Bariatric surgeries, all kinds that remove part of the stomach, or band the stomach or in any way physically makes the stomach smaller is related to nutritional deficiencies caused by malabsorption of vitamins and minerals. The way to combat these deficiencies include taking:

a probiotic daily
digestive enzymes with every meal
and all vitamins should be chewable or sublingual to be absorbed from the mucosa of the mouth

In Conclusion:

Remember I am a physician, and my job is to promote wellness in my patients. It is sometimes more important and lifesaving to take the above medications or have these surgeries, than to prevent a nutritional deficiency in the future. We must follow those medical decisions with trouble shooting addition of nutritional supplementation to replace what these necessary medications and surgeries remove. That is preventive medicine and why supplementation is often needed for our health.

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You are what you eat, and you use what food and drink you eat based on your genetics.

Weight loss requires professional advice, direction and oversight. Combining receiving the best advice on what you should eat and drink as well as tailoring it to your metabolism and medical condition is what you should receive from your weight loss program.

Before you embark on a weight loss program you need to know the following lessons.

Lesson #1: All Calories Do Not Create the Same Energy/Heat/Weight Loss in All People.

You can put a gallon of gas into a Maserati and Ford Fusion and they do not provide the same performance (different acceleration or speed, pick up and ride) different MPG or speed because these two engines are not the same. The Maserati burns fuel (calories) faster than the Fusion; it operates at a higher level of speed and performance, and it uses more gallons of gas per distance. Just like the difference in cars, the difference in our bodies is VAST!

I explain this truism every day in my office. One of my female testosterone replacement patients returned for her first follow up consultation. The blood levels were ideal and all the symptoms relating to testosterone deficiency were gone! However, the only thing she could think about was the fact that she did not lose weight (although she did gain muscle and lost fat) and her friend lost 15 lbs in the first 4 months!

Even though she and her friend were the same age their metabolisms were very different AND the fact that her friend did everything I told her to in regard to diet, limiting alcohol, taking supplements and exercise, but she did not, tipped the scales to cause her not to get the same result as her friend…in other words, her friend had a genetically faster metabolism, AND she put Premium “gas” into her metabolic car, changed the oil and took care of her car so it ran faster and better than the patient sitting in front of me who used regular gas, didn’t care for her car

and drove too fast and hard. Two people the same age with different metabolisms, diet, exercise, supplementation, and stress level have widely different responses to weight loss.

Therefore, medical weight loss advice must be individualized to fit just you!

The individual variables include:

Genetic programing
Current weight and diet
Length of time you have been overweight
Age
Blood type (also genetic need for certain foods)
Medical history/current diseases
Medications you are on
Supplements that you take or need to take
Exercise and physical movement

Fad Weight Loss diets are a fraud to sell books or to get attention. If it takes a 300-page book or a Social Media fad to sell a diet that is supposed to be good for everyone…it is a lie and may backfire!

When the cabbage soup diet was a fad many of my GYN patients did it. I had access to their blood types and knew that cabbage was bad for A blood types and slowed their metabolism. Despite my advice they still did the diet, and you know what happened? They gained an average of 10 lbs!!!! Their blood type determined whether this particular diet would work for them. This is an example of how important your genetics are to weight loss.

What are the genetic variables that affect your approach to weight loss?

Inheritance how our body burns calories—are you a Fusion or a Maserati?: there are many genetic variables that make you as an individual require specific foods and exercise programs to get to your ideal weight and be healthy. It is the job of your medical advisor to determine what these are for you and tailor your diet accordingly.

Your Blood type determines the best and worst foods for your metabolism and the number of days you should exercise.
Do you burn calories at rest, or does it take active exercise for you to burn more than the baseline of calories? If you are warm while you sleep, then you burn calories at rest and therefore will burn more calories than someone who does not, even if you eat the same things and expend the same active calories a day.
How much of each type of food do you eat? Protein/carbohydrates/fats.
- Protein takes more calories to metabolize than carbohydrates, and a lot more than fat, so the most calories are consumed by eating a high protein diet.
Mood Determines your Mindless Eating: Genetically are you more apt to eat when you are anxious or worried? This is a behavior that can be changed by counselling, behavior modification, or even just making you aware of your inherited problem.
Genetically do you always feel hungry? Genetically are you never full? These are genetically inherited qualities that affect the amount you eat and how often you go back for seconds. There are medications and behavior modification that can counteract this genetic reality.
Genetically does exercise or dieting result in the most weight loss? Believe it or not some people just have to diet without a lot of exercise to lose weight, others are programmed to exercise only for weight loss and then most of us have to use both methods to lose weight. Let me say that exercise does use up more calories, whether you are built to burn more with dieting.
Genetically how much lean muscle mass do you have? The more the better! Weight loss is aided by weight training three times a week, and the replacement of testosterone when you become deficient. Both of these muscle building methods increase muscle and decrease fat. Did you know that your muscle mass burns 80-90% of your calories. More muscle means more weight loss, but your muscle metabolism must be turned on with testosterone, insulin sensitivity, good blood flow and more metabolic factors.
The more fat you have the harder it is to lose weight because body fat doesn’t burn many calories. High muscle mass burns a lot of calories even at rest! The more muscle you have compared to fat the faster your body will lose extra fat. Weight training is helpful to building muscle and losing fat.
What percentage of food should you eat of each food type? That is genetically set.

Your ideal % of Protein, Carbohydrates and fat are genetically determined. Many of us have discovered our ideal food chart through trial and error, but a weight loss genetic test can tell you as well!

Your Age: The older you get the lower your sex hormone testosterone is. As you age testosterone, growth hormone decreases while estrone increases all of which cause and cause weight gain.

Testosterone stops being produced from women’s ovaries between 40-50 years of age. Men never lose all of their T but the level decreases from age 35 on to hit a clinically symptomatic level between 50-55 years of age.
Estrone increases as Testosterone decreases and causes both sexes to gain belly fat.
Do you have your sex hormones or not (particularly Testosterone)? Without T your muscles stop growing and burn fewer calories every day you go without T. This is why people tend to get old and fat as their T stops being produced (in women) or becomes clinically too low a level of free T at a certain age in a man’s life.
Growth Hormone decreases with age—adding nonoral T replacement increases Growth Hormone.
Menopause immediately makes women who don’t replace their estrogen and testosterone to gain up to 20 lbs without changing diet or lifestyle.
Osteoporosis occurs and worsens with age because estrogen and testosterone in women decrease over time. Testosterone in men decreases in men which thins bones. Loss of bone causes loss of muscle and both cause weight gain. More importantly, osteoporosis decreases the activity level of affected patients.

Lifestyle impacts your ability to lose weight:

How much water do you drink? You need sufficient water to lose fat. You should drink ½ your weight in pounds, in ounces of water to be able to lose weight. That volume of water you should drink increases to ounces of water = weight in pounds if it is hot outside or you are doing work that makes you sweat.
Do you eat cleanly- do you eat whole foods? Do you eat one salad a day? Do you turn down sugary foods and desserts. If the answer is yes, then keep it up because it is helping you lose weight!
Do you eat fast food cereal, cookies desserts and or doughnuts? If so, stop! All of these foods are massive producers of blood sugar, metabolic syndrome and obesity! These foods are literally bad for everyone!
Do you eat a balanced diet? Humans are built to eat a varied diet with some fruit vegetables, meat, fish, eggs, butter, healthy fats (non-meat fats), with some grains and we were NOT built to eat sugar!
Do you eat a lot of carbs? A Low carb diet can allow you to improve IBS, prevent cancer, and Alzheimer’s Disease, dementia, avoid bacterial and viral infections, high cholesterol and heart disease, diabetes, obesity….all the diseases that cause us to be sick and age are related to too much carbohydrate in your diet! In Japan, Alzheimer’s Disease is called Type 3 Diabetes!
Do you sit all day or exercise and move your body –taking 10,000 steps actually helps you lose and maintain our weight as well as exercising your heart!
Do you take vitamins and supplements to prevent deficiencies in your diet? If not then you need to write down everything you eat for a week and have your medical professional review it….My bet is that everyone in America needs supplements ! The minimum daily requirements on a vitamin bottle is the MINIMUM AMOUNT OF A VITAMIN THAT MERELY KEEPS YOU ALIVE! These levels are not the amount of a nutrient you need to be healthy!
I bet you think alcohol is a food? It isn’t! Alcohol is a toxin, use it with care. Just because your friends drink a bottle of wine a night doesn’t mean it is healthy…bad habits always want company!

Diseases that you currently have affects your ability to lose weight.

Are the glands that set your calorie burning rate healthy? If your thyroid is low, you will have to work harder at exercise, and you will have to eat less calories to lose the same amount of weight a person your size who has a normal thyroid. If you have sick glands you are bound to be “over-fat”
Diabetes and insulin resistance (abnormal your pancreatic gland) cause weight gain and an inability to lose weight if it is not treated. Metformin recreates insulin sensitivity, as does Mounjaro and Semaglutide medications.
Liver and kidney disease your ability to get rid of the fat you are burning and you store up toxins that also slow your weight loss. Follow the directions of your doctor and get the healthiest liver and kidneys you can! Fatty liver is secondary to Metabolic Syndrome, so treatment with Metformin, Semaglutide and Tirzapetide can cure this disease!
Heart disease—high carbs not high protein diet causes arterial plaque! You have been lied to because statins make money! Stop eating carbs and eat all the animal proteins you want! One of my patients has only eaten fruit, vegetables, grains, sugar and alcohol his whole life and he has severe atherosclerosis (hardening of the arteries) before he was 60! Avoiding animal products does not prevent heart disease.
Endocrine disorders like overactive adrenal (high Cortisol) and hypoactive thyroid, pituitary adenomas can cause an imbalance of the metabolism and they can cause weight gain and fatigue that make it hard to lose weight.

I will talk about Medications that cause weight gain—beta blockers, blood pressure medications, Statins, and others in a future blog.

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If you have hypothyroidism (Low thyroid), fibrocystic breasts, fatigue, metabolic syndrome, diabetes, hair loss, obesity, or high cholesterol then taking supplemental Iodoral can improve these diseases. These conditions have become an epidemic in the United States due to Iodine deficiency.

My longevity medical practice is all about keeping my patients healthy so they can live not only a longer life but one with quality. In the last 20 years of my BioBalance® Health practice, I have seen a flood of new patients with conditions that are in part secondary to iodine deficiency. Today in America, the majority of people need iodine and other supplements to their diet for many reasons:

Food manufacturers don’t supplement our foods as they did in the years from the 1940s to 2000.
The food that we eat (even fresh food) contains less nutrition than they did 50 years ago.
Fast food diets, processed foods and preservatives remove necessary vitamins and minerals that we need to be healthy.
Alcohol leaches nutrients from our bodies and alcohol consumption is increasing.
Chemical pollution has entered our food supply and now is stored in our bodies.
We have added a chemical to our drinking water, fluoride, which displaces Iodine in our bodies leaving us Iodine deficient.

Today I am going to address the symptoms and diseases of Iodine deficiency. This blog about Iodine is to inform you about the need for Iodine and what it does. I hope to never have to remind my patients about taking this supplement again after listening to the associated podcast or reading this blog!

Iodine is a micronutrient necessary for life. In a research article in the Journal, Frontiers of Nutrition, March 2024, a very succinct review of the illnesses that occur because of iodine deficiency and that can be treated (partially) with iodine supplementation. I recommend all of my patients who live in my area which has no iodine in the soil or ground water and where all the drinking water is fluorinated. The Iodine supplement, Iodoral, is not a drug, but a nutritional supplement that is sold over the counter. The Iodoral 12.5 mg bottle of 90 is $14.50 for 3-6 months supply. You can’t afford NOT to take it!

Why do we need this supplement at this time in America and many first world countries? Governmental intervention in our basic need for water caused most of our deficiencies. Iodine is produced naturally in the ocean by seaweed, and it is contained in the soil and ground water in areas of the country that are near the ocean and those areas that were covered by ocean water millions of years ago. So, if you think geographically, most of the US is in that “map”, except the Midwest. However, man and government has intervened and caused our population to be iodine deprived by adding Fluoride to our water.

The government and the FDA make decisions for us without looking at the subsequent damage that might be done by those decisions. In the 1949 the US government decided that EVERYONE needed to be protected from dental cavities so 75 years ago we fluorinated our water and that decision led to the epidemic of iodine deficiency. Fluoride in your drinking and cooking water literally replaces iodine, and takes its place molecularly, leading to generations of people with 25% fewer cavities and 100% increase in the list of diseases I have listed in the first paragraph! Fluoride is the biggest cause of thyroid disease. Wouldn’t it be better to use fluoride toothpaste once a day than drink it?

In some areas of the country, called the “Goiter Belt”, we don’t have any iodine in the natural ground water, so locally grown food does not contain Iodine. These regions have had a history of high percentage of the population with low thyroid, and goiters, even before we added fluoride to drinking water. This compounds the problem and the diseases from Iodine deficiency. I live in that area!

Before the 1970s iodine was required to be added to bread, salt and a few other foods. Ever since I have been seeing more Eating designer salt has caused people to not even get iodine in the salt they eat, Now we use all kinds of salt most of which don’t have iodine in them,.

So now you know what the problem is today as well as the answer, Iodine supplementation with Iodoral® every day!

How do you know if you have low Iodine and or Hypothyroidism?

Symptoms of low iodine mirror those of low thyroid:

fatigue,
swelling,
Abdominal bloating and pain
Constipation
hair loss and broken frizzy hair,
brittle nails,
dry skin,
cold body temperature BBT less than or equal to 98 degrees Fahrenheit,
weight gain,
depression,
slow metabolism,
slow pulse
low BP
fibrocystic breasts

So what will taking Iodoral® do for you beyond reversing the symptoms above?

Improved thyroid function which decreases fatigue, weight gain, hair loss, brittle nails, swelling, and slow metabolism….

The benefits to you and your thyroid gland are immense! Your thyroid hormones control your metabolism and control your thermostat. Every cell in your body requires thyroid, and therefore require Iodine. If your body doesn’t have enough heat, then your enzymes can’t work and our cells can’t do their jobs, heal themselves and skin, muscles and all our tissues suffer.

How does that work? Thyroid hormones T1, T2, T3, and T4 are made from one amino acid, Tyrosine, an 1-4 Iodine molecules! The molecular structure of Iodine calls for plenty of iodine nutrient in the blood stream to make thyroid hormones and to attach to iodine receptors on each cell that uses thyroid in your body.

Preserve the health and function of your thyroid gland.
You will feel warmer, your pulse and blood pressure will normalize. You will lose weight.

Your thyroid hormone keeps your body warm by stimulating mitochondria to burn calories. In this way thyroid hormone controls your weight, how fast you burn calories, how energetic you are, how well you think, how your hair and nails grow just to name a few benefits of thyroid. You need to add iodine to your diet to produce thyroid hormones to maintain all these vital functions for you!

Prevention of Fibrocystic Breast Disease. Women’s breasts absorb a lot of iodine and need Iodine to be healthy. The absorption by the breasts of iodine steals I from the thyroid and accounts for women having a much higher incidence of Hypothyroidism. The thyroid is starved without iodine and “dies”. Hypothyroidism is a Woman’s disease!
Fibrocystic Breast Disease. Women’s breasts are iodine sensitive and years of low Iodine can cause Fibrocystic Breast Disease. This is not a precancerous condition, but it makes it harder to find a cancer in a breast on a mammogram.
Weight Loss/Avoid Metabolic Syndrome

For both sexes Iodine is needed to maintain blood sugar control and the control of obesity. It is one of the necessary nutrients when it comes to weight loss. More importantly it can prevent Metabolic syndrome which is a combination of high blood sugar (diabetes/prediabetes), obesity, hypertension, and high cholesterol. If you have Metabolic Syndrome, you are at higher risk for Cancer, Heart Disease, Stroke, and early Death. It doesn’t take just iodine to treat this syndrome once you have it, but Iodine is key to making your medical treatments, diet, and exercise work to decrease your medical risks of disease and early death.

Lower your LDL Cholesterol

Hypothyroidism causes an increase in LDL Cholesterol; therefore it may increase the incidence of heart disease.

Organ Systems Other than the Thyroid Need Iodoral:

As you can see by the list above, vital organs other than the thyroid accumulate/store Iodine: salivary glands, stomach, pancreas, ovary and testes, which has led to the new realization that Iodine has effects outside of the thyroid.

Other Results of Replacing Iodine to what is clinically considered a high level in the US.

Blood sugar is lowered by adequate Iodine blood levels (199-299 mcg/L).
Insulin resistance is improved by taking Iodoral
Hypertension lowered to its lowest point when blood levels were between (300-499)
Gout: the higher the iodine, the lower the uric acid in the blood, therefore fewer Gout attacks.
Mortality rates increase to 33-75% higher in people with low iodine levels.
Inflammation and inflammatory diseases improve with iodine supplementation
Immune modulation is one of the benefits of iodine. If you have a poor immune system, it improves your resistance to communicable diseases. If you have autoimmune disease Iodine improves these diseases.

How could supplementing Iodine, removing Fluoride, from our drinking water do for us individually and our country? Japan is an example of high Iodine levels that benefit health.

What happens in other countries with adequate iodine levels? Japan has the highest level of iodine in the blood because they consume seaweed in their diet and most of their water and food has iodine in it. Of course, Japan is an island surrounded by iodized seawater! They consume 7 x the average amount of Iodine as Americans with healthy consequences. Japan has one of the lowest incidences of Metabolic syndrome and the diseases included in it. A study on Iodine consumption revealed that obese women had a significant weight loss when eating food in Japan.

Summary:

We all need iodine in our food and water or if we can’t get it, we must supplement it with an over the counter supplement, Iodoral ½-1 tablet a day (12.5 mg tablet). The “normal” reference ranges are skewed to the low iodine level, so many people stop taking iodine when they follow the reference ranges, however in this research paper the ideal blood levels were considered healthy up to 100- 399mcg/L while the Quest and Labcorps reference ranges are 52-109, much lower than what is considered healthy by research studies.

Iodine does not cause hyperthyroidism, however if someone has hyperthyroidism there is controversy as to whether Iodine should be supplemented. Make your choice: Health with an inexpensive supplement (Iodoral) or illness with fluoride and without Iodine.

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There is a lot of New Medical Information that is important for patients to make healthy decisions about their care or the care of their loved ones that you won’t hear about on the news.

For new research to reach you, the public, a researcher or a drug company has to spend a great deal of money for the public relations people to push information into the light. I compiled the research I thought you might want to know about that has been discovered during the past 6 months. I always use these studies to educate my patients and to change my protocols for treatment, although many of them have been part of my practice for quite a while, because they just confirm what I have been seeing in my Integrative and preventive medical practice for years.

The First Group of Discoveries Relate to Menopause, and the Risks of Being Menopausal

The most recent article in Lancet confirmed what has been obvious to me in my GYN practice for years. I am not sure why this actually required a study to prove that Menopause is tied to a higher rate of depression and anxiety, in conjunction with insomnia, higher stress perception, and hot flashes. This study documented what the loss of estradiol, progesterone and testosterone can do to women in menopause. The sad fact is that this article doesn’t tell the reader what they need to know, how to treat these symptoms.

However, I will let you in on a self-discovered fact: The replacement of the hormones that disappear before and during menopause can be replaced in a non-oral delivery system to treat these symptoms. I have 40 years of medical practice that proves my findings that agree with the problem, and my treatment with hormones.

The Lancet:

Menopause tied to mental health issues in certain women

A study found that when certain women are menopausal, they increase their risk of Depression, anxiety, bipolar disorder who experienced stressful life events, had poor sleep related to hot flashes, or had previous depressive symptoms of depression were more likely to develop menopause-related mental health problems. Researchers wrote in the journal The Lancet that some women escape the mental health effects of menopause altogether.

HealthDay News (3/6)

Another recent study about menopause discovers that a lack of estradiol in the post menopause causes women to have trouble thinking. I agree with that revelation, but why doesn’t the research take the next step and suggest a treatment to prevent this result of hormone loss? Why doesn’t the research tell us how to help women think by replacing their estradiol? Many other studies confirm that replacing estradiol will delay the onset of dementia by 10 years. Another study reveals that the replacement of testosterone will delay dementia it 10 more years. These studies occurred over 20 years ago, but this study doesn’t cite them.

Poor and worsening cognitive function is one of the most frequent complaints of my new patients coming to BioBalance Health® for treatment of menopause and low testosterone with bioidentical hormone pellets.

Dr Maupin:

I am continually reminded of the importance of testosterone and estradiol replacement is to aging men and women when they come back for their second pellet insertion and review their list of the symptoms they complained of before they started E and T pellets The most frequent response I witness when I ask if a woman’s ability to think, do her job and stay organized is completely better after 3 months of Estradiol and Testosterone pellets, is crying with relief! Many patients are deeply worried that they are developing dementia, specifically Alzheimer’s Disease when they first come to me, but are able to go back to work and or experience a renewed quality of life because their ability to think, they can now feel confident in their professions and careers. Dr M

Estradiol associations with brain functional connectivity in postmenopausal women

Testo, Abigail A. BS1; Makarewicz, Jenna BS1; McGee, Elizabeth MD2; Dumas, Julie A. PhD1

Author Information

From the 1Department of Psychiatry 2Department of Obstetrics, Gynecology, and Reproductive Sciences, Larner College of Medicine, University of Vermont, Burlington, VT.

The results illustrate the relationship between estradiol level and functional connectivity in postmenopausal women. They have implications for understanding how the functioning of the brain changes for individuals after menopause that may eventually lead to changes in cognition and behavior in older ages.

I have another problem with studies that should be shared with patients is that they often imply that menopausal women are “crazy” instead of saying that women after menopause develop mental health issues that can be treated with hormone replacement. Women who are menopausal are not mentally ill they are hormone deprived!

I view this as a “slam” and divisive attack on aging women. The fact that if we gave women what they need …hormonal replacement ….they would not suffer the symptoms of mental health disorders.

Menopause tied to mental health issues in some women

A study found that women who experienced stressful life events, who had poor sleep due to nighttime hot flashes, or who had previous depressive symptoms or depression were more likely to have menopause-related mental health problems. Researchers wrote in the journal The Lancet that some women escape the mental health effects of menopause altogether.

Full Story: HealthDay News (3/6)

The Second Group of Articles Is About The Loss Of Estrogen In Menopause Causes Heart Failure and Atrial Fibrillation.

This article from the European Society of Cardiology reveals that the longer women live without estrogen (e.g. is menopausal), the higher risk of developing heart failure and atrial fibrillation. Once again, there is no mention about how to prevent this disease! Why can’t they study the women who replaced their hormones and compare them to the women who didn’t?

Hormone Therapy May Boost Weight Loss for Postmenopausal Women Who are Overweight or Obese On Semaglutide, Study Finds My practice BioBalance Health® has a weight loss program that is very effective for weight loss using Semaglutides, and terzipatide. For women who are menopausal we have found that they lose weight much more quickly if they are on E2 and T pellet hormone replacement. This research article confirms the findings of this study. If you are menopausal and have gained weight after menopause that is hormonal and the faster, you can get on non-oral estradiol and testosterone replacement then you will be more likely to get to your ideal weight! March 18, 2024

Hormone therapy may boost weight loss for postmenopausal women on Semaglutides.

Healio (3/18, Welsh) reports, “Hormone therapy was associated with an improved weight-loss response for postmenopausal women with overweight or obesity treated with Semaglutides, according to cohort study results published in Menopause.” In the study, “postmenopausal women on hormone therapy had a higher percentage of total body weight loss at 3 (7% vs. 5%; P = .01), 6 (13% vs. 9%; P = .01), 9 (15% vs. 10%; P = .02) and 12 (16% vs. 12%; P = .04) months of semaglutide treatment compared with no hormone therapy.”

How and Why to Treat Metabolic Syndrome

Metabolic Syndrome is a combination of hypertension, high lipids, insulin resistance, obesity, prediabetes or diabetes, large abdominal measurement. This combination puts patients at risk for heart disease and early death. Many conditions and outcomes have been associated with metabolic syndrome, but now we have a treatment that can prevent one of the outcomes of this syndrome, the generic drug Metformin ER.

Metformin, Cognitive Function, and Changes in the Gut Microbiome Endocrine Reviews, Volume 45, Issue 2, April 2024, Pages 210–226, Published: 21 August 2023 Article history

Abstract

The decline in cognitive function and the prevalence of neurodegenerative disorders are among the most serious threats to health in old age. Metformin can preserve cognitive function by treating metabolic syndrome and improving the gut biome that produces neurotransmitters.

I am not naive enough to believe that the only thing that your brain needs to perform well is two sex hormones (E2 and T). This new research from the Endocrine Society describes how the generic, inexpensive medication Metformin ER, can help preserve an aging patient’s ability to think. That is primarily because the brain has insulin receptors, and when a patient has insulin resistance brain cells don’t receive enough blood-sugar to be able to think! By taking metformin ER (extended release) plus replacing estradiol plus testosterone in pellet form, the brain gets what it needs (blood sugar) and patients can think again!

The second factor the researchers found to be important to brain health and problem solving, is healthy gut bacteria in the intestines. This requires eating whole foods, especially fruits and vegetables every day, and not eating fast food, alcohol, simple sugars, and preservatives that kill good bacteria. We recommend a daily probiotic by Mega + the lifestyle changes above.

If you want to keep your ability to think for your whole life then you need E2 and T in pellet form if you are a woman and T if you are an aging male, plus Metformin ER daily and the above lifestyle changes.

Metabolic Syndrome, Obesity, is the Biggest Risk for Cancer

Metabolic syndrome may increase cancer risk by 30%

People with metabolic syndrome had a 30% higher chance of developing cancer over the course of a decade after diagnosis, according to a study published in the journal Cancer. The researchers also studied inflammation by tracking C-reactive protein, concluding that elevated levels of the protein along with metabolic syndrome were “significantly associated with subsequent breast, endometrial, colorectal and liver cancers.”

Full Story: National Public Radio (3/11)

The struggle to stay young and healthy is a difficult fight but the most important battle that you will wage as an adult. If people knew the whole truth, would they stop overeating, drinking, smoking, avoiding exercise, or stop taking illicit drugs? I can only hope that if we convince people to take care of themselves better and replace the hormones that are missing as soon as they are clinically deficient, then they will also listen to the truth about the various ways to support their health and prevent disease. I also hope that the doctors who write articles and do research stop treating women like crazy people instead of the gender that actually runs the world and not only nurtures the children but also organizes homes and businesses. We are NOT crazy when we need hormones to be replaced (PMS, MENOPAUSE), we are experiencing symptoms of hormone-deprivation, and we just need to be treated with the hormones that are missing!

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Last week one of my pellet patients asked me to see her daughter, even though I don’t see young women anymore since I began BioBalance Health for people over 40. I asked her why she couldn’t see her gynecologist and she told me that she was told that she had PMS and that was a condition that was treated by a psychiatrist! I have treated PMS successfully by replacing one hormone that is missing, Progesterone, two weeks a month, the same two weeks that women experience the symptoms of PMS. I agreed to see her although I wish my fellow gynecologists would learn how easily this can be treated and not make young women feel like they are crazy, because they aren’t!

NOTE: Before I give you the impression that I treat PMS currently at BioBalance® Health, I want to clear that up: I only treat PMS in my younger cycling patients (36yo. to menopause) who take testosterone pellets for other symptoms. My recommendation for finding a doctor who treats PMS in your area is to contact a local compounding pharmacy and ask the pharmacist which GYNs treat PMS, or contact one of the large compounding pharmacies, eg. College Pharmacy in Colorado Springs, or Belmar Pharmacy in Colorado as well to find a doctor in your area who can treat you. There are many good compounding pharmacies who have pharmacists who can tell you which doctors prescribe progesterone for PMS.

What is PMS?

PMS symptoms are only present 2 weeks a month, the 2 weeks before menstruation. This condition causes patients to feel different, not like themselves in the ways listed below, and also caused menstrual changes in the menstrual periods that follow the PMS symptoms.

The Emotional and physical Symptoms of PMS: All occur monthly, for 14 days

Depression
Anxiety
Anger and irritability
Bloating,
Migraine headaches,
Water weight gain,
Pelvic pain
Fatigue
Insomnia

The Menstrual Symptoms associated with PMS:

The GYN Symptoms that can occur secondary to PMS (poor progesterone production) include:

1)irregular periods, spotting for a week before the period starts

2) heavy bleeding, sometimes uncontrollable bleeding,

3) infertility,

4) multiple miscarriages

5) lack of ovulation, and lack of periods for months at a time like with PCO Polycystic ovaries

My History Treating PMS (skip if you already know this)

I have been a gynecologist in private practice in St. Louis County since 1985 when I graduated from my OBGYN residency at Mercy Hospital. My training gave me an excellent knowledge of GYN Surgery and Obstetrics, but a very minimal understanding of the hormonal cycles of women, including Premenstrual Tension (PMS). Since the 1980s when PMS was recognized as a condition of women, OBGYNs have been taught that PMS is a psychiatric disease that must be treated with psychiatric medicines, primarily anti-depressants. Most OBGYNs today still believe that women who have PMS are “crazy”, and either give them an antidepressant which rarely work to treat the symptoms or refer their PMS patients to a psychiatrist. In my case, I do not do either because PMS is a hormonal imbalance that causes emotional symptoms, and because psychiatric diseases are not cyclic every 28 days lasting 2 weeks, followed by 2 weeks of normalcy.

The Cause of PMS

Since 1988 I have studied the cause of PMS and with the help of a very intelligent compounding pharmacist, Pete Hueseman, I found the answer to the cause and treatment for PMS. I began to treat PMS hormonally and now have successfully treated hundreds of PMS patients with bio-identical Progesterone. It is a simple answer. PMS is caused by a deficiency of the hormone Progesterone during the two weeks after ovulation, from around days 14-28! This is not a complicated diagnostic discovery, and the treatment should be obvious to all doctors who treat young, fertile women. More about that in a minute…

From 1980- the present there has been no effective treatment for PMS approved by the FDA (just ineffective anti-depressants) because it is still categorized as a psychiatric disease. When I took my second American Board of OBGYN test in 1999, a question on my test was: “Is PMS a Psychiatric Disease that should be treated with antidepressants?” And the correct answer according to the American College of OBGYN was that that statement was TRUE, they believed and still do in 2024 that PMS is a psychiatric disease! In 1999 I had been treating PMS successfully with bio-identical compounded progesterone for over a decade with bioidentical progesterone in non-oral form (suppositories, vaginal tablets, vaginal cream, and transdermal creams), given only during the second half of the menstrual cycle, from ovulation until the onset of the period.

To understand PMS you have to understand how the three sex hormones work during a woman’s 28 day cycle. We count the days of a cycle starting at the first day of bleeding, which is day 1. While we have a period our estradiol, progesterone and testosterone are all at their lowest level in the blood, but by the end of our period estradiol (estrogen) and testosterone start being produced by the ovary. They increase and both peak at ovulation, usually day 14, giving a woman a viable egg and a surge in her sex drive to motivate her to have sex and fertilize the egg. On day 14 the egg is released from the ovary and the corpus luteum (where the egg came from on the ovary) starts secreting progesterone. This hormone increases and plateaus during the next 14 days, while estradiol and testosterone level out. The day before bleeding, when the egg is not fertilized, all three hormones drop precipitously and that causes the uterine lining that was growing under the control of estrogen, to shed and bleed.

PMS occurs during the second half of the menstrual cycle when the developing egg is not ovulated or is immature and ovulated but is not “ripe” enough to stimulate a decent progesterone blood level. In the case of PCO, many eggs develop but are trapped and don’t ovulate at all so no progesterone is produced. In all these cases, women with PMS are symptomatic both in the symptoms above and the menstrual abnormalities listed earlier.

All of the physiologic changes that take place in the PMS patient indicate an inability to conceive, or to conceive but have multiple miscarriages.

The Treatment for PMS:

The Treatment is bio-identical Progesterone, but the FDA didn’t have a form of bioidentical Progesterone that worked until the last 10 years, when Prometrium was produced. Prometrium is an oral pill containing natural progesterone in peanut oil. This works well for some women, but not for others. For those women we prescribe bio-identical compounded progesterone in sublingual, vaginal, transdermal and BLA Progesterone oral forms.

The most important fact about diagnosing PMS is to remember that the symptoms of PMS only occur 2 weeks a “menstrual” month (28 days of the cycle). The most important fact about treatment is that PMS should be treated with Progesterone the second two weeks of the menstrual cycle at bedtime.

Now my patients ask me to treat their daughters who are cycling and whose OBGYN follow the guidelines of ACOG blindly even if the suggested treatment (anti-depressants don’t work or make them worse). I can only hope that the method of treating PMS as a hormone deficiency, instead of a psychiatric disease, will be accepted by American College of Gynecology and that you can find doctors you can be treated by, by finding a compounding pharmacy who will refer you.

Compounding pharmacies in St. Louis: Neels’s Pharmacy, and Medical Arts Pharmacy (ask for Brock) in Clayton MO, Jennifer’s Pharmacy in Clayton, MO.

neelspharmacy.com

Phone number

(314) 849-3123

Medical Arts Clayton Pharmacy

https://www.medicalartsrx.com › compounding

jenniferswholehealthpharmacy.c…

(314) 862-7400

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The Problem: I see women and men every day who are deficient in their own production of testosterone because of age, testicular trauma, removal of their ovaries, chemotherapy, chronic illness, and medications. The cause of testosterone deficiency is as varied as the side effects and benefits of every different type of testosterone. This means that when you hear or read a headline like the one that came out last week:

“Testosterone Treatment Fails to Offer Protection Against Fractures in Men with Hypogonadism, Research Indicates”

You cannot take It at face value. This headline should read Testosterone replacement in the form of testosterone cream given at a low dose given at a low dose to men who already had osteoporosis doesn’t offer protection against osteoporosis.

The headlines that read the way this one is an example of the reality that everyone loves to hate testosterone. This makes informed decision making by a patient very difficult because of the jaundiced view by physicians and drug companies about replacement of one to the hormones that men and women both make when they are young, but which becomes deficient in most of my patient population as they age.

Why is there all this subterfuge and confusion about testosterone replacement? I believe it is the fact that allowing American’s to age out of jobs and make room for the younger workers; many people cannot afford testosterone on their own so they are jealous of those people who can and do afford it; The insurance companies don’t want to pay for anything they don’t have to; keeping people youthful and healthy is not a priority for American medicine based on acute care in the ER and operating room;

The group of naturalists who think aging is great, are people who either are out of touch or are very young; the use of testosterone by both sexes often makes the use of other medications unnecessary (anti-hypertensives, statins, autoimmune medications, etc, and also prevents patients from getting communicable diseases so the largest industry in the US, pharamaceutical companies cannot make more and more drugs to treat each symptom and disease individually; and lastly the government has made a very safe and natural hormone scheduled like amphetamines and pain killers by the DEA.

Now why are these tests misleading? All research studied are manipulated to have a desired outcome. You can do a lot with statistics…you can make a blue sky look black!

By given too little of a medication or vitamin, or by treating a disease for too short a time, or by picking the age group such that they won’t respond you can make any drug look ineffective!

So when you look at the studies on testosterone, you must look for the type of testosterone: is it a cream (which turns into estrogen as it passes through the skin? Or is it an injection of testosterone cyprionate which is not equivalent to natural testosterone and lasts 2 weeks because it keeps circulating through the liver and making more and more of the byproduct DHT than pellets or pure T injection?

Simply if the type of T is not the type that you are taking or are contemplating taking then you should ignore the studies conclusions because each type of T and each delivery system of T has a variety of effects, each different from one another.

“One testosterone is not equal to another form of testosterone. Therefore, a study that tests one type of testosterone does not apply to other forms of testosterone.” Dr Kathy Maupin MD

The factors that matter as to how much improvement you will get when you choose a form of T replacement are:

Testosterone chemical structure (the best is pure testosterone like in sub dermal T pellets)
Testosterone delivery systems (subdermal pellet, cream, vaginal tablet, oral, patches)
The dose/day or week or month
Duration of use
What tissue or organ system you are studying (e.g., bone takes many years to show improvement, while muscle increases relatively quickly with T pellets)
The age and condition of the patients studied
The starting blood level of testosterone Total and Free testosterone.
The resultant blood level of free T
The length of time a man or woman has been without testosterone before treatment

I see research articles every day in the many journals I read that are shared with the public, that denigrate testosterone replacement in general, while in my practice, with the most effective form of T I have found, that T pellets literally transform men and women who have T deficiency, most of whom are recently menopausal or over 55.

The successful studies that recommend testosterone seem never to make the front of journals, but this recent study about bone density made all the title pages of the digital version of journals. The result will be that doctors and patients everywhere who should treat their osteoporosis with the safest treatment available, testosterone, will be the victims of VERY expensive drugs that have more side effects and less effectiveness. Research trials no longer look for the truth. They look for “how do we get the answer we want to , so our drug that is not testosterone, will sell?”.

These headlines deceive patients and scares them from asking for testosterone treatment, which can relieve their symptoms with one hormone, Testosterone, instead of many drugs. An even greater benefit of testosterone given at the dose that relieves testosterone deficiency symptoms, this one hormone gives my patients back their quality of life.

In 2002 the WHI study scared menopausal women from taking their menopausal hormone therapy (ERT and HRT) which caused these women to develop anxiety, depression, frailty, osteoporosis, dementia, poor critical thinking, fatigue and many other symptoms that required treated multiple drugs to relieve just a portion of them. Women also developed marital problems because sex was so painful that they stopped having sex with their life partners. An unproven fear of breast cancer led to the loss of these women’s quality of life!

An example of one of my most severely affected patients went off her ERT (estrogen only hormone replacement) that she had been on for decades since her hysterectomy because her doctor refused to prescribe it for her. By the time she came to me she had developed depression, suicidal thoughts, agoraphobia, frailty and osteoporosis and she refused to leave her home. It took her months for her son, a doctor friend of mine, was able to bring her to my office to restart her treatment. Today she is still traveling all over the globe and fully enjoying her well-deserved retirement!

It has been estimated that in the 5 years after the WHI demonized estrogen replacement, more than 100,000 women died of diseases related to a lack of estrogen, and more experienced a loss of quality of life. Even now over 20 years later, many doctors have not restarted giving estrogen to their women patients.

Medical Thinking and rapidly changing standards of medical care when it comes to sex hormones has affected how we live, if we live, and how many drugs and diseases we get in our lifetime. We have effective inexpensive treatments for loss of hormones, why are we always looking for expensive and non-hormonal answers to the symptoms of menopause. In the last year pharmaceutical companies have developed a new drug with many side effects to treat hot flashes (fezolinetant/ Veozah, another new drug for osteoporosis (Tymlos 1pen, 1 injection/day = $2,134) and even a new drug for waning sex drive (Vylessi injection 2 times a week prn 1 month is $3,066/month) , also exorbitantly expensive! Instead of recommending replacement of relatively inexpensive hormone replacement with estradiol and testosterone (with pellets for women approximately $140/month, and for men $200/month), the Big Pharma companies try to strike it rich with multiple piece meal treatments for the symptoms of menopause and low T. I did not even mention medication for insomnia, migraine headaches, Viagra for men, lubricants for women and many other symptoms and treatments that T and E2 completely resolve.

Back to the research article in question about testosterone for men, which employed testosterone as a transdermal gel, at a low dose, and determined testosterone (over-generalization) was not effective, for building bone in osteoporotic elderly men! This was a defective study in every way, but the most important way was that it used T gel which turns most of the T into estrogen, so the effects are really from E2, E1 in men who do not respond well to E2. The abstract is at the bottom of this page for your reading pleasure.

I hope you are more selective in the future about what you believe and question the research that criticizes testosterone treatment, estradiol treatment especially the safest delivery system, pellets, when the research is short term, and generalizes the results from one form of Testosterone or estrogen to all forms.

Testosterone Treatment Fails to Offer Protection Against Fractures In Men With Hypogonadism, Research Indicates

MedPage Today (1/17, Monaco) reports “testosterone treatment didn’t offer protection against fractures in men with hypogonadism, a” subtrial indicated. The research found that “compared with placebo, men who were on a testosterone gel actually had a significantly higher risk for fracture.” The findings were published in the New England Journal of Medicine.

HCPlive (1/17, Iapoce) reports “the findings showed the 3-year cumulative incidence of all clinical fractures was nearly 4% among those treated with testosterone, compared with 2.8% in the placebo group.” Additional “data revealed the fracture incidence was also numerically greater in the testosterone group for all other fracture endpoints.”

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T.E.D. a NEW painless high intensity ultrasound treatment that actually regrows 65% or more of your hair. It is the most effective treatment overall and really the most economic treatment with the least amount of time investment, no pain and best results. Unlike hair implants, you can’t tell you have had a treatment to make your “lost hair” grow again!

The Problem of Hair Loss:

Many of my patients (most of whom are over 40) complain that they have thinning or balding hair-loss before we even start our hormone treatment with hormone pellets. Testosterone treatments with Testosterone pellets rarely increase the DHT blood level enough to increase hair loss. DHT is the metabolite of Testosterone which is responsible for “male pattern balding” also called hair loss associated with aging in men. Most of my patients have genetic hair thinning or balding, hypothyroid hair loss, or loss from a medication that they take. We treat these metabolic causes, but we can’t make hair grow back metabolically, we can just stop the loss! NOW WE CAN MAKE LOST-HAIR GROW BACK with TED!

Features of Alma TED:

TED is a FOCUSED high intensity ultrasound that drives serums into the scalp to the level of the hair follicle. Alma has worked 17 years on a serum for hair loss and they have achieved their goal! Only with TED will the serum get to the hair follicles that are “sleeping” and make them grown again! This pairing of ultrasound and specific serums are key to the unique success of TED.

Comparison OF TED with other treatments for hair loss:

#1 TED is the only FDA approved treatment for regrowing hair!

Six months ago, I was looking at various options to help my patients, and my husband, grow back their beautiful hair. After a comparison of multiple available treatment types for hair loss, I chose Alma Laser’s high intensity ultrasound treatment, T.E.D. that combines a unique hair growth serum delivered deep in the scalp to awaken sleeping hair follicles, stimulating growth, even in follicles that are dormant.

In 4 treatments that each last 45 minutes or less, TED brings hair follicles back to life without pain… I finally found the “holy grail” of hair restoration! It is affordable and PAINLESS. My medical skin care practice, BioBalance Skin®, offers free consultations to those men and women who want to have TED treatments to bring reverse hair thinning and balding.

TED this works for men and women with all causes of hair loss!

Total number of treatments: one a month for 4 months
Time of each treatment =45 min
Maintenance is at least one treatment/ year (average)
Cost of treatment package: $3,400
Cost of each Maintenance treatment, after $450 1-2 times a year
Pain= None!
Effectiveness= 65% of hair lost regrows
No down time!

Who is a candidate for this treatment>

Men and Women, all ages with hair loss of any kind (the younger you are the better)
All patterns of hair loss up to Stage 3 hair loss (stage 4 has areas of balding without any follicles)
Thinning hair all over the head
Hair loss due to medications, genetic hair loss, and androgenic hair loss
This treatment replaces the drug finasteride! (finasteride decreases libido and erectile function) without the side effects.
This treatment can accompany thyroid treatment (but not replace it) for hypothyroid hair loss.
Women with extensions can be treated and will eventually replace extensions.

Who is not a candidate/ or will have a less than optimal result:

People with metal implants in their brain or skull or metal plates in the skull
People with long term complete hair loss (their scalp has no hair and is shiny) > 5 years balding
Patients currently on Chemotherapy but is OK after chemo is completed.
Patients currently on immunotherapy
Trichotillomania- Mental health condition where the patient pulls her own hair out.
Patients with skin cancer of the scalp
Infections, open wounds on the scalp

Information on Hair Loss: All these types of hair loss, except the most extreme will obtain a good result from TED Hair treatments.

Hair loss that occurs with age has typical patterns of loss. The examples shown below are examples of male and female age-related hair loss. The same patterns occur from elevated androgens in some people.

Some types of age-related genetic hair loss are merely thinning of the hair, where individual hairs are spaced out making hair look “see through”.

PATTERN OF HAIR LOSS

NORMAL———– STAGE 1———STAGE 2————STAGE 3

TED HAIR GROWTH TREATMENT WILL WORK WELL WITH STAGE 1 AND 2 HAIRLOSS,

IT IS ONLY PARTIALLY EFFECTIVE FOR STAGE 3 hair loss

THE CONDITION OF THE SCALP IS IMPORTANT IN PREDICTING YOUR SUCCESS:

SMOOTH, BALD LONGTERM LOSS OF THE SCALP RARELY RESPONDS
THIN AND SPARSE AREAS DO RESPOND!

PROGRESSION OF FEMALE HAIRLOSS PATTERN

BOTH PATTERN AND CONDITION OF SCALP DETERMINES THE EFFECTIVENESS OF TED TREATMENTS

WOMEN’S HAIR LOSS—In general women lose hair all over the head or at the temples and crown of the head. The stages of female hair loss above all respond to TED except the most severe-long term loss.

COMPARISON OF OTHER TREATMENTS TO TED

I am asked by my patients, “How do I get thicker hair?”…or for the most common questions from those men who have been experiencing their hairline creeping backward every year, “How do I make this stop, I look like my dad!”. Over the years my Medical Health Spa, BioBalance Skin® has attempted to help my aging hormone replacement patients regain their thick and healthy hair and hairline with scalp injections with PRP and Aqua gold injections of serum and PRP, however effective these treatments are in stopping the loss for a period of time, none of our patients were able to tolerate the pain of the injections in their head for an hour, even after topical pain relief.

These invasive treatments really hurt not matter how we tried to remedy the pain. It turned out that our patients couldn’t tolerate one hour session, much less a series of treatments necessary to make a visible difference.

Hair implants take so much time and money (>$15,000) that it is like taking on another job and is really only effective for receding hairlines, not thinning hair. Patients have to have multiple treatments.

There are other options that do not regrow hair but mask the process. These all require ongoing treatment such as hair extensions, hair implants Hans Weiman hair restoration, all of which are prohibitively expensive, and are also painful and time-consuming.

The one drug therapy to slow hair loss that is used by men, Propecia® finasteride is minimally effective at stopping the loss of hair, and it does not grow hair where it no longer grows. This drug also has significant side effects that many men can’t tolerate including loss of muscle mass and erectile dysfunction. Our patients who receive T pellets tell me that finasteride decreases all the sexual and muscle improvement they have gained from T pellets.

Other new options for hair loss I investigated the required lifetime ongoing supplements (many of them) and ongoing treatment. The other option was significantly painful and not as successful as TED.

When I find a new and unique treatment to solve the problems of my patients as they age, I am compelled to find an answer!

For hair loss, TED is it! If you have thinning, receding, or balding hair don’t wait, the sooner the better for bringing back hair follicles permanently!

If you need visual documentation, please go to the Alma TED results page with this link to see picture proof of the results from TED treatments:

Link to example pictures of the results from TED. https://almainc.com/products/almated

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Last time I talked about the ways you can keep your skin healthy and the products I have found that medical grade products are effective to keep skin looking young and healthy. My last Healthcast/Blog was about what you can do at home to improve your skin and look younger.

This week we are going to talk about how to get the treatment you need to improve your skin if it is damaged and aging at the medical spa, and you may not have been able to be out of the sun or been able to follow the lifestyle changes I recommended that are necessary to avoid skin and sun damage. The problem is bigger, and the treatments are more drastic, and expensive.

When you have finally decided to do something to help your skin look younger, you must do an introspective survey of your face and prioritize the problems that you see, placing what bothers you the most as your first priority. I think writing this on a list and taking it to your consultation is the best way to proceed. When nothing is getting better with your own self-care, It is then time to get a consult from an expert who can tell you what you need to reverse your skin problems. Bring your list to the office consultation and decide on how much you can spend a month/or a year, on your own “renovation”.

What to know when you have your consultation:

When you have your consultation, you should be aware that there are at least 3 different treatments to treat any problem that you have. They have different levels of effectiveness and cost. At our spa you will be able to choose between three levels of treatment, but often, the consultant will weigh in on what the best procedure is for you.

The least expensive treatments take the longest time to reach your goal and are usually the least effective. There is generally a medium level treatment, which is a little more expensive and more effective than the least expensive but will take more time to get the results, and finally the most dramatic results and faster outcomes cost the most. If you need fast results and can afford the procedures, then tell your consultant at the beginning of your interview. On the other hand, if you have a limited budget but have an open time frame then tell her that too. This will help you get to the desired treatment fastest and make your consultation the most profitable for you.

In case this doesn’t make sense, here is an example: The treatment of age spots or brown spots has three possible solutions. The least expensive treatment is achieved by the use of topical serums at home and a series of facials in the spa. The outcome takes time and is not as effective as the other two options. The medium level of treatment (medium cost and effectiveness) is a VI or TCA Peel that has more immediate results and has some down time, but is less expensive than the most effective treatment, and more effective than the least expensive. The Laser IPL or Pixel treatments are the most expensive outside the operating room, they have some pain involved, but it takes only a couple treatments to rid yourself of the brown age spots that are on your face and decollate. In addition to the excellent results, these two treatments also tighten skin, and diminish wrinkles, while they remove the precancerous skin spots that make us look old. This is the highest price treatment but is faster and more complete than other available treatments.

Choosing the Treatment that is right for you: Your Goal, Time to get to Goal, Effectiveness of treatment, Downtime, Pain, and Cost.

I think it is best to inform your Skin Consultant about how much time you have before you reach your skin goal, if you can have some downtime or not, and how much money do you want to invest in your skin “re-birth”. In terms of choice of treatments at a med spa, you will get what you pay for. On our BiobalanceSkin.com website we have the three or four options for each skin problem (wrinkles, brown spots, sagging skin, eye lid droop, poor texture) that our patients present with. I like that method of comparing treatments for each skin care problem.

It should be transparent as to what your choices are, and what you get from a particular series of treatments. You should make your opinions known as to your priorities. That means what bothers you most about your skin. Think about it before your consultation and give her a list of priorities in writing which will keep her on track.

BTW, none of these treatments work if you don’t follow the instructions given to you for aftercare and follow-up treatments. Ask about before and after care at your consultation.

For example, If a patient has chosen a pixel laser resurfacing to remove her brown spots, and after 2 weeks all of her brown spots have come to the surface and peeled off, and she doesn’t use effective skin care products and doesn’t wear sunscreen and stay out of the sun for the appropriate time, then there is no guarantee that her results will remain excellent. You must take control of your own self-care because it is 50% of the treatment, and 50% of the outcome of our treatment. Please don’t use products from Walgreens if we told you to use something else after or before the treatment!

Price of each treatment series is usually critical to decision making…..each of us has a budget. However, you should understand that the least expensive treatments generally have a lower cost to the spa and are least expensive. For example, what follows is a comparison between the three choices for improving texture and tone of facial skin are as follows:

Least expensive: a series of Hydro-facials (30-45 minutes) one per month for three months, and three months of products, followed by a 3-month maintenance: This is the least expensive and doesn’t transform skin texture and tone as much, and doesn’t last as long as other available methods of treatment. If you have very little damage, are young and healthy, or you just want to maintain what you have, this is ideal for your needs. There is no downtime.

Medium price: For example, Micro-needling treatments, are a medium cost and effectiveness treatment. This treatment uses a pen that contains a tiny needle that makes tiny “holes” in the skin’s dermis all over the facial skin, neck and decollate, which then stimulates collagen production over the next 4-6 weeks, tightening and lifting the skin. In general, this treatment is done in a series to achieve the results you are looking for. 2-4 treatments done every 4-6 weeks is the typical number of treatments needed. Maintenance requires a few of these treatments a year. Down time is minimal, there is a redness that occurs for 24-36 hours and peeling of the superficial dead skin for up to a week, but it is not severe and can be covered with makeup.

Micro needling is ideal for younger patients to prevent the sagging and loose skin that comes with aging. It also makes the skin look fresh and glowing. Micro needling offers an Add-On of PRP to be applied and “injected” with the needles into facial skin to stimulate collagen production faster and more efficiently. Of course, this increases the price of the treatment.

Highest price: The highest price treatments are generally appropriate for older patients, or impatient patients: those women who have a timeline for improving their skin ( a wedding or event), and those who have the most sun damage. You also get extra goodies when you get Laser Pixel treatments. The Pixel resurfacing not only improves texture and tightness of skin, nut it also removes brown spots and helps fill in wrinkles! Lots of extras which makes the price worth it! There are several choices for the top-of-the-line procedures to improve texture and tightness and they are not all lasers.

One non-laser treatment is called Aqua Gold treatment which has three choices for what is injected and three prices. It uses a small disposable applicator that has many short gold needles to deliver a serum by “stamping it into the skin”. The injectables are hyaluronic acid injected below the epidermis and which combines the micro-needling technique with filler (very expensive) and Botox (very expensive) with an option to add activated platelets (a blood draw, spinning with an expensive activating compound). This treatment is expensive, but it is immediately effective, and the change is great. There is no real downtime, and the changes are immediate. A series of these treatments can revolutionize the quality of your skin.

The last component of getting the most out of your facial treatments includes buying the right products to help you maintain the beautiful results you have achieved through any of the above treatments. It is a waste of your money to buy inferior products that may reverse the improvements you have paid for. This is essential for preserving the improvements you have received from any of the esthetic treatments discussed in this blog.

Now if you think you need a facelift, you should see an injector consultant to ask if she can help with a much less expensive injection of Botox, filler, or both. Another treatment which is done without needles is the EmFace which uses magnetic energy to stimulate lift and muscle tone to literally do what a facelift does without a knife.

Facelifts total cost is $75,000-$150,000 and has down time of months, and includes drains, and pain. A series of EmFace series of treatments (4) is about $3500, without pain and without downtime. When faced with surgery, always look for another way to do the same thing!

Now you know what is ahead of you when you talk to a Skin Care Expert about how to achieve your beauty goals.

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You may be like I am, and you took your “young skin” for granted, because it had always looked good, healthy, and glowing. Sadly, the damage that causes wrinkles brown spots, age spots, and sagging jowls occurs years before the damage shows on your face! At age 40 I woke up, looked in the mirror and realized what I had been doing to my skin with baby oil and iodine plus 8 hours of sun a day, every summer, without sunscreen and moisturizer for the 30 years before and I realized I had to do something to reverse that process. I then began my study of skin, skin damage and how to heal it! I still and studying the new advances in skin care, nutrition for skin, and skin-care products.

But why is our skin so important? I have two answers, one as a doctor and another as an esthetic specialist. My “doctor answer” is that our skin is the largest organ in the human body, and it provides many benefits for us. The skin not only protects the more delicate organs of the body, but the skin excretes toxins for us from sweat glands, it cools us with perspiration, and protects our muscles and internal organs from trauma and the sun’s rays. Our skin also protects us from cold with hair that grows on our head and body.

The condition of the skin also acts as a reflection of our health. It is possible to look in the mirror and determine if you are healthy or not. The skin is also a window for others to judge our general health. This is a double-edged sword. It helps us self-diagnose medical problems or at least determine that something is wrong so we can make changes to our lifestyle or seek medical attention. Our skin also reflects fatigue (dark circles under our eyes, sallow color and lack of glow or shine), BUT it also allows others to discover our age, health status and whether we have cared for our skin or not! Our skin is a window to our internal health, so if you want to appear rested, healthy, and desirable, then you MUST take care of your skin!

I am not saying that nonphysicians consciously look at you and say to themselves, “that person’s skin looks sick”, but the condition of your skin determines unconscious judgements of the state of your health. It is for this unconscious knowledge that we have about the appearance of our skin, that drives women to seek out ways to make their skin beautiful and young. When we notice signs of aging, fatigue, and over-indulgence in our own skin we should take action if we want to reflect the impression of health and youth.

Very perceptive people can tell what our age is by looking at our skin….that is why women spend time trying to fool them by improving the natural condition of our skin! Our instinct to be and feel young motivates us to seek help. No one wants to look their age! Everyday Instagram and Facebook show ads that say…”Buy this and you will look #—- years younger” are barraging us. Those advertisers know our instinctive drive to turn back the clock and they use it to sell…but in general those “one answer ad campaigns” help the seller make money but won’t do a thing for your skin….Don’t be sucked into their sales job.

If you are over 40 you will require a multipronged approach to get your youthful skin back. This process requires a change in your routine, your lifestyle….the very hardest thing for humans to achieve!

As a doctor one of my observational skills that helps me diagnose patients before I even interview them Is my first impression of their face and skin—if the color of their skin is dusky, they probably don’t have good blood flow (atherosclerosis, alcohol consumption or illnesses like Diabetes) and if the texture of their skin is thick and “piled up” I know they have poor skin care habits and often are not healthy. I also look at the creases or wrinkles as well as brown spots that give away a patient’s age and sun damage history. There are many more signs of illness that I look for, but skin is like having Hercule Poirot (famous detective) sitting next to me whispering in my ear.”

For non-doctors the appearance of your skin gives strangers an impression of your age, and how healthier you are. Think of speed dating….you are introduced to Mr. Right and he immediately is not interested. He doesn’t even care to talk to you. His instincts say to him that you are not healthy and that you are older than you say you are, because of the condition of your skin. The same thing can happen at job interviews….you don’t want to look sick and old when you are going for a job. No one even consciously knows they are judging you…they just know instinctively get the message that you aren’t a candidate for whatever you are trying out for because of perceived old age and poor health….it is an unconscious reason for not choosing you!

So why not consider the simple steps it will take to transform your skin, and yourself, from looking old and sick to young and healthy? To get great skin, we must BE HEALTHY, in other words we must develop healthy habits as well as give our skin the attention and care it needs. Here is a list of what is required to heal you skin and begin to look younger and healthier.

DIET: whole foods, with a lot of water and fresh vegetables and fruit. No fast or processed food.
SUPPLEMENTATION: Vitamin D, Vitamin E, Biotin, Methyl Vitamin B12 and methyl Folate
DAILY EXERCISE: Gives your skin a glow with healthy oils and perspiration.
REPLACE HORMONES THAT ARE MISSING: Whole body Testosterone (pellets), Estradiol,
- Thyroid if it is deficient
CLEAN AND PROTECT YOUR SKIN: Treatment of the skin itself by washing and exfoliating dead skin off the surface twice daily, using serums specifically for the aging problem that bothers you most, and Moisturizers to keep the skin hydrated.

Ok. so you think, you can do this, but here is the kicker—you also need to make harder lifestyle changes, and stop your bad habits:

Stop Smoking
Stop Drinking more than 4 oz of wine /night
Stop fast food
Get 7-8 hours of sleep every night.

Now I hear the typical negative response coming through the computer…as if I am spoiling your party…I KNOW you don’t want to change your habits….or stop excessive drinking, smoking, and staying out late, so you are already finding excuses why this obvious, simple answer won’t work for you! If that is you, then stop worrying about your skin, because it won’t be any better than it is today….and it will get WORSE with age!

But if you will spend an extra 7-10 minutes a day on the health of your skin and you realize that it is time you clean up your act, then continue to listen to the things that you should do to have a beautiful body covered with glowing skin! A little work and change of habits will get lots of compliments and people may ask you how you got beautiful skin! The “happy” side-effect of taking care of your skin is that you are concurrently building a healthier body that will live longer without disease.

The above changes are a start but protecting and feeding your skin is important too! In the list below I will share what products and I use, but I have skin concerns that you might not have (I’m 69 and had a lot of sun damage as a teenager). These are examples, however if you are serious about having beautiful young and glowing skin, then using the medical grade skin products (those bought at your spa or dermatologist) are the most effective.

Internal Nutrition for Your Skin (Diet)—Whole food diet (lean meat, eggs, fruit and vegetables every day!) + Supplements to give you what you are missing in your diet, in higher doses
Stop Bad Habits (see above) and exercise every day
Cleansing skin that is exposed to sun, lack of humidity, and air pollution requires daily cleansing and humectants. Cleaning off your makeup from your face, neck and decollate (Face Wash= e.g. Glycolic Renewal- Skinceuticals) twice a day
Topical Nutrition (Serums) Skinceuticals e.g. CE Ferrulic, hyaluronic acid (Skinceuticals HA Intensifier) and other serums that feed your skin from the outside.
Protect Your Skin from Dehydration (Moisturizers), and drink plenty of water especially in the winter when the heat is on to replenish the moisture to your skin from the inside. My moisturizer is usually Triple Lipid Moisturizer from Skinceuticals®, but AGE Interupter Moisturizer is my favorite during the winter or when I am vacationing in cold or dry climates, because it holds skin moisture in the best. Intermittently I use Defenage Serum and Moisturizer Professional products when I want to take a break and expose my skin to alternative treatment (this makes both types of products more effective).
Protect your skin from damaging radiation from the sun (Sunscreen). You should wear sunscreen every day! In Missouri it is winter longer than summer (or so it seems), but until I found the ColorScience tinted sunscreen, I forgot my sunscreen all the time. This sunscreen is easier to remember because it is part of my makeup the I apply daily. It is a combination moisturizer, sunscreen, and foundation, I rarely wore sunscreen in the fall and winter before I found this product…not now!
Daily exercise to bring blood flow to your skin, brings healthy oil and blood to the surface of the skin and releases toxins through sweating.

Taking care of your skin at home is fairly simple and for the most part can be integrated into your daily routine. Here are the basic skin care steps:

Step #1 Cleansing your skin in the AM and before bed when you with a non-drying face wash.

(Skinceuticals Gentle Face Wash or LHA face wash). Follow this with a serum specific to the needs of your skin to repair sun damage, to fade age spots, or to improve the texture of your skin. For example, Skinceuticals CE Ferulic— It lasts all day and assists in maintaining hydration and improving the condition of your skin.

Step#2 Moisturize and Protect your skin from drying out during the day and while you are sleeping and not drinking water. The 8 hours you sleep is the longest time you go without oral hydration, so your skin needs protection to hold the moisture in. Moisturizers are generally a shield to prevent drying out. The best of these moisturizers both feed your skin and protect it from drying, like Skinceutical’s Triple Lipid Moisturizer before bed. Your morning routine is just like your bedtime steps, except after you moisturize, you should use a sunscreen that is equal to or greater than SPF 30, ideally with a tint instead of foundation.

Hint: If you brush your teeth twice a day, then add 5 minutes to your morning and evening self-care you can clean and apply your skin care routine to your dental care. Of course, there are many other types of topical products that preserve the beauty of your skin, but they are directed at specific problems such as acne, rosacea, deep wrinkles and discoloration, but it requires an expert in skin care to help you choose the most effective product for you.

My patients ask me what skin care routine I follow, and I give them the following list of products and vitamins I use because I know that skin requires nutrition from my diet as well as topical products.

Oral water intake: 80 oz of clear water a day for hydration
Diet filled with daily raw vegetables/fruit, and a salad daily
High protein and healthy fat in my diet (meat, fish, eggs, cheese, a variety of nuts, olive oil and yogurt)
Products I use:
- Face Wash Skinceuticals: Replenishing Cleanser twice a day
- Serums: Skinceuticals CE Ferulic to improve skin tone and texture, HA Intensifier to increase Hyaluronic Acid for skin hydration, and Advanced Discoloration Corrector for brown (age) spots.
- Skinceuticals Triple Lipid Moisturizer, AGE Interrupter Moisturizer, or Defenage Serum and Moisturizer
- Tinted Sunscreen by Color Science

If you have taken excellent care of your skin with medical grade skin care products throughout your life, then all you have to do as you age is continue the care you already established and add some serums. Serums treat the skin with needed vitamins, minerals and peptides that are applied externally. medical grade products cost more because they actually penetrate the epidermis penetrate the epidermis and provide building blocks to repair and supply your dermis with needed “supplies” for healthy “daily reconstruction”. So healthy diet with varied healthy and unprocessed foods, plenty of water, healthy fat and protein to “feed” your skin is a required step toward beautiful skin as you age.

In the end most of us have not been aware of the needs of our skin until our skin starts to show aging and damage. Because that is a common occurrence, BioBalance Skin offers a variety of treatments that you can receive at our Medical Spa that are all aimed at reversing the aging process by tightening sagging skin, removing age spots and wrinkles, elevating facial skin, fillers to inject to fill lost fat in our face as well as treating sagging upper arms and skin around our knees just to name a few. Next week we will be talking about the more aggressive methods of improving aging and damaged skin available currently available in our Medical Skin Care Spa and other spas like it.

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Every day in my office I hear horror stories about how my female patients are dismissed by the doctors they trusted to help them resolve their problems such as:

· Hot Flashes and night sweats

· Loss of libido

· Rapid weight gain

· Brain Fog

· Insomnia

· Arthritis associated with lack of hormones

· Anxiety/Depression starting in their late 30s

· New irritability

· New Migraine headaches

· Lack of motivation

· Fatigue

There doctors dismissed them, telling them they were just getting old, or they were “babies” because they can’t stand a few hot flashes, the doctor changed the subject, or my most unfavorite response to a plea for help, “It is just in your head”. Many other demeaning responses have been recorded, but I am appalled at these responses. For a patient it takes so much strength to ask these questions, and patients are literally at the doctor’s mercy. In case you didn’t get it, the doctor who says these things is covering up for his/her own ignorance. These are methods used by a person in charge who is challenged to answer a question he or she doesn’t have an answer for. In general, these doctors are men and women, however women have been trained by men and they taught women to do what they had been doing for years. These “medical” responses are used to belittle the patient to hide their own lack of knowledge. If you are dismissed in this way you should not put up with it. You can just never schedule with that doctor or practice again or you can find a new doctor who will hear your distress and treat you or tell you they don’t know how to help and refer you to someone who does. You shouldn’t put up with dismissive doctors.

Another dismissive phrase used by many doctors since the inaccurate WHI study is you’re your doctor tells you that he doesn’t BELIEVE in hormone replacement. You should respond that hormone replacement is not a religion, it is a medically necessary treatment for menopause! Board certified OBGYNs and Family Doctors should be trained in this treatment.

We women have not only been dismissed by doctors, but also by the Colleges (eg. American College of Obstetrics and Gynecology) that tell doctors how to practice. In my OBGYN training I was taught that most of women’s complaints were because they were depressed so they told us to put women on anti-depressants that just make them numb, but that did not treat our symptoms. Misogyny is alive and well in the practice of medicine, even in the group of doctors who are supposed to dedicate their lives to the health of women, Obstetricians/Gynecologists.

Discrimination CAN be taught, and I believe medical training still teaches these male oriented beliefs to new doctors who are almost 50% women. Medical schools allow women to become doctors because we are qualified, and they can’t discriminate anymore. When I was trained and for a few decades after I became a doctor, you would think I was a second-class citizen. I was left out of resident training run by the residents (almost all men). Those older male doctors treated me like and. Interloper and some even told me I was not supposed to be a doctor because of my sex. …I was never treated as if I was an equal from the minute, I started medical training and women now practicing over the age of 50-something were all trail blazers and were told all women were hysterical and complainers. I never accepted this view but now know that women complain because we are not believed and not treated with a treatment that really relieves our symptoms.

After my hysterectomy 2002 I was in private practice with like-minded women in Balanced Care for Women, and they tried to help me but admitted they didn’t have the knowledge. I had terrible symptoms that I now know was from lack of testosterone. The endocrinologists and primary doctors I sought help from belittled me and treated me like I was making the symptoms up! The worst experience I had was with endocrinologists who were women just saying what their male counterparts had taught them without really thinking. They “drank the Kool-Aid “from their male teachers and treated me like I was crazy because they were unwilling to admit they didn’t know what was wrong with me! I grew up in medicine (1977-now) under a cloud of sex discrimination and when I needed them most at the age of 47 my sister-doctors failed me…I know intimately how my patients feel when seeing doctors that demean them.

There has been a Federal Law to protect women since 1972, when the US government passed Title IX a Federal Civil Rights Law amendment, but in my experience the law was violated all the time.

Title IX 1972 (my interpretation is simplified and not the actual word for word amendment)

Sex discrimination is unlawful in choosing an employee, a medical student, funding for sports at the collegiate level.

I am a champion for women and women’s rights. We should require every medical student to be taught about this so the teaching from one generation to another doesn’t contaminate young doctors. Without this action the misogyny in medical care will continue. Recently The DEA required doctors to take an 8-hour course to help them learn to communicate with substance users in a more kind and sympathetic manner. The course’s direction to be compassionate and supportive to substance users should be taken for treating women as well. That would be a giant step for all of us. Wiping out discrimination takes generations but must start somewhere and that should be taught at the beginning of medical training.

After we conquer the minds of physicians then we will have to work toward equity in drug development (all drugs are tested on men, but women were not tested on new drugs until 2014), the FDA, the DEA, and Pharmaceutical companies. To make this happen patients will have to take part and not accept dismissive and discriminatory behavior by their treating doctors.

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That is a strong statement, however I am confident in saying that belly fat can put you at risk for Alzheimer’s disease, because it is a fact supported by medical research. These studies reveal that obesity, especially abdominal obesity (Beer belly, Gut, “Dunlap’s disease”…..), increases the onset and rate of Alzheimer’s dementia! Another reason to change your lifestyle to benefit your longevity.

Abdominal obesity can come from fat accumulation right underneath your skin (the fat you can pinch between 2 fingers) OR the fat that grows inside your abdomen like an apron draped over the intestines. It is called “visceral fat”, and this type of fat is what places you in the crosshairs for several diseases of aging including Alzheimer’s Disease, heart disease, stroke, diabetes, and rapid aging. A large belly is more common in men, but it is still a risk for women if they develop an apple shaped body.

Below is a picture of visceral fat, and a diagram of what it looks like in an artist’s sketch of a normal weight person. When the yellow fat doubles and triples in thickness the abdomen pushes out to look like a “beer belly”.

Visceral fat extends from your stomach over the transverse colon and your small intestines like an apron. This fat pad thickens with alcohol abuse (beer belly), high carbohydrate diet, overeating, junk food, under exercise and creates a large pad of fat that secretes inflammatory cells. The resulting inflammation is the vehicle that damages your brain leading to Alzheimer’s disease and damages your arteries leading to heart disease and stroke.

In my office we use INBODY machines that measure your Visceral fat, BMI, and percent body fat. Normal visceral fat is below #10 on our machine, BMI less than or equal to 25, and fat % for men < 19% and for women < 26%.

The Research: A recent study correlated the size of patient’s belly (visceral belly fat), and obesity with the amount of amyloid plaque (the cause of Alzheimer’s disease) in their brain. This was measured by MRI in the study subjects’ brains. The age of the patients studied was between 40-60.

The study found that the amount of visceral fat (fat inside your abdomen) is directly correlated with the amount of amyloid plaque and inflammation in the brain! That causes Alzheimer’s Disease.

If that doesn’t motivate you to lose your belly fat, then you are making a choice to eventually suffer from Alzheimer’s disease, a heart attack, a stroke or arthritis. If you are thinking that you will just wait for “something to happen”, then not making a decision to change your lifestyle is making a decision to take on illness in the future.

We have new medications to help you lose that belly fat and they really work. You should ask your doctor to help you and if they don’t understand the importance of arriving at ideal weight then look for a different doctor who will help you.

Even with medication you will have to put in the work and self-control to turn down unhealthy foods when others are being unhealthy. You will also have to add daily exercise to your schedule if you really want to avoid Alzheimer’s Disease, heart attack, stroke and early death.

The possible meds and habits that can help you lose your “belly”:

· Limit calories and or carbohydrates

· Increase daily exercise

· Diet pills (amphetamines that older patients usually can’t take)

· Xenical (Orlistat)-Side effect is fatty diarrhea

· Qsymia (topiramate/Phentermine) can increase BP

· Contrave for craving (naltrexone/bupropion) can decrease sex-drive

· Semelanotide (Imcivree-new), darkens the skin, expensive

· Metformin ER an oral, effective medication to treat insulin resistance, and promote weight-loss

· Victoza and Saxenda injections are diabetic treatments, that can cause GI reflux, however they work well for patients who have Type II Diabetes who need to lose weight.

Even though many patients lost weight with these medications, many could not tolerate the drugs listed above because of the side effects. These side effects limited our ability to help all patients lose weight…until now!

Now, for the first time we have an effective way to help most people lose their dangerous visceral (belly fat). If you have a big belly you are at high risk for inflammatory diseases like Alzheimer’s dementia, obesity, heart disease, diabetes, cancer and stroke.

The new weight loss drug’s generic name is Semaglutide, and has been marketed under several names: Wegovy, Ozempic, and Rybelsus. A second generic drug that is in the same family of drugs is called Tirzepetide, includes Mounjaro (for diabetics) and Zepbound (for weight loss). All of these drug’s work for weight loss, pre-diabetes and Type 2 Diabetes. Most insurance companies do not cover weight loss and they require a precertification for you to get the medication covered by insurance. This precertification process is time consuming for the doctor and her staff, which costs the doctor an increase in her overhead to employ a nurse to provide this service for the patient. In general people with a BMI under 30 will not be covered for Semaglutide or Tirzapeptide, however if their BMI is over 30, there is a chance insurance will pay for one of these drugs for a period of time.

The market price at the pharmacy is between $900/$1200 per month if you pay out of pocket to your pharmacy. Because of this fact and because we have so many patients whose pellets are not paid for by insurance, we provide access to the generic form of these drugs through a compounding pharmacy. The cost is a fraction of the normal out of pocket cost, about $560 for 3 months supply. In this way we have been able to treat many people who cannot afford to pay the exorbitant going rate for this medication.

Because it is costly for a patient to receive the medication no matter how they are able to get it, It is very important for weight loss patients to be compliant and follow a low carbohydrate diet, exercise daily and to refrain from alcohol consumption while they are taking weight loss medications. We require our patients who request these drugs to be seen at least every 2 months by one of our NPs or our weight loss specialist to help them get the best results possible.

These drugs work for weight loss and diabetes by multitasking. The ways the medication actually works are listed below: Semaglutide and Terzapeptide,

· decrease hunger between meals

· you feel full faster than normal so you eat less

· decrease sugar and alcohol-craving

· decrease the release of sugar from the liver when you are fasting, which turns into fat

· Prevent hypoglycemia which causes hunger and fat gain

· Makes patients more insulin sensitive.

Obesity is not just a lifestyle problem; it is a disease that should be treated with medicine PLUS lifestyle changes. These drug actions take place in the brain, stomach hormones, pancreas and liver, as well as in all the cells in your body.

At Bio Balance Health® have years of experience in treating patients with bio-identical testosterone pellets and we have observed that weight loss plus testosterone pellets for patients over 40 allows patients to lose fat without losing muscle. Now we add these weight loss medications to T pellets, and we have the perfect combo for safe weight-loss (really fat loss).

The biggest worry for patients is that they may not be able to get off this drug after they achieve ideal weight. I have found that the longer you have been overweight and the more overweight you are, the higher the risk of needing maintenance medications to maintain your ideal weight. We try to wean our patients off injectable meds by switching them to Metformin ER, a drug that insurance will pay for.

With these effective meds we finally, we have an effective preventive treatment to add to our testosterone and estradiol pellets for those people who view Alzheimer’s as their worst nightmare, and for those patients who are worried about heart disease, diabetes and stroke we can prevent the diseases that can ruin our “golden years”.

KCM

Research:

People with large amounts of visceral fat as they age may have higher risk of Alzheimer’s disease.

NBC News (11/20, Carroll) reports, “People who have large amounts of” visceral fat “as they age may be at higher risk of developing Alzheimer’s disease, a new study suggests.” The findings were presented at the Radiological Society of North America’s annual meeting.

HealthDay (11/20, Thompson) reports that investigators “compared brain scans of 54 people between the ages of 40 and 60 with their levels of belly fat, BMI, obesity and insulin resistance.” The investigators “found that people who had more visceral fat compared with fat found just under their skin tended to have higher amyloid levels in the precuneus cortex.” The “relationship was worse in men than in women, and higher visceral fat measurements also were related to increased inflammation in the brain.”

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At Bio Balance Health I order blood tests to evaluate my future patients before I even have my first appointment with them. I use them to find a baseline for an individual patient, and to see if hormones will help them with their symptoms. Blood tests work well for establishing a diagnosis but are not the only factor in determining an ideal dose of hormone that works for that patient. Symptoms and medical history supply most of the information for determining dosage as well as help me find other medical problems to treat at the same visit. Many diseases in the early stages are not treated by primary care doctors because they are overwhelmed with their number of patients and the short-time they are allowed to see them. Our goal is to prevent disease that have been missed or treat conditions at an early stage before they become severe.

Blood tests establish and confirm both hormone deficiencies and provide a baseline level before treatment and the optimal level for each individual patient. That blood level may or may not be within the range that is expected for a treatment success (written on the lab report). You are an individual and it is my job to find the ideal blood level of hormones for you.

Why would the blood level not tell the whole story?

Your body is genetically programed to both PRODUCE hormones from your endocrine glands and ACCEPT those same hormones in each cell. Every person is an individual and each person makes hormones based on their genetic map and environment. Everyone is programed genetically to accept hormones into their cells in an individual manner. This is the key to understanding the differences between patients’ responses to an equivalent dose of hormones, either excreted from their own glands or absorbed through their chosen delivery system (oral, vaginal, transdermal or subdermal pellets) after their glands have aged and don’t produce enough hormone, like estradiol and testosterone.

I was in Cambridge in 2014 for the release of my first book, The Secret Female Hormone, when I visited a medical bookstore. I discovered a large red book that weighed no less than 10 lbs was titled Testosterone. I looked through this book and found that there was information that I had not discovered in my research of the American medical journals and books, so I bought it and read some of it on the long flight home to St. Louis, MO. I found that this book had answers to questions I had uncovered in my then,13 years of hormone medical practice. My biggest question at that time was why 2 people of the same sex having the equivalent blood level of free testosterone often feel completely different. For example, I was trained that if a man had a blood level of free testosterone that was above 129 pg/ml and under 350 pg/ml (using Quest Diagnostics lab), then he should feel normal, like he did when he was in his thirties (barring any other illnesses interfering). However, I observed that some men felt great at 110 pg/ml while others at 130 continued to have the symptoms of low T. This puzzled me, but at that time I had no answer. Then I read the first chapter of Testosterone.

The answer is found in the individual differences in the receptors on each cell for that hormone, the receiving end of the hormone physiology. It informed me that receptor sites are genetically created differently in each individual and that one-size-does-not-fit-all!

You can bathe a person’s cells with what is considered an adequate blood concentration of testosterone for most people, let’s say men since that was the subject of the first chapter, of the book Testsosterone, but some men would receive and use only a small portion of the circulating hormone. Their cells were “resistant”, therefore they required a higher concentration of hormone, to activate their cells. This very important fact in endocrinology has been ignored until recently when we began to use genetics to find the differences between individuals’ receptor sites for all hormones and all peptide communicators. In the last 10 years we have found that receptor sites are the missing link in determining a person’s required dose of a hormone, and they are genetically determined.

Here is an example from the book in a very simplified translation. Think of a key and lock. Each cell has “locks” or receptor sites all over it, and the keys are the testosterone molecules. Some people’s cells have locks that are easy to open and turn on a cell. They are “sensitive” to that hormone. Some cells have difficult “locks” and they must be bombarded with a hormone “keys” to turn the cells on. This led the researchers to look for the snips of DNA that were responsible for the difference. They found them and then tested men from all over the world to see if there were regional groups, genetic groups, that contained more sensitive receptor sites or more resistant.

The results are quite telling and explain the differences between races and peoples in terms of how their bodies use the testosterone hormones available. The men with the most sensitive receptor sites live closer to the equator: Mediterranean, African, Brazilian, and those men with more resistant receptors had DNA from ancestors who came from closer to both North and South poles: Scandinavia, Canada, Europe, South Africa, Southern Argentina etc. The results mean that if you have a clear genetic line from one of these groups, we can predict whether you need a higher dose or lower dose to get the same resolution of symptoms. Most people in America are mixtures of genes so most patients don’t give me any information from their ancestry.

However, there are two catches to this system of determining an individual’s receptor site sensitivity; 1) In this century we are able to travel and find a mate on the other side of the globe and have been able to do so for generations, therefore we are “mutts”, or people who have multiple genetic sources in our DNA and therefore how we look or where we are from is not a good predictable factor for how we will accept our testosterone. 2) There is no commercially available test to evaluate the sensitivity of our receptors. Currently, the best science has found is to test DNA for the snips that predict sensitivity or resistance to testosterone!

This too will come to the practice of medicine, but “medicine” moves slowly and the government and people in control are always looking for a one-size-fits-all approach to illness and or aging, which makes me think this type of test will not be embraced by general American medicine.

At this point all I can tell you about dosing and blood levels is that you have an individual level that is good for you, so I try to figure out what that is, and “mark it” with your “perfect blood level”. I proceed with is the knowledge that there are many other factors that affect the blood level of free-testosterone (active form) and the effect it has on individual patients. This leads me to practice individualized medicine like a tailor makes a dress or suit that fits one person only. I have a lot of experience to recognize resistant or sensitive T receptor patients and I now know how to approach their care. It is NOT by trying to adjust their hormones into the very inaccurate free T levels printed on the blood lab sheet, however I do look at those numbers to establish a baseline for that person, and I do listen to my patients when they tell me whether their symptoms are resolved or not. Resolving all SYMPTOMS is the real sign of a successful replacement of testosterone in both men and women.

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When I tell my patients that they need a high protein diet, all they can think of is meat…but protein sources are found in many parts of our diet and eating a variety of protein sources is the key to health, we should find out what we should eat and why?

Protein contains amino acids that are the major building blocks to make our muscles, skin, connective tissue, tendons, ligaments and bones. It also supplies the components of our skin, hair and nails, and carries with it calcium (the major component of bones and connective tissue). Protein is found in cheese, milk, all milk products, whey for protein shakes, pea protein, fish, all seafood, chicken, lamb, eggs, Quinoa and beans for building muscle. Pieces of proteins make up every fluid the body makes, including hormones, enzymes, peptide communicators, the immune globulins, semen, breast milk, and vaginal discharge….is it any wonder that I tell my patients to increase protein in their diets!

Despite the need for amino acids and short chains of amino acids called peptides, we also need a variety of foods, all colors at every meal to provide the other building blocks of our body. For example, fat is a very necessary food for every person, at every meal. When I was pregnant, I wanted to feed my baby everything she needed to build a healthy beautiful brain, so I ate Braun Schweiger every day (made from liver) for lunch with a salad. The Braun Schweiger provided Rachel, my daughter, with the building blocks for an amazing brain. Our brains are almost all fat. That is the type of tissue that nerves are made of, but nerves also need B12 to work properly and B12 is primarily from animal products. It is relatively easy to include fat in our diets, but it is truly difficult to get enough protein to build muscle on a vegan diet. My vegan patients must be experts in obtaining protein from their diet and must be aware of the components in all the food they eat to get the proper nutrition.

Carbohydrates are made for “action”. Carbohydrates are required for exercise, walking and brains also burn carbohydrates when you are doing “brain work”. Carbohydrates are stored as fat if we eat them but don’t exercise! Think before you eat carbohydrates about your next 12 hours and whether you are going to exercise to burn the carbohydrates in your diet.

So How Much Protein Do We Need?

Growing teenagers, people who lift weights and try to gain muscle, pregnant women (need a minimum of 100 grams a day) and patients like mine on testosterone need more protein in their diet than the average sedentary, adult.

To quantitate the number of grams of protein you need to sustain your body with a high percentage of muscle, a person needs more than ½ their weight in grams of protein. For example, a 125 lb. woman with average to high muscle mass will need more than 62.5 grams of protein a day. A person with higher muscle mass will need more than that.

For athletes, weight lifters, patients trying to lose weight and sustain their current muscle mass, they need to eat the equivalent number of grams of protein to their weight, every day.

To do this a person will have to know how many grams are in each serving of their current foods and if they aren’t eating enough, they should add high protein, low carb protein shakes times before or after they work out or exercise. A typical protein shake will have 15 to 20 grams per serving and less than 5-10 grams of carbohydrate.

An average size hamburger has about 20 grams of protein. Add beans, peas, cheese, yogurt, butter, ricotta cheese, milk, eggs, custard, chicken, fish fillets, shrimp, and protein bars. Be careful not to overeat carbohydrate with your protein which can cause you to gain fat, while you make muscle.

Why do we need more protein on the days we work out, especially with weights? Weight training is a great muscle builder, in fact it is the best form of exercise for increasing your muscle mass. But why do people who engage in this type of activity require more protein than those who walk? The answer is in the physiology of human muscle when stressed by weight training exercises.

When you work out with weights you put specific stress on your muscles, and during the hour or hours you engage in this type of exercise your muscles are broken down. That’s right, initially you LOSE MUSCLE! The act of physical labor on the human body that uses weights against gravity causes stress on the muscle fibers and they are broken down, their components (all made of protein) are then excreted from the body. We don’t recycle much of the broken-down muscle! Instead, we must provide new building blocks, or amino acids that are circulated to the muscles from our diet, tp build back the muscle and even build more than was there the day before your exercised! This is the reason weight-lifters work out the top half of their body one day and let it rest (to build muscle) the next day while they exercise the bottom half of their body!

Now let’s talk about protein necessary for aerobic exercise like running or fast walking. Distance running does not build muscles in the legs (or anywhere else), because this type of aerobic activity breaks down muscles that are working hard, but they are not stressed against gravity enough to build muscle, unless the runner is obese. Obese people who do or do not exercise have huge calves not because they work out, but because their legs have to hold up more weight than it is designed to support so their lower legs lift a fat body every day! Runners, however, are usually slender, and their calves, quads, and hamstrings are slender too. They do not build muscles while running. The purpose of running is the production of endorphins for enjoyment, and the aerobic benefit to the cardiovascular system. Running also burns alot calories so carbohydrates are needed to give the current muscles energy to run. If you have ever looked at runners’ legs, they are not “cut” like lifters legs, that show the muscle bellies of the legs, but they are narrow long and smooth. These people don’t need as much protein as a lifter even though they are running every day, because they don’t require as much protein to build back what they already have plus more protein to make the muscles bigger! They just must sustain the muscle mass that is being used. Their need is in carbohydrates that give them energy to feed the muscle fibers.

As people age, they lose muscle mass unless they take testosterone and eat a high protein diet. Left to nature their muscle mass decreases by 3-8 % EVERY YEAR between the ages of 40 and 90, unless you take a healthy dose of testosterone. Aging adults are advised to eat more protein to prevent this catabolism but truly it doesn’t work if you don’t replace the hormone that signals muscles to grow which is testosterone.

Remember that protein comes primarily from animal products but can also be found in many kinds of beans and peas, but not in any fruit. Remember to grow muscle you need.

· Protein in grams per day equal to your weight

· Varied colorful diet with enough fat and carbohydrates.

· Testosterone

· Weight bearing exercise

Another reason supplements might not be necessary: “Protein is in every food group except fruit,” Dr Webb says.

Every human was born to eat a variety of foods to satisfy all their daily nutritional needs. The benefits of variety include the types of protein sources. Meat is an obvious source of protein, but “thankfully we can find protein in a multitude of plant-based sources, including lentils, tempeh, tofu, and beans,” Corwin says.

Barkoukis, a researcher on protein and nutrition, advises that "Variety in diet is the best plan,” she says. “Beans are an amazing powerhouse," however they do not have all the amino acids the body needs to sustain life. “Not all protein sources are alike, or equivalent. Animal proteins are “complete” in that they contain all nine essential amino acids, while most plant proteins often have some—but not all—of those aminos that we cannot make in our bodies, so we must get them from a food source.” Quinoa has all the essential proteins; beans are incomplete and should be combined with other sources.

For those who always ask how food work, here it is taken from a book called Human How do the proteins from foods, denatured or not, get processed into amino acids that cells can use to make new proteins? When you eat food the body’s digestive system breaks down the protein into the individual amino acids, which are absorbed and used by cells to build other proteins and a few other macromolecules, such as DNA. Nutrition.

1. In the mouth your saliva begins the metabolism of proteins with amylase that is produced in your salivary glands. Your chewing breaks protein down into small pieces to help digestion.

2. In the stomach acids (Hydrochloric acid from gastric juices and an enzyme pepsin to break down protein. Proteins take longer in the stomach to break- down so you feel full longer when you eat proteins.

3. The small intestine is the major player in protein digestion. Here the Pancreas secretes trypsin and chymotrypsin These enzymes break food protein into amino acids.

4. At the end of your small intestine there are specialized cells that transport protein into the bloodstream, and it circulates to where it is stored to make vital enzymes and building blocks for when you haven’t been eating.

5. Amino acids are recycled to make new proteins (muscle, enzymes, skin hair, etc. Amino acids to build other biological molecules containing nitrogen.

“It is critical to maintain amino acid levels by consuming high-quality proteins in the diet, or the amino acids needed for building new proteins will be obtained by increasing protein destruction from other tissues (stealing protein from your muscles) within the body, especially muscle. This amino acid pool is less than one percent of total body-protein content. Thus, the body does not store protein as it does with carbohydrates (as glycogen in the muscles and liver) and lipids (as triglycerides in adipose tissue). such as DNA, RNA, and to some extent to produce energy.” Eating protein is vital to life!

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There are almost as many different human metabolic variations as there are people in the world. Our genetics make us all unique in ways that vary the way we can lose weight or even gain weight. On the other hand, we all had to descend from humans who survived famine, lack of water and lack of nutrition sources, so in one way we are all the same…we have genes that helped us survive times that required of us the ability to maintain our weight even without eating! The people who genetically were unable to gain fat and keep it to hold them over during famine just didn’t make it to an age they could procreate. The rest of us whose ancestors survived, have given the majority of us the genes to maintain body fat.

Unfortunately, we have been blindly unaware of what man’s evolution and progress has led us to physically, and most of us are over-fat, and have trouble losing it! The very genes that allowed us to survive the beginning of man’s existence, are the same ones that make it hard to become slender. In addition, in our current societies in the western world, food is plentiful and inexpensive. Our genes have not changed, but our environment has, and we are becoming sick because of our obesity…how do we survive this “new world”?

You may hear a lot about insulin resistance, and I talk about it a lot on my Healthcasts, but it is insulin resistance that has allowed us to survive and has also led us to obesity today. The humans who were insulin resistant who also held on to their fat in times of starvation are also the humans who have become obese in the face of plenty. We can’t change our genes, but we can turn some of the obesity genes off through lifestyle and sometimes with the help of medication.

Despite our basic sameness, we are also each individual, and genetically programed so that some of us lose weight if we restrict calories, others lose weight only if they exercise; Some of us don’t lose weight with exercise; some people don’t lose weight with carbohydrate restriction or fat restriction, and some do. This is the ugly truth that lies behind the millions of books on diet, none of which work for more than a small number of us, and because it is a diet we can’t maintain it...what we need is to determine is the best weight loss program for each of us, by using trial and error, or by using genetic testing that tells us what our best pathway to a normal weight looks like.

To begin we must take baby steps and learn about food and what the words mean that we use when referring to food. Because there are many people who may have several hurdles to jump before they can live at their healthy weight, we need to all speak the same language of weight loss.

So let’s start with a bit of education about food.

WHAT IS A SIMPLE SUGAR?

A simple sugar is a nutrient meant to give you energy for physical activity. Eating a small amount of a simple or a complex sugar before exercise is a good idea. However, if you sit most of your day, working with your brain instead of your body, simple sugars can increase your fat storage because you aren’t physically working. This is true whether restricting sugar is your genetic method of weight loss or not. Too many simple sugars make you hungry and cause everyone to overeat.….causing weight gain and fat gain. So what are simple sugars?

Examples of simple sugars:

· Sugar, white, cane and brown

· Molasses

· Regular Soda

· Agave

· Honey

· Syrup-maple or any

· Rice, white and brown

· Cereals-all

· Oatmeal

· Donuts

· White potatoes

· Bread

· Pancakes/waffles

· Noodles

· All Grains: wheat, oats, rice, corn and anything made from them including flour

· Sweet tea

· All Cakes, brownies, candy, chips, and many energy bars

· All bagged snacks like pretzels, chips, cookies, and fruit with sugar added

· Pies and most desserts, except fresh or frozen fruit.

· Dried Fruit (has sugar added eat frozen fruit instead.)

· All non-milk-based salad dressings except plain Olive oil and vinegar.

Note: All diet sodas have chemicals that stimulate insulin like sugar. There are a few brands that use Stevia (an herb that is sweet, and not a chemical) and they are the exception so you can drink those without stimulating fat production. Other options are unsweetened bubble water or plain water.

Eventually eating a diet filled with simple sugars leads to obesity, and diabetes no matter who you are, therefore if you are in not working physically with your body all day, every day ( machinists, farmers -in the summer, factory workers, outdoor laborers) you should not eat these foods except in small amounts with a protein to lengthen the time until you feel hungry again.

The rest of us should rarely eat these foods. They should be considered foods for “special events”.

If you exercise aerobically and/or with weights for more than an hour at a time, then you may eat a small amount of simple sugars but eating small amount of complex sugars is healthier to help you maintain your muscle mass and your exercise stamina while losing fat.

COMPLEX CARBOHYDRATES: EAT INSTEAD OF SIMPLE SUGARS

SWEET POTATOES

Sweet potatoes taste sweet and have complex Carbohydrates so it takes longer for them to be digested which means they do not stimulate the secretion of insulin as fast or as high as white potatoes. They are a complex sugar.

Sweet Potatoes also have several health benefits including antioxidant healing role and anti-inflammatory properties.

CHICKPEAS (GARBANZO BEANS, BLACK BEANS AND LENTILS)

Legumes like chickpeas, black beans, and lentils are not only complex carbohydrates buy are a great source of dietary fiber, making them wise choices for a filling you up and satisfying the pre-workout carbohydrate requirement.

QUINOA

Quinoa is a good source of plant protein. It can be a substitute for bread or pasta.

WHOLE GRAIN BREADS LIKE DAVE’S LOW CARB & HIGH PROTEIN BREAD

Whole grain bread like Dave’s Bread has enough fiber and nut protein to prevent excessive stimulation of your insulin. Too much insulin leads to insulin resistance and causes fat gain instead of giving your cells energy.

One piece of bread per meal is all you should eat if you are overweight and or have Type II diabetes in your family. Make sure you are not eating more than 25 grams of carb in any meal.

WILD RICE- is a seed and not a “rice”

You should eat wild rice instead of any other type of rice and only in small amounts. All complex carbs should be eaten in small portions because in large portions they act just like simple carbs and increase weight gain.

NUTS: Cashews, Almonds, Walnuts, Chestnuts,

Nuts of all kinds can be a substitute for carbs in any form. A handful of nuts should be enough to decrease your hunger and increase your protein as well as decrease insulin response to eating.

The Combination of foods that you eat is also important. If you are going to eat any carbohydrate it should be paired with a protein and or a fat.

For example: If you are going to eat a piece of bread, then you can eat it with butter and or peanut butter or cheese or eggs. This slows the absorption of the carbohydrate from the bread and prevents your blood sugar from surging and plummeting after you eat, leaving you fatigued and sleepy.

In The Dr. Maupin’s Diet in my book the Secret Female Hormone, I recommend eating multiple times a day and controlling simple carbs and carbs from sugar and grains. Scientifically it is a fact that if you eat 25 grams or less of carbohydrate foods from sugar or grains per meal then you can prevent Insulin resistance and the additional fat that follows insulin resistance. It is also a good way to lose fat. In my diet a person can eat as much fruit and veggies as they desire, except white potatoes and bananas.

WHAT YOU EAT, IS AS IMPORTANT

AS HOW MUCH YOU EAT!

Other Strategies for weight loss include eating a protein with each carb which decreases the total volume of food you eat and increases satiety.

· Saving your carbs to be eaten before exercise.

· Portion Control of all food.

· Limit alcohol. 0- 4 drinks a week

· Daily exercise for over an hour/day.

· Drink a glass of water before you eat.

· Skip dessert

· Eat a salad daily

· Eat more than half your weight in grams of protein (Meat, cheese, eggs, milk products, whey protein and more)

The basic information was from my over 45 years of practice and Information provided by Inbody.

If you know by experience or you have had your genetics tested to reveal that limiting carbohydrates is needed for you to lose fat, then I hope this blog helped you understand what I mean when I tell you to limit your carbohydrate intake to less than 25 grams per meal.

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This subject is for men who have had a high PSA and who have been advised that they need a prostate biopsy to determine if they have cancer. Many men go into the doctor for the biopsy necessary for diagnosis without expecting the “blind biopsy” procedure that is done through the rectum and is extremely painful when the doctor blindly takes pieces of the prostate…over and over again. Blindly, means he is randomly picking a place to biopsy without a real target….with the urologist biopsying everywhere in the prostate 10 or more times. Finding a small cancer with this random or “blind” biopsy method is a less than effective way to find a small area of prostate cancer. Men who have had this procedure done rarely agree to a second round, under any circumstances and I agree with them.

I always do a PSA test before I treat a man with testosterone so I often am faced with the question of what advice I should give him in this situation before I feel it is safe to give him testosterone. Of course, if he has prostate cancer, even a high PSA, I will not give a man testosterone until his urologist says he is safe to receive it.

Until recently there was no radiologic way to screen a for prostate cancer. Now urologists use Ultrasound or MRIs to find an abnormality in the prostate that they can biopsy. This makes the procedure both more accurate and less painful.

The way this procedure was done in the past, and is still done throughout the US, always caused me to wonder why urologists hadn’t figured out a way to do it in a way that accurately biopsied a high risk area of the prostate, with one or two biopsies. Now Urologists use rectal ultrasound or MRI, like Gynecologists use vaginal ultrasounds to find and drain or biopsy ovarian masses, or to harvest eggs in IVF. The urologists have even borrowed the idea to use numbing medicine as well to make it comfortable. In the last 2 years I have found a few Urologists who have embraced the new, accurate biopsy procedure that used the MRI to find high risk areas and ultrasound to locate suspicious areas for biopsy, then used the same radiologic method to locate and treat discrete focal areas of abnormality with cryotherapy (freezing) or focused ultrasound.

Finally in August of 2023, a research article titled, “Focal Therapy for Localized Prostate Cancer in Older Men”, was published in the Journal of Urology.

This article describes a much more accurate method of treating prostate cancer that resulted in the diagnosis and treatment of low grade prostate cancer without recurrence and without complications, allowing men to have a conservative treatment for low grade prostate cancer, following a less painful and invasive diagnostic procedure. Compassion has finally come to diagnosis and treatment of prostate cancer. We applaud the authors.

August 22, 2023

Focal Therapy for Localized Prostate Cancer in Older Men

Allan S. Brett, MD, reviewing Habashy D et al. J Urol 2023 Jul Lomas DJ and Frendl DM. J Urol 2023 Jul

In an observational study, focal therapy was compared with radical treatment.

At some centers, focal ablative therapy (generally with high-intensity focused ultrasound or cryotherapy) is a treatment option for selected patients with localized prostate cancer. This option could be attractive for some older patients with comorbidities who might be candidates for radical prostatectomy or radiotherapy (according to tumor grade) but who wish to avoid complications from radical intervention.

Using data from national registries, U.K. researchers compared 262 patients (age, ≥70; median age, 74) who underwent focal ablative therapy with 262 propensity-score–matched patients who underwent radical treatment (mostly radiotherapy with androgen-deprivation therapy). At baseline, nearly all patients had intermediate- or high-risk disease. Estimated 5-year failure-free survival (the composite primary outcome, which included absence of salvage radical treatment, systemic treatment, distant metastases, or prostate cancer–specific death) was significantly higher in the radically treated group than in the focal-therapy group (96% vs. 82%). Estimated 5-year overall survival with focal therapy was 96%.

COMMENT

The better failure-free survival with radical treatment than with focal therapy (a 14 percentage-point difference) is not surprising. The challenge for individual decision making is to balance that difference against the higher rate of complications with radical treatment in older men — especially men with substantial comorbidities. We don't have long-term data from randomized trials to compare focal therapy versus radical treatment, active surveillance, or watchful waiting. But in the meantime, editorialists from Mayo Clinic conclude that focal therapy is “a reasonable strategy in older patients.”

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They insert a needle through the wall of your rectum and into the prostate to extract the cells for testing. This is a “transrectal biopsy.” Doctors usually take a dozen samples from various parts of the prostate. In some cases, they do the biopsy by inserting a needle through the skin between the scrotum and the anus.May 29, 2023

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Are you menopausal and have any of the following symptoms?

· Hot Flashes

· Night Sweats

· Dry Vagina

· Painful intercourse

· Dry skin

· Lack of sex drive

· Lack of motivation

· Fatigue

· Depression and or anxiety

· Change in body composition, with fat collection in the abdomen

· Loss of Muscle Mass and strength

· Irritability

· Inability to remember names and places

· Decreased ability to problem solve

· Insomnia

· Arthritis

· Body pain

These are all symptoms we currently are aware of associated with menopause and low testosterone. These symptoms can be treated and reversed with bioidentical estradiol and testosterone pellets.

Menopause should be treated like an illness that is universal but more severe in some women compared with others. If your symptoms affect your lifestyle, relationships and work then you should see a doctor who treats hormone deficiency and accept treatment!

It is not just about the symptoms that E-T replacement can cure, but the diseases that you can avoid by taking estrogen and testosterone after menopause. These avoidable diseases of aging include:

· Osteoporosis leading to broken bones and spinal stenosis.

· Heart disease and stroke

· Diabetes

· Alzheimer’s Dx and dementia

· Obesity

· Low muscle mass and inability to walk or move independently.

· Autoimmune diseases

· Loss of blood flow to Lower extremity, resulting in amputations and inhibiting walking and running

· Severe arthritis

· Gout

· Worsening depression and anxiety

· Frailty which is what causes most older people to be placed in a nursing home.

By stopping ERT or Testosterone like the ACOG doctors tell you to, you will start the symptoms all over again. My job is to offer you the right type of help to reverse the effects of menopause…both symptoms and diseases. Your job is to decide whether you want to get help and become healthy by taking nonoral estrogen and testosterone for the rest of your life.

Think of menopause as a disease and you will be more prepared to fight for your right to be treated by the medical system.

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Even though all women eventually stop having periods and stop making estrogen, testosterone, and progesterone we all have symptoms of menopause, even if you don’t recognize them as symptoms relating to loss of estrogen, testosterone, and progesterone after menopause. However, every woman experiences menopause differently. Some of us are devastated in every way by the multitude of symptoms that loss of our sex-hormones can create, on the other hand some women merely endure painful intercourse, hot flashes, headaches, and fatigue…or are told by their doctors that their

symptoms are “getting older” and they have to live with it! Aren’t your symptoms enough for you to demand treatment?

What I See:

Every day in the office and even in my private life I run into women who complain about their symptoms of hormone loss. When I offer a solution for their symptoms of menopause and low T, I am often shot down by my patient’s “fear” of hormones. For example, I was at a 70th birthday party recently and a flood of women came up to me and told me how young and heathy I looked. When they asked me what I do to achieve that, and I explain that I have taken hormone pellets with T and E2 since I was 47 and they can get the same results, they immediately say, “I’m not doing that! I don’t want breast cancer! Or “that will cause heart disease or gain weight! “. The media and their doctors who are not up to date in their reading of research have frightened them away from treatment for their symptoms! The doctors should read more and not depend on 40-year-old information (med school and residency). They just told me I was doing something right, but then the fear that society has instilled in them shuts the door on a chance to be healthy, mobile and at ideal weight forever. The opposition to us is strong and this is really brainwashing women away from taking care of themselves!

The recent (last 10-15 years) research has revealed that medicine has been wrong about much of the advice that we give patients based on flawed research and the need for the media to scare women into dangerous action (not taking hormones). These groups are literally making women suffer, take too many medications, and literally to be ill during the second half of their lives! The power of the press causes women to comply.

Here are the “facts” doctors were taught over the last 4 decades: that are lies!

Genetics hold your future. The new study of Epigenetics has revealed that we can turn off our “bad” genes with a healthy lifestyle.
Diet—the Food pyramid lied to the American people to make money for America. They advised us to eat grains and sugar, and now we know that that caused Americans to be obese and diabetic.
Exercise—Jogging long distances is healthy. Lie! Exercise helps weight loss in a percentage of patients however most patients who exercise to extreme are less healthy than other people who are moderate in their exercise. Moderation prevents the need for knee and hip replacements, the stress on the heart and kidneys causes early circulatory and renal disease.
“Hormones” –cause Breast Cancer. Estrogen doesn’t cause breast cancer however it can increase growth in estrogen receptor positive women. Not a cause, in fact women on ERT (without provera) had fewer breast cancers and less aggressive ones than women who took nothing!
Testosterone is a MALE hormone, and we can’t have any! Lie! We make three times as much testosterone in our ovaries as we do estradiol when we are fertile!

Do you see that we are manipulated into following false truths because our doctors are too busy to keep up and fear sells newspapers, magazines, and other news agencies. This is how we are discouraged from treatment by our gynecologists, our friends and society. Women are continually barraged with misleading information that makes us think that menopause is no big deal and we just have to live with it and get old gracefully, like our mothers did! However, our mothers did get estrogen and other treatments for menopause! Medicine has been completely revamped in the last 50 years, so we should be healthier, happier and have a better quality of life, yet we are prevented from achieving that through instilling fear in women.

While we are dissuaded from treating the symptoms of menopause that take away our productivity and quality of life, we are put in an untenable position. We are discriminated against because we are menopausal. The most recent example of this mission to cripple women’s success was on national TV when Former Governor Nikki Hayley, the 52 yr. old female Senator who is running for president, was described as inadequate because she was “past her Prime”, by a male politician who is in a party that touts the ability of an 81 year old man in that position to act as president of the US. This is one example of millions of examples as to how we are denied treatment to give us powerful and productive lives while we are denied the medicines to make that possible!

The powers that control us, Congress, Senate, the President, the FDA, and the NIH are for by our tax dollars, but they aren’t working for us. They perpetuate the myth that women are addled and inadequate because of our menopausal status, and then make it come true by lying to women about the risks of taking the hormone replacement that can make the second half of our lives productive. The people who make decisions about this subject use fear to “manage” us. Headlines and Titles of articles are the weapons they use.

The second hormone women need is testosterone, however testosterone is still claimed by men and they won’t share! Men have over 20 forms of FDA approved forms of testosterone while women have none! Testosterone deficiency causes many of the symptoms women experience but don’t associate with testosterone loss. Fatigue, lack of sex drive, loss of muscle, weight gain, belly fat, arthritis, inability to think, depression and anxiety that begins before 40. Doctors answer women’s questions about these symptoms by saying, “You are just getting old”, and then refuse to treat or help except with an easy but ineffective treatment, anti-depressants! That’s how doctors are trained. It’s disgusting that doctors just ignore our symptoms.

The facts:

Women make 3 times as much testosterone before menopause as we do estradiol, yet testosterone is still referred to by “experts”, including the American College of OBGYN who teaches doctors taking care of women’s menopause. So women are “held down” and discriminated against by the majority of men, who still run everything : the FDA who won’t approve Testosterone replacement for women; the government who won’t pay for testosterone replacement or non-oral bioidentical hormone replacement (which is how we receive our T); and the group that I will discuss today—the journalists who title research articles to scare us, not to educate us, and write them like we are children who need to be placated and brainwashed instead of just treating a uniquely female disease….MENOPAUSE!,,,with estradiol and testosterone.

We have allowed ourselves to be manipulated and we repeat the rhetoric men have initiated. Why aren’t we asking questions and making our doctors listen to us? They should be helping us. We are half the problem. We find it easier to buy into the lies and do nothing rather than treat our symptoms. We ignore the fact that doing nothing for ourselves is doing something negative for ourselves, one of their tactics used against us, is to scare us from seeking treatment for menopause with the current headlines (Like Hormone Replacement Therapy Causes Cancer and Heart Diseases). and messages barraging us to scare us away from treatment of our painful symptoms, while our decisions destroy our power to continue what we are still accomplishing after age 50.

Here are the titles of the medical and public articles recently in the news that scare women into thinking that they are damaged after menopause and have no safe treatment.

NEWS 7.2023 Ovarian cancer risk among women with

PCOS doubles after menopause

HealthDay (6/27, Murez) reports,

__________________________ Women Who Undergo Bilateral Oophorectomy Before Menopause May Have Greater Risk Of Developing Parkinson’s Disease Years Later, Study Suggests HealthDay (11/8 Norton) reports, Removal of both ovaries before menopause tied to risk of chronic health conditions MedPage Today (9/13, Robertson) reports

Gout risk higher for postmenopausal women Full Story: Healio (free registration) (8/14)

___________________________-

The association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women

Michopoulos, Vasiliki PhD; Huibregtse, Megan E. PhD; Chahine, E. Britton MD, NCMP; Smith, Alicia K. PhD; Fonkoue, Ida T. MD, PhD; Maples-Keller, Jessica PhD; Murphy, Amy BA; Taylor, Linzie BS; Powers, Abigail PhD; Stevens, Jennifer S. PhD

You get the idea. The underlying message of all of these articles is “Menopause causes illness and death”, yet what it doesn’t say is that treating menopause can treat and reverse everything about menopause except fertility. It is true that the symptoms of lack of estradiol and testosterone and the diseases that follow menopause can be treated with hormonal replacement, and risk of diseases of aging and the symptoms of estradiol and testosterone deficiency can be treated with Bioidentical E2 and T pellets! I see it every day in my BioBalance® Practice!

This describes the past, only you and other women can change the future!

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Often in medicine, doctors discover a new use for an old treatment or a treatment that is approved for one use and serendipitously doctors find a new use for a drug or medical device.

I have used a specific type of IUD in menopausal women on estradiol to prevent postmenopausal bleeding. The Mirena or Kyla IUD produces progesterone into the uterus to suppress the effects of estrogen on the endometrium, preventing post-menopausal bleeding and growth of fibroids.

In the May 2023 Journal of OBG Management the experts have discovered that these special IUDs can be used for more than just birth control. They don’t contain any estrogen, but they deliver the progesterone (progestin) where it is needed to the lining of the uterus for 8 years!

The cost of one IUD/8 years vs that of daily progesterone reveals a great cost savings by using a Mirena or Lyetta or Kyla (for uteruses that have not been pregnant) and a time savings for patients who are having difficulty with post-menopausal bleeding while on estradiol pellets, or any form of estrogen after menopause.

The way these IUDs work is that the soft plastic material of the IUD has a packet of progestin attached to it that slowly dissolves over 8 years. In general, I don’t advise the use of Progestins orally as it increases risk of breast cancer and heart disease ONLY when it is taken orally. The small dose that circulates locally in the uterus is only beneficial and is not circulated throughout the bloodstream.

The Mirena (I will use “Mirena” to represent all IUDs of the same genre because it was the first one FDA approved) is placed in the uterus in the GYN office, and a short string is left to stick out of the cervix to be palpable by the patient or the doctor to show that the IUD has not exited the uterus (which is rare in women not having periods, menopause).

Generally the patient is given a week of progesterone to cause her to evacuate the remaining lining of the uterus before the IUD is placed. This will decrease the spotting and bleeding after the procedure. If it is a difficult insertion of the IUD, the GYN will often do a post insertion Ultrasound of the uterus to make sure the IUD is in place.

There are a few menopausal women who cannot have an IUD after menopause. Those patients who have had an ablation of the lining of the uterus usually has scarring of the uterine lining so that an IUD would not be inserted easily or at all. A patient with a uterine septum is not a cancidate for an IUD. Patients who have had a perforation of the uterus in the past are not a candidate for this treatment either. Patients with fibroids on the inside of the uterine cavity are not a candidate either, because the IUD may rub against the fibroid and cause it to bleed.

However if you have a uterus and are on estradiol or oral estrogen and take progesterone or progestin with it to protect your uterus, and have trouble remembering the progestin or progesterone dose every night or you continue to bleed even on progesterone/progestin, then a Mirena would be a good solution for you!

There is a novel treatment for those women who we have been unable to give estrogen to because of uterine bleeding, and the Mirena IUD or one of its sisters is the answer!

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My medical practice at BioBalance® Health brings me many interesting issues that my patients have had to struggle with, before they finally come to me for T Pellets. The latest complaint that men bring to me on their first visit is their reticence to try T pellets because they already tried T cream, or T gel or T patches and they did not get the results that they expected and needed, so they believe T Pellets won’t help them either. Another problem the other forms of T can pose for men is that they try non-pellet forms of T and tell me that they felt a little bit better and they tell me that is all they thought they would get from any form of T replacement….they settle for feeling slightly better instead of feeling Completely Well!

Compared to FDA approved Testosterone Creams, Gels, and Patches, Testosterone Pellets at BioBalance Health are superior in every way! When deciding on a treatment or even when buying an important item for your home you should do your homework! I am going to tell you today why men should switch to long-acting Bio-identical testosterone pellets instead of the other forms.

Deciding between various forms of Testosterone

#1 Effectiveness of each form of Testosterone

When making a decision about which treatment to employ, you should look at whether the treatment will completely treat my symptoms, or just some of them/ and what are the side effects (what is the downside)? Below is a comparison from my book for men, “Got Testosterone?” that compares T pellets to other forms. Note that Creams/Gels/patches are all “Transdermal”, or delivered through the skin:

The reasons for why the quality of the treatment is different for trans-dermals and pellets is because the up to 80% of testosterone converts into estrogen as it is absorbed by the skin. Men don’t need or tolerate estrogens like women do, in fact estrogen binds up testosterone so it can’t be used by the body. So, gels, creams and patches give a man a small amount of T, but soon it inactivates the testosterone, and doctors think the dose is too low, so they raise the dose. The same thing happens over again and finally both doctor and patient give up and generalize the treatment failure and assume the man cannot take Testosterone (in any form).

Pellet testosterone dissolves under the skin in a layer of fat and goes directly into the bloodstream where it goes to work and attached to Testosterone receptor sights. A small amount is converted into estrogen, but it is not enough to inactivate the testosterone from the pellet, so the effectiveness of Pellet Testosterone is quite different from transdermal forms of testosterone, and is greatly superior.

#2 Side Effects/Risks

The flipside of whether a medical treatment of any kind is right for you, is the risks of the treatment and the likelihood of side effects. Knowing the effectiveness of a treatment and the risks, helps you decide whether it will work for you. Knowing these two most important factors help a patient make a decision on which treatment he wants to try.

There are risks that may not apply to you, however you should look to the side effects or risks that apply to you, to make your decision. In the table the highest risk is noted with three Xs, and the lowest risk is one X. The side effects of T in Pellets are much lower than other forms of Testosterone. You must review whether these are risks for you individually or not.

For example, if you are still of childbearing age or you still want more children than the lowest risk of infertility is offered by T Pellets, however there is still a risk. For those men who don’t have hemochromatosis then this risk is not a risk at all. This really means that risks must be individualized for each man just like dosage.

#3 Ease of Complying with Dosage and #4 Cost

Whether you can actually continue treatment for a long period of time is pivotal to determine whether you should take a type of Testosterone replacement. You should look at these factors:

· Can I realistically follow the dosing schedule?

· How many times a year do I have to go to the doctor’s office for this treatment?

· How much time will I waste a month waiting in a doctor’s office to get the treatment?

· Is it administered at home or at the doctor’s office?

The next part of this equation is the cost of treatment. Most testosterone medications are not paid for by insurance. If they are paid for, they have a high copay for most insurance. If you get your testosterone from a pharmacy, then to compute your fee you should multiply the copay by 11 months. If you have to go to the doctor to get the script, you should add the doctor’s fee as well.

I have compiled the cost of each kind of treatment based on the initial dose, which might not be adequate for people who use trans-dermal testosterone and need to increase the dose multiple times.

As for dosing, If you can’t remember your vitamins, your medicine or to brush your teeth before you go to bed I can guarantee that you won’t be able to remember your testosterone cream or gel, or pill.

In the End it is Your decision

Everyone must make their own decision about what type of Testosterone to use. Only you know whether you can be compliant with a daily regimen or would be better to come to an office to get your testosterone twice a year. Only you know whether an effective form of T like pellets is worth the cost of treatment, however, to make a good decision you should compute the daily or monthly cost of the pellets to compare apples to apples.

I see many men who have tried T shots, gels and patches, and come to me as a last chance to treat their low T symptoms with pellets. 98% of them are extremely happy and continue treatment, noting the difference between pellets and their previous T treatment. If you continue to use gels and creams because the FDA approves of it, or because your PCP orders it, but you don’t feel better, then you should try T pellets!

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Deciding between various forms of Testosterone

#1 Effectiveness of each form of Testosterone

When making a decision about which treatment to employ, you should look at whether the treatment will completely treat my symptoms, or just some of them/ and what are the side effects (what is the downside)? Below is a comparison from my book for men, “Got Testosterone?” that compares T pellets to other forms. Note that Creams/Gels/patches are all “Transdermal”, or delivered through the skin:

#2 Side Effects/Risks

#3 Ease of Complying with Dosage and #4 Cost

Whether you can actually continue treatment for a long period of time is pivotal to determine whether you should take a type of Testosterone replacement. You should look at these factors:

Can I realistically follow the dosing schedule?
How many times a year do I have to go to the doctor’s office for this treatment?
How much time will I waste a month waiting in a doctor’s office to get the treatment?
Is it administered at home or at the doctor’s office?

I have compiled the cost of each kind of treatment based on the initial dose, which might not be adequate for people who use trans-dermal testosterone and need to increase the dose multiple times.

Take a look at both the dosing schedule and the cost of treatment, and remember that treatment that doesn’t work, is very expensive because you are buying something that doesn’t work! As for dosing, If you can’t remember your vitamins, your medicine or to brush your teeth before you go to bed I can guarantee that you won’t be able to remember your testosterone cream or gel, or pill.

In the End it is Your decision

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Your Consultations with Dr. Sullivan or Dr. Maupin last one hour!
No other medical practices schedule an hour for consultations with each patient.

You will see a doctor and have time to discuss your issues!!!
Drs Maupin and Sullivan spend hours preparing for your first appointment. They know what medical problems you have, your medications and allergies, and based on your medial history they determine your treatment plan. This plan includes your pellet dose, treatment of other conditions or diseases that are out of control, a diet and eating plan, exercise advice, individualized supplement advice, and prescriptions for medications. Your health will benefit from the expert advice given by Dr. Sullivan and Dr Maupin and their team of Nurse Practitioners and Registered Nurses.

BioBalance® Testosterone Pellets are the most effective, lowest risk Testosterone Replacement:
We exclusively use Testosterone and Estradiol Pellets made from Non-Micronized Bio-identical Testosterone powder, from two compounding pharmacies who have been our providers for two decades.

BioBalance® Health has the most experience in providing Testosterone and Estradiol Pellets in the Midwest
We have been practicing anti-aging medicine and treating patients with bioidentical testosterone pellets longer than any other practice in the Midwest, over 20 years!

BioBalance® Health doctors and NPs provide such a unique and successful level of care that patients fly from all over the world to see them. We are innovators and we have learned how to trouble shoot side effects and treat them before they happen. We have such a unique treatment method that we have doctors who request training with us, and patients who spread the word of our success to their doctors and their friends.

BioBalance® Health Has the Highest Success Rate of any other provider of T and E2 pellets.
We not only offer quality and service to the practice of Anti-Aging Medicine/ Functional Medicine, we also have the highest success rate of any other BI hormone practice anywhere. We encounter the fewest side effects and complaints of any other hormone practice, and we are 95% effective at resolving the symptoms of hormone deficiency.

We Treat Much More than Just Your Sex Hormone Deficiency!
When replacing hormones and treating the symptoms of hormone deficiency is not enough, we treat our patients for other hormone deficiencies and diseases of aging: hypothyroidism, and Pre-diseases like pre-diabetes, obesity, fatty liver disease, and nutritional deficiencies. Our doctors and NPs often diagnose illnesses that your primary hasn’t found yet!

We apply cutting edge medical and nutritional treatments to keep you healthy as you age. Our goal for you is much more than giving you testosterone, it is lasting health.
We combat the sickness and symptoms of aging with a foundation of bioidentical hormones (testosterone and estradiol pellets) plus nutrition, weight loss, exercise advice, esthetic procedures and genetic evaluations to determine your health risks and to diagnose cancer early. We add new novel and effective ways to help our patients live healthier, longer, and more productive lives like the Gallery test for 99 types of cancer that finds cancer before traditional tests can (this test is for those patients who chose to have it and it is an additional fee).

You are Not Just a Number!
We are not a practice built on volume. We learn your history and know who you are when you see us. We make sure we keep your health history in mind when we make decisions for your treatment! Our staff is family to the doctors and to each other. When you enter our office, you will feel special and cared for!

Our results are remarkable! BioBalance Health receives most of our referrals from existing patients and doctors.
Our Patients tell us that they have never had such a complete evaluation of their symptoms and that no other hormonal therapy has made them feel completely well as the treatment they receive in our office. We are excellent Doctors and Nurse Practitioners who are determined to bring our patients back to health with the latest treatments and the most natural testosterone for both women and men. We individualize your care because we know that one size medicine doesn’t fit all! Before you come to our office, we study your medical history and your blood lab results, to create a treatment plan that we adjust during your initial visit based on your needs.

We offer the best Education for Patients available anywhere from Any Anti-aging, Integrative Practice in the US, and possibly the world. Dr Maupin has written 2 books for patients over age 36 that have been distributed in 6 countries, The Secret Female Hormone is for aging women and Got Testosterone? is for aging men. The Secret Female Hormone is the first book about testosterone for women was the first book of its kind published anywhere! Her book for men received the International Independent Publisher’s Men’s Health Award in 2019. Dr Maupin’s biweekly Health casts and blogs has grown in number to over 650, 20-minute episodes. found on You tube (www.youtube.com/@BioBalanceHealthcast) and our website, wwwBioBalancehealth.com. Dr Maupin is dedicated to educating her patients and the aging public with REAL information to help them make good decisions to keep them healthy and productive for a very long time. While traditional medicine has continued to concentrate only on the very sick, young, and fertile women and chronic diseases of the young, Dr Maupin fills in the gap providing advice for aging women and men with preventive medicine, hormone replacement, weight management and sexual dysfunction that mainstream medicine ignores!

We offer the most effective weight loss program for our patients, that allows you to buy real food to eat with the help of prescription weight loss medications chosen for your situation!
If our patients need help with weight loss after Testosterone Pellets, diet and exercise have been employed, we offer additional appointments with a Nurse Practioner (NP)/ RN team to help you lose the weight you have always wanted to lose. Our NP/RNs chose the right medication for you and monitor your weight loss with our body composition machine, In Body® to help you see the fat you are losing.

We combine “fat-loss” treatments with muscle preservation with testosterone pellets.
Preserving Muscle mass is critical to stimulating the metabolism and to anti-aging progress. As you reach your weight loss goal, BioBalance® offers esthetic body sculpting treatments, when you have lost enough weight to shape your body without pain or lost time at work. We acquired the most effective body sculpting EM Sculpt machine to sculpt your body with increased muscle, fat loss and tighter skin; EMsella for treating urinary incontinence and EM face for a non-surgical face lift.

We review your Medical History, Symptoms and Lab before making an appointment for you, to determine if you need our treatment.
We realize that you don’t want to pay for something you don’t need, so we review your medical history and blood work before you pay us anything or waste your time on an appointment that doesn’t lead to treatment. If we cannot treat your particular medical problem, we will give you your lab test results to take to your PCP and you will not have paid anything. We only make an appointment for you if we believe we can help treat your symptoms, medical problems and/or help you lose weight if needed. Unlike any other practice we offer hour-long consultations with our doctors for your first, follow up, and problem consultations.

Dr Maupin has created a medical practice dedicated to truly bringing her patients back to health: sexually, metabolically, nutritionally, and to help them look as good as they feel with her Esthetic practice, BioBalance® Skin.
BioBalance Heath is the fourth medical practice Dr Maupin created/managed over more than 38 years of practicing medicine. Bio Balance Health® is the culmination of all she learned from organizing the three OBGYN practices. She decided that the only way to be the best doctor she could be was to surround herself with the most intelligent Doctors, Nurses and Nurse Practitioners, the most skilled staff possible and to treat them and pay them well, like family. Through her experience, combined with Dr Sullivan’s business training and Family medicine background, she has created what she views as the finest type of preventive, hormonal medical practice.

We want our patients to feel healthy, and to be productive as long as they live!
Dr Maupin, Dr Sullivan, their husbands, and Dr Sullivans in-laws are all BioBalance® patients. Bio Balance® knows that the health we have as we age is primarily due to replacement and management of our hormones, nutrition, exercise and attaining ideal weight. Her plan behind the scenes is to create a medical practice that patients enjoy coming to, where staff is happy and well paid, and where doctors and NPs are encouraged to treat patients with cutting edge medical care for the benefit of their patients. Twenty-one years later, her dream is a reality and there is no other medical practice like it!

You only pay for what you get!
Your cost is based on what you receive, not on a large yearly fee that some other practices require. We are a cash practice because insurance companies don’t pay for preventive medicine or bio-identical hormone replacement for women. They also generally won’t pay for weight loss. For the services they do pay for we understand that many of our patients pay for insurance, and we try to use it when we can. Most of our prescriptions and labs we order are covered by health insurance directly. we will give you copies of your invoice to submit for your reimbursement from your insurance if your insurance allows. If you don’t have insurance or have a high deductible, we will pass along the discount the lab companies give us, so your lab cost will be much lower than if you paid them directly!

We live by the belief that we can offer medical treatment to our patients based on what we would want if we were the patient:

To be treated individually, kindly, and efficiently
To offer individualized treatment to each patient
In a practice environment that is uplifting and happy
From staff who feel like family
In a lovely environment that is not clinical like other doctor’s offices
With individualized personal care over time
To offer efficiency by stocking supplements and products on site for patients to buy on site
To only offer quality goods and treatments we use personally
To offer compassion that carries through everyone who works for BioBalance® Health and BioBalance® Skin.

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BioBalance® Health uses other forms of measurement to determine body composition, and to diagnose healthy weight, versus overweight and obesity. BMI is a calculation of healthy weight, overweight, and obesity using just two parameters: Height and Weight. The US government endorses and uses this measurement in many ways to manage citizens, categorize them and even pay their salaries. The AMA has been using this as a measurement of body health for decades. As of July 2023, the AMA is rejecting this measurement of health and illness.
Calculate your BMI

Go to https://www.calculator.net/bmi-calculator.html and you can calculate your own BMI. Below is a chart that many types of companies and people use as a reliable measurement to use for many purposes. Below is the NIH explanation of BMI. You can find your BMI and corollate it with how lean your body is. The Body Mass Index (BMI) Calculator can be used to calculate BMI value and corresponding weight status while taking age into consideration. Use the “Metric Units” tab for the International System of Units or the “Other Units” tab to convert units into either US or metric units. Note that the calculator also computes the Ponderal Index in addition to BMI, both of which are discussed below in detail.

BMI introduction

BMI is a measurement of a person’s leanness or corpulence based on their height and weight and is intended to quantify tissue mass. It is widely used as a general indicator of whether a person has a healthy body weight for their height. Specifically, the value obtained from the calculation of BMI is used to categorize whether a person is underweight, normal weight, overweight, or obese depending on what range the value falls between. These ranges of BMI vary based on factors such as region and age and are sometimes further divided into subcategories such as severely underweight or very severely obese. Being overweight or underweight can have significant health effects, so while BMI is an imperfect measure of healthy body weight, it is a useful indicator of whether any additional testing or action is required. Refer to the table below to see the different categories based on BMI that are used by the calculator.

Nurses have understood the fallacy of using BMI to judge whether a patient is overweight or not for decades, but the AMA and medical specialty societies have defended its use for as long as I have been in medical practice. However, BMI is a crude way to evaluate patients for obesity and we use a more accurate measure, a true body composition from an InBody® machine to determine exactly how much fat, muscle, and water our patients are made of and if they need to lose fat for their health. This true measurement of body composition gives us an accurate measurement of your percent body fat, weight of your muscle and your visceral fat (belly fat) measurement. You may say, “so what?”, but I’ll give you a few examples of how BMI is an INACCURATE measurement to follow for healthcare and for insurance, and other agencies that require employees to be a certain weight for their height.

In my practice I take care of two men whose height is exactly the same, 5-10 (70 inches), both weigh 200 lbs., and they both have a BMI of 28.69 which is considered overweight (normal is < 25). However, the two men are very different in their body compositions and therefore their health risks: Man number one has very little muscle and 30% body fat and is overweight and therefore is at risk for diseases that accompany obesity, high blood pressure, diabetes and heart disease. Man number two has a very muscular build with heavy bones and has a body fat of 19% and looks lean and is healthy and is not at risk for hypertension, heart disease and diabetes. The BMI makes them the same, and therefore their doctors and employers consider them the same for insurance, treatment of their illnesses and categorization in medical studies that determine the qualities that put patients at risk for diseases. Therefore, BMI is a very bad measurement to judge whether a person is at risk for diseases of obesity. The medical industry is big and slow, and this measurement will not be replaced with something else in the near future, however this gives you a basis for challenging the measurement as a basis for promotion, or a reason to deny you insurance or charge you more for insurance.

At Bio balance® Health we have used % body fat and abdominal visceral fat determined by a body composition machine (InBody) as our only measurements to determine future risk, and to determine whether someone requires weight loss treatment or not. BMI is very unfair to those people who are required to maintain a healthy weight for their jobs. Those men and women who are in the armed forces cannot be promoted in rank unless they have a BMI of 25 or less, however the training that is required and the strength and stamina to be in the active military means that they must work out and exercise to build muscle, which then disqualifies them from promotion because it causes them to gain weight, but healthy weight. Using the BMI as a measurement, can cause a person to be disqualified for promotion because they are well muscled!

Not only the US military discriminates against people with high BMI due to high percentage of muscle mass, the life insurance and health insurance industry does as well! A person is labeled obese and therefore “high risk” for illness and death just because they have a high percentage of muscle mass which is healthy, and not a risk. This makes some fit people uninsurable or increases what their life and health insurance costs.

The worst discrimination by BMI discriminates against genetically highly muscled groups of people. The BMI was created using white males and white females making them the standard, however some genetic groups from African, Hispanics, Italians and other groups of people from Mediterranean and middle eastern heritage are discriminated against because they have a higher percentage of muscle and bone mass normally, compared with Caucasians, eastern Indians, and Asians, therefore using the BMI causes these groups to look “fatter” when they are really more muscled with thicker bones, which is healthier, not a higher risk for illness.

Obviously, people with high muscle mass can still be obese, but it should not be determined by height and weight alone. This decision by the AMA has been a long time coming, and the number of people who have been harmed by this method of determining obesity is incalculable. BMI is just a measurement based on height and weight. For some average height and weight people, it is an accurate evaluation of normal body weight vs obesity. However, most people have various degrees of muscle mass, and it is the amount of muscle mass that skews the BMI measurement and judges some people as “obese” when they are at a healthy weight, and others are considered normal weight and composition even when they have a high body fat content and very little muscle.

AMA urges physicians to rethink use of BMI calculation

The American Medical Association voted this week to recommend that physicians not rely solely on body mass index as a way to evaluate whether a person is at a healthy weight, as there may be biases and inaccuracies inherent in the method. The AMA recommended that physicians also take into account visceral fat, body adiposity index, metabolic and genetic factors, and fat, bone and muscle percentage. Dr. Scott Hagan of the University of Washington termed BMI “a very poor measure of general health,” adding, “Someone with an elevated BMI may be perfectly healthy.” Full Story: The New York Times (6/15)

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Every physician and every overweight patient have struggled with achieving effective weight loss that was effective for most people, until now! Almost simultaneously 6 weight loss drugs hit the market approved by the FDA for different uses. The only drug approved for just weight loss is called Wegovy, a once-a-week injection that causes loss of appetite as well as a feeling of fullness when only a fraction of volume of an American meal is eaten. It also works by limiting the hormone glucagon that dumps stored blood sugar into the blood when blood sugar levels get low, and it decreases the craving that many overweight patients complain of. The majority of overweight people have been eating a high carbohydrate diet filled with sugared soda, bread, pasta, cereals, candy, cake, cookies, chips, crackers etc. This is the average American diet, and it is killing us!

Years of eating this diet has made us fat and insulin resistant, as well as malnourished. Humans need food for fuel, and we have made it into entertainment! We need a varied diet of proteins, fats, and carbs. Our genetics dictates how much of each group we need; however, the one size fits all mentality of the FDA and the US government has led citizens to believe that cereal and bread is the basis for diet because America grows grain and sells it to our citizens…it is a diet based on GNP not our metabolism. Simply said this has left most children and adults obese and fatigued because they are not getting the right nutrition from their food intake. Now we have to work backward, and the insurers of this country will not pay for the drugs we need to reverse the process.

The drugs above are all variations of the generic name Semaglutide. The only drug that is different is Mounjaro or Tirzepide. It is more effective for treatment of diabetes and obesity, however Ozempic and the only oral version, Rybelsus, are also effective for both Diabetes and weight loss. We generally prescribe Wegovy for weight loss without diabetes, and we can try to get it approved by insurance for weight loss. However, this is generally not approved.

The requirements for insurance to pay for these drugs for weight loss includes:

BMI over 30
Two other illnesses that are associated with being overweight, eg hypertension, heart disease, prediabetes.

Even with these requirements fulfilled they usually don’t pay for it! The price is $ 1,500 for one month! Three months is around $4,500. This is prohibitive for everyone.

To solve this access problem, Dr Sullivan has contacted several compounding pharmacies who will make the drug for weekly self-injection at a much lower price! The price is $540 for 3 months compared to $4,500. We have been recommending this avenue when we cannot get the drug paid for. The only difference is that patients must draw up the small amount of semaglutide in an insulin syringe and inject themselves with a needle instead of a “pen”.

This is the way we have been accessing this medication for our patients and we have seen unbelievable results! People who could never lose weight are losing and very obese patients who did not have the staying power to continue dieting to get appreciable weight loss are now approaching ideal weight.

The only people who cannot take this medication are those with a history of a specific type of thyroid cancer or a disease of the endocrine system called MEN II. You know it if you have one of these rare problems. Others love to eat so much that limiting their intake is a problem for them.

Special Cases: Those people who genetically are “never full”, or “always hungry”, this is the drug for them to make them feel full for the first time in their life….. Obesity from never feeling full or always hungry is genetic.

Dr. Maupin:

“I never understood those kids and adults who had to eat 24-seven or who could eat 2-3 plates of dinner. .I just had never walked in their shoes until I was pregnant…At that time in my life being 118 lbs and 5-3 when I got pregnant I never could catch up by eating enough calories to feed both of us. I felt full at the beginning of a meal but was always hungry, so I had to eat every 30 or 40 minutes. I was hungry all the time! It literally ruled my life, and it made me think about food all the time. I felt like I was in a prison of low blood sugar restricting my activities. NOW I understand how terrible a genetic albatross having the “never full” or “always hungry” is! Except for pregnancy, I know that inherited genetics make some people always hungry, and others never feel full, and my heart goes out to them. These GLP-1 drugs work well for people with these genes. PS. I was thrilled to deliver my daughter, and it was both the happiest day of my life to see our beautiful baby, but I was also so relieved not to be hungry anymore!”

If you have this genetic issue, then this classification of drug is for you! You will be able to get to ideal weight and you will have to stay on a maintenance dose to keep your weight at ta healthy level. How do you go off these meds when you have reached your ideal weight? We have our patients decrease their dose per week until they start to be able to eat reasonably. Sometimes we can’t get our patients off the medication completely, but the cost is much lower because a 3-month dose will now last 3-6 months.

We like to team up Testosterone pellets with semaglutide treatment for older women to make sure they don’t lose muscle instead of fat. The T-pellets help patients become lean, and preferentially lose fat, not fat and muscle.

What you can do with the medications to make them work faster, more effectively:

Exercise daily for 45 minutes or more—normal life activity is not exercise! Walking briskly means you can’t talk and walk at the same time.
Eat a low carbohydrate (know what that means), NO SUGAR, high protein diet with a lot of vegetables and fruits of every color 3 times a day. Snacks can be veggies, nuts, cheese, yogurt, eggs, and or fresh fruit. No baked goods, no crackers, bread, junk food or fast food.
High protein diet means eating as many grams of protein as your weight in lbs if you are active. Eat ½ of that in protein if you are not actively exercising that day.
A delicious protein powder that actually tastes good is Phormula #1. I like the mint ice cream sandwich flavor….I can eat that as a meal substitute blended with fruit 3 meals a day.
Drink filtered water and lots of it! At least 64 fl oz a day.
No alcohol
If you want to lose weight in certain spots like your waist or your thighs, I use the EmSculpt fat destroyer with skin tightening.

For those of you who have had trouble with your weight or have had trouble losing it and keeping it off, then BioBalance Health Weight Loss program is for you!

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Most women believe that the only reason to start taking estradiol when menopause begins is to decrease hot flashes and night sweats. But Estradiol replacement is so much more effective and versatile than just stopping hot flashes! When it comes to the replacement of testosterone for women, most still believe that T is just for men! If a woman has been reading for the last ten years, she may have picked up the fact that T brings back a sex drive and energy to women over 40, but most of the important benefits of Estradiol and Testosterone replacement are hidden from the majority of women. Journalists just aren’t interested in us after we are no longer young and fertile, unless of course we are involved with a scandal! The importance of replacing the hormones that are deficient after age 40, and the unpublished benefits that you can receive with E2, and T are the subject of this Blog.

After the age of 40, after our childbearing years, we experience a multitude of symptoms and changes that when asked, OBGYN doctors shrug their shoulders and tell their patients that these terrible, quality of life “downers” are “just aging” and therefore the don’t address them and won’t treat them! It seems medicine discriminates against women in mid-life by ignoring their pleas for help dealing with many symptoms of aging. These common problems are listed below, and I will address each of them in regard to hormonal solutions for these problems. By the way, the replacement of the hormones estradiol and testosterone will treat all of these problems!

Stress urinary incontinence—T increases the connective tissue that holds up your bladder, and estrogen supports the vaginal and bladder lining, assisting in working against gravity.
Irritable Bladder—T and E2 send blood blow to the bladder and stimulate nerves that may be “short-circuited” causing the bladder to spasm and refer the feeling of needing to urinate all day and night.
Recurrent Bladder infections-Testosterone and estradiol pellets thicken the lining of the bladder and the urethra, blocking an invasion of the bladder with bacteria which start a bladder infection.
Interstitial Cystitis is a very difficult problem that comes from severe inflammation of the bladder and causes affected patients to feel like they have to pee every 5 minutes. These patients can think of little else—T and E2 pellets decrease the inflammation in the bladder and thicken the lining of the bladder to protect the bladder lining from irritants in the urine.
Vulvodynia—a painful inflammation of the skin around the vaginal opening, the urethra and rectum. This condition has no effective treatment, however by taking systemic E2 and T pellets, women have gotten relief from this acutely painful problem by taking E & T hormone pellets.
Anemia—Testosterone increases the ability of your stomach to absorb iron from your diet and increases you hemoglobin and oxygen carrying capacity.
Painful intercourse from a dry vulva and vagina—E2 and T together thicken vaginal and vulvar skin, protecting the nerves in and around the vagina. The thickened skin and increased lubrication from these two hormones recreate the youthful stretchiness and moisture needed for painless intercourse.
Osteo-Arthritis—Testosterone suppresses inflammation and T and E2 together increase synovial fluid that lubricates the joints, stopping pain.
Hormonal Migraines —T and E2 in pellet form create a constant blood level of E2 and T which prevents hormonal migraines, which are stimulated by large fluctuations in E2 and T and from total lack of these hormones.

As you can see many of the complaints that perimenopausal bring to their doctors can be treated with a single hormone complication! Instead, they are told that these terrible symptoms are just a normal part of aging and that they should just “suck it up”! I believe that if the American College of OBGYN and the FDA would listen to women over 40 more, and “bless” the use of hormone replacement therapy in all forms, but especially Testosterone and Estradiol Pellets we would create a generation of women who were still productive, happy and without multiple doctors’ visits! How can the powers that are making the rules be so discriminatory against women! We are more than half of the public….we need help in this area of medicine.

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A month or so ago I had a woman come to me for hormone replacement and one of the symptoms that bothered her the most was Lichen sclerosis on her vulva, the area around her vagina. The symptoms are itching, burning, intolerance to putting creams and gels on the area, pain on intercourse, and the skin is fragile and breaks open and bleeds with intercourse.

My patient did not come to me to treat this problem, because she had been told by many other doctors that it was not going to get better. Lichen sclerosis (LS) is an autoimmune disease that affects the vulva and vagina. I know from reading the research and my 20 years of experience that our treatment with T pellets has decreased the symptoms and sometimes reversed many different autoimmune diseases, however I had not had a patient with lichen sclerosis before so I told her that I was hopeful that her lichen sclerosis would resolve with Testosterone and estradiol pellets.

After 3.5 months when she returned to the office she was grinning and said that she no longer had the LS…her gynecologist said it was a coincidence, because she had not been trained with the use of testosterone for treatment of post-menopausal symptoms, and autoimmune disease.

I had another surprise when I treated a patient who had become agoraphobic when her doctor had told her she couldn’t have any more post-menopausal hormones, even though she had had her ovaries removed 10 years before and before her hormones she had multiple severe symptoms of estradiol and testosterone deficiency. The ERT had resolved her problems but now they all came back more severely…she became depressed and anxious and afraid of leaving her house. Her son is an Internal Medicine doctor and he called to ask for my help with his mother. He had tried everything he knew of medically and nothing worked.

Agoraphobia is thought to be a psychiatric condition, but in this patient’s case it was merely a chemical reaction caused by a lack of estradiol and testosterone. After 4 months of E+T pellets she was planning a trip to New Zealand and her agoraphobia was just a memory! I had no idea that that condition could be due to menopause and lack of E2 and T. In the end it was clear that hormonal deprivation can cause agoraphobia and replacement can treat it!

I have prescribed T and E2 pellets to treat a different group of diseases, autoimmune diseases, like Lupus, Rheumatoid arthritis, Sarcoidosis, and Grave’s disease of the thyroid. The testosterone pellets are very effective at modulating the immune system and normalizing it, which decreases the severity and symptoms of these diseases. Even though I know that every person with an autoimmune disease that I have treated with T pellets, has gotten much better the specialists who take care of them won’t admit that it was testosterone pellets that improved their patient’s quality of life. There is plenty of research on the use of testosterone for autoimmune diseases, but it is not in the journals that Rheumatologists read. The research is in the Journal of Metabolism and Endocrinology.

Worse yet, These doctors have learned that “hormones” worsen autoimmune diseases, however the information they are quoting really only refers to oral estrogen replacement and not non-oral testosterone. This scares their patients from even seeking help for their hormone symptoms, and prevents them from improving their autoimmune diseases with a safer treatment, T and E pellets.

Here are some examples of my patients who have had autoimmune (AI) diseases and have come to me for E and T pellet replacement. Women with autoimmune diseases improve drastically with testosterone pellets! Not only do their symptoms of low testosterone and menopause resolve, but their symptoms of their autoimmune diseases improve! The old belief that hormones make AI diseases worse springs from the fact that oral estrogen (Premarin) that turns into estrone can decrease a woman’s free T and make her autoimmune symptoms worsen. However. Educated hormone specialists like Dr. Sullivan and me, know how to prevent this and in fact make the symptoms of AI improve. Here is the key to AI success: We give our patients with AI diseases a lower dose of estradiol in their E2 pellet, and a higher than average dose of T in their testosterone pellets, and we watch our patients get better!

The Rheumatologists can’t stop patting themselves on the back for the improvement in their

patients after I treat them and tell their patients that the hormones should be stopped! Patients are smart and they know why their symptoms disappeared! They chuckle at the arrogance of their rheumatologist. The Rheumatologists just look ridiculous when they claim a patient’s progress as from their own treatment, when it was really the addition of Estradiol and Testosterone pellets that improved their symptoms.

Some autoimmune diseases are progressive and very hard to treat in any way. I was quite surprised when T and E2 pellets halted the progression of lupus blindness and the progression of MS (Multiple Sclerosis)! It is remarkable and a “surprise result” that I was not told about in my training. One Rheumatologist, who is an acquaintance, told me that he stopped sending patients to me for hormones because they never went back to him! I count that as success.

There are many other diseases and symptoms that no one associates with Testosterone Deficiency or low Estradiol, that resolve or improve with the re-establishment of hormone balance. These include:

· Stress urinary incontinence

· Irritable Bladder

· Recurrent Bladder infections

· Interstitial Cystitis

· Anemia

· Painful intercourse

· Arthritis

· Irritability associated with Menopause

· Hormonal Migraines

We will discuss these other Unintended Benefits of T and E2 Pellets in Women in our next Healthcast and Blog. Stay tuned!

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There was once a Saturday night live skit that featured one of their actors, Eddie Murphy, teaching how to spell and say Py-ro-man-ia..and every time I see the word sarcopenia, I think of that skit…mostly because it is a word only researchers and doctors use to describe a condition where a person has lost a lot of skeletal muscle, leaving her or him without enough muscle to move around normally.

Sarcopenia is considered a side effect of aging….but it is really a condition of low testosterone level in the blood, that occurs with aging and results in disability. For people over 70, this is what happens, you lose your muscles if you don’t take testosterone replacement, and don’t exercise and eat enough protein. At any age your muscle is stimulated to grow by your resistance training, daily exercise, and it must be supplied with the building blocks of muscle which is protein from animal products in your diet. However, you can exercise daily and eat the right amount of animal protein and you will still become sarcopenic if you don’t replace your testosterone to a level that is clinically needed as you age. Muscle is only made in people who have enough testosterone.

I am hoping that the next generation of women and men who are 70-year-old now will not be bent over, using walkers, and wheelchairs, and unable to get out of a chair as they age. With long-acting testosterone pellets, in combination with daily exercise, active daily life and sufficient animal protein to make muscle I am working toward a world where humans aren’t put on the shelf because they can’t physically take care of themselves.

But muscle mass does more for you as you age than just get you from here to there without assistance. Your muscle mass also is the primary organ in your body that burns 80% of your calories and turns them into energy. The muscle cell itself is like a generator. It takes in blood sugar and burns it to make energy for your cell. The trick here is to maintain enough muscle mass to make enough energy and burn your calories! This takes the three elements above: 1) Young healthy free testosterone blood levels, 2) a diet including a large amount of the proteins needed by your body to make muscle which are found in animal proteins, and 3) exercise! Every day, many times a day you must be active to keep your body healthy and muscled.

What happens when free testosterone does not stimulate your muscles to make more muscle?

Here is how it works when you are young and have sufficient testosterone and when you replace your deficient testosterone. Every time you move or exercise you use your muscles. Your muscles make heat and energy for you and for your cells. Testosterone sends blood flow to your muscles to stimulate your muscle cells to take in blood sugar and make energy and heat. Testosterone does something more; it directs the muscles to regenerate after they are broken down the 24 hours after exercise and are discarded. The day after exercise, your use your dietary protein to rebuild your muscles. Without the stimulation of Testosterone to rebuild your muscle mass, your muscles break down as usual, but are not built up again! This leads to a never-ending loss of muscle, leading you to lose muscle mass, bone mass, and your best burner of calories! The endpoint is a person who is 75, looks frail, can’t walk fast, who has poor balance and falls and breaks bones. Older people who don’t take testosterone also replace their muscle mass with fat, so their weight may go down (loss of muscle with fat replacement causes the waistline measurement to go up and clothing size to go up, but weight may in fact go down from the lack of testosterone stimulating muscle growth. All of this is well known to doctors yet it is hard to explain in a 15-minute office visit.

Now let’s talk about what is new to our knowledge of muscle tissue and the diseases of aging.

In a research article from 2023, revealed the relationship between muscle mass and diabetes. Those people who had a high % of muscle for their weight had a lower chance of having insulin resistance and diabetes. Diabetes increases our risk for heart disease and death and requires many drugs and doctor’s visits and increases the risk of an individual’s early mortality. Think of it like this:

Replacing T to a premenopausal level in women and to a young healthy youthful level in men increases muscle mass, which uses up blood sugar, which in turn decreases the risk of adult-onset diabetes, which decreases your risk of heart disease and early death!

Another study revealed the relationship between muscle mass and early death and found that the more muscle you have the lower your risk of mortality. You and I know that you can’t have great muscle mass as you age, without testosterone but that was not mentioned. They just measured muscle mass and correlated it with the chance of death, and they found that the more muscle mass you have the lower your chance of death.

A study done on men only showed that the level of testosterone was associated with thicker cortical bones and estrogen in men decreased the cortical bone strength. Bone must have the tension of muscles to stay thick and healthy, so this indirectly gives us more information about how important weight training and resistance training is to your very life.

What Dr Sullivan and I do every day is assist men and women in curing their negative symptoms of testosterone deficiency as well as protecting them from becoming frail also called Sarcopenic as they age. It is not enough to get older if you are not functioning well and are able to take care of yourself!

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At BioBalance Health we use the information from a vaginal probe ultrasound, combined with information from your medical history questionnaire, and an extensive fasting blood panel to determine whether an individual woman is a candidate for estradiol and testosterone bioidentical pellets.

We also review the collated information to determine if we need more tests before we see a new patient.

The ultrasound of the pelvis gives us a visual picture of the ovaries and uterus of a woman. It is necessary to know if a patient is menopausal yet to interpret a new patient’s ultrasound. We obtain that information from your blood lab and medical history from the patient questionnaire. All three pieces of information are essential to our treatment plan.

What can we discover from the vaginal ultrasound?

We are ruling out (making sure a woman doesn’t have these pelvic problems):

Several of these conditions preclude the use of estradiol in any form, some require a visit to your gynecologist for treatment before we add estradiol to your hormones and some of these conditions increase the risk of side effects.

Endometrial Cancer
Endometrial hyperplasia
Endometrial polyps
Fibroids
Ovarian cancer
Ovarian cysts
PCO

**We use the vaginal ultrasound to determine the risk of bleeding on HRT.

***For the first 3 uterine pathologies listed above we look at the measurement of the Endometrial Thickness (ET), or finding an endometrial polyp necessitates a visit to her GYN for evaluation, and most probably an endometrial biopsy or D&C. This pathologic test will rule in or out Endometrial cancer, endometrial hyperplasia.

The other diagnoses are determined by looking at the uterine size, contour, whether there are uterine fibroids, and looking at the ovaries for cysts or masses and the presence or absence of fluid in the cul-de-sac (area behind the uterus).

Why would we order a Vaginal Probe US for our hormone pellet patients after the first visit, while they are taking estradiol?

Uterine bleeding is nonresponsive to treatment
Uterine size is getting larger (patient complains of pain or pressure)
High risk patients with recurrent uterine bleeding
To follow the growth of fibroids
To check the ovaries in patients who have a Family History of ovarian cancer (generally we have the patient’s GYN follow this).
To follow a benign looking cyst seen on the first US for growth.

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At Biobalance® Health we often find cysts or masses on the ovaries of women who are menopausal quite by accident. We order an ultrasound before we treat a menopausal woman with estradiol to see if there is a thickened lining that might cause bleeding under the influence of estrogen replacement, or to make sure there is no uterine cancer before we treat a new patient.

We also incidentally find ovarian masses or cysts when we are investigating pelvic pain or postmenopausal bleeding on our patients who are already on estrogen replacement. In general, since BioBalance’s female patients have their own GYN we don’t do pelvic exams in the office, therefore we don’t find a mass by palpating (feeling) the pelvic structures, however ovarian cysts and masses can be found by ultrasound as well as by physical exam. We generally find ours by vaginal ultrasound.

Why do we get ovarian cysts?

Before menopause we make an egg every month (if we are not on birth control) that grows within a fluid filled sack. This egg will grow to about 18 mm, or 1.8 cm before it ruptures and releases the egg. That is the miracle of ovulation. It is normal to see one or two of these small cysts on the ovaries of ovulating, fertile women. These small sacks are not cysts because of their size.

Ovarian cysts are fluid filled sacks attached to the ovary that are over 2.5 cm. They often occur secondary to a trapped egg that won’t ovulate for some reason, and the cyst will remain until the next period. If the cyst doesn’t dissolve before the next cycle, it can grow larger with the surges of hormones and it can prevent future ovulation, or it can cause pain from the stretching of the outer covering of the ovary. If a cyst is less than 2.5 mg. we don’t re-ultrasound in cycling women. If it is larger or continues to cause pain, we follow up an ultrasound in 6 weeks to see if it is growing. If it is growing but is still clear, depending on the size and the pain involved, we might do a laparoscopy to remove the cyst from the ovary. If it is growing and looks unusual in shape or density, we order 2 blood tumor markers for ovarian cancer. If those are negative, we follow up with another ultrasound in 3 more months.

In some patients, multiple ovarian cysts are the norm. Those patients with polycystic ovaries create multiple cysts each month and rarely ovulate. It helps to use the drug Metformin ER to improve ovulation in PCO patients (and the rupture of cysts). Some patients require laparoscopy to punch holes in all the cysts especially if she is trying to get pregnant.

What does a postmenopausal ovarian mass or cyst mean indicate?

Now for postmenopausal patient’s ovarian cysts and masses are much more worrisome but much rarer. Because the ovary is not metabolically active, and therefore not ovulating the menopausal ovary should look small without cystic structures, however there are some exceptions! The menopausal ovary that has a fluid filled cyst 2.5 cm or less can have been there since the patient stopped ovulating and it never deflated, or ovulated. This type of cyst doesn’t grow and is not malignant.

Ovarian cysts in postmenopausal women that are fluid filled and larger than 2.5 cm, or solid, or partially fluid filled and partially solid are suspicious for malignancy. In this case your doctor may order an MRI, a CT scan of the pelvis, and order cancer tumor markers. In most cases these masses are benign, or early in a malignancy and can be treated with surgery. Sometimes we find a suspicious mass that needs confirmatory ultrasound or MRI by a GYN Oncologist, tumor markers, and surgery would be scheduled to take the uterus tubes and ovaries and sometimes the omentum and lymph nodes.

When will a patient know that her mass if not malignant and if she needs surgery?

The surgeon may do a frozen section in the operating room to see if more than the ovary itself must be removed or your GYN may wait for the final pathology report to determine if it is malignant. That takes several days to a week.

How common is ovarian cancer?

Ovarian cancer is very rare and tends to run in families. If you have not had a relative with ovarian cancer, then you are not likely to have ovarian cancer if you have a suspicious mass. That does not mean you won’t’ need surgery, it just means the outcome has a high chance of being benign.

What can be mistaken for an ovarian mass on ultrasound?

There are several pelvic structures that might be confused with an ovarian cyst/mass. The most common is a pedunculated fibroid that hangs down from the uterus and looks like it is coming from the ovary. These muscle masses from the ovary are generally benign, but they can grow under the influence of estrogens. There are cysts called para-ovarian cysts that can originate from the fallopian tube. They are fluid filled and can actually grow, looking like an ovarian mass, but they are benign, and most are sedentary and don’t grow or become a problem. In my 25 years of operating on women I only had one of the next types of cysts that was thought to be a malignancy at first. It was a very large cyst, 12x 12 inches in diameter and I asked a general surgeon to come in and work with me to help with the surgery if it was a malignancy. In the end, it was a cyst in the retroperitoneal space, called a peritoneal cyst, that was totally benign, and the patient did not require any further treatment after the surgery.

Postmenopausal women who have had an ovarian cyst or ovarian mass you know that it can be an anxiety producing situation, however the great majority of the simple ovarian cysts in postmenopausal women are benign and surgery is not necessary. Most ovarian cysts are likely to remain unchanged or disappear during the follow-up period. The malignancy rate of these cysts is about 1 in 10,000, so worry is usually unnecessary. In my 25 years of private practice, I only operated on 5 patients with an ovarian cyst or mass that turned out to be malignant.

As gynecologic surgeons we are trained to investigate any ovarian cysts that are suspicious through ultrasound, or surgically even if there is a very slight chance that they might be malignant. We are expected to remove any ovary that is suspected to be cancer, even if the chance is minimal that the cyst is malignant. In our practice we send all our patients with suspicious ovarian masses to their gynecologist for evaluation and treatment.

American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology. Practice Bulletin No. 174: evaluation and management of adnexal masses. Obstet Gynecol 2016;128:e210–e226. doi: 10.1097/AOG.0000000000001768

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I learned about electrolytes in medical school as the substances Sodium, Chloride, Potassium, Calcium, Magnesium, and Phosphate we check on a metabolic panel. However, electrolytes are much more than values on a blood test. These minerals are some of the most vital substances needed to keep us alive. Electrolytes can get out of balance in normal daily life and put us at risk of illness and death if we do not replenish them orally along with rehydration with water. Our kidneys and hormones manage electrolyte concentrations as our intake of these substances in our food and drinks replenish electrolytes that are lost in urine, sweat, and bowel movements. We are not conscious of the bodily mechanisms that manage our water balance, urination, keep our blood pressure normal and supply our brain with these vital nutrients to maintain consciousness, and we become symptomatic only when we are severely deprived of them.

In my medical training, I also learned about how illnesses, and medications affect the amount of each electrolyte in our body however what I didn’t learn was how important it is for healthy people who exercise in the heat to replace their electrolytes. You don’t have to be an NFL football player or play in the NBA to require electrolytes when you exercise. With inadequate electrolytes you can become weak, and confused, lose muscle strength, faint or completely lose consciousness when you are working or playing games in the heat, even if you are drinking water!

To make my point I’ll relay a personal experience that you may have experienced as well, while playing a game outside in the heat. I don’t play much golf, but I do play in charity golf tournaments. They are generally timed at the height of the summer heat, and they take almost twice as long as a usual round of golf. This scenario sets all the players up for dehydration and a deficiency of electrolytes. For several years in a row, I noticed that I was well hydrated for about 3 hours by drinking 3 or more bottles of water while I played the first 9 holes. By the 10th hole I was becoming physically weak and mentally slow. I felt I should be ok because I was drinking water and staying hydrated. However, I felt like I was playing golf in Jell-O. I continued to drink water because I thought I was dry, and that is what I thought was wrong with me. Not so…instead of feeling refreshed by drinking endless water, I got worse. Two years in a row I didn’t finish the 18 holes.

What had I done wrong? I started using my diagnostic brain to figure out what I was missing. Was I sick or was there something wrong with my metabolism? While I was watching a pre-season football, I noticed the Gatorade that the players were guzzling. I had never tried Gatorade because of the amount of sugar in that drink. I pulled up the contents of Gatorade and found that not only did it rehydrate the hot and sweaty players with water and sugar, but it contained all the electrolytes that players lose when they sweat and exercise in the heat! Bingo! I bet that was what I needed to finish the golf tournament….electrolytes!

It turns out that I had been half right by continuing to drink water, however the more water you drink while you are exercising the more your electrolytes are diluted! It is not a reason to hold off drinking water, because dehydration can damage your kidneys and you can get heat stroke, however adding electrolytes is vital to surviving exercise in the heat. The following year I armed myself with many bottles of water and plenty of electrolytes in the form of NUUN. To every third bottle of water, I added NUUN electrolytes tablet…voila! I could play 18 holes in hot weather and sweat for 5 hours without fainting, or losing muscle strength, and quitting!

So how do you know when you are getting dehydrated and low on electrolytes? You pay attention to your symptoms! Like everything else, the symptoms of electrolyte deficiency is somewhat individual. The possible symptoms of electrolyte imbalance, either high or low electrolytes are listed below:

· Dry mouth and thirsty

· Restlessness

· Mental Confusion

· Weakness-overall

· Inability to stand up

· Muscle weakness

· muscle spasms

· Fatigue

· Heart palpitations

· Constipation

· Nausea or vomiting

· Diarrhea

· Slow or irregular heart rate

· Low blood pressure

· Headache

· Difficulty breathing

· Low or high blood pressure

· Fainting (Syncope)

Remember I’m talking about electrolyte imbalance that is associated with sweating, exercise, diarrhea, drinking a lot of water without electrolytes while exercising, but the same symptoms can come from food poisoning and the severe fluid losses that accompany diarrhea and vomiting.

I am not talking about electrolyte imbalance that can be a specifically related to chronic medical illnesses, medical treatments and medications. These imbalances are specific to a particular

electrolyte loss and are not treated with global oral electrolyte replacement, and requires an ER or Urgent Care for rehydration.

You may not think you need electrolytes but if you take diuretics, or if you go outside in the summer and perspire for long periods of time, you are at risk of losing your electrolytes no matter what your age, however, you become more likely to have this problem as you get older.

By the way, one of the most dangerous factors in electrolyte deficiency is alcohol consumption! Drinking alcohol uses up your magnesium and sodium, so if you drink while playing golf on a hot day, you are at high risk of having dangerous electrolyte deficiencies that can end in seizures and death!

Treatment for severe dehydration, and or lack of electrolytes is IV fluids with electrolytes in the ER. IVs with normal saline plus electrolytes will effectively treat dehydration from vomiting and diarrhea as well as from heat related dehydration, low electrolytes.

I don’t own any stock in NUUN or Gatorade, and my go-to prevention would be to add electrolytes NUUN SPORT to every 3rd large bottle of water while actively exercising in the heat, or drink Gatorade instead of plain water every 3-4 bottles of water. Gatorade comes in G0 which is without sugar, or G2 has a much lower sugar content. People without diabetes who are actively exercising can drink some sugar while they are exercising, and it does help muscles to function when they are stressed. Those with Insulin resistance or diabetes should use Nuun, Gatorade zero or G2.

As I say all the time—prevention is the best treatment! Be prepared …. with an electrolyte containing treatment to take BEFORE you feel dizzy or weak!

· Drink plenty of water while exercising, especially exercising in the heat, or spending hours in the sun

· Every so often drink something with electrolytes in it (NUUN-Sport or Gatorade products)

· When you start to feel weak, dizzy, muscle fatigue, Stop exercising, rehydrate, and consume salty products if you don’t have electrolytes with you, and lie down in a cool place.

· If you have symptoms of severe dehydration, muscle cramps, you stop sweating, and have changes in your ability to think, you should call an ambulance or go to the Urgent care or the ER for IV rehydration and balance electrolytes right away. Do Not drive yourself!

· This condition can be life threatening!

Just a little personal story: My husband (age 71 and I was 67) and our best friends (71 and 60) went to Cinqua Terra in northern Italy to take a famous hike between two of the towns perched high on the cliffs above the Mediterranean between Monterosa and Vernazza. It is beautiful walk and we had been looking forward to it. We were told it was 3.5 miles so we packed 2 large bottles of water each, I took NUUN electrolytes with me just in case, however we thought we would be hiking early in the morning. Then multiple roadblocks occurred to our plan—the ferry we were supposed to take was not running that day, and it took us 2.5 hours to get to the starting point of the hike. We started hiking at 10:30 am and the day was in the high 70s, and we were hiking in the hottest time of day. We were already behind the 8 ball, but we didn’t recognize it, and we had had a very early breakfast, so low blood sugar played a part as well.

Our plan was to be finished well before lunch time. You can imagine the rest…we are all great at sweating, especially my husband. John is 6-4 and 240 so his body required more water and electrolytes than the rest of us with normal body indexes. It took us more than 3.5 hours and it was hot and we were going up and down thousands of stairs made for donkeys..they were very high!

You can imagine the rest…we’d finished almost all our water by the halfway mark, and there is no place to get off the trail, or to get help. My husband began to feel weak and developed a headache, and dizziness. He was sweating profusely and couldn’t continue after 2/3 of the trail.

I had 1/3 of a bottle of water left and put a whole NUUN tablet in it (which he said tasted nasty)..but he drank it and laid down in the shade for 30 minutes. He rallied enough to get him to Vernazza, but there is no ER there, so he got cool by soaking in the ocean and recovered with water and more NUUN. I was monitoring him, checking his pulse that was thready, and his breathing.

I am not sure what would happen if We hadn’t had water and NUUN.

Protect yourself and your family with being prepared for summer exercise.

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BioBalance Health® pellets are very safe and not painful to have inserted. They are also the easiest form of hormone replacement a woman can have because the dose is adapted every 4 months and our patients only have to think about their hormones three times a year.

BioBalance Pellet therapy is associated with fewer side effects than any other hormone replacement, and we have a 95% success rate for resolving the symptoms of menopause and testosterone loss. Women’s lives are drastically impaired at menopause. BioBalance, and T pellets improve their quality of life to the level of quality they had before they were 40.

Dosage and pellet side effects are specific to the individual and it may take us a few pellet insertions and blood tests to get the ideal result. Finding your perfect fit is like having a custom suit made: hormone balance requires patience and several fittings, before we determine your maintenance dose, which will direct your dose of E/T for follow up pellet insertions.

We give a handout to each patient when she checks out after her first pellet insertion. We ask patients to follow the instructions given to them verbally and in writing in our office.

Risks of pellet insertion procedure, risk of taking estradiol and risk of taking testosterone are rare, but patients are given this handout, so they know what to expect. These same risks are on their consent that they read and sign before they even come to the office the first time.

Here are the most important instructions for immediate care of the insertion site:

· Take the pressure dressing off in 3 HOURS

· Take the steri-strip off in 3 DAYS

· Don’t traumatize your incisional area

· If you are allergic to tape please tell us

· For three days don’t submerge in water—hot tubs, bathtubs, the lake, a stream, or the ocean.

· For three days don’t exercise

· Don’t take oral or IV steroids if it is not life-threatening

Please tell us if you are on steroids or take blood thinners so we can alter our treatment plan.

The risks of the pellet insertion procedure include:

· Infection

· Bleeding,

· Bruising

· Allergic reactions

· Swelling

· Pain

· Reaction to the lidocaine with epinephrine :shakiness and anxiety, lasts a short period of time, and is not permanent. Tell us if you have this side effect, and we will use lidocaine without epinephrine the next insertion.

· Keloid scarring

As is usual for medicine , individual patients have a higher risk based on their medical history. Patients who are at higher risk for complications secondary to the pellet insertion procedure in patients who are:

· Diabetic

· Have an autoimmune disease

· Take steroids

· Have a clotting/bleeding disorder

· Keloid former

· If you have many allergies

· If you have orthopedic implants that require antibiotics at the dentist, then you should tell us so we can give you antibiotics.

Risks of taking testosterone pellets with BioBalance Health® in the first few weeks or months and are transient. These side effects usually resolve on their own without treatment.

The transient risks of testosterone treatment include:

· Over the top sex drive=Hypersexuality

· Vaginal itching from increased blood flow—it is not an infection

· Facial hair and acne (Prevented with Spironolactone preventive treatment)

· Weight gain from muscle mass and sometimes from conversion of testosterone into estrone which is a genetic risk.

· Increased muscle mass that is confused with weight gain.

· Lowered voice is only a problem when you are a singer. Generally, those who think they have a lowered voice really have reflux and it has nothing to do with testosterone pellets.

· Clitoral enlargement—this is a reaction to a new testosterone exposure, and generally will go away in the following few months.

· Thinning of hair at the temples and crown (Prevented with Spironolactone preventive treatment)

Women can take testosterone without estrogen before menopause, and after menopause if requested, however the symptoms of menopause will not be completely resolved with testosterone only pellets.

The risks of estradiol pellets are higher for patients with a uterus, than those women who have had a hysterectomy.

Those women with a uterus have the following risks:

• Uterine bleeding, growth of fibroids: Estradiol of any kind - pellets, pills, patches etc. - can stimulate the uterus to bleed. This can come from a thick lining, adenomyosis (spongy uterus), or fibroids. Prescribing progesterone, optimally sub-lingual progesterone or BLA progesterone from Belmar pharmacy, taken 1-2 times a day, counteracts this. Other treatments are surgical and offered by your Gyn. Your doctor will evaluate you for treatments: uterine wall ablation (80% effective), or a Mirena IUD. Sometimes bleeding will necessitate the choice between a hysterectomy and contin

Risks of estradiol pellets for women with and without a uterus:

· Vaginal discharge: Estradiol increases the moisture in your vagina. This is a gift to some and a curse to others. This wetness is not an infection, but a normal response of the vagina to estradiol. It needs no treatment, but if it bothers you, then the choice might be that you might have to stop getting estradiol of any kind, or just put up with the wetness, or decrease the estradiol dose with the next insertion.

· Bloating: This is sometimes caused by too high a dose of estradiol for a particular person, or the conversion of estradiol into estrone, which causes water weight gain. Some women need progesterone to balance the estradiol, to treat bloating. Others require a diuretic, or a low carb diet, thyroid medication, DIM supplementation or more exercise. Most of the time this symptom will resolve itself in a few weeks after it starts, as the body balances itself out. Bloating has many non-hormonal causes as well.

· Anxiety/Depression: Most women’s anxiety decreases as estradiol levels rise, but others feel irritable, and for this occurs only in a small subset of the population. For those patients we add progesterone SL (Sublingual tablets) to their regimen, and they improve. Think about whether you stopped your antidepressant when you started pellets. This is a premature move and can cause women to emotionally crash. Please continue your anti-anxiety medications, or your anti-depressants until 4-6 months has passed, and have the prescribing doctor help you wean off.

· Breast tenderness: This symptom is usually from a hormone called estrone, and not estradiol, but breasts that have not been exposed to estradiol for years sometimes hurt as they “wake-up”. This is generally limited to a month during the first pellet cycle. The product DIM can alleviate this symptom. Remember that stimulation of the breast can also cause them to swell and hurt! In rare patients, progesterone can cause breast tenderness.

· Weight Gain: Weight gain occurs for many reasons especially over the Holidays. Other times water weight gain can come from Estradiol. This water weight is self-limited and sometimes requires progesterone balancing, a diuretic, or thyroid replacement, increase of protein and decrease of carbohydrates and alcohol. • Migraine headaches: Estradiol in high levels that increase and decrease drastically destabilize the neurotransmitters and can instigate a migraine headache. Pellets increase very slowly, and decrease very slowly, so either your headache is a tension headache and not a migraine, or has a trigger other than estradiol, such as stress, weather change, or food allergies. Migraines generally improve on Estradiol and Testosterone pellets.

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The most common cause of hysterectomy in women are benign masses that grow within the uterine wall. They occur in 4 out of 5 women, and they can be small and asymptomatic, or they can grow large and cause pain, uterine bleeding, pelvic pressure, urinary incontinence and pregnancy complications.

Uterine Fibroids are “the most common tumor in women world-wide”.

Although benign, uterine fibroids are associated with significant morbidity; they are the primary indication for hysterectomy, and a major source of gynecologic and reproductive dysfunction, ranging from menorrhagia and pelvic pain to infertility, recurrent miscarriage, and preterm labor.

Fibroids are also referred to as “leiomyomas”, “myomas”, “fibroid tumors”, and sometimes slangily referred to as “fireballs”. They are in fact “ball-like” in shape and when we inspect them at hysterectomy, they are made up of swirling muscle cells that are laid down in concentric circles.

Gynecologists find fibroids when we examine a patient at their yearly visit by feeling an enlarged irregular uterus. The fibroids are within the wall of the uterus and often cause heavy uterine bleeding. Where the fibroids are, within the wall of the uterus, determines whether they are more likely to cause bleeding or not. Placement up against the uterine cavity (“submucosal”) increases risk of bleeding, and placement in the middle and surface of the uterine wall (“subserosal”) decreases risk of severe bleeding.

At BioBalance Health LLC we require every patient who comes to us who still has a uterus to have a formal abdominal and vaginal ultrasound to diagnose fibroids and other uterine abnormalities, before we will give them estradiol pellets. Testosterone doesn’t have a negative effect on fibroids so we can still put a woman on testosterone with fibroids. Otherwise, we have the risk of fibroid growth in our consents, and we discuss this issue when a patient’s ultrasound shows significant fibroids.

What causes a woman to be more likely to have fibroids during her reproductive years?

Triggers for Fibroid Development

· Race

· Genetics/ family history

· Diet

· Early Age at First Period

· Toxins in the environment especially in early life

· Obesity

· Advancing age

· Vitamin D deficiency

· Hypertension

· Pregnancy suppresses the growth of fibroids

Race: Both Black and Hispanic women are the most likely to develop fibroids and experience enough symptoms to cause the need for a hysterectomy. Black women are 3X as likely as white women to have fibroids, and they are more likely to have very large fibroids. In some circumstances fibroids can prevent pregnancy and cause recurrent miscarriages and preterm labor. 60% of African American women aged 35-49 years reported uterine fibroids, whereas 80% of those aged ≥ 50 have uterine fi-broids.

Genetics/Family History: If a woman has a mother or sister with fibroids, then that woman has twice the risk compared to a woman without a family history of fibroids. “Uterine fibroid-linked mutations in MED12” are the most common mutation we have found, however a mutation in the COMP pathway is also found to be associated with fibroids.

Diet: A diet with high intake of meat, fat and alcohol increases a woman’s risk of developing fibroids. A diet deficient in fresh fruit and vegetables also increases the risk of fibroid appearance and growth. Smoking is highly associated with fibroid growth.

Early age of Menarche is a risk for developing fibroids, which increases the years a woman is exposed to estrogens.

Toxins from the environment, and from alcohol increases the development of fibroids. Cleanses might help rid your body of toxins that might methylate your genes and stimulate fibroid growth.

Obesity and Being overweight: Body fat increases the estrone estrogens in the circulation, which stimulates fibroids to grow.

Advancing age until Menopause: When women enter their late 40s their ovaries decrease ovulation and the uterus is exposed to estrogen without progesterone, which causes fibroids to grow. After menopause, some fibroids shrink while others stay the same. When women take HRT their fibroids may be stimulated again, however because it is not cyclic, it is less likely to stimulate fibroid growth.

Hormone Replacement Therapy can increase the size of fibroids:

HRT is only one of the factors that causes growth of fibroids in menopausal women. If estrogen is balanced with progesterone (not progestins) growth is less likely. Testosterone has no effect on fibroids so replacing testosterone is not a factor for Fibroid growth. At BioBalance we have medicated pellets that combine Testosterone with Anastrazole which suppress the growth of fibroids. We use these on our patient who have known fibroids, if they are willing to undergo treatment with this

Vitamin D deficiency

The role of Vitamin D in development of fibroids is being researched at this time, however an adequate Vitamin D blood level is needed to help prevent Fibroid growth.

“Approximately 80% of African American women have vitamin D deficiency, compared with only 20% of Caucasian women”. This is one of the factors in Race being a factor in the development of fibroids.

Hypertension

Increased diastolic blood pressure is associated with a higher risk of uterine fibroids, regardless of use of antihypertensive drugs. Women suffering from hypertension are 5 times more likely to develop uterine fibroids.

Not Having Babies (Low parity)

Having had one or more babies (parity) is protective, and the more babies a woman has the less likely she is to have fibroids

What are the Symptoms of Uterine Fibroids?

Fibroids are benign uterine tumors, so patients are not at risk of dying of cancer, but women with fibroids often have quality of life issues, found in the symptoms listed above, that lead them to the final treatment for fibroids, a hysterectomy (removal of the uterus). So can we prevent these masses from occurring, growing and producing symptoms?

How Do You Know You Have Fibroids?

The growth of fibroids is generally slow and is accompanied by slowly worsening symptoms.

When there are many fibroids, large fibroids or submucosal fibroids patients seek help for their symptoms which include:

· Heavy uterine bleeding which can be severe leading to anemia

· Pelvic pain and pressure

· Large mass effect that puts pressure on the bladder and colon causing dysfunction of those organs like stress incontinence, and constipation.

· Painful intercourse

· Multiple Miscarriages

· Preterm labor

· Weight gain

What is the Diagnostic Process that Confirms Fibroids

When I was practicing OBGYN, and a women came into my office for a GYN exam and I felt.

The uterus was enlarged and irregular, it triggered me to do three tests to see if it was a fibroid, ovarian mass, pregnancy or other abdominal tumor. I would first order a rapid pregnancy test. Then I’d order blood work to see if my patient was anemic from heavy bleeding, and If the pregnancy test was negative, then I would order an abdominal and transvaginal ultrasound to get a picture of what I was feeling on exam. If I found a fibroid uterus, then I would have a discussion with my patient to see how severe her symptoms were. I would also tell her how big the uterus. The size of a fibroid uterus does matter. If it is greater than 16 pregnancy week size, it is likely putting undue pressure on the other organs in the abdomen. The speed of growth is also a factor because if the uterus grew quickly, then it has a tiny chance of being a malignant sarcoma. The risk of this is < 1%, however fast growth of a fibroid uterus is an indication to do a hysterectomy.

If the uterus is greater than 12 weeks size an ultrasound cannot adequately measure the uterus or reveal the inside of all of it so an MRI of the pelvis and abdomen is in order before surgery.

What Type of Treatment Can Shrink or Remove Symptoms of Fibroids?

The options for control of Fibroid Symptoms with Medications/Supplements include:

· Progestins or Progesterone without cycling

· Birth Control Pills

· Lupron and other drugs in that class (this puts the patient into a temporary menopause).

· Anastrazole (Arimidex®) which stops the conversion of testosterone into estrone and estradiol.

· Stop Estrogen replacement, or. Lower the dose of estrogen if you are menopausal.

· Treatment of inflammation (High CRP)

· Vitamin D supplementation

· Probiotics

· Supplemental vitamins and minerals

These are the first treatments doctors use to lessen the symptoms of fibroids unless bleeding is so severe that it becomes an emergency and then invasive treatments are used.

· Uterine Artery Embolization is done by a radiologist and puts a “plug” in the fibroid’s blood supply and then slowly the fibroid shrinks and dies. The only problem is that once you have had one fibroid, you can always make more. This may be a delaying process to allow a patient to make more red blood cells before a definitive surgery.

· Myomectomy is a procedure done under anesthesia, and it preserves the uterus while removing one or more fibroids. This procedure makes the uterus more fragile and puts it at risk of uterine rupture if a woman gets pregnant and goes through labor. Therefore, myomectomies are usually followed by a C-section for delivery to avoid the risks.

This procedure cannot be done on all fibroid uteruses. The doctor must determine if it is possible to preserve the uterus, since many fibroids invade the whole uterus.

· Hysterectomy is the one procedure that guarantees that uterine fibroids will not return.

After childbearing is complete a woman doesn’t need her uterus for anything. It is simply there to bear children and does not secrete hormones or provide any other function. A Hysterectomy is done under anesthesia and removes the uterus that contains the fibroids. If the cervix is not involved with fibroids and there is no history of cervical cancer, a supracervical hysterectomy can be done, preserving the cervix and the nerves that stimulate deep orgasms.

The Newest Research on Fibroids:

Knowing this information should make it easier for you to understand your doctors’ findings and what is ahead of you. I hope you can understand the risk factors and the possible treatments available to you.

References:

“Comprehensive Review of Uterine Fibroids….”Endocrine Reviews,2021, Vol. 43, No. 4, 678-719

https://doi.org/10.1210/endrev/bnab039

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If you are over 50 you have probably wished that you could have a face lift to bring you back to how you looked in your 20s or 30s. As an owner of a Medical Esthetic Spa named BioBalance Skin®, and because I am 68 myself, I have spent years looking for a facial treatment that would get the results of a surgical face lift, but without the pain, surgery and downtime. Because of the EmFace, I have finally found what I was looking for so I bought it! It is called EM-Face, kin is the first medical spa to offer this treatment that makes facelifts a thing of the past.

The EM Face is not only unique because the results of the EmFace are amazing, but it is also unique because it isn’t painful, it doesn’t require many treatments (EMFace series is 4-6 treatments, one per week), and does not require anesthesia, there is no down time, no loss of time from work, and you are not at the mercy of a surgeon’s skill to make you look like yourself at a younger age, instead of a young stranger (think Sharon Stone).

The EmFace treatment is done in our Medical Spa, and each treatment takes 30 minutes. There is no operating room or anesthesia needed and it takes 4-6 sessions 30-minutes long , painless treatments that you don’t even have to get undressed for! After your treatment you can go right out in the world without bruising or any sign that you had a face lifting procedure.

How does the EmFace work? It uses electrical stimulation of the facial muscles to pull your facial skin up toward your temples, and it also tightens the facial skin so it literally makes your skin smooth and removes wrinkles! Skin tone and muscle tone are improved and wrinkles disappear. …A face lift doesn’t improve your skin tone and it only smooths deep wrinkles.

Leaves no evidence of having a lifting procedure except that over the following 3 months you look progressively younger. This is an advantage if you don’t want your friends to know that you had anything done to make you look younger. A face lift is obvious and it is hard to hide the fact that you had a major procedure to regain a youthful looking face.

How long does it last? A Face Lift lasts about 10 years depending on the thickness and tone of your skin, as well as your age when you have the surgery. EmFace generally requires one maintenance treatment a year to maintain the “lift” indefinitely.

Cost comparison?

EM-face 4 treatments costs around $2,800 and 6 treatments cost $3600 at BioBalance Skin®and that’s it!.

A facelift surgeon can charge t up to $100,000 for his or her services. Then you have to add the additional costs of the operating room + the cost of the surgical assistant + supplies and usually you have to pay for one night in the surgery center.

For a facelift, plan on paying over $150,000 total (assuming you have no complications) vs a total charge of $2,800-$3,600 for an EMSCULPT facelift. Oh, I forgot to add the value of your time off from your job which can be 3 months after a facelift, before you want be seen in public.

Why does a face lift prevent you from showing your face right away?

Facelift Surgery on the face involves dissecting the skin away from the muscle and bones of the face, pulling the skin up toward your temples, trimming off extra skin and then closing the incisions with suture. This massive dissection causes a large amount of swelling and bruising, requiring drains placed in your face, for weeks. This damage lasts a long time and is PAINFUL!

It generally causes patients to remain housebound until they completely recover, which can be months.

EMFace causes none of these side effects and complications, so you can go out in public, or back to work right afterwards with a “glow”, and no sign that you had anything more than a facial.

What are the comparable risks?

The risks of a facial surgery of any kind are dramatic…damage to the facial nerve may not be recoverable, making you unable to smile or show expression on one side of your face. Surgery risks are always numerous and most surgeries include the complications of anesthesia, even death, infection, bruising, non-healing, nerve damage scar formation and facial drooping.

What should I do to prepare for either of these treatments for good results?

Replace your testosterone (improves healing), and estradiol (improves texture and tone of your facial skin.
Topical Skin Care, medical grade, (eg. Skinceuticals products) that stimulates the stem cells of your skin to grow and smooth the texture preparing for healing and tightening.
Replace your estrogen and testosterone if you are over 45, 4- 6 months before the “lift”.
Eat a high protein diet (more than half your weight in grams of protein/day)
Stay hydrated with water and sometimes electrolytes.
Lose as much weight as possible before the procedure.
Get monthly hydra-facials and or micro-needling to prep your skin
Take daily collagen supplementation in your coffee or tea
Take healing vitamins: Vitamin D 5,000 u/day, Vitamin Methyl B12 and Methyl-folate, Vitamin A 10,000-25-000 u/day, Vitamin C 1000 mg/day at the very least.

To help you make a decision, I have to tell you a little secret about what a facelift doesn’t do.: a facelift doesn’t take the place of getting filler every 6-12 months; A facelift doesn’t take the place of botox of other neurotoxin. After a face lift you will still need regular skin peels and hydrafacials, exfoliation, and rejuvenation of the face and neck with laser or micro-needling!

A facelift JUST LIFTS!

EmFace lifts sagging facial skin, smooths the skin on the face and forehead, and improves texture and tone of the facial skin while removing wrinkles and stimulating underlying facial muscles to become the same size and shape as when they were younger! You may notice that you don’t need a neurotoxin as often as you did before the EmFace. You may not need as much superficial filler to erase superficial wrinkles or dimpling. EmFace also lifts the corners of your mouth so the downturn of the corners of your mouth are not as obvious, in fact the corners of your mouth actually turn up like they did when you were younger.

This is what you’ve been waiting for! I know it was what I was waiting for…the EmFace machine wasn’t inexpensive, so the treatments using EmFace are not cheap….but they are drastically more affordable and less dangerous than a facelift! I have finished my series and am happy that I no longer dread the time and risk of having a facelift in the future.

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I spent the first half of my medical life as a gynecologist trying to figure out why my patients would come to my office asking what was wrong with them when they turned 40?

They felt they could not talk to their friends about it, and they were even embarrassed to tell me that even though they used to enjoy sex with their husband/partner, they now were repelled by the thought of it!

Remember this was in the 1980s through 2002, and the only way doctors knew anything about how to treat medical problems was because they learned it in medical school, residency or in their monthly specialty journal. At that time and throughout that time period the primary doctor for women, gynecologists, we never taught anything about sex and the problems that women had after 40 due to deficient hormones. I wasn’t taught how to counsel women about sexual problems. This was and is a great oversight by the Specialty society that I belonged to, ACOG, American College of OBGYN.

Then in 2002, when the internet grew to include medical articles and research, I could find journal articles about sexuality and dysfunctional sex after age 40…and with the help of Beverly Whipple NP who wrote the Science of Orgasm. I began to be able to put the pieces together so I could counsel my patients with real medical information about women’s sexual problems. The loss of orgasms and libido (sex drive) actually comes down to one hormone that is deficient! Unfortunately, it is the one sex hormone that ACOG doesn’t recognize for women, despite all the research that is currently available—Testosterone.

Replacing testosterone has made all the difference for greater than 50,000 female patient visits. I have treated with it in pellet delivery systems. Replacing deficient testosterone is not complicated and it is amazing to me that the medical community shuns the simple replacement of testosterone for women and advocates many drugs to treat anorgasmia (lack of orgasms) that are risky, expensive and often have no effect on a patient’s orgasms. I have a 95% success rate of bringing orgasms back to aging women and in fact have also been successful in helping my patients who have NEVER had one!

Recently I read an article about orgasms and how to get them back, that never once mentioned testosterone, the most effective treatment that would bring sleeping orgasms back!

A recent article in the journal called “Menopause”, titled Oh no! Where did my “big O” go? Or could severe menopausal symptoms have stolen my orgasm? Written by Simon, James A. MD, CCD, NCMP, IF, FACOG.

Here is what the author wrote to “educate” other gynecologists and family physicians. The author blames the lack of orgasms in aging women on the dry vagina caused by a lack of estrogen after menopause, however my 40+ years of experience has taught me that giving women estrogen either systemically or as a cream to the vagina, has not improved any woman’s orgasms in the absence of testosterone. It is amazing to me that they still get it wrong!

There are many scientific articles and studies that prove what I now have proven over the course of 20 years of giving women testosterone pellets and seeing them smile broadly when I ask them how their sexual life is going. They say that they have their orgasms back and sometimes are multi orgasmic! Their relationship with their partner is now excellent and they have a sex drive too! The treatment with testosterone pellets to women after age 40, is the only treatment my patients need to help their relationship and their sexuality.

There is another misconception by the OBGYN world. They believe that women’s sexuality gets better after age 60! After talking to so many women about their sex lives, I have evidence that this is a false statement, and one that will prevent women from getting treatment for their sexual dysfunction with testosterone pellets, while they wait for it to get better as they age. It is a lie that that occurs…the older a woman gets without estradiol and testosterone, the more dysfunction they have. After 150,000 patient visits since 2002, who come to me for hormone replacement and help with their sexual dysfunction, aging has only ruined sexuality for women, and never improved it. The dysfunction can start as early as 36 years of age and continues until they die. This recent article still gets it wrong! I can only imagine what the motivation of the authors are, or are they just repeating unsubstantiated beliefs from what they learned in medical school?

Remember, 35% of studies are blatantly wrong for several reasons:

1.The statistics are manipulated to prove a point

The wrong questions are asked of the patients
The study age group is not the real group of women that is affected
The title is a lie which scares doctors and patients alike.
Medical methods and dose are wrong to produce the patient’s resolution of symptoms.

I’m sure there are more reasons a study could falsely lead one to believe a lie, but they are not important here because I am giving you examples but not an exhaustive list.

The only thing in this article that rang true was the last sentence, “Significantly more research focused specifically on orgasmic function and dysfunction is desperately needed.“ I have to say that if the OBGYN profession would review the research from other fields like anti-aging medicine, endocrinology, and sexual health, or they actually observed what makes their female patients resolve their anorgasmia then it would be as obvious to them as it is to me what makes women have orgasms…testosterone! Testosterone not only brings orgasms back, but it does so much more for women’s sex lives as well…testosterone in the form of pellets causes women to have a normal sex drive, to have a wetter and stretchier vagina and vulva, increases the size of the clitoris that shrinks with age and makes orgasms easy! It is no wonder that I have a very busy BioBalance Health® Anti-aging practice!

Please Don’t give up searching for your orgasms….it will be found in one hormone, testosterone replacement!

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In the history of medicine over the last 2 centuries there have been many changes in the recommendations given to patients by their doctors. In general, to change the way medicine is practiced improving the care of patients, a new treatment had to be opposed by one or two courageous doctors who were willing to put his/her livelihood and status in the society of medical doctors on the line. Any medical practice that was contrary to the dogma that had been taught to doctors in training was looked down upon by medical peers and often the doctors who were trying to improve the life of their patients were ousted from their practices and lost their livelihood. I have been one of those doctors trying to improve the practice of medicine in the face of criticism and “name calling” by other doctors who didn’t want to change any of their practices. In all cases it took a decade or more to regain my status and acceptance by other doctors and in some cases the changes I have made for the sake of my patients are still not accepted, and most likely won’t be for another decade. How and why medicine improves is a painful and complicated process that is always opposed at first.

How Progress of Medical Practice Has Been Thwarted by Doctors’ Dogma

Example #1 Handwashing between examining patients, When Did That Become a Medical Requirement?

Doctors now embrace the practice of washing our hands between examining patients, and the practice of wearing one-use disposable gloves to do a vaginal exam on pregnant patients. However, before 1847 doctors didn’t believe in hand washing between examining patients. There were no sterile procedures or wash basins available in doctors’ suites, and vaginal exams were done on many patients in a maternity ward, one after the other without handwashing. Bacteria had not been discovered in that century and therefore washing away bacteria was unknown, then bacteria were discovered and the presence of dangerous “bugs” that one couldn’t see was questioned by the older doctors and the, but Ignaz Semmelweis proved that ha dogma of the day. With the discovery of bacteria by young doctors and scientists presented a change to the practice of medicine that the older physicians in charge didn’t accept. Then Dr. Semmelweis showed up on the scene, touting the new knowledge, and insisting that he must wash his hands between Obstetric patients in the ward. This set off an explosion and pitted the old guard versus one young, new doctor. His insistence in washing his hands caused the doctors to throw Dr Semmelweis off staff of his hospital and peer pressure caused him to be shunned by all of the physicians on staff. He had a hard time finding a medical practice and ended his life destitute and without anyone recognizing that he was right the whole time.

Medical handwashing became mandatory long after Hungarian physician Ignaz Semmelweis discovered its effectiveness (in 1846) in preventing disease in a hospital environment. He was before his time, and if he had been listened to, thousands of laboring women would have survived childbirth, instead of dying from childbed fever!

In retrospect we can sympathize with him because we now know he was right, and his refusal to accept a dangerous practice and to help women live through childbirth, was a personally costly stand to make, but was the first step toward an advance in the practice of medicine.

Example #2 Is Estrogen Replacement for Menopause: Dangerous or Healthy?

Reference--Menopause: The Journal of The North American Menopause Society Vol. 26, No. 12, pp. 1366-1374 DOI: 10.1097/GME.0000000000001405 ß 2019 by The North American Menopause Society

Estrogen for menopausal women has always been a hot potato for medicine. Many studies done in the 1950s and 1960s documented the benefit of giving women estrogen after menopause. Medicine embraced this belief, and the majority of women were put on Premarin, the most popular estrogen replacement. All went well until late in the 1960s and early in the 1970s doctors noticed that women with uteruses were getting uterine cancer at a very high number and the majority of women were taking Premarin. Research confirmed that estrogen replacement without progesterone/progestin could cause uterine cancer! This caused two things to happen: Research began within the drug companies to see if giving Provera®, a synthetic progesterone, would protect women from uterine cancer; The second thing that happened was that women immediately stopped their Premarin therapy and were suffering all over the US.

“Premarin” and “Estrogen” became bad words in the doctor’s offices, on the front page of papers. This emotional response to a drug name was hard to erase when several years later, when I learned about Premarin replacement through medical school. About that time Premarin + Provera, Prempro® was introduced to the public as the answer to getting uterine cancer in menopausal women. That took over a decade to scientifically establish safety, and menopausal women were without their estrogen to relieve their symptoms. It took that much time to produce enough research to prove that estrogen replacement was not going to cause uterine cancer, but they were right. Estrogen of any type when combined with a progestin protects against uterine cancer, not every case of uterine cancer because there are other factors, but the majority of the time. All was well in regard to E2 during the 1980s-2002 when the next shoe dropped.

In 2002 a flawed study was released from the NIH called the WHI or Women’s Healthcare Initiative, which was published with a headline that startled doctors and women patients alike “Post-Menopausal Hormones Cause Breast Cancer and Heart Disease”. This Press Release Title was a misinterpretation of the data in the NIH Research article that claimed that Estrogen plus Progestin caused heart attacks and strokes! The truth has been excavated from the huge report describing the study, in the 20 years since the WHI article was published, but the original misinformation won’t go away! The study scared millions of women off hormone replacement and caused doctors to stop prescribing them. The outcome of the WHI study is that one brand of estrogen, Premarin(estrogens) PLUS Provera a synthetic Progestin, together do cause heart attacks and strokes. However, estrogen (Premarin or estradiol) alone, does not cause either of these diseases and were proven to protect women from getting heart disease and breast cancer! The original press release of the WHI study should have been titled, Provera, a Progestin, Increases the Risk of Heart Disease and Breast Cancer, and the FDA should have pulled Provera from the market. If it had been properly titled and interpreted by the publisher, doctors would have just changed the Provera® prescription to a natural progesterone (bio-identical progesterone or Prometrium®, progesterone in oil) to take with estrogen, and women would not have had their quality of life changed for 2 decades without estrogen for their menopausal symptoms. I am shocked that Provera® is still on the market with this kind of study showing the damage it can do! I believe the FDA is protecting the pharmaceutical company that makes this substance.

I, personally, have not prescribed Provera® since before the WHI when I tested blood levels of my patients and found very high levels of estrone. As is typical, a fearful headline always stays in people’s minds even when it is proven to be a lie, so for 20 years, most women have not been able to treat their menopausal symptoms. Since 2002 a multitude of studies have been published (usually by women) stating the real benefits of estradiol replacement to prevent: Heart Disease, diabetes, obesity, dementia, arthritis, hot flashes, insomnia, longer life, and many more symptoms of aging.

You might guess, I never stopped giving estrogen to my post hysterectomy patients, and bioidentical progesterone plus estradiol to my patients with a uterus, to protect their uterus from cancer, yet to allow them to have the benefits of estradiol after menopause.

Because I read the whole WHI study, I realized that it was not estrogen, but progestin that caused the problem in the WHI study. However One very old doctor told one of my patients that I was going to “kill” her….he was just ignorant of the study. This seems to be how doctors react when they hear part of the information published about one of the medical treatments in question. Interestingly it is an emotional response that causes them to react negatively to new information instead of investigating it like scientists, which is what we are supposed to be! They have now been proven wrong and I look pretty good to the patients who remember.

You can see why it is both difficult to trust the information given us as doctors, and why even if we know the truth, it is difficult to treat patients in the negative environment that is caused by careless journalists.

This makes it difficult to make changes in medicine for fear someday, a researcher will find fault with it.

Example #3: Medical Advice about Drinking Water with Your Meals

100 years ago the JAMA Journal printed an editorial that said no one should drink water with their meal because it isn’t healthy. There was no scientific research to back up that medical advice and they didn’t say what would happen to you if you did drink water with your meals, but they were adamant that it was dangerous.

In the following century doctors have discovered and presented scientific proof that drinking water with your food helps your food digest, makes you feel full now doctors recommend that everyone drinks water with their food! This is proven with scientific research and finally replaced the previous dogma that restricted patients from the simple habit of drinking water with their meals. It took a long time to reverse the beliefs of people, and I remember that in the 1970s my parents believed that no one should drink water with food. The outcome of that habit was that they both had kidney damage as they grew older! They maintained an environment of dehydration in their bodies which is physiologically dangerous to kidney function.

Conclusion:

So why should we listen to these medical “experts” when they are not advising us in a healthful lifestyle?? Well, about half the time they are right, and half the time they are wrong---it’s a toss-up!

How does one tell the difference between bad and good advice from their doctor? You have to ask your doctor and trust her advice. As a doctor I read research that tests a given medical practice then I compare the outcomes of the research with the outcomes of my patients, and if their findings agree with my patients’ experiences, then I embrace the research and include it in my medical advice. If not, I don’t use that information and wait for a better study to parallel what I see every day.

You can do the same thing. If you think that the advice a doctor gives you is not consistent with your own experience, then you have to decide whether you take the medical advice and use it or not.

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There is an interesting conflict between the truth and the mainstream medical protocols surrounding statins, that we have noticed in our practice for a decade. Patients who are placed on statins soon develop weight gain and Type II diabetes, and those patients who already have AODM, become worse, gain weight and need more diabetic medications. I have questioned the brilliance of the FDA letting this side effect through their testing process for years. More importantly, why are statins always prescribed for people who have diabetes, even if their lipids are normal?

Finally, here is a recent study that documents this side effect, decades after we noticed this phenomenon.

The study is found in The Journal of Clinical Endocrinology & Metabolism, Volume 108, Issue 2, February 2023, Pages 385–396.

The reason for the study:

“Statins and possibly other lipid modifiers increase type 2 diabetes risk and body mass index (BMI). However, to what extent BMI mediates the diabetogenic effects of lipid modifiers remain unclear. “

The findings:

‘Genetically mimicked effects of statins and ezetimibe, but not PCSK9 inhibitors were associated with higher risk of type 2 diabetes (odds ratio [OR] 1.74 [95% CI, 1.49 to 2.03]; 1.92 [1.22 to 3.02]; 1.06 [0.87 to 1.29] per SD reduction in low-density lipoprotein (LDL)-cholesterol). Of these lipid modifiers, only genetic mimics of statins were associated with higher BMI (0.33 SD [0.29 to 0.38] per SD reduction in LDL- cholesterol), which explained 54% of the total effect of statins on type 2 diabetes risk.

Statins were considered a miracle drug for people who had had heart disease in the past, which is what statins were made for. To prevent another heart attack or stroke in this particular group. For some reason, as they were distributed as samples to doctors by pharmaceutical representatives they were pitched as preventive drugs to prevent heart attacks and strokes in normal people with high cholesterol. Statins became the drug to choose to prevent heart disease in normal people and that is where they hit a snag. There are many side effects that statins cause as seen in the recent study, and they also have not been tested by the FDA in women, who are the group of people who have the worst side effects and the lowest rate of MI from atherosclerosis. In addition it was sold as a drug without risk, and I even heard internal medicine doctors telling patients it should be put in the drinking water….a joke but that is what they almost did…they gave it to many people who had no plaque in their vessels and who were not going to have a heart attack in the future. The risks then outweighed the benefits and doctors should stop giving it to women and low risk patients, especially diabetics and patients who are obese, which is 50% of the US adult population.

Statins often have lasting side effects, such as statin dementia and severe sarcopenia (loss of muscle) as well as severe muscle-aches and pains that stop people from exercising. What should happen in medicine is that a doctor should weigh the risks verses the benefits. If they don’t know if a patient has atherosclerosis that patient should have an x-ray called Cardiac Calcium Scan every 5-7 years and if they don’t have plaque, then they should not get a statin. In addition, there is a genetic test to see if the severe effect of sarcopenia (muscle loss) will happen and if a person has that genetic snip, they should take something which is not a statin. If everyone was tested for these two things most people would not take a statin!

The blood sugar increases and the increase in obesity are side effects of statins that were evident in our patients who we test for testosterone deficiency, and who were later put on a statin by their primary care. We found that their lab parameters for diabetes immediately worsened. For those who had visible side effects, we stopped the statins and found that the lab tests went to normal after stopping the statins, and the side effects went away in most of them. We have been waiting for this research study ever since, and now it is official. The research matches our clinical experience!

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The Mediterranean diet was originally discovered from comparing different diet regimens around the world in the 1950s, and the researchers found that those people living around the Mediterranean had a lower risk of heart disease and related illness. The researchers then described the Mediterranean diet and advised Americans to follow this way of eating. It has been studied over and over again and it is still true that a Mediterranean diet is healthy for Americans. Doctors glibly tell patients you should eat a Mediterranean diet, but what really is the Mediterranean Diet?

I know what we are taught to eat the Mediterranean diet, however what Mayo Clinic describes as the Mediterranean diet, is not what I experience when I go to Italy and Greece. Let me start with what the Mayo Clinic lists as components of the Mediterranean diet.

They say that we should eat:

· primarily vegetables, beans and whole grains

· Eat fish twice a week

· Use olive Oil instead of butter

· Serve fresh fruit for dessert.

However here is what I observe of the Mediterranean diet that is really what Mediterranean people eat:

· Main courses generally include Fish, meat like lamb, beef, veal, and pork-they are NOT vegan!

· Fresh vegetables are included but “beans” are not a primary source of protein, however milk products, fish and meat are!

· Italians and Greeks do eat fish at least twice a week if they are on the coast, but not so in the countryside, or northern part of these countries.

· Pasta is a healthy carb and is made of semolina flour is generally served at every meal—but in much smaller portions than we eat.

· Homemade bread is served at every meal.

· Olive oil and Balsamic vinegar is generally used on bread instead of butter or margarine, however they use a lot of both olive oil and butter in their sauces and cooking.

· Desserts are usually sweet and made with creams or milk products and flour. They use honey and sugar to sweeten the desserts, and they do not just serve desserts consisting of fruit.

The main difference between how we eat and how they eat would not be possible for most Americans because it takes so much time, and most of us do not live in an area of the country that is warm enough to grow vegetables and fruit during the majority of the year! The following differences in their diet that actually make a healthy difference are as follows:

· Their portions are less than half the size of ours!

· They shop every day, so they don’t eat preservatives which are added to American food to increase shelf life.

· They make their own bread and pasta fresh, also without additives.

· They have a garden next to their house and because of the climate they are able to eat fresh vegetables and fruit throughout the year….most of Americans don’t live in a warm climate all year round.

· They walk everywhere! They get exercise just visiting their neighbors..everyone takes a walk after dinner. There are fewer cars used for getting places. They also live in smaller communities that are walking distance from everything they need.

· Nuts (Almonds, pine nuts) are integral to their diets, as a good form of protein

· One person in the family has the job of feeding everyone in the extended family. It is her job to shop and cook and grow vegetables for the whole family.

· Families come home for lunch and eat their heaviest meal at lunch so they can walk it or exercise it off!

· Exercise is key to the Mediterranean diet!

· Every day they eat extra virgin olive oil…tablespoons of it, and it is known to lower the risk of heart disease.

· Fast food, junk food, is available only in the cities and is not stocked except for Americans.

· Candy is an extravagance and usually has nuts or honey or other sweeteners but not white sugar or artificial sweeteners.

So….. like most great ideas, eating like a Mediterranean when you live in America is not practical for everyone and is not plant based…it is lean meat, fish, milk products, olive oil and cheese based. Not sure why they added beans…have never seen beans on the menu for either country I have traveled to, Italy and Greece several times each, so the Mayo Clinic’s version of Mediterranean Diet is not what Mediterranean’s really eat!

I believe for a person to actually be able to follow this diet in the US you can change some of your habits, but it is nearly impossible to recreate their society and eating habits. Try this: Cook with olive oil instead of other vegetable oils, put olive oil on your salads or drink a tablespoon of extra virgin olive oil daily to get a portion of the M. Diet. We can eat the same types of food but unless we go back to baking our own bread and hand making our pasta, cultivating a garden next to each house and apartment, move in with our grandparents so they can cook for us, and give up our cars in favor of walking we cannot recreate that diet here in the US, but we can embrace some of the achievable goals of that diet.

The goals of a Mediterranean diet can be achieved in a different way in the US.

We can go back to exercises in our schools and work out (exercise) daily as adults.

We can also attempt to clear out all processed foods from our homes and begin to eat fresh vegetables and fruit daily and serve fish 2-3 times a week. Shopping at a kosher deli would help you get healthy fresh bread without additives and grass-fed beef that does not have antibiotics and grain added to their feed. As for drinks you’ll have to clear out all canned soda, and replace it with filtered water, coffee, or tea. Sugar is dangerous in all forms and candy and baked goodies should be kept to a minimum. Buying local eggs are much healthier than those in the grocery store. Changing our desserts to fruit and or yogurt or plain ice cream without additives, especially soy. These changes can save your life and the lives of your family, but it takes everyone accepting the new parameters of eating. Remember that food is enjoyable, but it is primarily fuel for our mind and body’s energy so we can repair of our bodies and live a long, full life.

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Recently I had a shoulder replacement that went according to plan, and I healed amazingly fast. Of course, my surgeon was excellent, and he gave me preoperative instructions that were integral to the speed of my recovery. I began to think about the reasons people heal and why they may not heal from either surgery or an injury.

I started with the instructions given to me by my surgeon, and the reason he gave asked me to prepare my body for healing prior to the surgery. His instructions included diet, activity, and supplements to my diet. The first recommendation was to load my diet with protein to provide my body with the necessary building blocks to heal my muscles and connective tissue during the surgery and afterwards. His instructions told me to eat a diet including meat, milk products with yogurt and cheese, eggs, and protein shakes. The amount of protein a day required was grams of protein equal to my weight in lbs. For example: I weigh 125 lbs. and therefore I was instructed to eat 125 grams of protein/day. I ate the foods that he recommended, and I took daily whey protein shakes with 25 grams of protein each, plus 20 grams of collagen (another animal protein) every day in my coffee. That satisfied the need to eat the building blocks of what I would use to heal.

The next recommendation was to eat a diet with fresh fruit and vegetables at every meal, avoid sugar, and junk food, and avoid all alcohol and sugared soda and diet drinks. This part of the instructions provided the enzymes and vitamins necessary for healing, as well as advised me to avoid toxins and junk food which can prevent healing. Elevated blood sugar that accompanies intake of carbohydrate food and drink, promote insulin resistance and poor healing. Alcohol is a toxin that blocks the liver from normal activity and blocks processing of nutrients. It is absolutely contraindicated while you are pre-op and healing.

Next, there were supplement recommendations given to me to provide the necessary vitamins and minerals involved in healing, that are difficult to get in a normal diet. These included the Vitamins methyl B12, multi-methyl-B vitamins, Vitamin D, Vitamin A, Vitamin C, and the minerals Magnesium, Zinc, Selenium and copper. The additional supplements were herbs and other substances that help healing including Quercetin, NAC (or Glutamine), Bromelain and Probiotics.

I was told to start all of these recommendations 6 weeks before surgery, and for 6 weeks after surgery. I believe that following these recommendations is key to a great recovery after surgery or an injury.

The other factors that are key to success after surgery is to have a healthy level of testosterone, and I have taken T for 20 years and I realize that my health has been greatly improved after age 40 because of testosterone replacement. Testosterone is an anabolic steroid and is necessary for healthy healing. Most men and women have good levels of testosterone until they get older, and ovaries and testes stop producing enough T. When women become deficient at an average age of 45, and men at 55, our immune system decreases their production of healing white cells, our growth hormone decreases and stem cell activity decreases, all of which are deficient secondary to testosterone deficiency. This makes healing as we get older much more difficult unless we replace the key hormone of T.

The success of surgery is dependent on our overall health so we can heal, the skill of our surgeon, our own health status at the time of surgery, our diseases, and our age/testosterone blood levels, our nutrient status and our diet providing the necessary building blocks to heal our tissues. Surgery is not something you can just show up for, it is something you should plan to prepare yourself for and to follow up with excellent self-care until you are discharged from surgery, or until you are healed.

Other issues that can cause a surgery to fail or to be redone:

· Surgery did not completely fix the problem (lack of surgical skill or complications secondary to your anatomy or physiology).

· Your medical condition or medications can decrease your ability to heal (steroid treatment or treatment for autoimmune diseases).

· Diabetes, heart disease, autoimmune diseases, cancer or other chronic illnesses

· Old age, female over 45, male over 55.

· Testicular or ovarian removal

· Poor nutrition

· Lack of exercise

· Smoking and drinking alcohol

· Lung disease that decreases your O2 levels

· Obesity, Body fat % > 20 % in men and > 26% in women, or BMI > 25

· Medications that decrease your ability to heal: corticosteroids, cancer meds, autoimmune disease medications

· Lab results that indicate your poor risk of healing: High CRP (inflammation),

Anemia, Cortisol is high, Free T is low, Estrone is high in men > 30, High CO2 , high HBA1C, High fasting BS and fasting insulin > 10, Elevated liver enzymes, poor kidney functions, low white blood cells, low GH (IGF-1) < 150.

Follow the instructions that my surgeon gave me and get your hormones replaced, clean up your diet and lifestyle, and get as healthy as possible before and after your surgery so you will have the shortest recovery and the most successful possible.

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There is an increase in medical news and research articles that talk about what aging Americans can do to delay the symptoms and diseases of aging. Some of the articles note lifestyle changes and exercise and or supplements that can combat aging…..but these changes alone are NOT the answer! There is another group of news articles that state the problem that aging, and they leave the reader with the feeling that nothing can be done to prevent these symptoms and diseases. The call “aging” an untreatable part of life, therefore when these symptoms hit doctors tell their patients, “That’s just aging! Learn to live with it!” They rarely note the hormonal changes that are KEY to preventing the changes and diseases of aging: replacing testosterone for both men and women in a bio-identical non-oral form and replacing estradiol for women! In reality all the lifestyle changes alone will not work to reverse aging….it is a multi-pronged approach that brings aging men and women back to health: Hormone replacement first, diet and exercise optimization and supplementation of necessary nutrients.

After treating several thousands of aging men and women over the last 40 years I can state confidently that the one key factor in staying healthy, mobile, and able to think, is the replacement of testosterone with T pellets.

The medical community shies away from stating that testosterone is key to both men and women at any age. Why is that? I think it is because young men who treat themselves with illegal adrenal androgens that are bought on the internet have mistakenly equated these androgen products with the pure testosterone men make in their testes and women make in their ovaries. They are not the same and should be discussed specifically so they are not confused! Medicine also has not accepted testosterone as a female sex hormone! That is just an extension of the male-managed medical care in the US. Lastly the US government see older Americans as dead-weight to the society and they don’t want to make us live longer past when we are useful! Many decisions have been made by our representatives and senators in Washington who have no idea about medicine and aren’t educated that Men and women would cost Medicare less money, not more because they would be healthier for a longer period of time. For example, Medicare warns patients not to take their thyroid medicine after they are 65! What happens when they stop taking thyroid medicine? Patients die!

Many titles of current research articles talk the dangers of aging and then tell us we can’t do anything about it! When a written or spoken article coming from the medical community states that the symptoms that women’s experience after age 40 is called “perimenopause” they Miss-label the period of a woman’s life between 40 and 50 with a word that means “around menopause”, when in reality all of those symptoms occur because of testosterone deficiency, not estrogen deficiency! The word perimenopause makes doctors and patients alike think the problems of this era of life is estrogen when most of us have too much estrogen and testosterone deficiency. Just the word “perimenopause”,implies that estrogen replacement will fix them, when more estrogen will make a woman’s bleeding problems worse, not better. secret ingredient is! The secret label of our problem, “testosterone replacement”, is hidden from us which steers research and treatments away from the real problem….It is no wonder that experimental drugs to fix the symptoms of a woman’s decade after age 40 don’t work!

A word, or a label carries power with it, and when given the wrong name the disastrous outcomes are inevitable!

Because women begin to experience aging after 40, the sequence of events is important to get right so that we can replace what our ovaries stop producing in order of the natural hormone changes. The ovary stops making testosterone first, followed by progesterone deficiency plus estrogen dominance, with the last stage being the final one of loss of estradiol. If this was considered by the research community, then there would be fewer worthless studies based on replacing E2 in women between age 40-50 that of course fail, and more successful studies of testosterone deficiency, that are treated with pure testosterone, and the medical health of middle-aged women would be so much less stressful, and diseases of aging would be suppressed.

I hope that when you read news articles or medical research about middle aged women with the following symptoms you will think “testosterone deficiency” not perimenopause.

Testosterone loss after age 40 causes fatigue, gain of belly fat, loss of muscle, loss of sex drive, increase in autoimmune diseases and loss of motivation and ability to think logically. The more women who know what is really wrong with them the better!

In reality, “Testosterone” can be substituted for the word “aging”. In most medical articles that discuss the problems of advancing age, the conditions that are really caused by testosterone deficiency, are given the nebulous label, symptoms of aging or the misnomer, perimenopause. By doctors and scientists calling testosterone deficiency, “aging”, or perimenopause. It implies that these symptoms can’t be treated, and women must live with them! Sexual dysfunction, fatigue, loss of quality of life and obesity among other symptoms and diseases that happen to women between 40-55 can bet treated with T replacement. Their choice of words put women in a position of acceptance for their symptoms instead of a powerful position to resolve these issues with replacement of one hormone--testosterone! Ask your gynecologist for it! You are the patient/customer, and you should be able to get what you need!

However, after spending 20 years in my BioBalance Health ®Practice replacing women’s lagging testosterone, the rent research is very encouraging to me and to my testosterone replacement practice. BioBalance Health® LLC….More studies are done about women and their decreased sexual desire, and women who become depressed after age 40, as well as many other articles investigating the symptoms of perimenopause (low T) in women. Most current studies state at the end of the article, that there is no treatment for these symptoms, or that estrogen is the answer, or that new expensive drugs will relieve some of the symptoms, bringing along with them many side effects.

Why am I so sure that I am right? It is so obvious in my medical practice that testosterone is the treatment necessary to completely resolve over 20 symptoms and multiple chronic illnesses. I see the success through the results my patients experience. Not only do women return to my office 4 months after their first dose of testosterone pellets visibly younger, healthier and thinner, their lab results improve, and their symptoms are gone! This doesn’t happen in just a few patients, but in 95% of the thousands of patients I have treated.

But not only is the government against the healthy aging of women, the medical societies are against us too! They determine how doctors of their specialty think, and they brainwash their members by printing misleading studies and actual lies against the treatment with testosterone. In 2020 the Journal of Endocrinology and Metabolism castigated doctors who gave women testosterone for their symptoms in their May 2020 issue, then only 5 months later in the same journal they advised the treatment of women who have sexual dysfunction can be treated successfully with Testosterone. In the second article they stated that more than 30% of women over 40 have sexual dysfunction, and that these 30 % must be treated! What a quick turnaround! There are many articles in their research journal that support treating women and men with testosterone, however the doctors who are Endocrinologists must not read their journals because they have not embraced it as a medical society, so millions of women are left untreated by their endocrinologists.

The Journal of OBGYN has different problems. They are decades behind other specialties studying hormone replacement with testosterone. One of the reasons is that they only print the research done by OBGYNs. Other specialties do research on the sex hormones and their effect on cardiovascular disease, autoimmune disease, endocrine disease and cancer, however they are not printed in the only journal that OBGYNs endorse, and the only one OBGYNs read,the “green” journal! The very doctors who are supposed to be experts in the field of female sex hormones are informed meagerly while the other specialties do all the research, but they don’t acknowledge anything by other specialty organizations!

I understand why you may question this..in reality I am a skeptic, and generally must experience a situation myself, or witness it to embrace it. My skepticism is peaked when statistics are quoted, because there are many ways to make statistics lie. Therefore, medical research articles are not a gold standard. Lately they have been questioning their own belief that testosterone is not needed by women. I know what I see, and because numbers can be gerry-rigged to “prove” something that is not seen in medical practice, I don’t believe numbers that aren’t evident in my practice. When one patient…then ten…then thousands of my patients respond to testosterone by being cured of more than 10 symptoms, then I believe…I have treated thousands of patients from all over the world and I have seen miraculous results by replacing testosterone! But if this truth is not accepted by the whole of GYNs, then millions of women will have the quality of their post productive years stolen from them. What about patients who don’t know what is wrong with them and believe their doctors who say that they just have to “live with the symptoms” because it is “normal aging”?

Let me give you some examples from the literature:

An article from Endocrine Today, September 2022, whose headline reads, (Low) Skeletal Muscle Mass is Linked to Cognitive Decline In Older Adults With Type 2 Diabetes.”

This article supports the fact that when people get “old” they lose their muscle mass, and when that happens then they are more likely to lose their ability to think and take care of themselves.

OK, I agree with that, and most of us who are observant of aging people say “duh, of course that’s true, but why does it happen? Is it treatable?” The research article does not offer treatment suggestions; however, I know that the answer is testosterone replacement with bio-identical pellets! Both issues plague women who are menopausal and without both estrogen and testosterone. In my practice taking testosterone with pellets with or without estradiol can prevent these diseases that occur from years of estrogen and testosterone deprivation. Like many other research papers, this one never states how to treat the women who present to the doctors’ office with loss of muscle and cognitive decline, with or without diabetes…why can’t the PhD/MDs that write the papers put the pieces of the puzzle together?

We as doctors know that there are many symptoms and diseases of aging, but my colleagues tell patients that they have to live with it! We should know the answer to this simple deficiency. Aging begins with loss of testosterone and the symptoms can be treated successfully with non-oral testosterone for both men and women!

Why is this so? A minority of doctors are like me, we link the treatment we give our patients with the outcomes that we witness. Other doctors are no better than a computer, what they are taught in med school is what they tell their patients, and no more, whether they see improvement or not! These two groups of doctors are different based on their phycological make up, but the memorizers (the second group) do well in medical school because they can spit back exactly the lists given to them to read and remember, however they are terrible at problem-solving because they don’t know how to use what they see every day in their office to modify the treatments they learned in med school.

So many things have changed in the last 40 years since I left medical school! I am a problem solver and I keep learning…this leaves me open to the newest epigenetic research, the use of US and MRI for many diagnoses, and helps me discover the treatment for conditions that are only ignored by the researchers currently.

20 years that proves beyond a shadow of a doubt that testosterone is a replacement is key to healthy aging without symptoms and disease. But many Doctors repeat what they were taught in the dark ages, “You are getting old, you will have to live with it”, and turn and leave the exam room! Many doctors did this to me as a patient after my hysterectomy, and I’m a doctor who 20 years ago was looking for a treatment for my rapid aging after my ovaries were removed.

I was told that my symptoms of low Testosterone was just aging and it is not treatable. However now, 20 years later, I read over 40 journals a week and I have thousands of medical research papers to prove that the trigger for aging is the fall of testosterone blood levels that occurs in women in their 40’s and men in their mid 50s.

Yet Testosterone deficiency is still a condition that no one seems to believe there is treatment for, and patients are told all over the country, every day to suck it up and live with it or to take multiple drugs to make them not care about their symptoms anymore, but nothing actually brings them back to health except testosterone in a non-oral form—testosterone pellets. Subdermal pellets are the best global treatment for both sexes that bring us back to the way we felt when we were young! In this form T is not dangerous or risky…it is a simple two synapse logical solution: Testosterone replaces the testosterone your ovaries or testicles made before aging started, by just giving Testosterone back to you we are replacing what you are now missing! What a concept!

It is obvious that there is one answer to treat a multitude of symptoms and illnesses we don’t have a “medically acknowledged treatment” for. Why are we are unwilling to find a solution? Is it because women aren’t equal to men, even in 2022 in the US? Is it because the FDA is an arm of big pharma and wants to sell multiple expensive new patentable meds to earn the most money, instead of treating many symptoms and diseases with one medication/hormone? Is it because most doctors are men and think women are just hysterical and imagine their symptoms?

I am forever reading articles about the symptoms of aging, in which the authors act like the treatment for these symptoms is a Rubic’s cube that is difficult to treat, but in reality, it is so simple, maybe too simple for the hubris of medical people to consider that it is the answer to such a complex group of symptoms.

So, you should try what I am suggesting. You will see for yourself that with one hormone a multitude of symptoms can be treated! The list goes on and on.

Loss of sex drive and sexuality

ED in men and lack of orgasms in women

Pain with intercourse

Fatigue

Obesity

Insomnia

Depression and anxiety that begins at 40

Migraines that start after 36

PMS

Irritability

Loss of motivation

Arthritis

Dry eyes

Dry skin

Thin sagging skin

Loss of hair

Loss of muscle

Loss of balance

Joint damage

Memory loss

Change in body composition

Increase in belly fat

Increase in cholesterol and inflammation

Loss of immune function that triggers infections and cancer

Loss of Quality of life

Hot flashes

All of these symptoms can be treated with bioidentical testosterone pellets safely for men and with testosterone and estradiol in women. Why can’t the studies just say, the treatment for the symptom of aging is due to testosterone deficiency?

I would like to know why no one in the FDA, the researcher community, doctors who are in charge of the medical specialties in the US, and teaching physicians have told us this? Why are we always told there is nothing to be done about aging/low testosterone….it is our future to age, get sick, watch our bodies fall apart and our brains shrink and then we die? Not me! I am going to shout it from the house tops that we, mostly women, who are told there is no treatment, won’t take it anymore! We want testosterone pellets approved by the FDA for women and paid for by insurance!

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I often see patients at the office who come back to get BBH Pellets after a hiatus of months to years, that they tell me waiting was the biggest mistake they ever made. They were feeling so good after their hormones were replaced that they forgot how bad they felt before their treatment. Stopping their hormones brought back their symptoms, and they realize how much their pellets are doing for them!

This is human nature, and often happens because when we feel better, we forget quickly how we felt before treatment. The problem with starting and stopping pellet hormone replacement is that slowly all the symptoms come roaring back and then my patient wonders why they don’t feel well. Until they remember that the pellets made such a difference and come back.

Stopping Hormone Pellets for No Apparent Reason

Hormone Treatment with Pellets Is different than other medications because when a person stops therapy, pellets continue to dissolve slowly, so they continue to make our patients feel good before the pellet hormones wear out which can be 6 months for women and 12 months for men. Because blood levels of testosterone and estradiol from pellets are slow to increase and slow to run out, patients don’t notice an abrupt change. Generally, months after an insertion was supposed to be repeated, the symptoms of hormone deficiency are evident but patients may not put it together with not getting their pellets on time. Other medications make it easier to recognize the cause and effect, because if you don’t take a medication such as a diuretic or an ADD medication, you get the symptoms you are taking the drug for back in 24 hours. Even oral, transdermal and suppository hormones have a half-life that is less than hours long, so if a patient is taking oral estrogen for hot flashes, then discontinuing treatment would bring an obvious return of hot flashes and dry vagina right away. That makes it easier to the return of symptoms with the stoppage of the oral hormones. Short acting hormones or drugs make it more obvious to a patient that they need to take their medication or get they will get their symptoms back. I have to ask my patients to consider their pellet treatment as a lifelong therapy like taking thyroid or blood pressure medicine.

The result of stopping pellets is that a patient feels well for a while and then slowly goes back to their symptoms before pellets, and they don’t put it together and look for other causes and other diseases without results, until they remember they didn’t get their pellets inserted. This causes patients to delay feeling well and they don’t get the benefits of symptom relief or prevention of the diseases of aging during the time without pellets. For those patients who put realize what is going on and comeback “late”, it takes months to years to get their hormones replaced and balanced again.

Stopping Supplements Has a Delayed Response Too

Let’s look at another treatment that patients often stop and then don’t know why they don’t feel well. That is treatment with supplements. Supplements slowly improve specific symptoms by either treating genetic deficiencies or deficiencies in your diet that take a month to 6 weeks to have an effect and that same amount of time to wear off. Let me tell you a story that is an example of this very thing.

I was at dinner with one of my friends who is also my patient. He had a knee replacement a month before. His doctor asked him to hold the supplements that would cause bleeding at surgery 2 weeks before his surgery. My friend is a type A guy who believes that a little is good and a lot is better, so he stopped all of his supplements. Then 4 weeks after surgery and 6 weeks after stopping all of his supplements, he sat at dinner with us and looked “deflated”…he complained that he just didn’t feel good, and this was occurring more and more since his surgery. He left dinner early because he just didn’t feel well and that his symptoms had been getting worse over the last 2-3 weeks.

I did my usual casual questioning with a purpose—asked about his knee, pain meds, how long since his pellets, etc. All his answers didn’t give me a clue. I went home and looked at his last labs and meds and supplements. I then talked to him and asked if her had gone back on the supplements his surgeon told him not to take? He said, “I stopped taking everything two weeks before surgery! I never restarted them.” This “aha” moment hit at the same time for both of us…he needed his supplements both to heal and to replace the nutrients he didn’t get in his diet.

Supplements for patients who have no genetic deficiencies, who eat a perfect diet, who exercise daily and who have no bad habits or take drugs that would use up their nutrients, don’t need supplements. I haven’t seen a person who qualifies as too healthy for supplements including me and my husband. If there were a perfectly healthy patient who eats a perfectly balanced diet with enough fruit and vegetables, healthy protein, from home cooked meals without chemicals or preservatives, who eats no junk food or sugar containing food, and who doesn’t drink alcohol or any medication.

BioBalance Health uses supplements to make up for deficiencies in diet, or instead of medications for health issues. We make a plan based on a patient’s risk factors obtained from their history and blood tests, and we explain why patients should take these supplements. Lastly sometimes medications use up your enzymes and vitamins. For example, when a patient who was on a statin had fatigue and muscle aches, I prescribed CoQ10 because that important nutrient would be used up by the statin would be taken off the CoQ10 when they stop the statin.

Patients who can’t or won’t add foods to balance their diet then we recommend the supplements that are needed to take instead of eating foods they don’t like, but need.

All patients on a weight loss diet require a multivitamin, protein supplements to increase the amount of protein eaten daily to more than ½ of the patient’s weight in grams of protein.

Some medications use up a normal supply of a certain vitamin. An example is that the medication Metformin uses up B12 stores in the body so the patients taking metformin should be on B12 in a multivitamin, monthly shot, or a separate supplement to make up for the B12 the metformin uses up. The lack of B12 shows up as generalized pain, muscle pain, neurologic numbness or lower extremity neurological abnormalities. Alcohol consumption is also another habit that uses up B12. All patients who drink alcohol more than occasionally should be on plenty of B12. B12 cannot be overdosed because after you use what you need, you urinate the rest out through the kidneys.

Another example of what happens when you stop taking supplements that are indicated by a patient’s symptoms it takes weeks and months to feel the difference, or to get the original symptoms back. A long-time pellet patient who would not go without her pellets, asked me if she could stop her supplements…she was just tired of taking them. In fact, she had stopped them months before and she had a “new list” of symptoms. I did some lab to see what her blood levels were, and she had a low Vitamin D level, B12 level, her estrone was elevated (stopped taking DIM) and she was gaining belly fat and blaming pellets. After a consultation, she decided to start taking her supplements again, and a month later she felt great and lost some belly fat!

Recommending supplements is part of our treatment that we provide with our preventive medical therapy for our Pellet patients. Supplements are not required but recommended to make up for the modern lifestyle, diet, alcohol, lack of sun exposure and exercise. The fact that the effects of supplements might be silent, causes patients to doubt their activity, and usefulness. When all supplements are stopped we can often see a subtle decrease in a patient’s symptom relief and overall well-being.

Sometimes understanding why we as humans are apt to do things that make us less healthy or sicker sometimes makes it easier to follow recommendations of our doctors. I see the benefits of vitamins, minerals and supplements that my patients take every day in their blood work and their symptoms. Sadly the medical community, funded by the drug companies don’t want us to take supplements….the medical studies they do on supplements always say they don’t work…however they create a study that will result in no improvement by lowering the dose too low, shortening the period of taking a supplement or they choose their subjects so that NO drug or supplement will work. You can make a study say almost anything you want it to…

Don’t stop your thyroid medicine!

I live in the “Goiter Belt” in the middle of the US, so many of my patients need thyroid replacement, which resolves their low thyroid symptoms, and makes their lab look normal. It is unfortunate that some doctors are so poorly trained in thyroid treatment that they look at a person’s lab while they are on thyroid medicine and say, “See, your lab is normal so now you can stop taking your thyroid!”. The thyroid gland does not regenerate, start working again or heal unless you have the rare kind that occurs after childbirth and then resolves after 12 months. Otherwise, taking thyroid is for life, and unlike pellets and supplements, you will feel the symptoms come back right away. Taking a hypothyroid patient off their thyroid replacement medicine leaves them severely hypothyroid and unable to stay awake, with chronic swelling, low heart rate, low BP, weight gain, severe fatigue and hair loss, and feeling cold all the time. The doctors who do what I describe above and take patients off their medicine should go back to medical school physiology.

“Figures often lie, but liars always figure!” –my husband is a lawyer, and he uses this phrase all the time in his arguments.

It is true that a medical study can be manipulated to conclude anything you want it to. A researcher trying to prove something can manipulate the structure of the study, or choice of participants in the study, or just title the article so that it implies something that is the opposite of the true findings, like the NIH did with the Womens Healthcare Initiative in 2002.

When I see different results in my office than what the studies tell me, I trust what works for my patients, and double the veracity of the study. Later I am usually happily surprised that the study was deemed inaccurate because it was done wrong, the population was one not in my patient population (like all patients are Asian, and I have very few Asians in my population) or the assumptions of the results were inaccurate. Using the information that patients give them and determining the best treatment for that individual is the job of a doctor…to read studies critically and compare them to the results seen in their own patient populations, then use what they see with her own eyes to treat their patients.

I hope I have encouraged patients who wonder what their pellets or supplements are doing for them after years of successful treatment who might think they will stop because they are “cured”, to think again. Menopause, Testosterone deficiency and hypothyroidism don’t just go away! They are something that must be treated to bring you back to a quality of life, you will have to treat these deficiencies until you die, or have a medical reason you have to stop treatment. Sadly, pellet therapy and nutritional supplementation are not curative if you don’t take them, you go back to how you felt before treatment!

You might lose years of joy and health by stopping the treatments that make your health and quality of life better. Think it through and talk to your doctor or NP before you make any changes.

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The best way to decrease you risk of developing illness and cancer, as well as a cancer recurrence, is to get your immune system as healthy as possible. Everyone’s body makes cancer cells daily, but your amazing immune system protects you by killing them before they multiply.

The key to preventing chronic illness, cancer, and a cancer recurrence, infections such as viruses or bacteria, and chronic fatigue is to turn the clock backwards to when you were young and your immune system’s “power center”, the thymus gland, was large and active. The thymus gland makes T Killer and T helper white blood cells that kill cancer and bacteria. The thymus gland is key to your immune system, and it shrinks with age. It is large and active when we are children and gets smaller and less active as we age. After age 60 you may notice that people get sicker and that is when they have the most frequent cancer diagnoses. The thymus gland can be stimulated again by “feeding” it and stimulating it into action again.

The best way to improve your immune system’s health and reverse the thymus’s aging process is to make your thymus more active, like it was when you were younger. The best way to achieve this is to replace testosterone, stimulate growth hormone (if necessary), eat healthy food and avoid unhealthy food, add daily exercise to your lifestyle, achieve ideal weight, take supplements, and use immune-boosting peptides like Thymosin alpha-1 or Thymulin and or take medications like Metformin ER.

The following lists are meant to be helpful for you to improve the status of your immune system.

Medications/Hormone Prescriptions that improve Immunity:

Testosterone pellets and injections
Metformin ER 500 mg-2,000 mg
Thymosin alpha-1 peptide (currently unavailable)
Thymulin peptide
Peptides that stimulate the Growth Hormone. Eg. Sermorelin, Ipamorelin, CJC..

Supplements that Support your Immune System & Recommended Daily Dosing:

Vitamin C - 1,000 mg/day
Vitamin D3 - 5,000 IU/day
Zinc - 30-50 mg/day
Methyl-B Complex from BioBalance Health - 1 /day
Magnesium Glycinate or Magnesium Complex from BioBalance Health - 400-800/day
N-Acetyl Cysteine (NAC) from BioBalance Health – 1800 mg/day
Inositol 1-2 grams a day
Choline 425-550 per day
Glutathione (given im, IV optimally) 50-600 mg/day orally (20-40 mg/kg of body weight 3 x a day)
Airborn®

Diet:

Lots of fresh fruits, vegetables, eggs, and animal protein (meat and milk products)
Citrus fruit
Limit caffeine to no more than 2 cups/day
Avoid sugar, synthetic sugars (Saccharin, Equal®), alcohol, gluten, and processed foods
Avoid preservatives, and food coloring/dyes (especially Red #40 & Yellow #5)

Exercise: Doing 45min of cardio per day or more is optimal! Add weight training for the whole body.

Red Light Therapy: 20 minutes a day stimulates the mitochondria to make more immune cells, and to activate them.

Sunshine: 45-60min/day is optimal! No sunglasses or sunscreen.

Medications to AVOID:

Statins
Steroids
Drugs that treat autoimmune disease called biologics

Medical Treatments to avoid if possible that Suppress the Immune System

Immune suppressants
Treatments for autoimmune diseases
Cancer treatments such as radiation and chemotherapy

Habits and substances to avoid that suppress the immune response (the thymus gland and the cells that it produces. Avoid the habits and environmental substances that follow:

All types of tobacco products
Smoking anything—tobacco, THC, etc. causes the lungs to be damaged and to carry carcinogens into the body.
You can put an air purifier in your home and or office.
Alcohol, yes including wine and beer (they are toxins)
Drugs not prescribed by a doctor and some that are prescribed by a doctor. See “Medications to Avoid” above.
Fast food
Sugar, honey, simple carbohydrates that raise the blood sugar
Inactivity
Short lengths of sleeping. Humans need at least 7 hours of sleep.
Night work/shift work
Indoor light > outdoor sun light
Tap water that contains chemicals and fluoride--only drink purified water
Use of chemicals on your lawn and pesticides in and outside of your home because they are carcinogens

No one can avoid all bad habits and substances that block your production of White Blood cells and protect you from cancer, autoimmune diseases and infections, however you can take steps to improve your immune system to decrease your chance of these diseases. The most important change you can make that protects you with just one change is to replace testosterone with bioidentical pellets, if you are over 40 years old. Testosterone in pellet form is the one hormonal replacement that will improve your immune status more than any other single treatment or supplement. So what is stopping you from preventing future illness and suffering?

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You probably have never heard of the need for Iodine in your nutrition, but it is a trace element that is vital to human life, because iodine plays a role in all of your hormones, your immune system, your metabolic rate and yes, your breasts!

Iodine is produced by seaweed, and is a natural mineral in the soil, sand and ocean of any area of the globe that has been under the ocean or near an ocean currently. Iodine is present in most of the US except the Midwest. Unfortunately, the glaciers of the last ice age, scraped off the topsoil, and the iodine, from the Midwest of the US and carried it to Canada.

The Midwest, where I live and practice medicine, is ground zero for the diseases secondary to iodine deficiency. If you live by the ocean, you probably get enough iodine, however the farther away you are from the coast, or if you live in the US Midwest, the higher your chance of having iodine deficiency.

Where do we find Iodine concentrated in our body? The thyroid gland takes 75% of the iodine, and the rest is distributed to the breasts, ovaries, muscles and blood.

The breasts need iodine to be healthy and normal, and insufficient iodine causes women to develop fibro-glandular conditions that obscure masses on mammogram, and make the breasts feel “lumpy”. There is a direct relationship between iodine deficiency and breast disease.

Taking Iodine can reverse the fibrocystic condition of the breast and it can give your thyroid gland the iodine it needs to make T3 and T4, and keep your metabolism burning calories.

Hypothyroidism and fibrocystic breast disease are primarily diseases affecting women, and both conditions occur most frequently at the times in a woman’s life-cycle when breast growth is most active. Breasts are most actively growing during the following times: puberty, pregnancy, and pre-menopause. I noticed the occurrence of these diseases at these times in my GYN patients when I practiced OBGYN. I did a breast exam on every one of my patients and I noticed that breasts because more cystic in my patient’s early teens, during pregnancy and between 35 and 50. However my practice is in the middle of the “goiter belt” of the Midwest and almost every woman had somewhat cystic breasts due to a lack of iodine. All the mammograms I saw were fibrocystic, which doesn’t increase their chance of getting breast cancer, but does make reading a mammogram more difficult. Fibrocystic breasts make mammograms have a “static” like quality which decreases their accuracy.

Here is how this works…when you are a child and have enough Iodine for your thyroid function, you were thin and active, then you are less likely to have hypothyroidism as a child. About 2 years before puberty, a girl’s breasts start to form and they soak up the iodine from the blood, stealing it from the thyroid. This makes these young girls gain fat, they become fatigues and often have all the symptoms of hypothyroidism, like hair loss, thin eyebrows and lack of motivation. During those two years as their breasts grow, women who have plenty of iodine in their diet, don’t’ become hypothyroid and don’t develop cystic breasts.

The young women who effectively increase their iodine intake, or who have small breasts don’t require very much Iodine, escape the puberty process with a normal thyroid. Other girls soak up more of their Iodine in their breasts and starve their thyroid. The thyroid shuts down, they gain fat, are fatigued, get all the symptoms of low thyroid, and get lumpy breasts. This leads to a group of women who get Hypothyroidism and FCBDX (fibrocystic breast disease) at puberty.

The second time of life women get hypothyroidism is during or after pregnancy when their breasts are much larger than ever before, and are lactating, using up their iodine. Hypothyroidism can occur at this time is unlike other times of a woman’s life that puts a woman at high risk of developing hypothyroidism, they can actually get over hypothyroidism within a year of developing it. Generally, once you have hypothyroidism, you never get over it and you must take thyroid replacement medication the rest of your life.

How can you prevent the breast changes from low Iodine intake? You would think that the government would supplement foods with Iodine to prevent this, but in their usual manner of bad dietary advice, they took Iodine supplementation out of bread and other baked goods in the 1960s under the false assumption that iodine caused hypothyroidism, when it doesn’t! They replaced it with Bromine, which cripples the thyroid gland and can cause hypothyroidism. In addition, they added fluoride to water and that effectively blocks the effectiveness of iodine. It basically kicks Iodine off the thyroid hormone molecule and replaces it with Fluoride which stops thyroid function. Why does the government not reverse its previous stand on Iodine? Because they would have to admit they made a mistake! That seems to be more important than the health of the American public.

How to prevent and treat the diseases of low Iodine? You can move out of the Midwest and buy a house on the beach where iodine is literally in the air, and every time a wave crashes on the beach, iodine is dispersed in the air and you absorb it through your skin and lungs. If that isn’t practical, you can eat a lot of sushi that has seaweed wraps or you can increase your intake of seafood to supplement your iodine. If that is not practical, then you can take a supplement call Iodoral, ½ to 1 tablet (12.5 mg) a day. Taking iodine can literally reverse both fibrocystic breasts, and hypothyroidism….you should take iodine if you have low thyroid and are taking thyroid medicine because you still need it for your breasts and the receptors on your cells also need iodine to let thyroid hormone into the cells!

In addition to ingesting iodine as a supplement, avoid the substances that block iodine from working: Fluoride and Bromide. Don’t swallow your fluoride toothpaste, in fact, buy non-fluoride toothpaste, filter the Fluoride out of your water and only buy bread without Bromine added. A trip to the beach every few months can load up your iodine cache because you can absorb it through your skin during a walk on the beach

My plea is that governmental agencies that produce guidelines for food production reintroduce iodine into the list of fortification that is required in food!

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One of the new tests available to doctors and patients without a prescription is a test that tells you if you currently have arterial plaque and gives you reassurance for 12 years that you will avoid a heart attack from blockage of the coronary arteries. The CACS looks for calcium buildup that shows white on the CT scan. Where there is calcium in the arteries there is plaque. To me this is a wonderful preventive medicine adjunct to the care I give my patients. I no longer have to look at high cholesterol numbers and worry that my patient is going to have a heart attack, because I have found that high cholesterol is not always associated with development of arterial plaque!

Let me back up and explain to you what heart disease really is. Your heart is a muscle that never stops beating until you die. It is fed by arteries that cross over and around the heart and the arteries feed the heart with oxygen, nutrients, and proteins to feed and repair the heart. Heart Disease is really disease of the heart’s arteries. It occurs when cholesterol sticks to the arteries of the heart, which narrow the pipeline that feeds the heart. As the plaque grows the arteries narrow more and more until the vessels clog and a part of the heart is deprived of oxygen and nutrition. That part of the heart muscle dies…that is a heart attack.

Cholesterol in the blood does not mean the development of heart disease. Yes, there is cholesterol in the plaque, but it takes inflammation which is the glue that sticks cholesterol to the arteries. Some people have high cholesterol their whole lives and never have arterial plaque or a heart attack. Cholesterol is not a bad lipid, it is necessary to our whole body, and our brain is mostly cholesterol, every cell wall in our body has cholesterol as the main component, so lowering cholesterol too low can harm you! Statin dose that makes your cholesterol too low is damaging to your brain and all your cells. There is a new kind of dementia called Statin Dementia! This is why I think you should not take a statin unless you have arterial plaque, or your habits increase the inflammation and the formation of arterial plaque.

My own experience is key to my belief in this test. In 2002 one of my friends who was a surgeon died at the age of 47 of a heart attack. He had no sign of this ahead of time and it came as a surprise to everyone who knew him. I always have had high cholesterol and my husband has had it too, he was even placed on a statin at age 40, so I set us up for the NEW TEST the CACS. At that time the test was brand new, and the research wasn’t back however seeing is believing and we have used ultrasound for diagnostic purposes for years in OBGYN, so we both had the tests. Now the test is $99 at most radiology departments and at that time it was $1000/test! I didn’t care because it was worth knowing whether we would have a heart attack in the near future. It turns out that we both had a score of zero (0) and there was no plaque! Yea, I felt better and stopped worrying about my cholesterol. I was 47 and my husband was 51.

I never recommended this test to my patients because the stats weren’t totally back yet, and it was very expensive, until years after I began my BioBalance hormone replacement and preventive medicine practice. I began to read about the test and that it was reliable and a good way to tell if someone needed a statin or not. I began to recommend the test to anyone including anyone at risk or on statins.

Over the next 20 years I ordered tests on my at-risk patients (those who had family histories of heart disease but normal cholesterol and those who had high lipids that didn’t come down with bioidentical hormones. I was surprised when over the 20 years, at least half of the patients who had high cholesterol had no arterial plaque (no risk for heart disease and MI) and about half the patients who had positive family history, but normal cholesterol had no plaque! So lipids and family history didn’t mean anything! These are the 2 reasons that patients take statins! Patients are given statins blindly for positive family history and high cholesterol not knowing whether they are at risk or not, and one test for $99 can tell if you need statins or not!

By the way, when I was 63 and John was 67 we had another CACS and I was still 0 and John who had been on statins for 27 years did have plaque! His score was 141! The statin didn’t work to prevent narrowing of his cardiac arteries. His new cardiologist was on board and put him on a different kind of cholesterol lowering agent and I put him on Celebrex to prevent inflammation that stimulates plaque formation. Without this test he would have been on a drug that was not working— a statin!

What is the test like?

The test is a 2 picture CT scan. It takes 5 minutes and can tell your doctor a lot! It is recommended after 40 in men with a family history or who are on statins, and women after 45 who have the same risks or who are just anxious over having a vascular disease like an MI. It also tells us about your other arteries, and those leading to your brain and pelvis without taking a picture of them. If you have plaque in the arteries of your heart you surely have plaque in your other arteries all over your body!

The pictures are taken when your heart is contracting and also when it is in diastole or relaxing.

Your doctor will tell you what the test says and means for you, however if you are a 0 amount of plaque you can breathe a sigh of relief that your heart arteries are not blocked with plaque.

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My patients who are listing their symptoms of menopause and low testosterone invariably check the box next to INSOMNIA. In addition to insomnia, they tell me that it is the one problem that they have that affects all their other symptoms of menopause such as difficulty thinking and memory, depression, restless legs, muscle aches, irritability, and generally sabotages their quality of life. This subject has finally been studied in depth by the J or Endocrinology, and I want to share the information with you.

Insomnia is one of the symptoms that plagued me after my hysterectomy and removal of my ovaries. When my sex hormones, estradiol, and testosterone were depleted, my sleep was significantly disrupted. We spend 1/3 of our life sleeping, recharging and healing our brain and body. Prior to my hysterectomy I had always been able to sleep. For an OBGYN who is always sleep deprived, I was able to lie down between deliveries or surgeries and sleep for 20 minutes and wake up refreshed. After my hysterectomy I couldn’t even sleep when I had a chance to at night! I was literally the walking wounded, and medicine told me this was completely unrelated to hormones…..I had proof that it wasn‘t and no one would listen to me. I added estradiol to replace the only hormone that medicine accepted as a product of the ovary, but estrogen made me fatter (I gained 20 lbs after my hysterectomy) and didn’t help my sleep, it just decreased my hot flashes, but didn’t stop them. My life path led me to Dr Gino Tutera who knew that I needed testosterone as well and the loss of T was the source of all my symptoms. Voila! The first night after my pellets were inserted, I slept all night! I woke rested and all my symptoms went away from that day on! Medicine had failed me…and I began to question everything I learned. The medical articles blamed insomnia on everything else that is downstream from T and E2 loss…..hot flashes, anxiety, depression, worry, getting olde, or normal aging.

The latest research from the Endocrine Society confirms the findings that I discovered 20 years ago…that the loss of ovarian and testicular hormones cause insomnia.

There is emerging evidence that menopause-associated hormone loss contributes to this elevated risk, but age is also an important factor. The extent to which menopause-associated sleep disturbance persists into postmenopause above and beyond the effects of age remains unknown. Untreated sleep disturbances have important implications for cognitive health, as they are emerging as risk factors for dementia. Given that sleep loss impairs memory, an important knowledge gap concerns the role played by menopause-associated hormone loss in exacerbating sleep disturbance and, ultimately, cognitive function in aging women. In this review, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining the sleep–wake cycle in younger and middle-aged females, with evidence implicating 17β-estradiol in supporting the memory- promoting effects of sleep.

They now admit that insomnia is independent of aging, it occurs when ever sex hormones fall below the genetic normal for a patient. We see this most acutely in patients who have their ovaries removed before menopause.

So if sleep is vital to avoiding dementia and Alzheimer’s disease, and necessary to your ability to think and problem solve, and to prevent depression and anxiety how does this work?

The basic timing and duration of sleep is regulated by homeostasis (balance of the brain). A person has a necessary amount of sleep needed and everyone is unique. As you are sleep deprived something called “sleep pressure” increase until you go to sleep and relieve this pressure. The second factor in timing and duration of sleep is circadian rhythm, aligning your sleep and wake cycles to the light and dark cycles of your environment. Estradiol and Testosterone affect both of these natural regulators of sleep.

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Medications are getting more expensive, and the % of the price of each medication goes up every year as insurance companies hold on to their profits. This one fact should make you listen read this blog, but there are more recent changes in medicine that has caused the average patient to take more total medications, and government with the FDA are making the personal cost of medications higher while they create legislation to prevent the use of cheaper and more medications for each medical condition that you have. So it comes down to the following agencies of “health” make more money at your expense: 1. Insurance companies, 2. Medical practices and doctors who are paid by insurance companies make your appointment times shorter and the number of issues they can take care of at one visit, one, 3. The governmental agency that your tax dollars pay for, the FDA block the basic medications from approval because they are not patentable and the FDA is REALLY just another arm of the pharmaceutical companies. None of these groups want you to be healthy, because they all make more money when you are sick and need more and more medications, that you pay more and more for every year.

How do we deal with this and make ourselves healthier and at a lower cost? Efficiency! That means that you will have to do several things to protect yourself. The first and most important thing is to take fewer medications by treating the disease that causes the symptoms you take several drugs for, one for each symptom. I will give you an example that I deal with every day, the symptoms of menopause. Women who go through menopause not only have obvious symptoms of menopause, but they also have many other symptoms that medicine doesn’t connect to the loss of estrogen and testosterone in women. For example, we all know that hot flashes, insomnia from night sweats and painful intercourse from vaginal dryness are all caused by loss of estrogen, however medicine teaches doctors to treat these symptoms separately, instead of replacing estradiol + progesterone if you have a uterus. Treating the cause, replacing estradiol as a patch, pill, vaginal tablet or pellet can treat these obvious symptoms of menopause, but current medical practice tells doctors to give that patient one drug to treat a dry vagina—vaginal estrogen, or vaginal DHEA, or a vaginal SERM, all of which are less effective and much more expensive than giving a woman one prescription of estrogen replacement to treat the whole body and all the symptoms plus many other symptoms that are secondary to low estradiol/testosterone, but are considered unrelated to menopause, so they need many more prescriptions (and more doctors)!

Symptoms that are considered unrelated to menopause and hormone deficiency, are treated by other specialties with multiple other drugs. For instance, many types of arthritis begin with loss of testosterone and estradiol before and at menopause, however they are treated by a rheumatologist with multiple very expensive medications that have severe side effects. If menopause is treated with non-oral estradiol and testosterone, then there would be fewer patients with autoimmune arthritis and autoimmune diseases. Most of my patients who have developed these diseases after menopause before they see me are better after I treat them by replacing the hormones they are missing! One Rheumatologist told me he wasn’t going to send me any more patients because after his rheumatology patients saw me they were better and didn’t need his care anymore! They never went back to him. That says it all. My patients who have these diseases not only don’t need the other expensive medications, but they also don’t have pain or destruction of their joints anymore!

Another symptom of menopause is insomnia. There are many over the counter drugs that are out of pocket and many drugs for sleep that help your inability to sleep that occurs after age 40.

However, when my patients get their testosterone and estradiol replaced, they don’t need sleep medicine anymore! They save much more money on their copays and over the counter drugs than they spend on their hormone pellets and feel more rested after they get their “sex hormones” back, without other drugs! Insomnia is not currently considered secondary to menopause by medicine and the FDA, but it is! My patients are proof! My patients don’t have hot flashes, irritability, or painful intercourse either, so replacing hormones treats 3 symptoms of menopause and more than 2 other medical diseases, that are thought to be independent of hormone replacement.

Lastly many women develop migraine headaches at the end of their 30s or the beginning of their40s and they need at least 3 drugs to treat their migraine headaches, and they still are left leaving work to go home and sleep in a dark room the rest of the day. I know how bad this and the other symptoms of testosterone loss and menopause remove quality of life and limit your productivity at your job….I had all of these symptoms after my ovaries were removed and they all went away the week after I had my first estradiol and testosterone pellets inserted.

Please consider the efficiency of replacing two hormones, estradiol and testosterone every 4 months for an estimated cost of $170/ month for pellets that are placed under the skin and don’t even need to require daily dosing, AND you can treat ALL of your menopausal symptoms and symptoms of aging, make yourself more productive and a better employee, not to mention getting a great sex life again, and you save money by taking the place of 3-9 other drugs you take over the counter and as over-priced high copay prescriptions!

What this takes on your part may be to find a practice that is like mine that not only replaces hormones but helps you prevent all the diseases of aging! Mainstream internal medicine and primary care is no longer designed to make your healthier, just to put you on more and more expensive drugs that not only stresses your wallet but causes side effects and only leads to more expensive medicines but wastes your time by making you come to the doctor’s office multiple times to write you refills and make you pay copays! You don’t get healthier that way.

As long as medicine as a business and pharmaceutical companies can make money this way, they won’t change so you will have to figure out how you are going to negotiate the system to get what you need!

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Do you want more energy, improved your immunity, develop better skin and to look younger? These are just a few of the benefits of Red Light (LED therapy), and BioBalance Skin has a Red Light Sauna.

Our Red Light sauna is a 20 minute treatment that you can have once a day every day if you want to. You just have to be willing to sweat….but you can sit and work on your phone or computer for 20 minutes while you just sit there. Red Light Saunas make you younger and healthier with an improved immune system just by sitting there—it is a cellular cleanse.

Recommended treatments are 1- 3 x a week, for 20 minutes. It will dehydrate you and you should drink water before and after the therapy.

Facts: Did you know that red light therapy also called LED Therapy and can activate your metabolism by exciting the mitochondria within your cells that are contained in your cells of your major organs and metabolic systems in your body.

We recommend weekly Red Light therapy in our redlight spa at BioBalance Skin. A Red Light sauna treatment is 20 minutes long.

Instructions: You should bring clothing you can sweat in, that expose at least your arms and legs, but more skin exposure the better. Your skin absorbs the red light, and it stimulates every part of your body. You will get hot and sweat but your phone and laptop will not, you can work in the sauna, but it is more effective if you are relaxing for 20 minutes.

BioBalance Skin® : Please schedule your 20 minute appointment by calling BioBalance Skin® at (314) 648-5710.

We provide towels to sit on and dry off with, and the redlight sauna with each treatment.

The cost is $35 for each 20-minute treatment Monthly packages of 8 treatments are $245/use within a month – a year, 8 treatments per month or spread them out within a year from the first treatment.

You will sweat so be hydrated when you come to BioBalance Skin®. You can drink water while you are in the sauna too.

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For decades OBGYNs and oncologists have been denying estrogen replacement to women who have had ER positive Breast Cancer because they believed that estrogen would increase the risk of breast cancer recurrence…As of July of 2022, The National Cancer Institute has reversed the previous position that estrogen in local form for bladder and vaginal atrophic symptoms, and for the systemic form of estrogen would increase the risk of recurrence and death. Now the findings of the most recent study are that the replacement of estradiol in any form to postmenopausal women who are symptomatic (vaginal dryness, bladder infections and bladder irritability and urinary incontinence), as well as ERT for hot flashes, and depression in postmenopausal ER + breast cancer patients reveal that the risk of death and breast cancer recurrence is no higher among women who take ERT compared to women who take nothing!

In my OBGYNB residency and for my ACOG boards, I was taught that Estrogen replacement was dangerous for women who have had a positive family history of breast cancer, for women who have + ER, + Breast cancer in the past, and for women who are at high risk for breast cancer. The latest study repeals that belief!

This study finally does an “about face” to the previous belief that Estrogen Replacement Causes recurrence or a shortened life span. The newest study proves what I have seen in my gyn practice: patients taking ERT after non-metastatic breast cancer were safe and had the same rate of recurrence as women who took no estrogen.

In the latest study by the National Cancer Center found that estradiol benefitted women in general and was safe. The biggest difference between those women who did take estrogen after breast cancer and those who didn’t take estradiol was that women on estrogen had a normal sex life and lived a healthy quality of life, and those without estradiol did not. This finding is the same conclusion I came to by watching my patients with and without Breast Cancer, who took estrogen because of severe menopausal symptoms after non-metastatic ER+ breast cancer. Recurrence of breast cancer in my 29 years of GYN practice and in the 20 years of BioBalance Health® medical practice was no more common in those who took E2 replacement than women who took no estrogens after cancer!

Finally, research reveals, and I hope medical practice guidelines will soon include the OK to give estradiol of women at risk for Breast Cancer and those who have been successfully treated. The refusal of doctors to give women what they need after menopause and successful treatment for breast cancer has damaged many women’s lives…Doctors need to realize that quality of life is important and fear of non-documented beliefs just hampers the health and quality of life of their patients.

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When the human body is exposed to radiation (even the sun), toxins, stress, unhealthy food, infection and extremes of temperature and physically stressful environments, it creates unstable free radicals, charged cells that travel through the body causing cellular damage. For example, oxidative stress causes oxygen, which is usually a beneficial element in the body, to divide into two oxygen molecules, each with a charge. The oxidative stress makes O2 into two oxygen free radicals. The two free oxygen free radicals are harmful to the body, and the damage is in the mitochondria, and the cell can’t efficiently make energy out of Oxygen and sugar. Oxidative stress is somewhat like putting a pillow over the mitochondria so the cell can’t breathe!

How do we get exposed to free radicals?

Sun, processed foods and toxins in the environment. Inadequate supply of antioxidants, fat, and protein, lack of fiber in the diet, inactivity, drugs, smoking, lack of sleep.

Many common items in our diet increase free radicals: Processed flour, wheat, gluten, sugar, sweeteners, and trans-fats.

Source Of Free Radicals and Oxidative Stress

Air pollution.
Cigarette smoke.
Alcohol intake.
High blood sugar levels
Consuming large amounts of polyunsaturated fatty acids
Radiation, including excessive sunbathing.
Infections by bacteria, fungi or viruses.
Excessive intake of iron, magnesium, copper, or zinc
Too little oxygen in the body
Too muchoxygen in the body.
Intense and prolonged exercise, which causes tissue damage.
Excessive intake of antioxidants, such as vitamins C and E
Antioxidant deficiency

Prolonged oxidative stress (exposure to free radicals) leads to increased risk of negative health outcomes, such as cardiovascular disease and certain types of cancer. It is also thought to contribute to degenerative diseases such as Alzheimer’s Disease, Parkinson’s Disease and Dementia as well as the aging process.

The Treatment for Oxidative Stress, and Mitochondrial Damage

Oxidative stress is treated with antioxidants, microniutrients, supplements, and refraining from bad habits such as smoking, drug use and alcohol. The antidote t o oxidative stress is found in Antioxidants which are found in fresh fruit and vegetables as well as meat, healthy fats and eggs. They are also made in the body of humans and animals, and can be given as supplements. Antioxidants work by combining with free radicals, which literally defuses them, so the free radicals cannot damage the cellular mitochondria.

“Antioxidants are molecules that fight damage by free radicals, unstable molecules that can harm cellular structures. Antioxidants do this by giving electrons to the free radicals and neutralizing or defusing them.”

Fresh Foods That Contain Antioxidants

Dark Chocolate.
Goji Berries. ...
Blueberries
Coffee
Cranberries
Green tea
Garlic
Grape skins
Popcorn
Yogurt
Broccoli

Vitamins & Nutrients That Are Antioxidants, Found In Many Foods But Can Also Be Taken As A Supplement:

Vitamin E,
Vitamin D,
Carotene, Vitamin A
Vitamin C
Omega 3
DHA
Alpha-lipoic acid
L-carnitine
Coenzyme Q
Selenium
Reservatol (found in grape skins and wine)
Sulfur containing amino acids
Iodine
Methylated Folate
Glutamine (eat bone broth)
NAC

How do Antioxidants remove free radicals?

Anti-oxidants actually sacrifice themselves to remove free radicals. The antioxidants bind with the body’s free radicals, making the free radicals safe by taking the charge from them, and then they (the antioxidants) are recruited to protect the cells from oxidative damage.

The outcome of unfettered Oxidative Stress is damage to cells, proteins and DNA. This causes aging, disease, degeneration of tissues, and finally cellular and whole-body death.

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Mitochondria are discussed in antiaging advertising like they are understood by the common man. Even TV discussions and podcasts discuss mitochondria like we are all biology majors, but to most people mitochondria is a word but most people don’t know really what they are. Most people think Mitochondria are “good”, but what are they? Some examples of ads that use the word Mitochondria, reads

“Take these Anti-oxidants every day and you will heal your mitochondria, and live longer…”

“Your mitochondria are sick and need to be treated with BLANK to bring you back to health, just buy….”

In reality, most students of biology and medical doctors are the only people who understand what they are and how they work, what can make them “sick”, and how to make them operate normally within each cell of our body. Simply mitochondria are organelles that take BS and Oxygen and make energy. You can think of it as “breathing for the cell” , by taking blood sugar and O2 and creating energy, CO2 (carbon dioxide) and water H2O. Mitochondria are the tiny determiners of our ability to metabolize food and make the energy the cell needs to do its job effectively.

I bet you never thought anything about the fact that when you breath oxygen it goes into your blood stream on your red blood cells, and delivered to your tissues by diffusion through capillaries and enters the cells within your tissues…but what does it do then to sustain us? That is where Mitochondria come in…as they work as I described in the previous paragraph.

Another important piece of information about the mitochondria is that they are passed from mother to child, which means your metabolism is secondary to the genes only your mother gave you! We call this genetic communicator that tells cells how to function metabolically, mitochondrial DNA!

To locate our mitochondria, we must take a microscope to the human body, and successively dissect her into smaller and smaller parts: A whole human body, divided into organ systems eg. Skin, Gastrointestinal system, then divided into smaller parts called tissues such as muscles and neuro-tissue. Smaller still are the specialized cells that make up the tissues, call cells. Smaller still are the mitochondria that are located within each cell in the body, providing energy to the cell, to make the whole-body work!

Mitochondria are small, oval, sub-cellular “ energy packs” located inside every cell in our bodies. These small oranelles within our cells turn sugar (glucose) from our food, into ATP (energy) and Carbon Dioxide (CO2). They act like miniature lungs, taking in sugar which is made of oxygen and carbon, and returning CO2 as a by-product. Scientists say that mitochondria’s activity is “respiration”! The CO2 passes out of the cell and is excreted by the lungs.

So why do we use Mitochondria as a catchword for a way to sway lay people to buy a product to keep them healthy? It is a way to explain complicated physiology to people who aren’t trained in a particular science like medicine or biology, and a way to sell products. The word mitochondria is associated with sickness and how to get better and it becomes a catch word everyone knows and wants to “fix”.

However, if it is a fad or an advertising method to sell something, knowledge of what mitochondria need to make energy, is a valid pursuit.

In short, your cells need plenty of oxygen, healthy foods, exercise and a clean environment to make energy effectively in your mitochondria.

Because our food sources do not have adequate nutrition for us and our mitochondria, we must eat foods that are particularly packed with nutrients and or add supplements such as resveratrol, Alpha-Lipoic Acid, L-carnitine and omega 3 oils to heal our “sick mitochondria”.

All the while we are trying to “help our mitochondria” with nutritious food and supplements, many of us are inactivating our mitochondria just when we need them most! How you ask? Those of the many people who take statins are inactivating their mitochondria 24-7. That is how a statin works! Statins inactivate mitochondria to decrease the production of cholesterol in the cells. So why are we killing our ability to make energy and to be healthy, just to decrease our chance of getting heart disease later?

Statins are only worth the risk if you have already had a heart attack or are about to have one and have narrowed atherosclerotic arteries. Statins don’t treat anything, but your cholesterol lab values, and only prevent additional buildup of more plaque. Some of my patients think statins are cleaning up the arteries, but they do not do that! The risk for a heart attack includes blocked arteries, inflammation, smoking and a high Homocysteine level and Family history. To clean up blood vessels, Zetia is the atherosclerotic cleaner-upper without the risks of a statin! Zetia leaves your mitochondria alone!

To know if you actually have atherosclerotic plaque, you should have a cardiac calcium scan to see if you do or not! I have high cholesterol, and no plaque (I had one test in 2002, and one in 2019. High cholesterol doesn’t necessarily lead to heart disease, but it does definitely stop your mitochondria from working!

Since the mitochondria are so important to health, we will talk about How mitochondria can get sick and cause us to be sick in many ways throughout our body.

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One of my patients asked me why I was putting her on Metformin if she wasn’t really diabetic yet, another woman I was consulting on asked why I’d put her on a dangerous drug, and another patient with Fatty Liver refused to take Metformin because it is for Diabetes and not for Fatty Liver! These patients made it clear that I had to create a Healthcast and blog about the miracle drug, Metformin.

Metformin has been around since 1994 while early in my private practice. Metformin quickly became the first line therapy for type 2 diabetics. was the first line of treatment for type 2 diabetics. In that 40 years using Metformin for diabetes has opened a whole range of other diseases and conditions that Metformin can be used for, such as:

Reducing risk of Cancer recurrence, all cancers
Weight loss
Lowering triglycerides
Treating insulin resistance
Treating Prediabetes
Mood Disorders, Psychiatric problems
Decreases NAFL from becoming Liver cancer
Polycystic ovarian Disease
Infertility
Aging and the symptoms of aging
People on Metformin have a lower rate of mortality

How does Metformin work?

Metformin exerts its hypoglycemic effects by:

decreasing glucose production from the liver
increasing insulin receptors’ sensitivity in various body tissues
increasing secretion of growth differentiating factor, which reduces appetite and calorie intake.

When I find a patient with signs of Diabetes, a high HBA1C, and or an elevated fasting Insulin level (above 10), or consistently elevated FBS I prescribe Metformin for patients who don’t have AODM yet, but who will progress to it if they are not treated and learn to eat low glycemic foods, and to exercise. Generally, the patients that I label with Metabolic Syndrome, revert to normal and don’t proceed to AODM.

I also use this drug for weight loss because most weight gain in women after 40 is because they have become menopausal and have a loss of testosterone which causes them to gain weight and become insulin resistant. Metformin, Diet and Exercise all work together to reverse the process and decrease a woman’s chance of getting AODM.

What medical Diseases and Problems Do I use Metformin for?

Other patients who may or may not have IR, but who have elevated liver enzymes from Non-Alcoholic Fatty Liver Disease (NAFL) are placed on Metformin to reverse this problem as well. I have seen many patients who thought they were doomed to having fatty liver and possibly developing Liver Cancer, become healthy, lose weight and normalize their previous Fatty Liver.

High Triglycerides (TGs) are generally from too many simple carbs over time and increase as insulin resistance gets worse with aging and length of time eating the wrong diet. Diet and exercise are necessary to drive the TG down to normal, but patients rarely stick to these lifestyle measures unless they see a visible change in their body composition. Metformin can make that possible and be the factor that leads patients to a healthier lifestyle.

“Cancer Loves Sugar” so I try to explain that the 2 largest factors in recurrence of a cancer or even getting any cancer are obesity and dysregulation of blood sugar with insulin resistance. Both can be transformed by diet exercise and metformin! You can literally decrease your cancer risk by losing weight and not eating simple carbohydrates.

Elevated Prolactin levels that are not in the tumor range are lowered in both men and women with Metformin.

The article in the latest Psychiatry Today shows a use for Metformin for mood disorders.

Psychiatrists use metformin ER to decrease the weight gain often caused by anti-psychotics. They also find that metformin increases repair in the brain and activates the brain to increase Motivation, cognition, and dopamine. This is a benefit for patients who may be on antipsychotics for life and need help with the side effects.

Countering Inflammation that causes osteoporosis, degenerative brain diseases, frailty and arthritis.

Antiaging is stimulated by Metformin..how does it work?

Improving nutrient sensing

Enhancing autophagy

Enhancing intracellular communications

Protecting against macromolecular damage

Delaying stem cell aging

Modulating mitochondrial function

Regulating gene transcription

Lowering telomere attrition

How Do I prescribe Metformin?

There are two types of Metformin, the short acting form of metformin which is made to be taken with each meal to manage BS after eating for diabetics only, and the long-acting type of Metformin, which is called Metformin ER or XR, and this is the type I use for every other problem including IR, and Prediabetes. The long-acting form must be taken with a meal, or it simply will not work! Generally, the dose is started with on 500 XR tablet with the largest meal of the day, then increasing each week to the max of 4 x 500XR tablets per day if needed. I write smaller doses for less severe dysregulations, and larger for severe IR, Obesity, and higher weight individuals.

Don’t take Metformin plain for the conditions above unless you have Diabetes and need help lowering your blood sugar. For patients who are on either form of Metformin for long periods of time, Methyl B12 should be prescribed as

Why are we all not on this drug?

The FDA works slowly and even though many of these attributes of Metformin are known in the medical community, doctors tend not to use a drug that is not approved by the FDA…even though medical studies have proved its benefit! For those of us who know that the FDA may never look at this drug for any other uses, and that our patients need it now for reasons other than metabolic syndrome, we forge ahead and use it off label for the reasons above!

Ask your doctor about this inexpensive medication that can do you so much good!

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At BioBalance Health our primary goal for our aging patients is to reverse the process of aging and treat their symptoms and body composition changes that come with loss of Testosterone in women and men. We also have a secondary goal to make our patients healthy for a lifetime and prevent the many diseases of aging!

The diseases of aging are also started when Testosterone is deficient, years before we actually are diagnosed with one of the diseases we associate with aging. I am listing the diseases of aging below so you can decide if you already have one of them or if your family history put you at risk for them. We treat preemptively for these diseases if we see any sign of them and often can prevent them, stop their progress or decrease the symptoms of these diseases.

If you have one or more of the Diseases of Aging or they run in your family:

Adult Onset Diabetes (Type 2 Diabetes)
Vascular Disease
High lipids
Heart Disease
Autoimmune disease after 40
Obesity
Insulin Resistance
Chronic fatigue
Hypothyroidism
High Cortisol
Obesity
Osteoporosis

then BioBalance Health® can bring you back to health and prevent the diseases and symptoms of aging for you! Please go to our website to fill out our forms and we will call you to make an appointment! BioBalancehealth.com.

If you have noticed that you look old in the mirror and have:

Sagging facial jowls
Large and deep eye circles
Sagging lids
Poor facial skin tone, and large pores
Sagging body skin and loss of muscle mass and strength
Crepey skin
Loss of facial cheeks
Deep parenthesis around your mouth
Smokers lines above your upper lip
Full face or body sagging
Urine loss –stress or intermittent urine loss
Loss of eyebrows, causing lack of facial definition
Facial hair and acne
Unwanted hair anywhere
Brown spots
Deep facial wrinkles
And more……

Then make an appointment at BBH BBSkin® to have a consultation, develop a treatment plan just for you and take care of the visible signs of aging skin .

Our weight Loss program can be combined with the BBH treatment and BBS beautifying skin treatments.

We provide diet and exercise treatment plans, and then make them, more effective by adding Testosterone pellet therapy i(f indicated), and or medications like Ozempic, Rybelus, Appetite suppressants, Metformin and oteher cutting edge weight loss meds and individualize your treatment plan, while we follow your progress with our INBody Body composition scale. We also offer Lipo-plus and HydroxyB12 shots in our office for our pellet, weight loss and esthetic patients. Sometimes we incorporate peptide treatment and supplements to assist the rest of our diet program.

Some people are more difficult than others to start weight loss…but as you heard from our patient who sent a letter to Dave and Trish.

If this sounds like what you need and you are in the area of Kansas City or Saint louis where our offices are located, then go to our website and hit the button New Patients and change the course of the second half of your life!

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BioBalance Health LLC turns 20 this year! We have been changing the lives of our patients for two decades. Every day I get amazing positive feedback, that makes me KNOW that I have found a unique answer to aging and a health program to treat all the symptoms of aging and prevent the diseases of aging with replacement of one hormone, TESTOSTERONE! We offer Replacement of bio-identical pellet Testosterone for men and women, and estradiol pellets for women combined with treatment of all other hormone deficiencies, and preventive treatment and lifestyle changes. We also have a very effective Medical Weight loss program that is very effective using multiple methods of weight loss and the newest weight loss medications tailored to your individual challenges. We even follow your weight loss with an advanced body composition scale. Our third avenue to fight aging is our medical spa, BioBalance Skin®, that fights aging and makes our patients look as good as they feel.

I created BioBalance Health LLC to be the ultimate medical practice to treat patients over 40, to treat the symptoms and diseases of aging. BBH practices medicine the way it was meant to be –individualized for your specific issues—with the goals of bringing women and men back to robust health, physically, sexually, mentally and esthetically. BBH is my dream medical practice both for our patients and our medical and esthetic staff.

My patients are amazed at their progress and ecstatic about how they feel, in contrast to the debilitated feeling they had before coming to us. Bio-identical Testosterone pellet treatment is the foundation of our Anti-aging treatment plans. Our goal is to bring you back to quality of life, with a great sex drive and a younger body and mind. I get a lot of positive feedback in the office from our patients who tell me the following things:

“You saved my life!”

“You saved my marriage! We love each other again and have recovered the sex lives we had in our 30s”

“I have Rheumatoid Arthritis and have been limited by pain to sitting in a chair all day long. After my first Testosterone and Estradiol pellets, I painted the whole inside of my house”

“My insomnia was severe and affected every area of my life but with testosterone pellets I sleep through the night and wake up refreshed. My medical problems have all improved.”

“I had ED and was treated elsewhere with Viagra and Cialis which improved my physical problem, but it didn’t help my lack of desire. With BioBalance I got testosterone pellets and treated my prediabetes, atherosclerosis and I am healthier, and I have a sex drive and no ED!”

“I am 68 and I feel like I am 35 again! Everyone asks me what I have done to look so good, and I just say BioBalance!”

BioBalance Health is known for offering their new and follow up patient’s hour-long consultations with a doctor to review all of a patient’s health history, lifestyle and lab results finishing with an individualized treatment plan.

Recently I was forwarded a letter from Dave Glover and Trish Gazall our key advertising voices in the Midwest on AM 1120, FM 97.1 They both have been treated for the symptoms and diseases of aging and weight loss with much success and this letter was sent to them, about BioBalance Health®. The letter- author wants to remain anonymous.

Shortened. Letter to Dave Glover

Dear Dave and Trish,

I want to give a shout-out to BioBalance Health. BioBalance has made such a difference in my health!

I remember about 10-14 years ago when you (Dave) had Crane Durham on your show, and he essentially said people are fat because they are lazy. At the time, I had been exercising regularly, with little to show for it. I had polycystic ovarian syndrome and had both of my thyroids removed, due to thyroid cancer. It was really demoralizing to know that people would make assumptions about my character and work ethic based on how I looked, without knowing anything about my medical struggles.

At any rate, I eventually resigned myself to the fact that my body was destined to be fat and there was nothing I could do about it. Exercise wasn’t helping and diets worked only if they were extreme and only for so long, so I finally gave up trying to fight it.

Over the years, I listened to your advertisements for BioBalance Health and didn’t give it much thought. But for some reason, I decided to give BioBalance a try in the summer of 2020.

I was amazed at how thorough their medical intake and blood testing was! They asked me about everything — even a foul ball hitting my head at a Cardinals game was of interest to Dr. Sullivan and I had never given the incident a second thought. Dr. Sullivan determined that medications I was being prescribed for my thyroid replacement by my Primary Care Doc was not adequate. She also diagnosed me with a metabolic syndrome. After struggling all those years, it was a relief to know that there really was a biological element behind my weight gain.

For a while, I didn’t really notice much of a change …… But Dr. Sullivan kept testing and kept tweaking my treatments. Jodie Tankersley convinced me to stick with it, and Lo and behold, we finally found the right medications for me and I began losing weight! I have lost 9.1% of my body fat and am down 35.5 pounds! (All of this was WITHOUT any significant change in diet or exercise. Don’t get me wrong – they have advised dietary changes and I SHOULD be following them. But I wanted to test if it really was about body chemistry and medication.) I still have some way to go before I get back to my pre-child-bearing weight. But I am so encouraged and motivated now that diet and exercise will just help me go further.

I don’t think it is hyperbole to say BioBalance has been life-changing for me. Dave, I am often skeptical of your pitches because you tend to over-sell. But, in this case, I don’t think you can say enough. I honestly thought this was going to be another dead end in my struggles and I am so grateful to be wrong. Please continue to encourage your listeners to try BioBalance – even if nothing else has ever worked.

BioBalance is the real thing. If you have the symptoms of aging, we can reverse the process and bring you back to health!

If you have experienced three or more of these symptoms, you may have Testosterone Deficiency Syndrome. But take heart – there is hope! You don’t have to live like this any longer.

Loss of libido
Anorgasmia or difficult orgasms
ED
Can’t Sleep
Fatigue
Hair loss
Anxiety starting after the age of 40
Depression starting after the age of 40
Memory loss
Weight gain
Stubborn Belly Fat
Loss of balance
Hot flashes
No motivation
Muscle tone loss
Loss of muscle mass and strength
Arthritis
Stamina decrease
Sagging skin

I ask my patients whether they have these symptoms anymore at the second consultation and I generally get a “no’ to each one. If they are not all cured, then I develop a treatment plan that will adjust the dose of pellets or one of the other treatments I started at the first visit and inevitably all the symptoms are gone on the second or third pellet visit.

Review of lab and patient’s initial symptoms is done in the first 2 visits and yearly to make sure our treatment plan is making an individual patient all better!

Next week we will review the diseases of aging that BBH treats or prevents by using the foundation of testosterone and estradiol hormone replacement. We will talk about prevention of diseases that occur with aging and treatment of the disease of aging with hormones and lifestyle changes. Our goal is to make our patients healthier no matter how old they are and to improve their quality of life. It is a lofty goal but one that we have been successful to achieve in thousands of patients over the last 20 years.

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Women always ask about my goal for their blood level of free Testosterone after insertion of testosterone pellets. That is a good question, and it is not easily answered. When I was trained by Dr Gino Tutera in 2002, and he taught me that the optimal range for Free T in women who take T pellets to be over 15 pg/ml. He taught me that each woman is an individual and the blood level that they need is specific to their metabolism and genetics. To determine the perfect level of T free for an individual we should follow the resolution of her symptoms after her T pellets are inserted. Today we will talk about the research done by Dr Rebecca Glaser, published in Maturitis 74(2013) that confirms my practice of adjusting the dose of pellets based primarily on the resolution of Low T symptoms. Prescribing pellet Testosterone for woman is not easy and her doctor must find her own ideal blood level.

Testosterone replacement for women has been ignored as an essential hormone replacement for women, and until recently was not considered a major sex hormone in women. Premenopausal women have 15-20 times more testosterone than estradiol circulating in their blood streams. This makes testosterone the most prevalent sex hormone in premenopausal women, yet it is still mislabeled as a strictly male hormone!

After late 30s to mid 40s women develop a deficiency in testosterone and develop a host of symptoms that doctors have sadly called the symptoms of “aging”, when the symptoms are directly related to the lack of free T in a woman’s circulation.

Both pre- and post-menopausal women over 36 may experience the following symptoms of testosterone deficiency:

Sexual dysfunction-lack of libido and loss of orgasmic function
Anxiety, irritability, depression
Physical fatigue
Lack of the feeling of well-being
Poor cognition
Memory loss
Insomnia
Hot flashes
New autoimmune diseases
Arthritis
Weight gain
Muscle loss and physical weakness
Pain
Vaginal Dryness
Irritable Bladder
Migraine headaches
Osteoporosis

One of the reasons that the majority of doctors don’t use T pellets is because it takes intense individual training after residency and time and attention to each patient, her symptoms, and time for multiple adjustments of dose before the maintenance dose is determined. This is something a doctor or nurse must do all the time to be good at it and the doctor must have a complete grasp of endocrinology, nutrition, and gynecology to become good at this type of T hormone treatment.

Once the pellet dose is determined it is the most convenient dosing schedule (once q 4 months, only 3 doctor visits a year) with 100% compliance because the T Pellet dose is given in the office, very rare complications, and an amazingly complete resolution of symptoms, which has not been seen in any other T preparations, bio-identical or not, given with a different delivery system.

With the right doctor or Nurse Practitioner, a knowledge of pharmacology, endocrinology, gynecology and nutrition, this form of T delivery to women brings them back to a more youthful body and mind as well as prevents diseases of old age such as Osteoporosis, Heart disease, Sexual Dysfunction, mood disorders and autoimmune diseases to name a few.

In the research paper by Dr Rebecca Glaser: Testosterone implants in women: Maturitis 2013 Dr Glaser explains that there are many problems secondary to following blood levels to determine dosage, and explains why following symptom resolution is the preferred way to provide this type of Testosterone replacement:

Specifically,

Blood tests of free T are rarely repeatable and often wrong—it is not a good, repeatable blood test. The only thing less reliable is saliva testing which I don’t recommend.
No single blood test represents the true daily blood level of free T in pellet patients. How fast your body uses the available T up, varies by number of hours or sleep, stress level, estradiol and estrone levels and amount of exercise engaged in per day.
Fat metabolic activity: T pellets are inserted into fat in the hip and as we are now discovering, the ability of fat to dissolve a steroid hormone placed in fat is individual and determines how quickly the pellet is dissolved and needs to be re-dosed. There is no test for this, so trial and error is needed using different dosage to determine ongoing maintenance dose.
ARs (Androgen receptors) are distributed throughout the body and the number of Ars plus the “stickiness” of the receptors for free-Testosterone in the blood, is determined both by genetic makeup and age. ARs of people with dominant genetics from the northern latitudes, are relatively resistant to binding, and these receptors must have a higher blood level to respond at an optimal level. Women who have their dominant genetics closer to the equator, require less free T to achieve optimal symptom relief. The genes are not specifically discovered as of yet, it is impossible to test a patient to see if they have strong or weak receptors. This discovery is found through trial and error. Age also causes a loss of the # of receptor sites, therefore more T mgs are needed in the pellets.
Estrogen interferes with the free T level from a particular dose: Binding to SHBG decreases the active form of T (T free) per dose of T pellet. The amount of estradiol and estrone a woman has been given or makes, decreases the amount of active T free. The lower the Estrogen levels, the lower the SHBG and the more T free is available.
Cortisol Binding Globulin goes up when Cortisol increases secondary to life stress, surgeries and illness. This binding globulin inactivates the testosterone and decreases the percentage of active T.
Speed of a woman’s Liver metabolism is increased by multiple drugs that go through the P450 system, alcohol intake, fatty food intake, and amount of environmental chemicals that act like estrogens. One patient’s liver metabolism of T through the P450 system is individual and is not the same for another woman of the same age, weight, etc. The speed of breakdown of T determines how fast the T pellet is used up.

There are several other dosing issues that are addressed after the first pellet insertion in preparation for the second insertion. Most important is whether their symptoms are completely gone. If they are, we leave the dose the same, if not they usually need more T dose, or they are converting T into E1 and E2 which binds the T free and lowers the effect. For this we exchange one of the T100 mg pellets with one TA 90/10 pellets, which blocks the conversion, and releases the T free and stops increasing the E1 and E2.

There is a small percentage of women of women who do not tolerate TA pellets. They feel like they have no sex drive and don’t feel their T free as they should….it is an opposite reaction, because in everyone else the T free is higher, they feel more sex drive and lose belly fat. If the “opposite” patients still need to lose belly fat and lower their T-free, DIM, zinc, and Calcium D glucarate can be used to lower the Estrogen in the circulation.

I agree with Dr Rebecca Glaser MD, who states that dosage should be guided by safety, tolerability and clinical response, rather than a random T or T free levels, yet I always draw blood levels to find out if a woman’s ideal blood level specific to her has been reached, and if it is repeatable.

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At a get together of friends, I was pulled aside by a good friend who asked me how she could prevent dementia, because the mother she loves is in a memory care facility and she never wants that to be her future! My answer was brief, but I can now think of so many other things I could have recommended for her, and I thought I would share them with you, and I will give her a copy of the blog that goes along with these suggestions.

I read research every day that tells doctors what causes dementia and increases risk of getting dementia at the middle or latter part of life. When I get to the basis of all the findings in the medical articles, it is detailed as I will discuss, But the basic qualities and problems to treat include INFLAMMATION, ATHEROSCLEROTIC VASCULAR DISEASE, OBESITY, HIGH SUGAR DIET, HIGH BP SMOKING AND ALCOHOL AND POOR DIET.

Risk of Dementia Includes the following categories of Modifiable Risk factors:

Low Testosterone and estradiol

Chronic inflammation
Obesity
Diabetes
High BP
Depression
Cigarette/cigar smoking
Hearing loss
Binge Drinking and excessive alcohol intake
Sedentary lifestyle
Lack of sunlight
High carb diet—sodas, sugar
Aging= low sex hormones, poor production of nitric oxide and poor absorption of oral vitamin Bs
Chronic injuries and pain that cause chronic inflammation—get that knee or shoulder fixed!
Chronic heart disease---arrythmia, atherosclerotic heart disease

Foods to Eat Prevent Dementia

Eggs in moderation
Cumin
Anything with protein
Yogurt and other foods (Kambucho) with probiotics and lactobacciluus
Clean fresh foods
Meats and fish that are fresh or frozen, not preserved, or processed
Steamed or fresh vegetables (not canned or processed)
Seeds and nuts (raw and roasted without salt preferable)

Foods to avoid to prevent dementia: Inflammatory foods and soy products

Milk, especially cow’s milk. (High carb content) especially skin milk!
Soy
All phytoestrogens
Wheat
Food with preservatives (all processed foods have preservatives)

Modifiable risk factors

Replace hormones that are missing with bio-identical hormones, non-oral delivery system

Estradiol pellets, patches, gels, for women
Progesterone for women who miss it or who have a uterus
Testosterone pellets, creams, gels
Thyroid replacement. Armour Thyroid for women and levothyroxine for men
Neurotransmitters by taking probiotics

Suppress LH and FSH –high levels increase risk of dementia and osteoporosis (new study)

Take estradiol and testosterone for women—enough to suppress FSH and LH to pre-menopausal levels
Replace Testosterone for men

Keep Blood Sugar Normal

Eat a low sugar and low carb diet—
Treat prediabetes with meds
Treat diabetes with meds
Decease alcohol; intake to 1 4 oz glass of wine a day and < 1.5 oz of alcohol/day
Get to ideal weight

Achieve Ideal Weight –Obesity and Overweight Increases Inflammation That Increases Dementia, so Decrease Inflammation

Eat properly--Eat your base caloric intake or less daily
Low carb diet
Eat ½ X -1 X your body weight in protein daily
Drink clear water equivalent to your weight in ounces (you weight 130—drink 130 oz of water a day)
No Soda
No alcohol until you achieve ideal weight
No desserts or baked goods, rice, wheat products until achieve id3al weight
Supplements—see below

Exercise Daily

Aerobic exercise--for > 40 minutes a day
Weight training 3-4 times a week

Red Light Therapy especially in the evenings—activate your mitochondria!

Directed toward skin for 20 minutes a day
Specific red-light therapy –to face or area of pain

Natural light in AM

Step outside at sunrise or early morning for 15-30 minutes—no sunglasses

Sleep

in a dark room with quiet at least 7 hours a night
OK to take melatonin at bedtime to sleep

Supplements -Take a multi vitamin every day like Thorne daily Nutrients 2/day +

Antioxidants: Vitamins C, A, and E
Vitamin D3
Vitamin Bs—Methyl B12, Methyl Folate oral or injections
Anti-inflammatory supplements:

Aspirin 81 mg/day

Milk thistle

Curcumin

Omega 3 and 6 oils

DHA

NAC

DIM

Arteriorisol

Minerals:
- Zinc 30-60/day
- Magnesium 300-600/day
- Electrolytes: especially in summer during exercise NUUN supplement\
Increase Nitric oxide and keep BP less than 140/90
- Neo 40
- RX Cialis daily 2.5- 5 mg/day
- Eat beets—lots of them

Non-modifiable risk factors:

Race (Am Indians and Blacks have a higher risk)
Early age of menopause (without hormone replacement)
Genetics: HLA-DR15 tissue type, APO-E ¾. And 4/4
Less than high school education

Just a word about genetics. We now know that even if you carry genes for dementia, you can modify your genetics…there is hope! This new concept is called epigenetics, and it shows that the factors we employ above can put certain dementia genes “to sleep” and activate other genes that are going to make you healthier! We are no longer a puppet of our genes!

Genetic Risk for late-onset Alzheimer’s disease (LOAD), the most prevalent dementia, is partially driven by genetics. To identify LOAD risk loci, we performed a large genome-wide association meta-analysis of clinically diagnosed LOAD (94,437 individuals). We confirm 20 previous LOAD risk loci and identify five new genome-wide loci (IQCK, ACE, ADAM10, ADAMTS1, and WWOX), two of which (ADAM10, ACE) were identified in a recent genome-wide association (GWAS)-by-familial-proxy of Alzheimer’s or dementia. Fine-mapping of the human leukocyte antigen (HLA) region confirms the neurological and immune-mediated disease haplotype HLA-DR15 as a risk factor for LOAD. Pathway analysis implicates immunity, lipid metabolism, tau binding proteins, and amyloid precursor protein (APP) metabolism, showing that genetic variants affecting APP and Aβ processing are associated not only with early-onset autosomal dominant Alzheimer’s disease but also with LOAD. Analyses of risk genes and pathways show enrichment for rare variants (P = 1.32 × 10−7), indicating that additional rare variants remain to be identified. We also identify important genetic correlations between LOAD and traits such as family history of dementia and education.

If you’re a doc you probably understood this abstract from a recent article ..if not.. disregard.

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BioBalance Health® has always been on the cutting edge of the newest medical methodology available. In the fight against cancer, we are now using he newest genetic methodology to find cancers early, when they are treatable. Throughout my almost 40 years of practicing medicine, I have believed that medicine should embrace preventive care and be based on the belief that we should only react to a disease that is already established. Now we finally have one test that screens for 72% of the cancers that we can’t screen for. It is hard to believe that out of the 55 types of cancer we can only screen for 5 Cancers! Medicine has only developed 5 screening tests that are currently in use to find cancers early.

Galleri is one simple blood test that screens for 50 types of cancer, to find them at early treatable stages, before they create symptoms, metastasize, or produce any symptoms. Galleri was created for those patients who have a positive family history of cancer, or those patients who are fearful of getting cancer of any type, and for those patients who have been successfully treated for cancer who want to find out early, if they have a recurrence!

Galleri It is the dream child of a company who has been testing and retesting it with the finest geneticists in the US. We are offering this test through our office as an option for those who need it to truly practice preventive medicine! With Galleri, you have a good chance of being cured of cancer through very early detection!

Before Galleri® was invented patients only had 5 cancers that could be detected early by screening tests. The following list enumerates the 5 cancers we have screening tests for.

Breast cancer: Mammography can find cancer after it has been growing for 11 years.
Cervical Cancer: Pap and HPV Test only finds the virus and possibly the cells that might be cancer.
Colorectal Cancer, Colon Cancer: Colonoscopy and stool tests
Lung Cancer: Low Dose C-T Scan
Prostate Cancer: PSA Test

Routine screening tests are recommended because they have been proven to save lives by detecting some cancers earlier.3 The Galleri test does not preclude the use of the 5 screening tests that are currently in use, however there are more than 50 cancers that Galleri® can test for, and you receive your results in 10 working days.

It is time to look at cancer more broadly, in addition to the 5 cancers that are routinely screened for today.

The most important cancer is the one that you or your loved one may have — and curing cancer starts with knowing you have it!

If cancer runs in your family, and you lose sleep worrying about it you should take the Galleri® Test. If your genetic relatives (father mother, aunt or uncle, sisters or brothers or children have had cancer then testing yourself for cancer with Galleri® will answer the question as to whether you have it or not.

Our patients at BioBalance Health® are offered this test yearly for high-risk patients and as needed, often less often than yearly. The test is not covered by insurance as it is a new test…but can you wait until it is covered? Worrying about cancer can make you literally sick by stimulating your adrenal gland’s production of cortisol. This worry impairs your immune system that protects you from cancer, putting you at higher risk!

The only risk of Galleri® is the cost…$ 1,250 paid directly to the Galleri® company at the time of your blood draw.

50 Types of cancer detected by Galleri®

The Galleri test is a multicancer early detection test that detects a common cancer signal across more than 50 types of cancer through a simple blood draw.

Adrenal Cortical Carcinoma

Ampulla of Vater

Anus

Appendix, Carcinoma

Bile Ducts, Distal

Bile Ducts, Intrahepatic

Bile Ducts, Perihilar

Bladder, Urinary

Bone

Breast

Cervix

Colon and Rectum

Esophagus and Esophagogastric Junction

Gallbladder

Gastrointestinal Stromal Tumor

Gestational Trophoblastic Neoplasms

Kidney

Larynx

Leukemia

Liver

Lung

Lymphoma (Hodgkin and Non-Hodgkin)

Melanoma of the Skin

Merkel Cell Carcinoma

Mesothelioma, Malignant Pleural

Nasal Cavity and Paranasal Sinuses

Nasopharynx

Neuroendocrine Tumors of the Appendix

Neuroendocrine Tumors of the Colon and Rectum

Neuroendocrine Tumors of the Pancreas

Oral Cavity

Oropharynx (HPV-Mediated, p16+)

Oropharynx (p16-) and Hypopharynx

Ovary, Fallopian Tube and Primary Peritoneum

Pancreas, exocrine

Penis

Plasma Cell Myeloma and Plasma Cell Disorders

Prostate

Small Intestine

Soft Tissue Sarcoma of the Abdomen and Thoracic Visceral Organs

Soft Tissue Sarcoma of the Head and Neck

Soft Tissue Sarcoma of the Retroperitoneum

Soft Tissue Sarcoma of the Trunk and Extremities

Soft Tissue Sarcoma Unusual Histologies and Sites

Stomach

Testis

Ureter, Renal Pelvis

Uterus, Carcinoma and Carcinosarcoma

Uterus, Sarcoma

Vagina

Vulva

The Galleri test is intended to detect a cancer signal and predict cancer signal’s origin to inform diagnostic evaluation.

Cancer cases enrolled in CCGA Study1 were assigned a “cancer type” as defined in the American Joint Committee on Cancer (AJCC) manual (8th edition)2 (For this list of Cancer types detected, some of the names were modified/edited to organize for easy reference). Cancer signals were detected across more than 50 AJCC-cancer types, which supports the potential for the Galleri test to detect a cancer signal over a diverse range of cancers across a wide biologic spectrum.

If you are a Biobalance Health® patient you can ask your Nurse Practitioner to make an appointment to have your blood drawn at our office.

The Galleri Test was created by GRAIL.

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Don’t stop at the headline of a written article or blog about hormones or you who take hormones will unnecessarily feel anxiety all the time. Journalists and bloggers often get you to read an article by first scaring you with a scary title….then reassuring you in the article. This is the first and primary problem with making assumptions about hormone therapy from, including estradiol, testosterone and progesterone.

Research Translated into Lay Language Generalize All Hormones into One Big Group

When reading anything about “Hormone Therapy being dangerous or safe, the author is lumping hundreds of types of hormones into one category and by doing that, dooming hormones to look like a failure, when they are not.

Not all hormones are alike, and the difference between how you take a hormone (oral, pellet, vaginal, etc.) changes the safety and effectiveness. The other factors that change the effectiveness of hormones like estradiol and testosterone include:

Whether they are they are synthetic or bio-identical (made from vegetables to look just like your own hormones)
What type of hormone is it? For example Estrogen has 3 human forms: Estradiol (young women’s estrogen), Estrone (old women’s estrogen from adrenal), and Estriol (pregnancy estrogen)…the type you take matters. Horses have over 17 types of estrogen and none of them are human, but we use pregnant horse urine to make Premarin for humans.
The dose (the amount given). By lowering the dose of any hormone, you can make it ineffective!
The number of times you take it ( 2-3 times a Day, daily, weekly, monthly) determines whether you can keep up with the dosing or not. This determines compliance.
How you take it : oral,. Transdermal, pellet, or intramuscular determines the activity and the effectiveness as well as the side effects of a hormone

All of these factors change the effectiveness of a hormone treatment in humans. Most of the time, the investigator of a medical study uses one type of hormone for his scientific tests, but generalizes the side effects or the effectiveness of that one specific type of hormone, to ALL hormones in that category, eg. Testing Oral Premarin and generalizing it to every type and kind of estrogen on the market.

For instance, Premarin® a synthetic estrogen from Pregnant Horses, was the estrogen used in a study that determined that “estrogen” causes a woman to be at risk for blood clots. This is true of the oral hormone Premarin and many doctors took their patients off all estrogens based on that one study. Much later, years, other types of estrogen were tested for increasing the rate of blood clots and were found NOT to increase the rate of blood clots. After many studies of different delivery systems of estrogen, the final agreement is that all non-oral forms of Estrogen Do NOT cause blood clot formation in women taking them.

That sounds like justice was served, but for the 10-20 years in between the Premarin study and the other studies and the time it takes to get a final agreement of doctors, women were denied all forms of estrogen from their doctors based on this inaccurate interpretation and generalization of one medical study!

For example, if a scientific study stated that all ice cream flavors tasted the same, could I convince you that all ice cream, of all flavors, taste the same? Of course not, because you have experience eating different flavors of ice cream and you know that every flavor of ice cream and even different companies making the same flavor tastes different! That is the biggest clue to doctors reading a study. If the results don’t match their experience, they question it and should follow their experience until more study is done. Some doctors follow blindly the results of studies or follow the ones they WANT to follow because it relieves them of work. That is one factor in causing doctors to stop prescribing estrogen based on the study that said all estrogens caused blood clots, was that of laziness! Hormone therapy requires hours of explanation, which means time in the office and doctors who are overworked found a way out for themselves to shorten their days! Not talking about hormones and stating, “I don’t believe in hormone replacement therapy”, was their mantra and the cause of so many women being untreated with postmenopausal estrogens! If your doctor says that, then flee! Find someone who can take care of you properly.

The doctors aren’t the only ones who create the atmosphere of false information. The medical research community is trying to do with the medications (hormones) called HRT (Hormone replacement therapy) and Testosterone. Researchers are trying to tell us that all hormone treatments are the same with the same side effects and the same qualities, no matter what they are made of (plants vs chemicals) or what hormone is contained in them (horse estrogen with 18 types of horse estrogen, none of which are similar to human estrogen) that the way they are given (oral, transdermal, injection or pellet) matters to the effect that they have on a patient.

The effect the hormone makes, and the metabolic effects are all lumped together by the research community. It’s like saying all Labradors are great hunters. They aren’t, but to do a study you need to make a blanket statement to prove a point. This doesn’t make sense in many areas of study, but it is really misleading in hormone research.

To get to the truth one must use a specific hormone in their tests and to get anyone to read about it they must inaccurately generalize to all hormones! They spend their time writing papers about how “estrogen” (all of them) and “testosterone “(every type, brand, and delivery system) cause side effects and diseases. These grossly overgeneralized conclusions about hormone replacement, leads to false beliefs and fears that cause doctors and patients alike to be afraid of prescribing or taking any of these medications, hormones, that are desperately needed by women to feel and be healthy.

Remember a title about hormones can be misleading! Even studies are often overgeneralized, so their results are alarming for no reason! You have to ask someone who sees many hormone replacement patients what they actually see! Experience is everything when deciding what research is really true!

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Many people don’t get what they need from their doctor’s office appointment in this modern age of 10-minute doctor visits. They complain about it but don’t know how fix the problem.

I would like to challenge you to prepare yourself for your doctor’s visit before your doctor appointment, because it is the only way you can get the treatment you need.

Doctors are smart and the most intensively trained professionals in our society, but they are often not the best communicators. Your success when trying to get the right treatment is half your responsibility and half your doctor’s. Here are a few things you can do to start the office visit for a problem you are having, in a way that helps your doctor come to the right treatment for you.

PATIENT’S ROLE:

DO write down your Chief Complaint (the primary problem you are seeking a solution to) and bring it with you. Think about it before your go to the office, or while you’re in the waiting room.

Then write down your symptoms in a list. These symptoms that you have, when they started and how severe they are, become the clues for your doctor to solve the mystery of your medical problem. If your doctor gets distracted, you can hand him the list of symptoms you have written down.

DON’T launch into a long story! Stories are often convoluted and unrelated to what the problem you are seeing him or her for and will confuse the issue for your doctor. The office visit is not long, and you will waste your time talking about what you had for lunch instead of what is bothering you.

Years ago I would accompany my MIL to the doctor and she would tell him everything that occurred since her last visit..what she ate, when she went to bed, trouble with her heating and cooling system…and I could see the doctors eyes glaze over. She never got to the reason she was there, and he doesn’t have ESP, so it took multiple office visits to get to the bottom of a simple problem, so that she could receive treatment. Remember, are there either for a health checkup or for a problem. Tell your doctor what you are there for, in a few sentences.

DO give your doctor any lab or radiology reports from your referring doctor at the beginning of a problem visit with a list of your symptoms so she can read them while you talk and get the clinical facts from them as you tell her what is wrong.

Add any related problems that started at the same time as your primary problem.

Remember, some symptoms that occur at the same time as your primary problem may be related to your medical problem and some may not. It is the doctor’s job to help you decide what is related.

An example is that sometimes a patient in our office will notice hair loss when they are taking testosterone and immediately think it is the T pellets, however there are many other medical conditions that cause hair loss. The many medical problems that are likely to be the cause include low thyroid, lack of protein in the diet, adrenal oversupply of cortisol, stress, autoimmune diseases, and medications. Your Primary problem may not be for the reason you think it is, but these other medical issues need to be evaluated to find the cause.

On the other hand some medical problems happen secondary to a treatment, or a procedure, and infection or a trauma. You should tell your doctor those things that have happened around the time of your problem starting.

My husband had symptoms of a Pulmonary Embolism on January 6th. He got a J&J vaccine on January 3rd. Was that the cause or was the fact that he had a positive covid test the cause? We will probably never know but now doctors have found that the J&J vaccine can cause PEs (pulmonary embolisms) on the second shot, and that is what might have caused his. His cause is figured out in retrospect with new problems that doctors encounter in their practices. Luckily, they treated the problem, and not the cause and he got better over night!

IT is always better to know the cause of illness, but it is not always essential to treatment.

Sometimes doctors cannot give you a definite diagnosis until they put you through the necessary tests to gather more information (clues). It is necessary to go through the testing to prove or disprove a diagnosis, so please be compliant and get the necessary testing for your doctor to put all the pieces together!

BTW if you have had a test to diagnose a problem, then get the test and wait for the follow up appointment to get the results, unless it is an emergency. However, if the doctor said she would follow up by phone or email and you haven’t heard in 7-10 days then call the office to make sure the test reached her and that she will contact you. You can’t believe how many medical records; radiology reports and lab tests don’t reach the doctor in this age of fax and email reports. However, it is better than waiting for the mail to come in like we used to do!

Sometimes, doctors don’t know the answer, or need you to see a specialist to get a particular diagnosis. We can’t know everything, and we don’t guess about a diagnosis. Sometimes a type of doctor is not able to order a certain test because your insurance won’t pay it if she orders it but will pay for it if a specialist orders the same test.

Sometimes in newly diagnosed diseases and rare diseases your doctor won’t know the answer until more research is in!

For instance, Covid is now known to cause hair loss in both men and women, but that was not medically proven for the first year of Covid until we formulated the data from patients all over the world.

If you don’t have your symptoms relieved by a certain treatment, or medication, but the doctor says you are “cured”, tell them that your symptoms aren’t gone, and that you would like to try either a higher dose or another medication or treatment. This should be accepted by the doctor, and they should try to treat your symptoms, not just the lab.

Sometimes symptoms are not from what they treated you for, or is a known side effect of the medicine, or they just haven’t gotten the treatment right for you. They should tell you that. If your doctor is not willing to adjust or change your treatment, try another doctor who will listen to your symptoms.

Doctors can’t know everything and sometimes doctors are not trained on certain areas of medicine, like hormone replacement for men and women, especially testosterone for women. In this case they should send you to someone who does know what they don’t…that’s called a referral.

Summary:

If you do your thinking and writing your symptoms and have a clear idea of how you would like the office visit with your doctor to turn out, then your doctor should listen, diagnose and treat, test you further, or refer you to another doctor to treat your special condition.

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The list of the factors that bind T so you can’t use it and those that produce estrogens block free testosterone in both men and women of all ages. The list of lifestyle choices and is much longer than the list of factors you can use to stimulate testosterone.

Soy in many foods: It is a fact that foods that are processed have many “fillers” that are invisible to the person eating them. These fillers are often the culprit decreasing naturally produced testosterone levels and available or active T called free T. The biggest problem at the present is the addition of soy to nearly every processed food, even ice cream. Soy is a phytoestrogen. Phyto Estrogens in food (not medical estrogen) act as a female hormone, limiting the effectiveness of testosterone and the production of T.

To avoid soy in everything you eat, you must do two things: 1. Eat basic meals cooked by you or a family member from fresh foods that do not include canned or processed foods, and 2. you have to look at the label and only buy products without soy. Currently there are only 2 brands of ice cream that don’t add soy.

Soy gives men a “Beer Belly” and all other foods with soy will also increase the fat collection in the abdominal area of both sexes.

Soy is the primary proteins of vegans and therefore it is consumed in large volume therefore has more of an effect on lowering free T and T levels.

Eating out of and microwaving in plastic containers (even drinking water out of plastic) causes our bodies to absorb the plastic chemical’s estrogen. This does us no good and is a contaminant and toxin that we store in our body fat. It is the biggest enemy of T. It is everywhere and is considered the leading cause of lowering the average T level of men aged 15-40. It is everywhere so stop cooking in it and drinking from it when you can! Don’t eat out of plastic bags, or microwave plastic containers, or plastic bags with food in it.
Diabetes should be treated, and blood levels of sugar should be kept in control as low as possible for type 2 diabetes.
Omega 6 fatty acids shrink the testes while the Omega 3 FA increase the activity of the testes
Dairy has inherent estrogen in it and animal feed often contains soy, and that makes the milk and meat higher in estrogen.
Trans Fats—Are in most processed foods.
1. Chips, any snack food that is not dried fruit or nuts
2. Commercial baked goods, such as cakes, cookies, and pies.
3. Microwave popcorn.
4. Frozen pizza.
5. Refrigerated dough, such as biscuits and rolls.
6. Fried foods, including french fries, doughnuts, and fried chicken.
7. Nondairy coffee creamer.
8. Stick margarine.
Alcohol is a toxin and slows fat loss, damages the liver, and increases estrogen production in the liver, which inactivates testosterone.
Obesity is dangerous to us in so many ways. The mere fact of being obese increases our risk for multiple diseases, but fat also converts testosterone in to estrone and estradiol in both men and women. The fatter a person is the less free testosterone he or she has.
Being a Couch Potatoe. being inactive, is deadly for testosterone production and free Testosterone. Inactivity increases fat production and estrogen production. Moderate exercise every day is the answer!
Over activity causes an increase in SHBG which binds testosterone. Marathoners and professional athletes run the risk of binding their good total testosterone so that it is not free to bind to Testosterone receptors.
Fasting can cause increase in free testosterone by increasing SHBG. Humans were built to eat small amounts often, and eating one meal a day increases SHBG, that inactivates free T.
Licorice root (in black licorice), Ashwaghanda and all mint family herbs even basil decrease active Testosterone blood levels.
Phytoestrogens are in many women’s natural supplements that are touted to decrease hot flashes. They only provide minimal relief, but also increase fat gain and estrone levels that cause inactivity of testosterone.
Medications can lower the testosterone levels in both men and women

Oral contraceptives increase estrone so much that they inactivate testosterone and suppress FSH and LH that stimulated the production of T from the ovary.

Oral menopausal ERT and HRT binds up T and causes decrease of all of the benefits of T from replacement and natural T production however minimal after menopause.

Finasteride and Dutasteride given to prevent hair loss or prostate enlargement

causes a decrease of DHT to a point where sex drive, erectile function and muscle mass are impaired.

Arimidex can cause an increase in testicular production of T, but in a small production of men and women it can inactivate the receptors for DHT and T.

As the research about testosterone progress, we will find more and more lifestyle issues that decrease T total and T free levels that can interfere with normal production of T and free T in both men and women. As these are studied researched, we will update you on the issues you can base your lifestyle and medical treatments on.

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What are the factors that stimulate or inhibit your own Testosterone (T) production?

There are foods, supplements and activities that stimulate testosterone production,

Just as there are foods, supplements and activities that lower your internal T production. Today I would like to address the factors that increase the production of testosterone in both men and women.

However, there are limitations on these nonmedical pathways to a higher testosterone level:

One is your age. If you are a woman and menopausal then there are no foods or lifestyle changes that will stimulate your ovary to come back to life and make testosterone. Women have a finite lifespan for their production of estradiol and testosterone, and it ends at menopause. Estrogens can be made in the fat and the adrenal but pure testosterone is only made in the ovary, and when the ovaries “die” that’s the end of testosterone production.
Men make testosterone throughout their lives, but their testes become resistant to stimulation around age 55, but they can become resistant as early as age 40, and then nothing other than T replacement will increase testosterone levels.
A person’s body has a genetically driven sensitivity to the hormone Testosterone. Your heritage or the origin of your ancestors determine how you will “feel” with a particular blood level of testosterone. This has been studied by looking at the genetics of the T receptor on all the cells of your body. Receptors are more sensitive the closer you get to the equator in the western hemisphere, and the receptors are less sensitive if your ancestors’ origin was closer to the north and south poles than if they were from around the equator. A certain level of testosterone doesn’t have the same effect testosterone on both groups. In other words, those genes from around the equator need less testosterone to get the same effect as those people from extreme high and low latitudes. We are all different and our genes have an effect on our treatment.

If you are a menopausal woman or over 40 then the manipulations of diet and exercise will be less likely to increase your testosterone production.

There are foods and activities that inherently stimulate your internal testosterone production if you are a woman under 40 or a man under 50. After that you generally must replace your T to improve your symptoms of low Testosterone.

Eating fewer fast foods and more of a well-balanced Mediterranean diet with fresh foods can optimize your testosterone production.

High protein diets with grass fed animal foods and plenty of fish will optimize your testosterone production. Cholesterol containing foods provide the necessary building blocks for Testosterone in the body.

Getting to your ideal weight will increase the free Testosterone in your blood stream making you feel your testosterone more.

Getting 7-8 hours of sleep a night will increase the production of T, because T production is stimulated at night when you sleep.

Sleeping in a dark room stimulates the production of Testosterone, Growth hormone (muscle development) and Melatonin (deep sleep).

Daily moderate Exercise (not necessarily running a marathon) will stimulate your production of Testosterone.

Supplements can stimulate production of Testosterone. There are several supplements targeted to stimulate testosterone that contain carnitine, inositol, choline.

Protein in the diet provides the building blocks of muscle and testosterone and allow the activities and foods that stimulate the production of T have something to build with. People with a low protein diet (no eggs, fish, beans, milk products or meat) have a more difficult time making T.

Most combination supplements that are touted on TV to increase your T are herbs and supplements that decrease estrogens like DIM, or supplements that increase your T by providing the hormones that are precursors to T like Pregnenalone and DHEA.

Herb Fenugreek 500 mg increases free T production

Decrease in DHT with the herb Saw Palmetto can decrease the production of DHT and increase free Testosterone, however it is important not to decrease the DHT too much because it is important in sex drive and building muscle.

Ashwagandha decreases cortisol, and cortisol binding protein that inactivates T, therefore it can increase free T. If you are taking T supplementation, then don’t take this supplement because it can cause you to not feel your free T.

Zinc piccolate and Arginine improves prostate function and health, therefore your volume of ejaculate increases, and free testosterone is improved as well

Lastly supplements that increase your erectile function by increasing Nitric Oxide e.g. Neo 40.

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Sexism and bigotry are still alive and well in medicine. I have experienced this often during my 40 years in medicine. Women are considered hysterical to the medical man (and some women) which has been what men think about us since time began. This has passed it’s “sell-by” date, as has the bigotry against people of color, but it is present, and we must somehow get what we need and get around the attitudes of medical personnel.

My best advice is to not act hysterical because the male brain then flips to the thought that we are imagining this medical symptom! But if you cannot help it then have someone with you who can talk like a man---“just the facts”, don’t embellish and don’t give them a long story…they lose interest, and forget why you are there.

Tell the ER Doctors and EMTs”

That you think you or your loved one is having a heart attack
The estimated time you started having these symptoms
If you took an aspirin, then tell them
Have your medical history written on your iPhone app: look up this icon on any iPhone
Have a list on the iPhone app or on a list in your wallet.
Give all this information to your healthcare provider right away.
Answer questions succinctly and quickly…no stories!

We are successful at treating heart attacks and preventing disability and death in older men, but women of all ages and people of color, both sexes, are not being treated optimally, certainly not as well as their older white male counterparts.

“Despite a decline in the number of overall heart attacks, this number is rising among young adults,” Dr. Banco adds. “And young women and young Black adults have poorer outcomes after a heart attack compared to men and white adults.”

Journal of the American Heart Association: symptoms of heart attack

Chest pain, pressure, chest tightness, burning in the chest
Shortness of breath
Left arm pain,
Jaw pain
Upper back pain
Heart burn
Passing out

As doctors, we have been taught that women have different symptoms than men when having a heart attack, AND we have been taught that men have many more heart attacks than women. Only half of that is true. Women have fewer heart attacks when they are compared to young men of the same age, BUT women reach the same rate of heart attacks as men after menopause and if they are not replaced with estrogen. Our female patients at Biobalance Health actually have fewer heart attacks than is normal for their age after menopause because they are replaced with estradiol pellets.

Young adults 18 to 55 years old who come to the emergency room with chest pain may wait longer and get less thorough workups when they’re female or Black, a new study suggests. But they have fewer heart attacks than men and women as they age.

The studies show that the care women receive is biased and are not considered at risk for heart attacks. An expert Gulati say in Everyday health,

“There is implicit bias in how we care for women,” Gulati says. “Women are still not seen to be at risk for heart disease (https://www.everydayhealth.com/heart-disease/). It is still seen as a man's disease, despite the fact that cardiovascular disease remains the leading cause of death in both men and women.”

Delay in treatment should not be discounted. It can mean the difference between life and death and health and disability.

“Time is heart muscle,” Dr. Gulati says. “So, these noted delays and less aggressive care of women have the potential to translate into delays in care, less diagnostic testing, deaths at home for some discharged, and continued worse outcomes after a heart attack in young women — particularly young Black women.”

If you have the symptoms of a heart attack, you should take a baby aspirin (81 mg) and call 911. Time is obviously very important to the heart and lack of oxygen from a heart attack damages the heart muscle and therefore can leave you with a damaged heart that will limit your activity and lifestyle.

No matter who you are, you should tell the EMT that you think you are having a heart attack, and they will go as fast as possible to the hospital and treat you on the way. If you cannot talk then make sure you partner with your partner and make sure you help each other communicate with the EMT and doctors.

Remember you only need to tell them that you think it is a heart attack and that your symptoms are, (choose yours), chest pain or chest pressure, shortness of breath, left arm pain, jaw pain, and or upper back pain.

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Most of you know that when I replace Testosterone hormones for my female patients who lose testosterone as they age. I only used Bioidentical Estradiol and Testosterone in the form of long-lasting subcutaneous pellets. I have limited my practice to only use this type of delivery system because pellets deliver a steady supply of Testosterone, without daily variation in blood levels, and have the fewest side effects of any type of testosterone replacement. However, nothing is perfect, and it is important to know what the side effects of any treatment are. There is no medical care that I know of that does not have associated side effects in a small percentage of patients.

There are several problems that can occasionally occur after pellet insertions. We follow a strict sterile procedure protocol and provide a complete instruction sheet to our patients and verbal instructions on how to take care of the insertion site. Despite all precautions, a few patients have complications associated with their pellet insertion. I will dedicate the accompanying blog to the side effects of the pellet insertion procedure. The side effects can be caused by allergy, infection, as well as not following our instructions. The problems that are possible, but rare:

Expulsion—the pellet comes back out
Allergy
Infection
Seromas: Fluid around the inserted pellets
Reaction to numbing medicines

Remember that the procedure safety is only as good as the operator and choosing your doctor carefully for experience and attention to safety. The more experienced your doctor is in pellet hormones and the more she concentrates on pellet only therapy, the less risk you will have.

For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the Healthcast for #603. This presentation will include the slides and audio explaining the procedure and side effects. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

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Most of you know that when I replace hormones for my female patients, I only use

Bioidentical estradiol and Testosterone in the form of long-lasting subcutaneous pellets.

I only use this type of delivery system because pellets deliver a steady supply of T and have the fewest side effects of any type of testosterone replacement. However, nothing is perfect, and it is important to know what the side effects of any treatment is. There is no medical treatment without any side effects. There is no medical care that I know of that does not create complaints by patients.

There are several problems that occur during the first 4 months after the T pellets are inserted and usually present during the first 4-12 months of treatment. I will dedicate the accompanying Healthcast to later side effects of Testosterone pellets and what we recommend to lessen these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The later side effects include:

Facial Hair and Acne
Androgenic Hair Loss
Voice Lowering
Weight Gain

For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #602. This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

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Most of you know that when I replace hormones for my female patients, I only use bioidentical estradiol and testosterone in the form of long lasting (3-6 months) subcutaneous pellets.

I have limited my practice to this type of delivery system because pellets deliver the most stable dose with the fewest side effects, while supplying a steady supply of testosterone compared to other delivery forms of bioidentical testosterone. However, no medical treatment is perfect for everyone, and it is important to know what the side effects of any treatment is both as a doctor and a patient. There is no medical care that I know of that does not create complaints of some form by patients. Sometimes it is because they have not listened, or not read our literature given them at their appointment. We try to prepare patients for the temporary symptoms of their first Testosterone insertion

There are several problems that occur during the first 4 months after the T pellets are inserted. These side effects are treatable and temporary. and usually present during the first 4 months after the first pellet insertion. I will dedicate the accompanying Healthcast to the early side effects of testosterone pellets and what we recommend lessening these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The immediate side effects of this type of testosterone

Temporary issues in the first 4 months:

Vaginal Itching-not an infection!
Clitoral enlargement!
Hyper-sexuality
Weight Gain=muscle gain

These four complaints compose the most common phone calls we get after treatment with Testosterone pellets, even though we give our patients handouts preparing them for the adaptation changes the female body goes through when readjusting to testosterone blood levels in their bodies. The changes caused by testosterone deficiency occur slowly, so slowly in fact that you may not realize the numbness of the vulva and vagina, the shrinkage of the clitoris and vaginal opening, and lack of libido and muscle mass that accompanies loss of T. It takes several months for reversal of those deficiency symptoms and the adaptation that takes place as everything goes back to the normal you were accustomed to when you were younger, before testosterone became deficient. It is the re-adaptation to testosterone that causes the symptoms during the first 4 months.

For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #601. This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women #600-603.

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Most of you know that when I am replacing hormones for my female patients, I only used Bio-identical estradiol and Testosterone in the form of long-lasting subcutaneous pellets.

I only use this type of delivery system because pellets deliver a steady supply of T and have the fewest side effects of any type of testosterone. However, nothing is perfect, and it is important to know what the side effects of any treatment is. There is no medical treatment without any side effects. There is no medical care that I know of that does not create complaints by patients.

There are several problems that occur during the first month or two after T pellets are inserted, and others that occur after months or years. To be completely candid, I will spend the next Healthcast #601 describing the side effects that occur during the first insertion cycle from Testosterone pellets, and the measures and treatments we use to prevent and treat them.

For a full introduction to this series of 4 lectures, please go to my website biobalancehealth.com and look for the videos which will have the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

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50% of men who receive Testosterone replacement therapy (TRT) have elevated Red Blood cell counts, and high Hemoglobin and Hematocrits. The numbers that are considered normal are usually normal for men at sea level, and an elevated H/H doesn’t necessarily mean that a man will have any negative effects

If you have lung problems, or disease:

For those men who have COPD, Chronic Bronchitis, or asthma, high counts are an adaptation that help you live with a compromised ability to oxygenate your blood. You should not get your blood dumped because the high counts are keeping you alive!

If you live at high altitude or if you spend a large amount of time at high altitudes, then you don’t necessarily need your blood phlebotomized because you need higher counts to live or vacation there. Men who live at high altitude have adapted to a lower oxygen level making more RBCs.

If you are an extreme athlete, or you train excessively you may have high red blood counts to help you collect and distribute oxygen during your exercise. You won’t have to remove blood unless this level remains a year after you stop excessive exercise.

Why are doctors telling us to get phlebotomies (blood dumped) all the time?

The problem with having a diagnosis of Erythrocytosis from TRT is that it is almost always confused with the disease called Polycythemia Vera (PCV). PCV does carry with it a high risk of blood clots, strokes and heart attacks. The two conditions are completely different, but ER doctors and surgeons only know that a high H/H is a sign of PCV, and PVC causes blood clotting…but they don’t know that elevated H/H from TRT or adaptation to a disease doesn’t cause the same medical problems as Polycythemia vera..

One of the ways we can separate the disease of PVC from the condition of Erythrocytosis:

The CBC will show us the difference. PVC his elevated RBCs, H/H, Platelets and WBCs…all of them are elevated. Erythrocytosis only has an elevated RBC, and H/H.

If your doctor gets excited about your elevated blood count, please tell him we have evaluated you for PVC and you don’t have that, so you are not in danger for clotting or CVDx.

Here are the differences between PCV and Erythrocytosis from TFT:

| Polycythemia Vera | Erythrocytosis | | Blood test: high RBC, High H/H and High platelets, High WBC | Blood test: only high H/H and RBC | | Abnormal Platelets, increase clotting | Normal Platelets, no increase clotting | | Genetics: + Jak 2 mutation | Genetics: no mutation | | Cause is genetic requires blood dumping to lower all counts or hydroxyurea meds | Causes: High Altitude, TRT, COPD, Familial cause | | Treatment: requires blood dumping to lower all counts or hydroxyurea meds | Treatment not necessary to keep it below HCT of 50. Some people do better with higher counts especially COPD, High Altitude Living, exercise at high altitude. | | A lot of Research that supports the theory that these patients are at risk for blood clots and coronary artery disease. | No research paper that says high H/H from T causes CVDX, Stroke, or Blood clots. | | Abnormal platelet number and function cause the vascular diseases and clotting | TFT is associated with normal platelet counts and functions. | | Jak 2 increases clotting factors and platelet production, and erythropoietin from the kidneys and increases clotting. | Way it works: T directly stimulated the bone marrow to make more RBCs. No other blood products are elevated |

Remember: It is not T that causes high H/H to require blood dumping, it is the confused medical community that goes crazy when they see high H/H and cry malpractice! In many cases we are dumping blood to appease the primary care doctors. We ideally would like to keep a man’s H/H below 20/55.

Other reasons for elevated H/H:

Do you have COPD, Asthma or chronic bronchitis? Don’t get your blood dumped. The high counts are helping you.
Do you have, or have you had elevated platelet count with your elevated red blood cell count? If you have, please tell your primary or your BioBalance Health Nurse Practitioner you will be evaluated for PCV with a genetic test.
Do you live for part of the year at high elevation? If yes, then it is not necessary to phlebotomize you to get your counts down because you need those RBCs.
Do you eat high iron foods (liver, braunsweiger, pate, bone marrow, Deep green leafy veggies) ? If so of if you are taking iron, you can stop because you shouldn’t need it while taking T, because the bone marrow is stimulated to make more red cells with T.
Do men in your family die of CVDX before age 50? Then you might have PCV! Get an iron panel + a Jak 2 genetic test.

Blood Phlebotomies:

Men over 70, should only have 250 cc removed at one time and told not to exercise for a few days. Blood pressure and blood volume take longer to equilibrate after the age of 70.

Make sure these patients have a lot of water and that they drink it and eat something after the phlebotomy. Remember you just removed blood sugar, dropped their blood pressure, and dehydrated them by removing blood. They may be dizzy, but they have to sit until they are stable.

Blood tests for erythrocytosis/ PCV:

CBC

Iron panel

Ferritin

Jak-2 mutation

Hereditary hemochromatosis

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A doctor must have an ideal, healthy range for any test which they are using to diagnose a patient. Diagnosticians cannot decide whether this ideal level or “reference range” is accurate without a great deal of scientific investigation, so he or she uses what is listed on the lab report which results in misdiagnoses. Blood panels are expensive and should have the information listed with the result that explains what circumstances make the test fall into the healthy and asymptomatic range. This is a problem with most large national labs, and it is leading to great numbers of misdiagnoses. Let me give you some examples of the problem with how labs are reported:

Female Estradiol

Published Lab Reference Range

Postmenopausal: < or = 10 pg/mL

Estradiol is the female estrogen that disappears after menopause. Before menopause the average blood level of E2 is 60-250 pg/dl depending on the pre-or post-ovulation stage of the menstrual cycle. That range of estradiol is healthy for women. Lack of estradiol (which occurs at menopause and creates disabling symptoms) is unhealthy for women and the reference range should show that lack of E2 is “abnormal” and not within reference range.

The lab considers that Estradiol levels are “normal” after the age of 40, if they are <60, and even zero. This implies that women are healthy and without symptoms when they have no estrogen. When a PCP who doesn’t look at hormones every day looks at the ref range without adjusting her interpretation for stage of pre-or post-menopause. They may think that women without estrogen is healthy and without symptoms. Women who have their estradiol replaced after menopause are not symptomatic when they have an Estradiol between 60-250 pg/dl, but they have hot flashes, night sweats, anxiety attacks and painful intercourse if their E2 is less than 60 pg/dl. The blood level of Estradiol less than 60 should be placed in the out-of-range column.

Female FSH Female LH

Published Lab Reference Range Published Lab Reference Range

Postmenopausal: 23.0 – 116.3 mIU/mL Postmenopausal: 10.0 – 54.7 mIU/mL

FSH/LH are 2 pituitary hormones that do not cause symptoms when they are under 23 and 10 respectively. If a woman is premenopausal, or on sufficient estrogen replacement after menopause their FSH and LH are low, and they are asymptomatic. We test FSH and LH hormones to find out if is a patient is menopausal. If her FSH is over 23, and estradiol is under 60 then the patient is menopausal OR they are taking enough Estradiol to suppress their LH and FSH levels to normal (less than 23/10 respectively).

Why do the labs consider very high FSH and LH levels to be “normal” or “in range” even though these elevated hormones cause many symptoms in menopausal women? High LH and FSH are not healthy or normal, but the lab says that anyone over 40 is normal with these extremely high FSH and LH. None of this is reported or mentioned on the lab sheet. The reference range for FSH and LH is listed under “Normal “if the FSH and LH are higher than 23/10, even if the FSH is extremely high and the patient is symptomatic! Recently studies have shown that High LH and High FSH levels themselves cause osteoporosis and dementia. It is now even more important to give a woman enough Estradiol to suppress these 2 hormones.

Female Testosterone Free

Published Lab Reference Range

Postmenopausal: 0.2 – 5.0 pg/mL

Free Testosterone levels for women: Finding a test that can correctly report testosterone levels when they are in the low range, such as female blood levels, is difficult. Testing for accurate female testosterone levels to compare with a reference range, has many problems. For instance, no one really claims to know what the “normal” level of free T is for is for young healthy women. Large scientific studies looking at free T levels in young healthy women are just now commencing.

However even though the test for free T in women doesn’t have a reliable, repeatable blood level based on pre-menopausal healthy women, I still use it for a marker to tell me if a patient’s free testosterone level improved along with the resolution of her symptoms. I was trained to only test for the free T with the normal number for young premenopausal women is > 7 pg/ml.

Male Testosterone Free

Published Lab Reference Range: 35.0 – 155.0 pg/mL

T and free T for men: The reference range for men is very low. The way the lab obtains these numbers for their reference range for testosterone is by using the blood levels of men who come to their lab to get their testosterone drawn. This results in the “reference range” not representing healthy young men, but representing “sick men” of all ages, usually old men, who are having their blood drawn at the lab for other reasons. Testosterone and free T decrease with illness and with age. The way the reference range of T and T-free is skewed to a much lower level than is optimal. With a low range misrepresenting the ideal, men who have low T and free T and are symptomatic and are not treated. The range I use is 400-1500 the average for healthy young men between 20-40 years old. No man feels good with a total T of 234-400, the low end of the range considered normal for men by Quest and Labcorp. This misrepresentation is preventing many men from treatment.

The way they derive their blood range for total T and free T is not scientifically sound, and that affects whether a man is treated or not. Physicians who treat aging men know and should know that testosterone decreases as a man age (after age 40), and becomes symptomatic at age 55, on average. Most men are symptomatic when their free T falls below 129, not below 35.

All testing of blood levels of hormones that decrease with age should be compared to those levels of young healthy people of the same gender. I like to compare hormone tests to the well accepted interpretation of bone density. Bone density decreases with age just like the sex hormones. Because bones decrease in density with age, we compare all women to 29-year-old females who have normal bones. This same scientific method should be used for sex hormones that decrease with age. We should compare sex hormones to the blood levels of healthy young men or women of the same gender.

The faulty basis judging a man’s adequacy of testosterone is also used for evaluating IGF-1 (Growth hormone) and all the sex hormones. It looks like we have a lot of work to do!

Male and Female IGF 1

Published Lab Reference Range: 50 – 317 ng/mL

IGF-1 is age-adjusted on the lab sheet to the age of the patient, not compared to normal healthy patients of the same gender. IGF-1 measures growth hormone which is a hormone that is “normal” before age 40 and declines thereafter. To know if you have low growth hormone a patient should be compared to healthy people who are young, under age 40. An example of why this comparison don’t work for aging patients: the IGF-1 of one 70-year-old compared to another 70-year-old does not tell you if the hormone is less than optimal, or just normal for your age. IGF-1 should be compared to 20–40-year-olds, not the average for your age!

Estrone is an adrenal estrogen. It is normally ½ of the Estradiol level in women before they are 40 and women maintain a ratio with Estradiol (the ovarian estrogen) of E2:E1 of 2:1. The numbers are not significant, the ratio is. This is ignored on lab tests.

Insulin level is dependent on whether the patient is fasting or not. Both labs only list the non-fasting range, even on patients who ARE FASTING. This oversite leads to fewer patients who have insulin resistance being diagnosed and treated, which leads to more patients with AODM.

Example: The range that is on the lab report for both Quest and Labcorp is a non-fasting range (2-24), but the healthy fasting the range is 2-10. (Epocrates). However, the fasting range is not listed on the Lab report even though all of my patients are fasting! This causes me to write in the normal fasting blood level of insulin.

Thyroid Panel is misleading and is not accurate in many cases:

Male and Female T3, Free and T4, Free

T3 - Published Lab Reference Range: 2.3 – 4.2 pg/mL

T4 - Published Lab Reference Range: 0.8 – 1.8 ng/dL

TSH (.45-4.5) is only accurate for patients who are NOT on thyroid medicine. If you are on thyroid medicine, to be accurately replaced your TSH should be less than 1.0 (read the insert of Synthroid, the most widely prescribed thyroid replacement. There is no separate normal for patients on thyroid medication.

For patients NOT on thyroid medicine TSH is not updated for new research. In the last 10 years TSH has a been found to be more accurate with a smaller range of normal, 0.45-2.5. This has not been reflected in the TSH of both labs.

Free T4 levels reported on lab reference ranges have unscientifically been adjusted over the last 15 years without true scientific research. This change is based on obtaining reference ranges from the group of sick people getting their blood drawn at a particular lab, and not a group of young healthy people who don’t have any symptoms of low thyroid. This is a cost saving effort that has devastating effects on women especially who have symptoms of low thyroid, but who do not have a free T4 outside the reference range, so they are not treated. FreeT4 is 0.8-1.8 ng/dl is reported on lab reports as the “new normal”, when the range based on a young healthy group of people is 1-2.5 ng/dl.

We know that the group of people who go to the lab for bloodwork are generally older, sick, and may have thyroid disease. They are not a group of subjects to use to define “normal” or “healthy”. Making this situation worse, thyroid function decreases when a patient is ill, so ranges obtained from this group of patients is not “normal or healthy”. The medical director of Quest has confessed to using these sick patients to obtain their reference ranges for thyroid.

Free T3 levels have lowered over the last 15 years without scientific basis. The same issue occurs with free T3 as with free T4. The range is now 2.3-4.2, pg/ml. and has lowered every few years over the last 15 years. The range that is based on young healthy patients is 3.0-4.5. This affects many patients who are on thyroid medication whose doctors lower their dose if they are between 4.2 and 4.5, and patients are not diagnosed if they fall into the range between 2.3 and 3.0.

This slow, unscientific lowering of the ref range by lab companies based on their sick population has negatively affected many women who need appropriate thyroid replacement and is unscientific.

Conclusion:

The reference ranges listed by the largest labs in the US are unscientifically derived and misleading. It makes it impossible for patients to interpret their own labs appropriately. These inaccurate “normal” referred to as “reference range” also make it impossible for young inexperienced doctors and busy doctors who are quickly going through the labs but not really looking at the changes in the numbers but whether the lab lists the results in the “in range” or, “out of range” columns.

These numbers are expensive to order for patients and doctors and should be reported with accurate “normal” that have the most recent research applied and who use normal healthy young people to derive the “reference ranges”.

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Dr Sullivan and I spend much of our visits with our patients explaining the meaning of each lab test that we order for our patients. We explain what a lab test is meant to evaluate, which lab tests measure their general health or their hormone status or tell us whether they may have side effects from hormone therapy. After our patients go through their lab test results, they realize that self-interpretation is literally impossible. We must also explain why we write in different reference ranges from those of the lab. This blog is meant to help you and our patients understand the problem with the current reference ranges printed on lab tests.

Choice Of Laboratory Companies Is Vital to Getting an Accurate Result!

Lab tests are vital to our treatment of hormone deficiencies and our practice of preventive medicine; however, we always balance our results with our patients’ symptoms when we decide on a treatment plan. We preferentially order tests from Quest labs, but we also receive results from Labcorp, private hospitals and doctor’s offices. We prefer Quest labs because they are the most accurate in terms of reporting reproducible results, which indicates accuracy.

Another competing lab continually change the test we order to another test that is always inaccurate. I have talked to LabCorp’s medical director about this, and he said that the fact that they change the test I order is a problem, but the fact that the results that I get from one Free Testosterone level is drastically different from the other test they offer by a power of 10 did not bother him. His only defense was that the Endocrinologists think this is ok, so I should think its ok. Well Truth is truth and that is an excuse like the dog ate my homework. In addition, LabCorp is currently giving us “wrong” results on the test for Estrone that we must repeat by Quest just to get an accurate, reproducible blood level that matches the symptoms of our patients!

We want our patients to have their lab paid for by their insurance company to save them additional out of pocket expense, so we choose Quest because they have drawing offices all over the country and because they have contracts with all US insurance companies. Quest has also given us a patient discount for patients to self-pay that is many times lower than what they would pay to the lab itself. This is usually for patients who don’t have insurance or who have high deductibles, but anyone can take advantage of it if they don’t want to use their insurance.

Importance Of Lab Results and Reference Ranges Determines Whether a Patient Is Treated!

Once we get lab results and medical history, we decide whether we can help a patient with hormone replacement. If we have inaccurate results OR inaccurate reference ranges, we can’t determine the true health of a patient. So, what is wrong with the reference ranges on current labs.

Tests that don’t account for the gender of the patient, even though there are gender differences found in recent research (e.g. Lipid panel, Thyroid panel), the labs don’t differentiate.
Tests that don’t adjust for whether a patient is taking a medication or not.

Eg Thyroid panel normal are different ranges for patients who are on thyroid replacement.

Gender specific tests that assume that a female patient is cycling monthly even if they are menopausal. Cycling women have a lower Hemoglobin and Hematocrit because they lose blood with periods every month and the “normal” for women is based on cycling, bleeding women. The lab uses this “normal” for menopausal women, women on the pill, and women who have had a hysterectomy too! In these three cases, H/H levels are the same as the level of Hemoglobin, Hematocrit, and ferritin as men! The CBC should be adjusted for the menstrual status of a woman.
Some blood tests should be drawn when a patient is fasting, but reference ranges are not changed for non-fasting patients. The lab company has the fasting status written at the top of the page and should adjust for that factor.
Not using scientific methods of developing a “healthy” blood level: Reference Ranges for thyroid are changed yearly based on the thyroid tests the lab did in the last 12 months of tests. This is not scientific. I have watched the lab tests change yearly for over a decade. I have only recently discovered that the “new” blood levels are obtained from testing the “sick and old population” that comes into the lab for other reasons and get their thyroid tested too. The proper way to develop a scientific healthy range (reference range) for a blood test in general and specifically for thyroid is to test young, healthy people of the same sex who have no symptoms of low or high thyroid disease. The ranges they are using are leading to the misdiagnosis of thousands of women.
Doctors have not changed their testing protocols with new technology. Lab methods have improved, and the results are more accurate, so the reason endocrinologists and PCPs only test TSH levels instead of free T3 and free T4 plus the TSH, has disappeared. Most doctors test only TSH levels like they did in medical school decades ago.
Test result that are average for an older menopausal woman is the basis of the reference range instead of comparing all women to young healthy ranges. This is an example of gender bias. When men’s FSH and LH are outside the normal youthful range, they are considered abnormal! Female FSH and LH levels go up when a woman is deficient in estrogen (menopausal), and symptomatic with hot flashes, anxiety, and sweats. LH and FSH are considered normal when they are very high, even though women are miserable and symptomatic. Reference ranges should indicate young healthy levels when a woman is not symptomatic.

There are so many inaccuracies and adjustments that must be accounted for when a doctor interprets blood tests by just looking down the column of “out of range” results, we must use artificial intelligence to take into account age and compared to young healthy, sex, fasting status, medication status and develop young healthy blood levels for women as the healthy range we are looking for. indicates lack of symptoms and disease.

If total cholesterol, is representative of a dangerous score when it is over 200, then it should not be obtained by adding the good cholesterol plus the bad cholesterol.

Total cholesterol is not equal to risk for heart disease. 50% of men and women with elevated total cholesterol have zero cardiac calcium scores, and 50% of both sexes who have normal cholesterol numbers have high plaque numbers.

I disregard the total cholesterol in women, and only look at the LDL level.

CBC and Ferritin: The gender differences that are adjusted for in the CBC, Hemoglobin and HCT, is misleading for postmenopausal women, and is not corrected for the fact that non menstruating women have the same H/H ref and Ferritin range as men.

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I have always told women who are menopausal that giving Estrogen to them after menopause lower’s their risk of Alzheimer’s, decreases their insulin resistance and helps decrease belly fat. There are many studies that prove that testosterone decreases the risk of Alzheimer’s Disease (AD) and delays the timing of AD by 10 years. This is what I have always told women to reassure them about taking estrogen and testosterone after their ovaries stop making both hormones. It is a simple concept that the practice of medicine has made very complex, however this new research article in Nature 3-2022 by Dr Kamoroff, helps support the practice of replacing the hormones that women lose with menopause, estrogen and testosterone, to prevent the diseases of aging including Osteoporosis and Dementia.

Let me explain the response of the female body to our ovaries shrinking and essentially dying, which is what women’s ovaries do when we become menopausal. The ovaries are the primary source of estradiol (young women’s estrogen) and the only secretor of testosterone in women. Other androgens are produced by the adrenal gland, but they do not provide a woman with the benefits of pure testosterone.

At menopause blood levels of estradiol (E2) decrease to nearly zero. Free T (the active form of T), and estradiol also decreases to less than 60 pg/dl from a pre-menopausal range of 60-250 pg/dl. In response to this radical change in a woman’s chemistry, and very low levels of Estradiol and Testosterone, the pituitary raises the FSH and LH production, the hormones that, previous to menopause stimulated the ovaries to make more E2 and T. After menopause the increasing of FSH and LH continues to increase and cause hot flashes and night sweats. These two hormones are only suppressed by a woman replacing Estrogen and or Testosterone (T). When women get E2 and T, it causes the FSH and LH to “relax” and stop sending out high levels, so hot flashes and night sweats stop. If E and T are not replaced, LH and FSH continue to be elevated and these symptoms can continue for life!

This most recent study by Dr. Kamaroff goes one step farther toward what I already know about ERT (estrogen replacement therapy), and just described. The only way to stop the cause of elevated FSH and LH, and hot flashes and night sweats, is the replacement of estrogen and testosterone. Giving enough estrogen to achieve pre-menopausal blood levels of these two hormones is to give higher doses than the FDA approves of. It is our goal to prevent AD, dementia and Osteoporosis my dosing adequate Estradiol and Testosterone in the form of subcuticular pellets. Low dose estradiol is not the way to be healthy after menopause. Women need adequate hormones to shut down the FSH and LH surges and that is the way to prevent several of the diseases of aging.

Simply, this new study links the elevation of FSH and LH to the onset of dementia, Alzheimer’s Disease and Osteoporosis (thinning of bones) after menopause.

But how does FSH and LH cause dementia and Alzheimer’s disease? This study blames the elevation of FSH and LH for causing inflammation and the accumulation of B amyloid on neurons in the brain is a response to inflammation. This accumulation of plaque causes Alzheimer’s Disease (AD). It seems that the recommendation of the American College of OBGYN gives to doctors to limit the dose and the time ERT and HT are given is counterproductive to the health of women’s brains and bones. The result is that most women are given too little estrogen, and therefore are still at moderate risk for AD and Osteoporosis. When we give compounded E2 and T with pellets, the FSH and LH are suppressed to pre-menopausal levels, and therefore it is the best way to prevent hot flashes but also prevent osteoporosis and AD that can develop without a sufficient amount of estrogen. It is in this way that women without ERT or who have low dose estrogen replacement oral, or patch have a higher risk of the diseases of aging, AD and Osteoporosis than those women who are given an adequate dose that provides pre-menopausal blood levels.

A second study reported at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022, also reported that the longer a woman is without estrogen, the higher her risk of developing heart disease and dementia. This is consistent with the first study I cited, that links high LH and FSH to these diseases of aging. This study looked at women who go through menopause early, before 40, who therefore have more years of high LH and FSH, and a longer period of time associated with inadequate estradiol and testosterone. The earlier women experience menopause the higher the incidence of Dementia by 1.3 times the rate of women who went through menopause at the normal time, after age 40. The healthier aging without disease occurred in women who had more exposure to Estradiol and Testosterone, and less exposure to elevated FSH and LH.

The bottom line for both research studies is that estradiol is one of the keys to healthy aging, pivotal to preventing the devastating diseases of aging like Osteoporosis, Heart Disease, and Dementia. Estradiol is a hormone that should NOT be dosed to achieve a minimal blood level, and when it is replaced after menopause with reasonable doses meant to achieve a normal physiologic blood level , this one hormone brings a woman’s body back to homeostasis and can lead to healthy aging without the diseases of aging.

March 22, 2022

Follicle-Stimulating Hormone's Role in Alzheimer Disease, in Mice

Anthony L. Komaroff, MD, reviewing Xiong J et al. Nature 2022 Mar

Blocking FSH in ovariectomized mice protected against cognitive decline.

The incidence of Alzheimer disease (AD) is particularly high in older women, as are levels of follicle-stimulating hormone (FSH). This observation led investigators to wonder whether blocking the action of FSH might be beneficial. In mouse models of AD, ovariectomy (with its associated sharp rise in FSH level) promptly increases the degree of deposition of both β-amyloid and tau, which are cardinal pathologic features of AD.

Following ovariectomy in mice, the researchers administered a monoclonal antibody that blocked the action of FSH. The antibody reduced deposition of both β-amyloid and tau in the brain and protected against cognitive decline. The mechanism for this effect is that blocking FSH also blocks an enzyme that causes accumulation of both β-amyloid and tau. Further incriminating FSH in AD pathology, deposition of β-amyloid and tau also was reduced by using genetic engineering to knock out receptors for FSH, and deposition was increased by raising levels of FSH. FSH also is produced at low levels in males, and the FSH-blocking antibody also reduced hippocampal and cortical deposition of β-amyloid and tau in males. Experiments showed that two other features of menopause — low estrogen levels and high luteinizing hormone levels — did not explain the AD-like features seen in ovariectomized mice.

COMMENT

Many, but not all, findings in mouse models of AD have been replicated in humans. Blocking FSH also reduced bone loss and visceral fat in mice. Given all these theoretical benefits, one might surmise that trials of FSH blockade in humans will be undertaken.

Study: Early menopause may signal women's dementia risk

A preliminary study to be presented at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022 found that women who experience menopause before they reach 40 years of age may have a 35% increased risk for dementia later in life. The researchers also found that women who entered menopause before they turned 45 years old were 1.3 times more likely to receive an early dementia diagnosis by the time they reach 65 years of age.

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I have been in the Pro-Testosterone after Prostate Cancer Team with Dr. A. Morgentaler ever since I read his book and heard him lecture at AMMG annual meeting 12 years ago. After that I read all of the studies that supported this opinion and now two new studies by Thomas E. Ahlering etal. Department of Urology, Irvine medical Center, Department of Medicine published in BJU International 2020. This study is a game changer in the treatment of Post Prostate Cancer patients and for those worried about getting prostate cancer in the future.

The bottom line is that testosterone replacement in men who have had prostatectomy for prostate cancer is protective and helps prevent recurrence!

For those men who are afraid of getting prostate cancer in the future, keeping your testosterone level at a youthful level is protective to prevent prostate cancer.

“Prostate cancer is the most common non-cutaneous malignancy in men, accounting for ~20% of all cancer diagnoses [1]. Prostate cancer is also notable in that after a radical prostatectomy (RP) men have a predicted average survival of 22 years [2]. “2020 TRT.BCR.BJUI.

Despite the fact that even men with high grade tumors have less than a 50% chance of mortality from prostate cancer, 30-40% of men usually have recurrence of prostate cancer after being treated. When faced with this risk men who have a recurrence must decide between two risky treatments: radiation and estrogen therapy. Both treatments limit the quality of life that these men can achieve.

The belief that testosterone causes prostate cancer was started in 1941with a flawed study of only a few men and has persisted until recently. This “belief” has prevented men from replacing waning testosterone, for fear of occurrence or recurrence of prostate cancer.

In 1996 Dr Morgentaler showed that there is an increased risk of prostate cancer in men with a low Testosterone level. He also proved that administration of T to men who had their prostate cancer treated, would benefit from testosterone replacement therapy.

Ahlering did a study matching men based on their snip genetic status and pathologic stage of their prostate cancer. Patients were compared with those men who did not receive any T replacement.

Those men who had TRT had a much longer recurrence-free time period than those who took nothing. Those men in both groups were similar in terms of severity of recurrence and treatment needed. The difference is quality of life for the men who took T replacement!

The results of the study showed that TRT is not dangerous to men, does not cause prostate cancer and doesn’t increase the risk of recurrence or dying of prostate cancer is even lowered the rate of recurrence by 53% for men with prostate cancer treated with Testosterone. This study also proved that T doesn’t increase heart disease.

Why is T good for men who have survived treatment for PC? T stimulates the thymus to make T-killer cells and T-helper cells which is our defense against cancer, T also decreases insulin resistance, which lowers glucose levels, decreases obesity, therefore lowers blood pressure and inflammation, which lowers heart disease and the occurrence of all types of cancer.

This is the opposite of what we were taught in medical school, and it is difficult to reverse medicine once it has brainwashed a generation of doctors with the wrong information.

T is good for more than maintaining your sex drive, and sexual function. T can also prevent prostate cancer and other cancers as well as obesity, Insulin resistance and heart disease. It is time we let the bright light of truth shine on this new and amazingly simple reality for aging men. Testosterone can protect you from both getting prostate cancer, and from getting a recurrence of prostate cancer after the initial treatment!

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I answer many questions about Estrogen Replacement Therapy ERT every day. Many of these questions are based on outdated information that women, and even doctors have not updated in the last 30 years. There has been a lot of research on ERT in the last 2 decades and women need to know the truth! Today I will address all the misinformation that is out there.

First a few definitions of the lingo doctors use when talking about estrogen:

ERT (estrogen replacement therapy) definition is replacing estrogen, in any form, to women who are menopausal and have had a hysterectomy. Women who have had a hysterectomy do not need progesterone because progesterone is given to protect the uterus from PMP bleeding and uterine cancer.

HRT (estrogen and progesterone therapy) definition is replacing estrogen, progesterone, or progestin in any form to women with a uterus. The progesterone or progestin is given to prevent the uterus from bleeding after menopause and to protect the uterus from uterine cancer.

ET and EPT mean the same as ERT + Testosterone, and EPT is HRT+ T in any form.

At Biobalance Health® we only use bio-identical estrogen and testosterone in pellet form and bioidentical progesterone, no progestins.

What is the difference between progesterone and progestins?

Progesterone is the hormone made by women after ovulation to support the lining of the uterus and a potential embryo. It is natural and made by the corpus luteum of the ovary. Progestin on the other hand, is a chemical that was created to balance the estrogens in the birth control pill and oral menopausal medications. Progestins have many side effects and contribute the complications that many women get from oral hormones. Natural progesterone in all forms have very few side effects and protect the uterus from developing uterine cancer.

How long can I take Estrogen? Don’t stop! The reason women are so confused is that the College of OBGYN placed arbitrary limits on how many years a woman can take the form of estrogen they prescribe—oral synthetic estrogen and progestin…..and they keep moving the limit. The current limit of how long a woman can take estrogen is arbitrary and not based on non-oral estradiol replacement but guesses and small studies they do on oral estrogen and progestin. They view ERT and HRT both as a one size fits all and it can’t be farther from the truth!

Does estrogen cause breast cancer? No estradiol DOESN’T cause breast cancer. Your biggest risks of developing breast cancer are obesity, large intake of simple sugars, insulin resistance, Type II diabetes, alcohol intake and lack of exercise. Estrogen has been circulating through your body for decades and estrogen doesn’t cause breast cells to change into cancer cells.

There are some cancers of the breast (ER receptor + breast cancers) that are stimulated to grow by estrogens, and we don’t give estradiol to women who have had these breast cancers unless they have had a double mastectomy and did not have positive nodes.

Estrogen DOES and can cause uterine lining cancer (not ovarian cancer) called endometrial cancer. We give women with a uterus progesterone to take with their estradiol pellets to counteract the stimulation of the endometrial cells into cancer. We require our patients to take progesterone (bio-identical) to protect them from any danger from uterine cancer.

Does Estrogen cause blood clots?

Oral estrogen can cause a woman to be more likely to get a blood clot. Oral estrogen circulates through the liver first thing before it is circulated through the body and in that way stimulates the production of fibrinogen and other subsets of blood clots to start the “ball rolling”. However, non-oral estrogen (pellets, patches, creams, gels, sublingual tablets, and vaginal tablets) does not have the same effect. There are many studies in the last 20 years that substantiate this fact, but most doctors have not gotten the message and still advise women who have had a blood clot not to take any estrogen of any kind! They are wrong.

What does estrogen replacement do for me?

Estrogen keeps women young both physiologically and physically

Estrogen prevents osteoporosis
Estrogen prevents the vagina from shrinking, prevents it from atrophy (drying out)
Estrogen maintains the bladder and prevents incontinence and bladder infections
Estrogen prevents painful intercourse after menopause
Estrogen keeps a woman’s skin soft and her hair growing normally
Estrogen prevents hot flashes and night sweats
Estrogen prevents insomnia
Estrogen prevents heart disease
Estrogen maintains the immune system
Estrogen prevents Alzheimer’s disease and dementia

Why did the physician groups stop estrogen replacement therapy to women?

They reacted to the WHI study with an emotional response before they even read the study and determined whether it was true or not! The doctor’s leadership are so afraid of lawsuits they immediately recommended taking all women off estrogen and not restarting. Meanwhile woman all over the country were in physical and emotional pain from their lack of estrogen. Most of the doctors never read the WHI study, but I did! It did show that PROGESTINs do increase the rate of breast cancer and heart disease, but not progesterone. They didn’t even study progesterone until later when it was proven safe.

Progestins also increase the risk of heart attacks in women, but estrogen taken without progestins were safer than taking NOTHING!

Let me recap: The WHI study has been proven wrong. It said that E2 was dangerous and caused breast cancer and heart disease. It was misinterpreted and the cause of breast cancer and heart disease was finally found to be the progestin (not progesterone) that was used for HRT in the study. The women who only took estradiol because they had a hysterectomy had a lower rate of breast cancer and heart disease than those women who took HRT and who took nothing!

So, what do you do If your doctor doesn’t “believe in” estrogen replacement?

Find a new doctor! Don’t listen to old, false information repeated by your doctor. You know what you need. Women are very astute at self-diagnosis and after menopause to feel better we need estrogen!

Find a doctor to give you non-oral estradiol with or without natural progesterone because this decision can literally save your life!

At BioBalance Health we replace estradiol in the safest way to keep women healthy, safe, and without the diseases of aging. In women with non-estrogen receptor positive breast cancer, we offer estradiol with testosterone in non-oral long acting pellet therapy. You can live well and healthy as you age!

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Call BioBalance Skin at 314-648-5710 to make an appointment

There are hundreds of facial skin peels out there that provide one benefit each. The VI Peel is not just one peel with one effect, it has 4 different peels for different needs patients have. The first three peels are graded by how much damage you have, how thin your skin is and how much treatment you need. The fourth facial peel provides treatment for acne and acne scars.

The FIRST secret to the VI Peel is that it literally is active on your face for three days! The Second secret is that the VI peel has 5 “acids” that do different things for your skin, so the treatment is often as good or better than two combined laser treatments. Three VI peels a month apart vs three laser treatments at less than half the price!

The second Secret of the VI peel is that it uses 5 acidic and active peel products combined in one peel, as well as two anti-inflammatory products to calm the skin.

The ingredients include:

Glycolic acid penetrates the skin deeply and carries the other ingredients with it.
Lactic acid hydrates and lightens brown spots, hydrates and firms the skin
Mandelic acid reduces oil production and suppresses pigment production to even skin tone and brighten the face.
Trichloroacetic acid treats texture, pigment, acne, and wrinkles, and drives the other active ingredients deep in the skin.
Phenol is an anesthetic and mimics TCA treatments

The first three types of peel provide extensive exfoliation, decrease of brown spots, and treats superficial wrinkles and tightens the skin.

VI Peel uses all of the ingredients above and is primarily for brightening and tightening. For younger patients with minimal damage and patients with Rosacea.

VI Peel Precision is for normal Anti-aging skin with average damage.

VI PEEL Precision Plus is the strongest peel for thickened skin and Antiaging.

The fourth peel is called VI Peel Purify + Booster for Acne and Acne scarring and hyperpigmentation.

The treatment time is short in the Spa, but you must be able to use specific products for after- care for the next 2 days. The peel is actively working for 72 hours and avoiding the sun completely, using the provided towelettes to wipe down the area several times a day is required.

How do I recover? The first day you will look like you got a sunburn, but some patients do not have any downtime the first day. The end of the second and third day the skin will begin to peel, and you must refrain from picking! You may trim the already peeled skin off, but don’t assist the peeling.

These peels require 2-4 peels, one a month for complete resolution. Other treatments that. Treat the same problems often take 3-6 laser treatments so this takes less time.Each peel is about $300 and is painless.

VI has also developed body peels for those of you who have severe sun damage on the decollete, arm/hands, back or legs. The peel is effective for brown spots, acanthosis nigricans,

The body peels take longer to peel..usually 4-7 days and treatments are farther apart, every 4-8 weeks. They even have an app to track your progress on your iPhone!

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Biobalance Health began in 2002 as a medical practice that provides the best, most effective delivery system for testosterone replacement for men and both T and Estradiol for women. This is still the foundation of our practice because hormone replacement is necessary or the other methods of staying healthy after 40 to actually work.

I have seen thousands of patients who follow my individualized directions on testosterone and estradiol replacement, diet and supplementing their diet, weight loss, exercise, and lifestyle changes realize their goals of feeling and looking younger. These patients become truly healthy through these combined treatments. In contrast, I have seen the patients who want a quick fix with hormones who ignore the recommendations I give to them to become the younger healthier person they desire to be. These patients fail to achieve their goals. There is NO QUICK FIX to become healthy! If you don’t want to participate in your goal of developing a healthier body and mind and just want to take a pill or get a pellet, then you don’t want to see me!

There is a primary rule in medical care called the Law of Intention: Achieving health requires the intention of the doctor to heal her patient, AND the intention of the patient to follow the treatment plan of the doctor to get better! Intention not only means you think about getting better, but that we both work toward that goal!

There are thousands of medical studies that back up my treatment method of following a multi-pronged approach to health and they are right, but it isn’t easy!

I recommend my female patients receive testosterone pellets after age 40, and men when they begin to have sexual erectile function symptoms, around 50-55.

At the first office visit I present a treatment plan that includes several paths of treatment. I call it a “parallel approach” for hormone replacement, weight loss (if necessary), following a healthy diet, finding an exercise that they can stick to in any weather for at least an hour 3 x a week, as well taking temporary medications or specific supplements to prevent the diseases of aging like diabetes and heart disease, and taking other supplements to specifically attend to a patient’s deficiencies. All these changes and treatments must be worked on at the same time, which is why I call it medical care “in parallel”…following a plan for every area of health at the same time.

Story: One of my patients had trouble losing weight and she did weight loss consults with my Nurse Practitioner who advised her on every area needed for her to achieve her goal. My NP came to me frustrated because after several visits and multiple medications and supplements she still wasn’t losing weight. I joined them in the consultation and asked some direct questions, “ Do you still eat candy and drink soda?” “yes”, she said sheepishly. Do you take the supplements we have told you to take?” “Well… I start the new ones that you suggested but I stop the ones you told me to take in the beginning..I don’t like pills”. “How about the medications we asked you to take? Metformin, and phentermine? “ I take the phenteramine!” I asked and she told me that she thought we just wanted her to take the last one prescribed to her, but not the first medication, even though my NP had told her to stay on both meds! So here is a formula for failure that many doctors experience with their patients. Start one thing and when it doesn’t work stop I start something different…over and over again! This method never gets anyone with a weight problem to lose weight. You have to add meds and supplements to a treatment plan when someone is not responding to the one med alone. Weight loss treatment is not forever and these meds are temporary! Following all of our directions and taking the meds and supplements we prescribe is necessary for weight loss patients to succeed. They took years getting unhealthy and unbalancing their metabolic system by gaining fat, and it takes time and multiple concurrent treatments to lose fat!

Think of a 6 lane highway, all going the same direction with the same end point.

Each lane is a different area of your life to prevent and treat diseases and the symptoms of aging.

Lane 1 is replacing the hormones that decrease with age: Testosterone for both sexes, estradiol for women and balancing the other hormones that are deficient.

Lane 2 is your fuel to feed your body—your diet must be right for your genetics, lifestyle and the diseases you already have.

Lane 3 Supplements to your diet for vitamins and minerals you don’t get in your diet or you don’t get where you live (anywhere north of Florida needs Vitamin D), al people who don’t live near an ocean need Iodine replacement . Diseases such as Osteoporosis not only need E2 and T but need the building blocks of bones: Vitamin D3, Vitamin K, Vitamin C, Calcium and Magnesium.

Lane 4 Medications to treat diseases you already have. For example Insulin resistance and Pre-diabetes is rampant in people over 40 who are overweight. To combat this disease and prevent it from progressing. For this I use an old medication called metformin ER to treat Insulin resistance which allows the patient to lose fat and obtain normal weight. When they reach normal fat % 19% for men and 26% for women we can stop the medication.

Lane 5 Feed your gut Biome. You have more bacteria living in your gut than you have cells in your body, and they are necessary! The bacteria in your intestine digest your food, protect the delicate wall of the intestines so it doesn’t become leaky and lead to autoimmune diseases. Good bacteria help the gut produce the neurotransmitters in your brain that not only help you to think but also keep you from being depressed and anxious. The more types of bacteria in your gut the better and the closer you will be to your ideal weight. Antibiotics and steroids like prednisone kill good gut bacteria and promote bad and dangerous bacteria. It is important that everyone take a Probiotic and eat a salad and or raw vegetables to feed and protect their gut bacteria. We are symbiotic with the bacteria in our gut..neither of us can live without the other!

Lane 6 Exercise daily! We have not evolved from our ancestors days on the savannah where we ran after and caught and killed our food or gathered it from bushes and other plants. We were made to be physically active all day! We have created a sedentary world where we sit and that is very BAD for our health. I think exercise choices should be based on any disabilities or injuries that you have and on your personality. In her Book, The Eight Colors of Fitness, Suzanne shares the type of exercise that is best for each Meyer’s Briggs personality type. If you don’t have a clue what exercise you would like to make a part of your life then reading her book is my advice…then just do it!

My practice BioBalance Health is meant to guide you and treat you with the most effective methods needed in your life to reach the goal of health. When making a plan for achieving health think of these 6 areas and follow the plan…all at the same time!

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Aquagold® is the newest type of microinjection process that utilizes hundreds of tiny gold needles to inject neurotoxins, filler and PRP right under the skin to stimulate the youthful turnover of facial skin cells and treat all the signs of aging. This treatment can be used successfully on the hands, neck and décolleté too. This process is essentially pain free after application of lidocaine gel and can be done much more quickly and with less trauma than micro-needling, with better outcomes.

In addition to skin injections PRP can be injected into the scalp to increase hair growth in areas of the scalp that are thinning.

The benefits of Aquagold®

Aquagold® treatments require very little downtime and allow you to go to the office or out of the house a few hours after the treatment.
Aquagold® can also be adjusted to your needs by adding PRP to filler and neurotoxin injections.
Aquagold® can inject PRP + Filler and + Neurotoxin which makes your face look smoother with smaller pores, better texture and fills the small lines around your eyes and mouth.
Aquagold® is a complete makeover for your face: Best results are achieved with 3-4 treatments, spaced one month apart. Some of my patients do it every 3 months like they do botox.

There are three levels of treatment: You can choose the level of treatment that you need

Silver Aquagold + neurotoxin + filler = $
Gold Aquagold + Neurotoxin + filler higher % of active ingredients= $$
Platinum Aquagold= PRP + Neurotoxin+ Filler = $$$

Post Care: After this treatment, post care is to leave it alone and only use a mild facial cleanser before bed the day of the treatment. The next day only use lightweight sunscreen and very little makeup.

By the third day you can cleanse and treat your skin as you normally do, and the results are evident!

Who Can Have This Treatment:

Anyone who does not have a tatoo or infection in the area of treatment
No sun exposure for 2 weeks before and two weeks after each treatment or it will impair the results
You must wear sunscreen at all times

Who Can’t Have This Treatment:

Pregnant
Nursing
Active cancer treatment
On immunosuppressants for autoimmune disease or cancer
On steroids

This treatment should be done at least a month after a laser , not before, and a few weeks after botox or other neurotoxin injections. You will LOVE the way you look.

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If you ever wondered if there was something other than anti-cancer chemicals, quarantine or vaccines to help protect you from cancer and viral illness, there is a safe, inexpensive and effective medical treatment. Why haven’t you heard of this wonder drug? The FDA has blocked the US population from access to this immune stimulator in the middle of a pandemic! I can’t tell you why, except that it gave us a way to improve our immune status without other preventive treatments. It is not dangerous so you can only imagine your own reasons for this action.

‘In this blog I am going to inform you of this option so your will know about it and possibly help drop the ban on compounding pharmacies from making this communicator protein. I have included quotes from medical and scientific journals to support my information.

At the end of the blog, I will list the sources for my information in case you question my information, you can look it up!

“Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying, enhancing, and restoring immune function. Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies, as an enhancer of vaccine response, and as a means of curbing morbidity and mortality in sepsis and numerous infections “, World Journal of Virology 2020 Dec 15; 9: 67-78.

This “bit of protein” is called a peptide, and it is just one of thousands of peptide communicators produced by the human body. When we are young and healthy these communicators are all working well in healthy mature adults, but as we age, we lose the ability to produce many of the peptides that keep us healthy, like Thymosin alpha 1. This is the reason that people over 60 get sick and die from infections that don’t kill younger people.

In the Journal of Virology this information was written in December of 2020, during the Covid Pandemic:

Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells. …. thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.

What does Thymosin Alpha 1 do?

Thymosin alpha-1 (TA1) functions as a stimulator to the thymus gland. This gland produces white blood cells including but not limited to T-Killer cells and T helper cells (CD4+/CD8+ T cells) those WBCs that kill viruses, bacteria, fungus, and cancer cells.

The thymus gland is located behind the “breastbone” and is largest when we are born and shrinks as we age. As it gets smaller, our immunity to everything decreases which is why older people get more severe infections and take longer to heal, and why older people need stronger vaccinations than younger people to get the same effect.

TA1 has many functions other than increasing the number of T cells, it also increases their killing ability and modulates the T cells, so they respond to both abnormally directed immune responses (autoimmune diseases) and stimulates the activity of T cells against infections. TA1 decreases inflammation and is effective in treating pancreatitis and Hepatitis C. Regarding viruses TA1 decreases viral replication, therefore limits both the infections, communicability, and the severity of all viral infections.

For cancer patients this peptide is amazing at limiting both incidence and growth of cancers. It is unparalleled in its activity against cancer recurrence.

..thymosin alpha 1 works via two main mechanisms: Either stimulating the immune system or employing its anti-proliferative activities on tumor cells. The protective action of thymosin alpha 1 against oxidative damage because of its effect on liver superoxide dismutase and glutathione peroxidase has been explored by Armutcu et al [26].

I have given TA1 to patients who have small tumors or failure of cancer treatment, when there is no more treatment left for them, to stimulate their own immune system to kill cancer cells. There are basically 3 other ways to kill cancer. Surgically remove it, kill it with chemicals that also kill beneficial cells in your body (chemotherapy), or radiate the area of cancer. However mainstream medicine rarely uses the fourth most effective and least dangerous method of stimulating the natural immune system and preventing and killing cancer. One of the unused methods of killing cancer cells is prescribing TA1 which stimulates your own immune system to kill cancer cells.

This fact is rarely discussed by doctors, but it is a fact that everyone produces cancer cells in their bodies daily and when they are young and healthy their own immune system kills those cancer cells. When we are young, cancer is rare because our immune cells are activated by TA1 produced in our own thymus glands. As we age, our thymus shrinks, our TA1 decreases and some of these abnormal cells are missed and not killed, which allows these cells to grow and proliferate into what we call cancer. The true cause of cancer is the loss of normal immunity (TA1) to kill cancer cells.

Due to the action of thymosin alpha 1 on other cell types, it is used as a therapeutic agent for diseases with evident immune dysfunction [4]. Clinical trials with thymosin alpha 1 for diseases like DiGeorge syndrome, non-small cell lung cancer, hepatocellular carcinoma, hepatitis B and C, HIV, and melanoma have been conducted and yielded promising results. FDA approved the orphan drug thymalfasin (Zadaxin) for treatment of malignant melanoma, chronic active hepatitis B, DiGeorge anomaly with immune defects, and hepatocellular carcinoma due to its immunomodulatory and anti-tumor effect.

These diseases are the ones approved by the FDA for treatment with Thymosin alpha 1, in the form of the pharmaceutical called Thymalfasin, however they have ignored the elephant in the room: Thyomsin alpha 1 is effective against cancer, and preventing cancer recurrence, autoimmune diseases, viruses, parasites and bacterial infections. Why isn’t it used in the US to stimulate our own thymus to act like it did when we were younger? I can’t understand it! When we needed this compounded drug the most—in the middle of a pandemic, the FDA prevented all the compounding pharmacies from making it! This could have been an answer for those people who could not or would not get vaccinated, but in the beginning of the pandemic, production was shut down!

Thymosin alpha 1 works and there is a lot of research to back this up, but it is unattainable in the US since Covid started. I had several patients with recurrent cancer on this peptide for years before the pandemic, and it prevented a recurrence. These patients got their medication from compounding pharmacies, and it had to be discontinued because no compounding pharmacy was allowed to make it. Why? Both patients, who had. exhausted their mainstream medical options for their cancer, are now experiencing a recurrence of their cancer without being able to get this drug.

With all this proof and knowledge about the power of Thymosin alpha1, to prevent and treat viral illnesses and cancer, why have you never heard of it, especially at a time of pandemic when this peptide could do so much good to prevent and treat the virus that is causing our pandemic, especially for those people with immune dysfunction, cancer, autoimmune diseases, and immune senescence of aging?

First, the government enacted an FDA letter to all doctors threatening discipline for doctors and healthcare workers who recommended “unproven” therapies for the Covid virus. Included in this new law, rule, is to silence anyone saying to their patients that Vitamin D (which has now been proven to protect against Covid), Quercetin which has supporting evidence in the medical literature to prevent the recommendation of doctors to patients from suggesting these methods of preventing supplements to our patients. If anyone can explain why our own government is working against us (both patients and doctors who are working to save lives), and using our tax dollars to do it, please tell me.

I always thought being a doctor in America meant being able to use any safe and effective means that I know works effectively, to treat my patients. Doctors were effectively gagged by the FDA letter sent in December 2020, from telling my patients about preventive medicine practices that stimulate the immune system and protect us from infection. Now I have lost respect for the government who treats us all like we are uneducated and sheep who will follow whatever they tell us. They use the one size fits all in a decade when the practice of medicine is becoming more aware of the individuality of patients especially in the melting pot of the US. Drugs are ridiculously expensive and unaffordable except for the very rich. We often use compounding pharmacies for alternatives to this price burden for patients and offer inexpensive alternatives that patients can afford.

I am listing the medical references that support my information. I don’t generally do this but I believe it is important to support my blog.

References:

World Journal of Virology: Thymosin alpha 1: A comprehensive review of the literature, 2020 Dec 15; 9: 67-78. Regulatory Focus, webpage, FDA Targets Remdesevir , Thymosin Alpha In Compounding ,concerns, posted Feb 24 2021 by Kari Oakes.

American Journal Health System Pharmacy. May 15, 2001;58(10):878-885.

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(Quotes are from the 23 and me Blog. November 2021)

Last week we talked about the research 23 and Me has done determining individual responses to the three Covid vaccine, based on the genetics of the HLA type of the individual. This week we will review their research on people who have gotten Covid infections and become Long-Haulers, those patients who develop long lasting illness and organ damage from getting the virus. We will look at the genetic characteristics of those patients who are at risk for Long Hauler condition after Covid.

“A recent study by researchers at the Translational and Clinical Research Institute within Newcastle University found that an allele (gene) protective against severe COVID-19 symptoms in the HA gene, at HLA-DRB104:01, was found at much higher frequency in people of Northwestern European ancestry.”*

That means that if your inheritance, your ancestors come from northwestern Europe, you are less likely to develop a severe case of Covid, or “long haulers” complications. They have also found that those people with Blood type O and B are less likely to have severe effects to covid, the vaccine to covid and less likely to have severe long-term side effects of covid infection.

The way I look at this is that if you can determine your risk of severe infection or severe reaction to the Covid virus from your genetics, then you can decide whether you should take the risk of getting the vaccine, or not, and the risk of getting infected and having long-term reactions to it, so you can determine whether you should always wear a mask in public or not, get a vaccine or whether you should fly on a plane or not.

Without knowing your risk how can you determine how to run your life in a pandemic? We should be concentrating on three things:

Determining individual risk, based on genetics, so an individual can make an educated decision about his activity, vaccination and or use of masks.
To find this risk you must know your blood type, your HLA type (which most of us don’t know), and whether you are protected from severe long haulers, by ancestors who were from northwestern Europe.
Be realistic about your risk dictated by your lifestyle, and that can be somewhat controlled by how we live our lives: If you are obese, smoke, are over 60, eat processed foods, drink alcohol daily, don’t exercise, or if you have any diseases or take medications that suppress your immune system, you should take all precautions including getting vaccinated. More importantly you should change your lifestyle and go on a mission to get healthy.

Besides cleaning up your life, there is no magic bullet that protects everyone. We now know that Covid 19 can be deadly to certain individuals, and to others it doesn’t even make them sick. The same genetic HLA type people who have bad reactions to vaccines also have the most severe infections with Covid 19. This puts these patients in a trick box…they need to be vaccinated but they are at risk for complications, however if they get the covid virus they may die. In this case looking at other health factors may tip the scales toward vaccination or the opposite toward quarantine for an unknown time. A doctor should be the one to assist you in this decision.

The one non-genetic factor that puts you more at risk for reactions to the vaccines is a previous Covid 19 infection. If you are at risk otherwise and need to have the vaccine to protect yourself from death or long-haulers then waiting 6 or more months since your Covid infection to be vaccinated is advised.

I wish the best to you all…this is a time of learning for doctors and virologists alike…we increase our knowledge every day and I will try to keep you up to date with the research and the advice based on that research.

At this time, to be preventative, everyone should improve their immune status by eating a good whole food diet low in carbs, high in fruit and veggies, and by taking Vitamin C 500-1000mg/day, Zinc 15-50 mg/day with Copper 2-6mg/day, Quercetin, Methyl B complex, have your hormones replaced including estradiol and testosterone after menopause and testosterone for men after age 55-60, and exercising daily.

Then determine your genetic status if possible and take the precautions necessary for your level of risk.

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In an article published in November of 2021 by the genetics company, “23 and Me”, new information was revealed that refutes the belief that the risks of getting and or dying from Covid 19 is equal for all humans--are a one size fits all proposition. Today I would like to relay the information that I have learned from research done by 23 and me over the last two years during the covid pandemic. This is not my finding, but that of this genetics company who carried out a one- and one-half year research study by asking those people who had given their genetic histories to 23 and me for research questions, if they got the infection, and if it was severe or minimal or anything in between. They also did research on the genetics of those patients who succumbed to covid, and on those patients who did not get the infection even when exposed. This study was to find out what genetic inheritance makes us at risk for severe covid infection and what inheritance (snips of DNA) makes us relatively immune to Covid.

This research inherently questions how the risk of infection has been portrayed by our government, as a luck of the draw type of risk with one answer…vaccination. The findings suggest that each person is an individual with genetic and lifestyle factors that give him/her individual risks of getting the infection at all, as well as dying of the infection are partially due to an individual person’s God-given genetic makeup.

When people and governments panic, decisions are made with broad strokes and a one size fits all solution is created and following these solutions is required by citizens. This is also a lot like how medicine is conducted currently… one dose per person no matter how old or how big or small. In contrast genetic studies like this one disprove that there is equal risk and equal treatment or prevention for each individual. 23 and me has found that one or three vaccines will not have the same risks or benefits for every person who gets the vaccine. Human Genetics is the basis of variation in diagnosis and treatment in medicine, and now has touched all of us with a one size fits all answer to a pandemic, leaving some people to make an uneducated decision to avoid all vaccines and treatments because they know the government should not be practicing medicine, and the other extreme of people who follow all recommendations of governmental medicine who then suffer the side effects and or worse from the solutions they demand (vaccines).

Let me assure you that we are all genetically different and there are certain genes that cause us to be more or less susceptible to a disease, virus or bacteria and all diseases. That is what this blog is about. My mission is to help you make an educated decision based on what we know and what we don’t about the vaccines that are being required of us, and the disease that can also harm us.

Governmental medicine, that has been dictating our personal medical care for 2 years, assumes we are all the same and therefore they have the same answer for each of us. We now know that that is not the case. Some people have genetics that prevent them from even getting Covid, and that same genetic snip will protect a person from getting symptoms from it even if she or he gets infected with the virus. Other groups of people have pieces of their genetics called snips that cause them to be more likely to have a bad case of Covid or even die from it. Having the government give you advice as to your individual health is a bad idea. We need to have advice that is specific to our situation. That means telling us the truth about our genetic susceptibility to any infection that is considered an epidemic or pandemic.

In the research by 23 and Me combined with other genetic companies, the pandemic which has halted our world for two years now has been found to be an individual type of virus that affects each of us differently. Let me describe some of the things they have found out about the Covid infection and our unique response to vaccines.

..people react differently to vaccines, noting that those who previously had COVID-19, as well as women and younger. people reacted the strongest to the vaccine.

The Genetics Behind the Different Reactions to Covid 19 Vaccines (Nov 9. 2021)

We found that some variants in a complex of genes involved in immune response are associated with being more likely to have a strong (bad) reaction to the vaccine and some make it less likely.

I am one of the 23 and me customers who volunteered my time to answer questions for 1 ½ years about my exposure to Covid 19, my lack of infection when I was exposed and my reactions to the vaccines that I took.

“That (participation) has allowed our scientists to quickly explore how genetics plays a role in the susceptibility and. severity of COVID-19. We've also looked at other aspects of the pandemic like its impact on sleep, physical activity, and how it has hit some communities harder than others. In this latest study, we looked at the factors associated with "reactogenicity", or how noticeable a person's response was to the vaccine.”

They found a strong association between variations in the HLA genes—the human leukocyte antigen complex, which is involved in immunity, and are what is tested to find out if your tissue type is compatible for an organ transplant.

“These genes encode for a number of proteins that make up the major-histocompatibility complex, which is on the frontline of your immune system's infection recognition system. These results. show that variations in the HLA complex are related to the degree to which one feels ill after vaccination.”

All three vaccines work by teaching your immune response to recognize the virus and they act quickly to attack and kill the virus it is protecting you from. So why do some people feel very sick after a vaccine, and others feel nothing?

The 23 and me findings suggest the primary function of HLA molecules is to present foreign antigens on the cell surface in order to elicit an immune response. As such, the HLA plays a key role in presenting the proteins derived from the vaccine to the immune system.

Because of this some HLA types (your genetic type) carry a strong (negative) reaction to the vaccines and others little or no reaction. Therefore, when you combine a prior history of Covid 19 infection + younger age + female sex + certain HLA types you find that these individuals have severe side effects to the vaccines.

But what HLA types did we find to cause more severe side effects?

This is the table in the 23 and me article: The first and last HLA type do not have severe side effects from the Covid Vaccines. The three in the middle do have a high risk of severe consequences of taking the vaccine. It doesn’t mean no one in the first and last group will have a side effect..it is just a CHANCE of not having a side effect. That is the other problem in medicine—nothing is a sure thing…and if you are the one that gets the disease, then it is 100%.

I think knowing the risks of vaccination for each individual vs the risk of getting the disease we are trying to prevent, will give each of us an educated idea of what to do for ourselves. To do this we need to have all the information….the side effects that are possible, and the ones that we are more at risk for individually. The study of our genetics would make us prepared next time to guide patients with specific snips to get one treatment, while someone else may not need it or would have a low risk of getting the infection at all, and then the vaccine would not be necessary. This pandemic was our warning shot….genetic study will be the gateway to all of us surviving the next round.

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At BioBalance we have been treating women who have had ER positive breast cancer with Testosterone Pellets for 20 years Testosterone pellets improve their quality of life and actually decreases their risk of recurrence. This fact has been proven not only by research but by our experience. We believe that quality of life after cancer is very important and we not only believe that testosterone replacement is helpful to improve sex drive, muscle mass, skin texture, and other symptoms of aging, but also treats the symptoms of estrogen deficiency safely.

The first thing patients have to deal with when told that they have Breast cancer is how to treat it. There are many opinions about what treatment is the best and how much treatment is needed. In my 39 years of diagnosing and following the treatment of breast cancer patients, the history was that doctors started by throwing the kitchen sink at even the earliest smallest cancer and not only prescribed either radiation or radical surgery, and chemotherapy. We have been working our treatment path away from these radical therapies to an individualized therapy based on the aggressive nature of the cancer and severity or spread of the cancer. We should have done this long ago, and we would have helped more women regain their sexuality and their self-esteem, but this is how the practice of medicine works.

I always have to go through the process of putting myself in the shoes of the patient I am talking to and ask myself what I would do if this was me with this disease. I have had a love hate relationship with chemotherapy for Breast cancer unless the cancer had metastasized and chemo would improve life expectancy at least 50% over other treatments. In many cases, Chemotherapy is lifesaving, but it also caused so many side effects and impaired the immune system which can cause a second or third cancer somewhere else down the line. I would make sure if I had the cancer that before I took the advice of a surgeon or a medical oncologist, I would weigh the effectiveness AND the side effects of each treatment mode for my stage of cancer.

In addition to knowing the numbers of the effectiveness of a breast cancer therapy, and weighing the real risks, I would want to know the risk of long-term damage to my immune system and how much disfigurement I would have to endure afterwards.

Many women make the decision for which treatment they receive when they are in shock over their diagnosis. They don’t hear or can’t think through the fact that removing your breasts without provision for reconstruction, or radiation damages the skin so much that no reconstruction is possible after the fact. I can’t tell you how upset my patients have been when they have chosen a treatment that is more radical than their cancer justified, based on the emotion of fear, without understanding the side effects until it was too late. A woman’s breasts are extremely important to her self-esteem therefore preserving them and or reconstructing them after mastectomy is extremely important. It is because of this issue, that in 2001-2002 I sponsored a bill with our new Governor Holden who passed it into law by executive order. This new law required insurance companies to pay for the reconstruction of breasts that have to be removed to treat breast cancer. In Missouri, the passing of that bill made all the difference to women who have been disfigured with mastectomies to treat their cancer, and many states followed our state’s law.

I can tell you that my logical plan to treat estrogen positive breast cancer would be to have the following treatment If I developed breast cancer: I would have a biopsy to confirm the type and the spread of my cancer, allowing the biopsy of one axillary node, to avoid the side effect of lymphedema in that arm that comes with removing many nodes. Then, if necessary, I would have a mastectomy with nipple sparing surgery and reconstruction at the time of mastectomy. If I had ductal breast cancer, I would have a bilateral mastectomy because it is often bilateral, even if it is not visible at the time of the first surgery. I don’t want to worry about breast cancer in my remaining the rest of my life! If it was contained in the breast tissue that was removed, I’d be able to lead a normal life and take Testosterone and Anastrazole to block the testosterone from converting into estrogen.

Chemotherapy has been recommended for patients who have low grade, and stage or early breast cancers to improve a patient’s survival as little as .1%! Because taking chemo increases your risk of other diseases and cancers it should give you an appreciable survival advantage to take that risk. Always ask your oncologist how much your survival will be improved by taking chemo. You will have your own number to accept chemo…I would have to have 33% improvement in my survival to take traditional chemo. Taking aromatase inhibitors which is oral chemo-like therapy, is often recommended and has very few side effects if you take testosterone pellets with it.

Another treatment for breast cancer is radiation. It is often disfiguring and the damage to the skin can’t be fixed with plastic surgery, so I would only do that if there was spread to the lymph nodes, or for a recurrent cancer. Chemotherapy should be reserved for those women who have metastasized and need it to save their lives. The question you should ask your oncologist is what % will chemotherapy increase my survival? If it is minimal, I would think twice before going forward.

In the NE Journal of Medicine December 16, 2021 they agree with me about the course of treatment not requiring chemotherapy if certain criteria are met: If a woman has ER positive Breast cancer and has 0-3 axillary nodes positive and a recurrence score < or = to 25 they can forgo chemotherapy without a negative impact on disease free survival.

This solves the Cancer treatment portion of the equation, but what should you do about those symptoms of estrogen deficiency that women experience after menopause? The answer for my patients is NOT nothing, because if you do nothing you are making a choice! Try testosterone pellets and minimal estrogen cream to the vagina for lubrication. The small amount used on the vagina will not be absorbed into the body enough to stimulate the estrogen receptors of cancer cells.

Testosterone pellets have been found to address the symptoms of menopause, and to improve the number and function of the immune cells called T cells (cancer killing blood cells), and stimulate T cell activity to kill cancer cells of all kinds.

If you have been given the advice that you cannot take T after you have ER + breast cancer, then get another opinion…the cancer doctor’s goal is only to keep you cancer free but they usually have no concern about your quality of life, and the research they read is not about improving your symptoms of estrogen and testosterone deficiency. The relief of these symptoms is not on their radar, but it is definitely worth trying T to relieve your symptoms of menopause.

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Kathy: Today we are welcoming back Brett Newcomb, the co-author of our book,

Got Testosterone?, as well as co-author of our first book The Secret Female Hormone to announce the release of our third joint project, and our first audio book, Got Testosterone?

Brett: Our audio book, Got Testosterone? has just been made available on Amazon books, Audible, and dozens of other audiobook access points.

Our book Got Testosterone? is dedicated to men, to help them get through the aging process by choosing the one most effective treatment, testosterone pellets. We felt the need to write this book because there is a subterfuge that keeps this information from men and keeps them sick and sexless as they age. We want men to know that the replacement of one hormone testosterone can both treat their symptoms and prevent the second half of their life from being non-productive, sexless, and filled with illness. This book tells the truth to men and offers a plan of action for them to prevent the diseases of aging by taking Testosterone replacement with long-acting pellets.

Kathy: We are proud of this work because it is wholly ours…we wrote it, and Brett is the voice of the book as well. In that way, we can offer our listeners a wholly homogenous work for their listening pleasure. Brett and I tried at every turn to talk to men in this audio book like they wish to be talked to—concise information, delivered in a logical fashion with a limited number of examples to make our necessary points.

I was asked many times by my patients why we would spend 3 years writing each book, and another year producing an audio version of our book for men, Got Testosterone?. I explain that with all the confusing information out there, I think it is important to tell the truth about testosterone replacement, so men can make informed decisions about their health as they age.

When I am in my office seeing a male patient, I hand our book, “Got testosterone?” to them to read. Many wives have told me that their husbands probably won’t read it, but they would listen to it when they are driving. I made a decision to record an audio version of our book so that men would listen to it and receive the truth about testosterone.

Brett: We are very proud of this book. The year it was released, 2019, Got Testosterone?, won the first place award for men’s health books, from International Independent Publishers. This recognition was very big for us, and it recommitted us to increasing the number of men who would access the information in our book. Recording the audio book was the way we arrived at to bring our findings about testosterone replacement for men.

Brett: People all learn in different ways, and our audio book is for those people who learn by listening and like to listen to books as they drive or listen as they do things around their yard or as they exercise. A book must be read or heard to educate so we decided to cover both the access points for our patients.

Kathy: It is not typical to ask one of the authors to record the voice for the book. I chose Brett to read our book for many reasons, but the over-arching reason is that his voice is distinct and memorable. This fact was obvious when we attended medical Anti-aging conferences, and men and women alike came up to Brett to tell him how they loved listening to his voice during our Healthcasts. That sealed the deal for me…if both men and women admired his voice..who would be better to tell our story?

Brett: I have had quite a lot of experience in broadcasting, TV and radio. This audiobook was an opportunity to use my experience as the voice of our book.

Kathy: Other than working with the company that distributes audiobooks, I did not do the woman’s work on the audiobook of Got Testosterone? Brett and our audio

Specialist performed the complicated task of recording, re-recording, and editing the audiobook. Brett, can you explain how an audio book is composed?

Brett: The book professor, Nancy Erickson, ( thebookprofessor.com) referred us to an audio genius, Aaron Reppert (www.AaronReppert.com) of Travsonic Studios (www.travsonic.com/aaron-reppert/) , who is an expert producing audio books, and who did all the tech and editing and many, many other processes that take hours, days, and weeks of work over the past year and a half.

I got together with Aaron of Travsonic at his sound studio and spent many hours reading in a soundproof room with Aaron critiquing all the time. He had an impressive array of screens and sound editing machines around him and he coached me, and edited and retaped sections of each chapter. He edited everything to comply with distribution requirements and did his magic, and voila! We have an audio version of our book Got Testosterone?.

Kathy: Nancy Erickson also was integral in our process of distributing the book. She put us in touch with a distributor, Lantern Audio Distributor, who brought our audio book to the public through many outlets, including the most well-known Apple Books, Audible, Audiobooks, Nook Audio, Google Play, Walmart in the US and throughout the worldwide with audio-press.

There was even more work that had to be done to publish our audiobook. The book cover which was created by the COO and art director of BioBalance Health®, Joe Baalmann, had to be redrafted to fit the DVD discover dimensions. He also made sure all the requirements of the distributor were carried out. Behind the scenes work is often painful and unrecognized, but we were thankful for his work and talent.

Brett: The audio publishing world has stretched our experience with communication methods farther than we had imagined we would go. Previously we successfully worked with social media, You Tube, Traditional Book Publishers and Independent Book Publishers. The audio book was a unique experience for us. We hope you all take advantage of being able to listen to the information we have compiled and have made available to everyone. The goal is a healthy life for men after age 40, and to prevent the symptoms and diseases of aging.

Kathy: Our goal has always been to bring patients and other doctors and Nurse Practitioners the un-tainted truth about the best and healthiest treatment for men over 40 as they age. We think prevention of disease is the way forward in a world that is saturated with an expensive pill for every symptom, and a questionably effective treatment advertised on the internet, and on TV. being healthy throughout your life is the only way to avoid illness and the expensive, painful, and often ineffective treatments used once you are sick. If you are over 40 and a man, or the woman or man who loves a man over 40, then please stop listening to commercials and get some truthful answers, and listen to our book, Got Testosterone?.

Thank you for joining Brett and me for this healthcast about our new audio book for men, Got Testosterone?

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EMSculpt-® is a new treatment for sculpting your body into the body you want, and we have it at BioBalance Skin®! EmSculpt® is not for people who need to lose 100 lbs. all over, but for those of you who want to lose specific areas of fat to sculpt your body, without pain or surgery! This technology is the best there is and is very effective for building specific muscle groups and removing the fat from on top of them so you can see the actual individual muscles.

EmSculpt Includes two types of treatment that are used at the same time to provide two different benefits: the first is electromagnetic contraction of the muscles providing thousands of contractions of the muscles in the area of the body you want to build which usually increases muscle mass 25%, while the second treatment dissolves 30% of fat in the area after 4, 30-minute treatments. The treatments should be given a week apart for 4 weeks, and for 30 minutes each. You can increase the muscles in your abdomen, melt the fat and get your

Waistline back! If your calves are too small you can just use the EM part to increase the size of the muscle in your calf.

I’m 67 and one of the issues with getting older is the loss of muscle mass and the deposition of fat on top of the muscle so that age causes women especially, to look fluffy and soft, instead of muscled and “cut”. Worse yet, you usually gain muscle in the wrong places and lose fat where you would prefer to keep it.

Pellet therapy with testosterone makes it possible for post-menopausal women to build muscle and lose fat. Without T, fat loss and muscle building are next to impossible after menopause. We replace the testosterone with pellets first. Then as a patient is beginning to lose weight, we suggest EmSculpt® treatments for losing fat and gaining muscle in the right place. Why not just exercise you say? Because you will probably lose your breasts and bum, but not your belly fat. Moreover, 30 minutes on the Emsculpt® is like doing over 1,000 crunches…and it is hard to do 50 of them!

If you have had surgery and have been told not to exercise for a period of time, this machine will help you keep your muscle and lose fat while you recover. other dieting or exercise is needed!

It also is ideal for those patients who want to augment certain muscle groups to make their contour better, when exercise wont’ work…or the area that you need to exercise is difficult to isolate like your inner thighs.

In one month and 4 Emsculpt treatments on my abdomen, I gained almost 1 lb of abdominal muscle and lost 2.9 % body fat, and 4.5 lbs.

Insert my inbody results.

I have been trying to lose those inches for 3 years.

Many people are worried about the side effects of a treatment. These facts should ease your mind.

--No pain!

--30 minutes per area

-series of 4 treatments one week apart

You can have this treatment on several areas of the body that need more muscle and less fat: Abdomen, inner thighs, outer thighs, front or back of the arms, and upper back, and calves will soon be approved by the FDA.

-You can do one to three areas at one 1.5-hour appointment

How it works:

you come in 4 weeks in a row, for a 30-minute treatment, and a 45-minute office visit
We do an Inbody before the first and after the last of 4 treatments
You must be well hydrated (drink 64 oz of water before the treatment)
You take off all of your metal jewelry and piercings
You lie down and your RN or esthetician places the paddles or one paddle if you are small over the area you want to treat.
The machine contracts your muscles and simultaneously stimulates the fatty layer to destroy fat
You will feel like you had a workout!

Who cannot be treated with this device?

The electromagnetic part of this device acts like a magnet, or an MRI, so patients with any implantable medical devices cannot have these treatments. Joint replacements with metal in them can heat up with this treatment. We must ask you to fill out a medical questionnaire so we can make sure that there is no metal in your body or near the area we are treating. Metal IUDS like the copper T or copper 7 will prevent you from getting this treatment.

It is necessary that the area that is treated must not have any open sores, or tattoos on them. The lymphatic system must be fully healthy to carry away fat, and you should be without a fever, cancer or infection and well hydrated.

If you aren’t happy in your swimsuit then please schedule a consultation at our BioBalance Skin® for EMSculpt®, to shape your body for swim season, now.

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Last week we reviewed the traditional weight loss medications that were used commonly before this very effective new class of weight loss drugs. Like most medications, drug companies’, researchers and doctors find amazing new drugs for a use that the drug was never intended for. An example of this is the drug Viagra. It was initially being presented to the FDA as a blood pressure and cardiac drug. It increased nitric oxide and that dilates arteries, which lowers blood pressure and eases the work on the heart. On the pathway to approval, they found that Viagra was the first drug discovered that could create an erection in men who were important.

In 2010 a drug-group called GLP-1 receptor agonists was introduced as a treatment for diabetes. This class of drug, much like Viagra, was found to induce loss of fat, while preserving muscle mass resulting in weight loss. The first drug name was Victoza (liguride), and after the weight loss aspect of this drug was confirmed, the weight loss drug was named Saxenda. These drugs are injectable only but are subcutaneous delivered with a “pen” and are extremely effective for weight loss.

If a patient doesn’t have a problem with injecting a subcutaneous medication every day, then this drug has it all! GLP-1 RAs causes weight loss 3 ways: 1) They decrease hunger, 2) they cause patients to feel full when they eat half as much as usual, and they 3) speed up their overall metabolism so they burn more calories at the same level of activity. These drugs can also be continued for life if necessary to maintain a healthy weight.

These drugs are perfect for pre-diabetics, and Adult-Onset Diabetics (AODM), because not only is weight loss successful but insulin resistance is treated with this medication. As usual, with any excellent answer to a problem, we are limited in its use by the cost of this medication. For those people who need to lose weight and can go on it for 6 months or less to achieve their goal, it is still unaffordable. There is no way to write a script for this medication and expect a patient to pay $667-928/month, and unless they have diabetes insurance will not generally pay for this drug. The side effects from Liguride may also be a reason it can’t be used by everyone. Patients who have GI reflux, Barret’s esophogus, or GI ulcers can’t take this drug because it slows the emptying of the stomach and makes these conditions worse.

Prior to 2010, Metformin ER had been used for the treatment of pre-diabetes, AODM, and Insulin resistance for years, and has been effective for weight loss in many patients who have these conditions as the reason for their obesity. Metformin ER is inexpensive and is paid for by insurance, unlike all the other weight loss drugs, because it is also used for diabetes. In my practice, for patients with IR, AODM, hypertension, and heart disease who need to lose weight

This is a very safe and effective way to lose weight, but it only works when a patient follows a low carb diet, and daily exercise to be truly effective. Metformin literally makes my patients healthier and is considered one of the most effective anti-aging medicine available.

Another rather new combination of drugs used for weight loss is Naltrexone/Bupropion is not one that I have used in the office because of the high risk of side effects. I suspect in other medical hands it can be effective.

The newest drug, Semaglutide, sold under the name of Ozempic and Rybelus, is extremely effective and is given as a subcutaneous shot that can be self-administered once a week so compliance is not a factor. Rybelus must be taken daily but is a pill and not an injection, so is good for those with needle phobia. Semaglutide in either form stops hunger, makes my patients feel full, and increases the speed of metabolism so they burn more calories than other people at the same level of exercise. Ozempic/Rybelus can be given to patients who are not candidates for amphetamines and who have reflux side effects from Victoza/Saxenda.

Ozempic/Rybelus is well tolerated and can be given to anyone who will give themselves a shot once a week. The only problem with this medication is the cost, 4-6 weeks costs $900-$1200. We have found a way around this for those patients who can’t afford this price and have gotten it down to about $500/2 months. If you think about it, you can be very compliant and not use it very long to get to your ideal weight, then you would only have to use the drug for a short period of time. We have achieved a great weight loss for our patients when we manage their diet, exercise, and replace testosterone with pellets if they are over 40, by seeing them in the office every month until they achieve their ideal weight.

We always recommend a low carb diet, keeping a diary of food, water and daily exercise in My Fitness Pal app, which makes all of these treatment methods more successful than the experts claim. There is no weight loss that lasts without dieting and exercise, even with medication.

Taking a drug to lose weight is your chance to change your lifestyle so that you can keep the weight off after you stop the medication. You have to be completely on board to actually succeed at achieving your ideal weight….and staying there.

Talk to your doctor about these drugs …but only if you are ready to change your lifestyle for the better..you must be all in to get healthy for life!

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During 2021 several new weight loss drugs have been approved by the FDA for weight loss. The Lancet is a very well-respected medical journal and in December of 2021 they-compared the available medications intended to help people lose fat and become healthy. Today I will discuss the weight loss medications that we use to assist our patients in weight loss and in our next Blog I will review the new, very effective weight loss drugs that have been released, and explain how doctors choose the right weight loss medication for you.

At BioBalance Health® we provide medical weight loss treatment utilizing all the common methods of managing food intake, and exercise, and we add medications that are chosen for each patient based on their age, medical conditions and type of trigger that causes overeating. This is referred to as an individualized medical weight loss program and we have been very effective. Choosing a treatment program for each patient requires that we order blood lab tests, measure body composition at each visit, and find out a patient’s history of weight gain to determine the most effective weight loss drug to prescribe for each patient. We also use blood type diets, which are a type of genetic evaluation that determines the best and worst food for each person. It has been scientifically discovered that different body types (endomorph, ectomorph or mesomorph) require different forms of exercise and this observation plus blood type, and personality type helps us suggest the most effective type of exercise. In the future we will be employing genetic testing to determine which medications would be the best for each individual.

Today we will discuss the medications available by prescription that can make weight loss, or rather fat loss, possible. Because we are all different it is true that one particular medication, like one particular diet is not effective for all people. The first thing we consider is the medical condition of the patient including other medications that they are on which might interact with weight loss medications, and we don’t want to give a patient that would make her blood pressure or other condition worse.

After considering the safety of a particular treatment for an individual patient, I consider an individual’s problem with food:

Does she have anxiety that she soothes by constantly snacking?
Does she eat sweets because of a metabolic dysfunction like hypoglycemia, that causes her to be tired when her blood sugar drops and she eats sugar to regain energy,
Does she have bad eating habits from never learning how to eat cleanly, or how to cook?
Does she always feel hungry even right after she eats which is genetically determined?
Does she have a genetically determined inability to feel full?

Because there are so many reasons for people to be overweight, many solutions must be found to treat the problem that causes weight gain.

The first and most popular weight loss class of medication is appetite suppressants, or amphetamines, are ideal for patients who always feel hungry, who are young, and who don’t have hypertension, or heart disease. Amphetamines are the same medication that are used for ADD/ADHD, and both constant hunger and ADD originate from a deficiency of norepinephrine in the brain. Patients with untreated ADD and weight gain are a perfect match for amphetamine appetite suppression.

Amphetamines were the first weight loss medication available for appetite suppression. They were commonly prescribed to women beginning in the 1960s. These medications were widely used and were very effective, however they were often habit forming and only continued weight loss as long as they were taken. When they were discontinued patients generally gained their weight back. This particular class of medication didn’t fail to result in lasting weight loss because of the drug itself, but when given without diet and exercise training, patients could not sustain the weight loss after the drug was stopped. Today we still use amphetamines for appetite suppression and weight loss, but we combine it with low carbohydrate diets and daily exercise to achieve long lasting weight loss in a select group of patients. The names of these drugs are Phentermine, Dexedrine, and phendimetrazine.

In the 1980s a drug called Orlistat® was introduced. This weight-loss medication worked by causing fat that was in a meal to pass through without being digested and absorbed. The fat passes through to the intestines and resulted in fatty stools. This medication worked by decreasing calories absorbed from fat in the diet. This was somewhat effective for patients who would not, or could not diet, but who still wanted to lose weight. This in itself did work for a time in some patients, but was not an effective lifetime plan, because there was no accompanying training on how to eat appropriate amounts of food, and how to incorporate exercise in their diet. This medication is now over the counter even though it prevents the absorption of fat soluble vitamin like Vitamin D, A, and E. Worse yet Orlistat causes the side effect of fatty diarrhea, fecal incontinence, and terrible gas. This medication was not a long-lasting answer to obesity because it was not well tolerated and because it didn’t cause patients to change their overeating habits so what weight was lost, came back when they were off the medication.

The third weight loss medication is a combination of two drugs, Topamax (an anti-seizure medication) plus amphetamines, specifically phentermine. This duo is effective as a long-lasting weight loss answer for patients who are always hungry and can’t control their appetite, as well as patients with food addiction, and sleep related eating disorders. This treatment requires that a patient takes 25-100 mg of Topamax at bedtime and a dose of phentermine in the morning. Weight loss with this drug combination is effective when it is combined with low carbohydrate diets and daily aerobic exercise. This weight loss medication can be used long-term, however there are side effects for some patients which makes it intolerable. Some patients experience dizziness, diarrhea, insomnia, depression, and numbness, that can cause patients to stop taking it, as well as to change to another medication for weight loss. Many of the patients who have had success with these drugs, can’t say enough good things about this combo!

Next week we will discuss the new weight loss medications, who they are effective for and their side effects. I hope you join us to discover the new long-term answers to weight gain and obesity.

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We made a discovery at the last AMMG anti-aging meeting in Dallas…we found a non-invasive way to treat urine loss in women! It does much more than just treat your urine loss and also vaginal laxity to improve your sexual response!

The best part is that this treatment consists of 30 minutes of sitting on the Emsella machine 6 times over 3 weeks…no pain, no surgery, you don’t even have to take your clothes off!

EMSELLA by the company BTL, is intended to provide entirely non-invasive electromagnetic stimulation of pelvic floor muscles for the purpose of rehabilitation of weak pelvic muscles and restoration of neuromuscular control for the treatment of urinary incontinence in women. It is FDA approved!

Because I practiced OBGYN for 29 years I know that childbirth and aging have a devastating effect on the bladder and bladder function. It is not unusual for women who have had vaginal deliveries especially after difficult deliveries and a long pushing stage, to have to wear diapers, pads, or Depends for the rest of their lives. Until now the only treatment for premenopausal women has been bladder surgery with or without pelvic reconstruction. These operations are not only expensive, but they require 6-12 weeks of recovery and abstaining from sex. Even then, bladder function is usually better but not necessarily without problems like post-voiding dribbling, difficulty starting the urine flow, pain with urination and more. These operations “tie up” the bladder to attempt to bring the bladder back to the right position, however it does not treat the lax and stretched muscles in the pelvic floor that are meant to support a normal bladder.

Emsella focuses on strengthening the muscles of the pelvic floor that hold the bladder, vagina, and uterus up against gravity. One 30-minute treatment equals 11,000 Kaegle exercises and strengthens the pelvic floor. The result is a tighter vagina, normal bladder function, and it even treats rectal incontinence that can often accompany urinary incontinence.

Post-menopausal women often lose their bladder control because of loss of estrogen and testosterone at, and even right before, menopause. I suggest replacing estrogen and testosterone with pellets first, for 6-12 months can improve bladder function. If bladder function is better after that interval, but my patients aren’t dry, I suggest starting

Emsella® treatments for 3 weeks to strengthen the muscles….in addition to their hormone replacement.

This solution to the incontinence of bladder and rectal contents is truly a natural solution by using electromagnetic energy to contract the muscles of the pelvic floor and perineum which literally “exercises” the pelvis and bladder into a normal position, with recreated strength!

This treatment treats both Stress Urinary Incontinence (urine loss with coughing and sneezing), Irritable bladder (bladder spasms that cause urine loss), rectal incontinence, uterine and vaginal prolapse (the uterus and vagina “falls down” to the vaginal opening, vaginal laxity that contributes to lack of stimulation during intercourse, and labial lengthening that comes with age. The FDA is also testing this same machine for male ED, which will be approved in the near future.

For women who develop bladder incontinence, and any of these other the Emsella® is a perfect solution that is pain free, doesn’t involve intravaginal treatments or injections or surgery. In three weeks a woman can get control of her bladder and sexual enjoyment with EMSELLA!

Key words: Emsella, electromagnetic energy, bladder control, urinary incontinence, stress urinary incontinence, rectal incontinence, menopause, sexuality, sexual function, labial, prolapse, uterine prolapse, estrogen, testosterone, rectal tone, vaginal laxity, pelvic floor, natural solution, bladder surgery, pelvic reconstruction, sexual enjoyment, diapers, pads, Depends.

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When I started practicing medicine, I realized that there were many medical problems and patient symptoms which had no treatment approved by the FDA. This was frustrating and I realized I had a talent for finding alternate treatments that were compounded by a compounding pharmacy for my patients. I followed research, basic science, and the advice of a compounding pharmacist to find these treatments, and miraculously they worked! Many of those treatments are now accepted by the mainstream medical establishment and even the FDA. That was over 35 years ago…

I have continued to research treatments to address the problems of my patients. Many times, I have read research novel uses for an old drug or research that finally documents the treatments I have been successfully employing in my practice for years. My husband is a really entertaining guy and when I tell my husband that mainstream medicine has finally accepted and now endorses a treatment I have been using for 10-20 years, he has a pat response: He sings an old Mac Davis song,, “Oh Lord it’s hard to be humble when you’re perfect in every way……your medical discovery is finally endorsed!”. He is making sure I don’t get full of myself because I found a treatment long before the “other guys”.

It is one of my two favorite things…finding the answer for a patient’s pain or illness! It is hard to wait for the huge leviathan of medical knowledge to finally endorse what I have been seeing and using for years!

The practice of medicine was and is supposed to be using what a doctor knows, has learned and what she has read in the form of research, to deductively find a solution for individual patients, instead of following a well-worn algorithm that rarely works. What most patients experience in the doctor’s office is a watered-down treatment, orchestrated by the insurance companies to save them money and to pay doctors very little for their work. They only pay for 5 minutes of a doctor’s visit and decrease what they pay every year, so that doctors are expected to treat one thing at a time, and never has time to look at the whole patient picture. It is one of the reasons I left the practice of insurance run medicine…I wanted to be able to put the pieces together for each patient and create a treatment plan to make each patient healthier so they could enjoy a quality life. That is what I do now...I live the dream of most doctors. I have enough time to look over every part of a patient’s life and create a workable plan that involves not only hormones but treatment of pre-diabetes and Pre-heart disease and other diseases of aging. Making people healthy has always been my goal and in the last 20 years I have been able to do so!

This situation came up recently when I read a research article in the Journal of the AMA (JAMA) that stated that Statins, such as Rosuvastatin, atorvastatin, simvastatin, and pravastatin, frequently make patients’ diabetes worse. The title stated, “Association of Statin Therapy Initiation with Diabetes Progression”. This is something I discovered in private practice, and from reading research a long time ago, but the majority of the doctors in my community contradicted my advice to my patients to stop statins, if they had not had a heart attack, so their diabetes would improve, and it always did. Some of my patients were no longer diabetic when they were taken off their statin. If they had a lot of plaque on their arteries, I put them on Zetia, a non-statin lipid lowering drug, which did not affect their AODM. I was ecstatic when I read in JAMA that now the majority of the doctors will treat patients like I have for the last decade.

Think this through logically. Why would you take a medication to lower your chance of heart disease if you weren’t at risk for it anyway. A high cholesterol doesn’t mean you have arterial plaque. Many patients have high cholesterol and have no plaque in their vessels. If that is you, you could be taking a drug to prevent a problem you’ll never have, and develop type 2 diabetes, a disease that can cause heart disease and damage to your arteries.

My advice is to take statins only if you have had a heart attack, had stents placed, or a stroke from arteriosclerosis. If you have a cardia calcium scan of zero-50, and have not had any of the previously mentioned heart problems, then statins aren’t doing you any good, and they might cause you to have type II diabetes, which in itself can cause heart disease and strokes.

So, for all the times I have been criticized for treatments that work, don’t cause complications and make people well, I am now tooting my own horn like Mac Davis did in his song. The proof is in the current medical articles that appeared years after I already treated patients with this “new discovery”. I am just thankful that I can have the time and motivation to practice like am able to do now.

More importantly take a statin only if you need it, in other words, only if you already have proven arteriosclerosis.

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One of the questions I ask my patients about when they first come in for Estradiol and Testosterone pellet replacement is whether they have trouble remembering names of things and places, or if they have difficulty remembering how to get somewhere or if they are just having difficulty thinking through problems that they haven’t had in the past.

The reason I ask this to my new patients is primarily to find out if they have symptoms of low testosterone and low estrogen (in women). It is widely known that replacing testosterone in both sexes and replacing T and estradiol in women can improve recall and speed of mental tasks. If taken in the first 10 years of loss of these two hormones Taking Testosterone plus or minus Estradiol delay the onset of dementia, especially Alzheimer’s disease.

A new study in Clinical Endocrine News 6/2021 shows that a lack of enough thyroid hormone

Can also cause brain fog. I always treat low thyroid in my patients as well to make sure they become completely hormonally replaced, to improve their symptoms and prevent future disease.

Just a little information about the thyroid gland. The thyroid gland is located in the neck right above the collar bone at the base of the neck. It extends a few inches laterally and is shaped like a butterfly. When the gland is having difficulty making enough thyroid hormone it enlarges and looks like a thickening of the lower neck or like the neck is getting “fat”. This is called a “goiter”.

The hormones made by the thyroid gland are distributed to every cell in the body and are the primary determinant of how many calories you can burn. Thyroid hormone stimulates the production of heat in the body and that indicates the burning of calories. The thyroid hormones, T3 and T4, not only make burning calories and making heat possible, but they also make hair and nails grow, and assist in cell turnover (exchanging new cells for old).

Patients with low thyroid may or may not have a goiter, but generally they are very fatigued, and their hair breaks off and falls out, their skin is extremely dry, and they feel cold all the time.

The list of all of the symptoms that can occur from low thyroid are below.

The following are symptoms of hypothyroidism:

Fatigue, loss of energy, lethargy
Weight gain
Decreased appetite
Cold intolerance
Dry skin
Hair loss
Sleepiness
Muscle pain, joint pain, weakness in the extremities
Depression
Emotional lability, mental impairment
Forgetfulness, impaired memory, inability to concentrate
Constipation
Menstrual disturbances, impaired fertility
Decreased perspiration
Paresthesias = nerve entrapment syndromes
Blurred vision
Decreased hearing
Fullness in the throat, hoarseness
Generalized swelling and bloating

The treatment for hypothyroidism is relatively easy…patients are given an oral thyroid medicine. The reason many people are walking around with hypothyroidism is partially the fault of the government and the medical community. 40 years ago, the primary necessary component to make thyroid hormone is Iodine, and we used to supplement our foods like bread with iodine. This kept many Americans who don’t live near the coast (where there is plenty of iodine in the soil and air) supplied with iodine and prevented thyroid disease. Ever since the government stopped requiring foods to have added iodine, the number of patients with hypothyroidism has rapidly grown and they either don’t get treated because the lab numbers are adjusted to cause fewer people get a diagnosis of hypothyroidism even when they need it, or doctors don’t follow the method of determining dose of Synthroid. Doctors are trained to give the very lowest dose of thyroid possible and not to check the real thyroid hormones (T3 and T4) but to check the TSH which doesn’t tell a doctor the real thyroid hormone level and doesn’t parallel the symptoms a patient is experiencing.

Back to how thyroid hormones affect the memory and thought process. Many people are evaluated for dementia every day because they have memory problems and difficulty thinking, however their doctors do not evaluate the thyroid hormones when evaluating these patients. It is well known that low thyroid hormones and low Testosterone can cause problems with mentation, but these hormones are not tested. The patients who do not have traditional dementia or Alzheimer’s disease are told that they don’t have those devastating diseases by their neurologist however the cause of the problem is not looked for in the levels of thyroid and testosterone. Most people live in fear of having Alzheimer’s because they can’t think anymore but are never treated for the real causes which are hormonal! Other people are given too little thyroid, which is like not treating them, but doctors act like they are giving a narcotic and must be worried about addiction, when this hormone is necessary for life, and quality of life!

One of my hormone patients was the best example of the damage that doctors who are stingy about giving thyroid medication. Judy, 49-year-old came to me for many symptoms, only a few of which were related to low thyroid, however she was most concerned about her ability to think! I explained that she had three reasons she couldn’t recall names of friends and restaurant or street names. She immediately started to cry, “You mean I’m not crazy and I‘m not imagining my symptoms, and I don’t have dementia?” I have been to 5 doctors asking about my thyroid function because I had a lot of the symptoms and they all told me I was normal, and maybe imagining my symptoms! My GYN told me he doesn’t “believe” in replacing hormones after menopause, so he refused to give me any hormone replacement after my total hysterectomy! Do you mean I can get better?”

I treated Judy’s thyroid deficiency by the weight-based formula= weight in pound/2.2, times 1.75. That gave me the dose in micrograms of levothyroxine. Her number was 150 of levothyroxine, however I use Armour Thyroid for women. The formula to convert the mcgs of levothyroxine to Armour thyroid is 100 mcg= 60 mg of AT. I wrote her a script for 90 of Armour Thyroid and in 4 weeks her symptoms were gone! This formula is not a secret or hard to find..it is on the insert the pharmacist gives you when you pick up your prescription! Sadly,most doctors don’t know how to prescribe thyroid properly. The key to adequate thyroid prescribing is when your patient’s symptoms are gone, they are usually at the right dose!

I also replaced Judy’s estradiol and testosterone with pellets which took care of her other menopausal symptoms, and other causes of memory problems. She is back to normal, thinking clearly, not living in fear of having dementia and happily living her life again.

Brain fog can be from any or all of the three hormones estradiol and testosterone in women and testosterone in men, and thyroid in both sexes. Don’t give up. Find a doctor who will treat your thyroid with enough thyroid and remind them that the dose isn’t right if your symptoms of low thyroid aren’t gone.

There is a multitude of effective and safe treatments that mainstream medicine has not accepted yet, and I hope they change how they view the thyroid and thyroid deficiency. However, our patients are suffering now, and can’t wait for mainstream medicine to come to the realization that patients should feel better and have their symptoms treated, it is not just the numbers on a lab sheet that need treatment!

It seems to take decades for medical guidelines to catch up with medical research and curative hormone replacement. “MEDICINE” will not arrive at these answers for years. Patients can’t wait for the leviathan of medical practice figures this out. Your knowledge should help you negotiate treatment with your doctor, so you can live a full and productive life!

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Not all inflammation is damaging, however long-term inflammation can damage healthy tissue, create disease, allergies, and heart disease. We know that a limited exposure to inflammation is needed to heal injuries, but exposure to inflammation for an extended period causes the changes that occur with autoimmune diseases, it breaks down the collagen of joints, and skin causing joint pain and sagging skin, arteriosclerosis and creates a hyper-allergic state like asthma and eczema. We test for inflammation with a blood test called Highly Sensitive CRP.

We try to control inflammation in our patients to help them avoid the consequences of inflammation listed above. We do this by treating our patients with curcumin, and turmeric two herbal supplements that decrease inflammation. This is generally not enough to reverse longstanding inflammation. We use all the ways we know to limit the damage done by inflammation.

We also use the following methods of inflammation reversal:

Testosterone replacement when low T is found
Cox 2 inhibitors, Celebrex prescription
Weight loss
Treating longstanding infection or injured joints that continue to cause chronic inflammation
Treatment with Omega 3 oils, and decrease of the intake of Omega 6 oils

We have reviewed the first four methods of treating inflammation in other healthcasts, but we have become aware of a very effect oil and increasing the amount of Omega 3 oils. Omega 3 oils in your diet. We find Omega 3 oil in Marine fish and shellfish, so if a person increases their intake of fish like: Salmon, Halibut, Herring, Sardines, Trout, Oysters, Mackerel, and Tuna. You should eat at least 3 servings of fish a week or you can take Omega 3 oils in the form of DHA and Eicosatetraenoic Acid (EPA) every day as a supplement.

Omega 3 oils (DHA and EPA) are used by the body to limit the inflammatory process. Inflammation can be improved by limiting Omega 6 oils and increasing Omega 3 oil.

Omega 6 fatty acids primarily increase inflammation by increasing prostaglandins which have many positive actions in the body, so the goal is to increase Omega 3 oils from marine fish and shellfish, over and above the Omega 6 oils. By changing the ratio between Omega 3 oils and Omega 6 oils we can prevent or improve the symptoms of Crohns’ Disease, inflammatory bowel disease, endometriosis, and autoimmune disease.

The healthy amount of Omega 3 oil required to maintain a health, and prevent inflammatory diseases and side effects, is much higher than the amount that most American’s ingest every day. The ideal ratio of Marine Omega 3 oil, to the Omega 6 oils from seeds and nuts is 4:1. Most Americans consume Omega 3: Omega 6 oils in the ratio of 1: 20. New studies say this puts Americans in a state of inflammation throughout their lives and therefore there is a huge increase in inflammatory based foods.

In the past, we thought that oils made from seeds and nuts was healthier than fat and oil from animals and corn, so we thought we were healthier when we cook with oils made from seeds like sunflower oil or peanut oil. We now find out that that change in our diet has caused us all to be filled with inflammation! Now we know that Olive oil is the best oil to cook with to avoid using sunflower oil and other nut oils.

Patients who have inflammation on blood work (highly sensitive CRP > 3) require diet changes that changes the fats that they intake, decreasing the nut oils and increasing olive and fish oil.

This lifestyle change takes up to up to 18 weeks to reverse inflammation, but the process can be hurried along by taking fish oil with DHA, and EPA. Fish oil has both DHA and EPA in it.

Omega 3 oils should be increased for patients with high CRP, to decrease inflammation, and the diseases caused by it. If you have a high CRP this indicates inflammation, then changing your diet to eat more fish oil with DHA and EPA in it for as long as it takes to decrease your symptoms and your HS CRP is required. It is no wonder we have so many autoimmune diseases in our present patient population…our diet has changed to an unhealthy high level of Omega 6 fats and a low ratio of Omega 3: Omega 6 oils and the outcome is a deluge of autoimmune inflammatory diseases, allergies, and obesity!

Omega 3 oils are also vital to the health of your brain and arteries. For a long healthy, productive life, changing your diet is necessary. Sometimes being someone who doesn’t follow the crowd pays off, and in this case the crowd is headed off a cliff like lemmings!

You are what you eat and suffering from these diseases is the outcome of eating the wrong way!

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#8 You drink alcohol while you are dieting. Alcohol is a toxin, not a food and slows or stops weight loss. When you drink, your liver prioritizes your alcohol and gets it out of your system first….then fat and other toxins that you need to metabolize. Drinking every day keeps you from processing and losing fat…so it keeps you overweight. When dieting..stop drinking!

#9 You don’t drink water…just diet soda or tea or juice. Water consumption is necessary to mobilize and get fat out of your body. You MUST DRINK 8-10 8 oz glasses of water a day to be able to get rid of fat! Drink water…its free!

#10 Your medicines are working against you! Anti=psychotics often used for sleep cause weight gain, as do anti-seizure meds and ORAL estrogen (birth control pills, postmenopausal hormones, especially Provera) and ORAL testosterone, and some blood pressure medications like beta-blockers. Ask your doctor for alternatives if possible. If not, then you will have to emphasize the other ways to lose weight…it will just be a little more difficult.

#11. You eat because you are bored, not because you are hungry. This is a common reason people just can’t lose weight. Emotional Eating! Food should be your fuel, and you should consider what you are putting in your tank. Whole foods, clear water, fruit, meat, fish, and veggies are necessary to give you your energy to go through your day. Eating mindlessly should be replaced by eating at meals. Start by doing something else with your hands that keeps you from eating—do your nails, sudoku or crossword puzzles, petit-point, or hand sewing. These activities will keep you occupied and your hands busy. If you must eat something, make it pistachios with the shells—you will burn more calories getting the sells off than eating the nuts!

#12 Your gut bacteria have become damaged by antibiotics, fast food, and alcohol. You need healthy gut bacteria to absorb your nutrients and to lose weight. Feed your gut Pro-biotics and a salad every day and you will build a biome that will help you lose weight. The need for a healthy gut is cited every day in medical literature. People with just a few types of gut bacteria are fat and those people with many forms of gut bacteria are normal weight…You just must add a probiotic to your vitamins every day and eat salads to feed your bacteria!

#13 You don’t take vitamins and supplements: Our food is not as nutritious as it used to be.

To be truly healthy we must add to the nutrition we get from our food, especially when we are dieting and removing carbs from our diet. Everyone in the US should take Vitamin D 5,000 units/day, magnesium glycinate 400 mg/day, methylated B complex vitamins, probiotic, Vitamin E 400 MIU, Vitamin A 25,000 units, Zinc 15 mcg, and trace minerals.

If you are dieting you should add DIM ES 250-500 mg, chromium, protein powder with 25 gms of protein 1-2 times a day, Berberine, and vitamin K 100 mcg/day.

#14 You don’t plan your meals or your shopping list—you just buy food that looks good.

Being healthy and having the right foods at home is not more expensive but takes a few minutes a week. Shopping for food should be a stealth attach not a dirty bomb. When you go to the store you should have planned what you will cook for dinners, and what should be available for lunches and breakfast. There are expensive foods you don’t need to pay for the fresh foods you do need.

Here are my shopping guidelines: It is about WHAT you eat!

Use a list and a plan
No cereal, or oatmeal—especially instant oatmeal
No chips
Crackers should be whole grain
No rice (unless it is wild rice)
Buy fresh food for salads daily
Buy meat (ham, turkey) and cheese for sandwiches (one piece of bread each sandwich)
Bread should be high protein, nutritious (Dave’s bread)
Food for meals should be fresh or frozen veggies
Make multi-meal soups and stews—hold the bread
Leave the soda and everything except bubble water at the store
Leave anything that is baked goods and sweets alone
Use milk-based dressings, not sweet dressings on your salad, or olive oil and balsamic vinegar
Add nuts and dried fruit to your salad
Have nuts, cheese, yogurt, and dried fruit or fresh fruit available for snacks.
Eat lots of cheeses/butter—ricotta, cottage cheese, butter, blue cheese, feta cheese
Eggs are good!
Fat is not a bad thing for dieting..it fills you up and doesn’t stimulate insulin. No low-fat diets because they have sugar in them.
Get rid of junk food in your pantry—clean it out and donate or trash these foods..and don’t buy it again.
Growing kids need more carbs…but teach your kids to eat healthy carbs!

#15: You don’t Eat right for your Blood type.

Genetically, certain foods are either good or bad for your genetics. Follow the blood type foods for you type…(Dr. DaDamo, Live Right For Your Type).

Remember: Our parents didn’t necessarily feed us what was good for you…they just continued the habit of feeding you what they learned to cook from their mothers. In addition, you can have many different blood types in a family and the same food that is good for one of you is not the same for another member of the family.

Don’t perpetuate bad eating in a family!

Please take this to heart and follow the plan and you will be able to achieve a healthy weight!

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I have seen so many patients who come in for anti-aging Testosterone and estradiol who are 50-100% overweight and who do not follow my instructions for weight loss, that I am tired of talking to myself in my office! It is frustrating to try to help a patient who doesn’t really want to help themselves when it comes to denying oneself food or sugary drinks, or alcohol to lose weight……many of my patients just shut me out when it comes to diet and exercise.

I think being obese allows people to feel like a victim in our society when they are not! Working at being healthy is WORK! The benefits are that you get to your ideal weight, your joints don’t have to be replaced, you can exercise, walk, and keep up with your kids and grandkids and you will live longer and happier. If you take the easy way out and whine when I tell you to stop eating and drinking certain foods, then you are making the decision to be sick and overweight.

I am a prime example of working at being normal weight: I have the genes for adult-onset Diabetes and for Obesity (yes there are genes that make it harder to lose weight), but I am not diabetic or obese. A doctor taught me how to eat and not be hungry as well as to exercise to fit my body type, to keep me normal weight. It isn’t fun or easy….but I’m accustomed to it and I know every day I have to eat properly to be healthy!

Let’s start with going over the reasons you have trouble losing weight…you may have some or all of these reasons….but they can be adjusted if you have the courage to go for it!

#1. All calories are not equal: This means that any food has calories in it but foods made of one type of food like a carbohydrate, isn’t equal to the same number of calories as a protein. A calorie is a measure of the energy you can get out of any type of food, but your body uses the food differently based on the type of calorie it is, and how your metabolism is set up, genetically.

Example: If you eat 2 pieces of white bread you eat around 200 calories of carbohydrate. Instead, if you eat 3 eggs you have about the same number of calories, but your body doesn’t use them the same way. If you are already overweight, you are insulin resistant so a carbohydrate will overstimulate your insulin, and the carb calories will make fat and not energy. If you eat 3 eggs your insulin will not be over stimulated, and you will be able to make energy from the eggs.

A low carbohydrate diet is the one all women over 40 should follow to remain healthy and normal weight. NO SUGAR, NO CANDY CAKE< BAKED GOODS OR SODA! The carbs should be in the form of complex carbs like nuts, vegetable, and fruit carbs, but no corn syrup sweeteners.

#2 Your genes are working against you, and you may have inherited the genes for weight gain, Obesity, and or diabetes, but it isn’t necessarily going to cause you to be obese or diabetic. We now know that a person can turn off their genes for obesity and diabetes by living a healthy lifestyle. The study of this fact is called Epigenetics.

You are born with the genes from your parents and grandparents; however, genes are not a blueprint for your life that can’t be changed…If you eat a low carb diet and exercise daily you can turn your genes off and look and feel different from the blue print you were born with.

#3. You just diet and don’t exercise. Diet alone will not give you lasting weight loss. It is true that people who diet and fast can lose lbs. quickly, but it is generally a loss of water. Lasting weight loss takes eating right and exercise at the same time!

#4. You just exercise and don’t eat a low carb whole food diet: Exercise alone is not an effective weight loss method. Sadly, we can always out eat our exercise, and diet alone without exercise is not effective because our bodies were born to move, and they shut off calorie burning if you are sedentary. The more muscle you have, the more ability you must burn calories. It takes exercise to create and maintain muscle mass.

Exercise + a Healthy low carb Diet is the only way to lose weight!

#5. You are over 40 and gaining weight. Your successful ways of losing weight no longer work. After age 40 testosterone from the ovaries and testes decreases and goes away which causes weight gain. Testosterone is vital to weight loss because testosterone turns the calorie burning that occurs in our muscles, on. You need to replace it when you don’t have any!

Weight loss requires muscles and testosterone to burn calories efficiently. This is the reason most women gain weight after 40—testosterone decreases, the muscles don’t burn calories, and the muscles are replaced by fat. The smaller your muscle mass, the lower your basal metabolic rate.

#6. You just eat junk food and carbs, no salad, or fresh foods. Everyone who wants to be healthy should eat a salad every day. We are omnivores—we are built to eat fruit, veggies, nuts, meat, and a wide variety of fresh foods. Salad fills you up and provides nutrients that everyone needs. Salad also feeds your gut bacteria that make your feel-good neurotransmitters and peptides communicators. If they don’t get roughage…they aren’t fed and you don’t absorb nutrients or make the right neurotransmitters….you gain weight and get depressed!

#7 You don’t eat meat or high protein foods—Humans must eat half their weight in grams of protein every day to maintain their muscle mass and burn calories! If you don’t eat enough protein, you will lose muscle and decrease the number of calories you burn in a day. To find the number of grams of protein you need per day, divide your weight in pounds in half. The result is the number of grams of protein you need per day. If you exercise daily…you need even more!

Next week we will discuss the reasons you are having trouble losing weight, #8-15.

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I always hear my patients say things like, “I don’t care if these pellets cause me to die early, I’m taking them anyway because they improve the quality of my life and relationships”….I have to stop and correct them!!!

NO! replacement of estradiol and testosterone to women after they lose their own hormones makes you live longer!!! There are many research articles that prove that the replacement of hormones decrease the rate of dementia, osteoporosis, cancer, heart disease, Parkinson’s, autoimmune diseases and poor immunity that leads to death from infections, but it is hard to find a research article that says “Hormone Replacement Therapy is Associated with Lower Mortality”….but it does! American College of Cardiology March 8, 2017, published this study and supported it with real statistics---why didn’t we hear about this? Probably because if you are healthy because of estrogen replacement…then you don’t need so many meds and the drug companies don’t make as much money on medications!!! If you doubt that they have the power to suppress information, then you are dreaming!

You don’t have to give up a long life to lead a quality life! My goal in treating my patients is to lengthen and strengthen them against all diseases! Hormones are what makes us bulletproof when we are young, and if we replace them, we don’t age as quickly and we avoid the diseases of aging. In my books The Secret Female Hormone, and Got Testosterone? (Available on Amazon), I describe the diseases that can be avoided or delayed by taking bioidentical testosterone pellets for both sexes. This is just one of the thousands of research articles I have found that prove that replacement of E2 and T for women and T for men make us live longer.

The article cited here tells us that women taking estradiol for hot flashes and vaginal dryness also decreased their risk of death from atherosclerosis, decreased plaque buildup in the heart’s arteries, compared to women who did not take estrogen after menopause.

It also states that the replacement of E2 has been considered controversial because of the flawed 2002 research by the NIH (WHI STUDY) that stopped women all over the country from receiving prescriptions from their Doctors for estrogen. The doctors didn’t read the study…just the headlines and stopped prescribing estrogen. It was also easier for them to never have to talk about estrogen again…but their patients suffered. I can remember all the screaming horrible phone calls we received after my patients stopped taking their estrogen on their own after reading the NIH headline…the headline was in fact wrong…it was Provers—a synthetic progestin (NOT PROGESTERONE) that caused the results…not estradiol!

I never took my patients off estradiol because I knew the truth…and I needed the replacement of my estrogen after my oophorectomy, and I couldn’t think or sleep or anything else!

Now 15 years later we get the right information that estrogen replacement saves us from heart disease (the biggest killer of women), and osteoporosis, stroke, and even cancer!

The 2002 WHI study cause American women to stop taking estrogen—60% of menopausal women took E2 replacement in 1998, and less than 23 % inn 2012. 6 percent of women died during the average follow up period of 8 years.

During the study period women on estrogen replacement therapy (ERT) were 30% less likely to die of heart disease than women not on estrogen at the same ages, Estrogenized women also had much lower rates of diabetes, high blood pressure, high cholesterol, and higher rates of zero plaque on their cardiac calcium scans!!

The lower rates of plaque are due to the estrogen effect of decreasing cholesterol and diabetes. Studies show that women with high levels of estrogen during

premenopause, have the cardiovascular health of men 10-20 years younger than they are! After menopause that advantage is lost, but women have the opportunity to regain cardiovascular benefits by replacing estrogen.

What are your reasons for not replacing your lost estradiol? It saves your heart and vessels and prevents many diseases of aging. If you replace your estrogen with pellets, you avoid the risk of blood clotting problems found in oral estrogens, and there is no increased risk of breast cancer either! What is your reason for not replacing your estrogen? Your doctor won’t write a script? Change doctors to someone who is up to date and not too lazy to bother with your hormones!

Reference Am College of Cardiology MARCH 8, 2017, “HORMONE REPLACEMENT THERAPY ASSOCIATED WITH LOWER MORTALITY”.

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Vitamin D is not just a vitamin, as most people think, it is a HORMONE called Cholecalciferol that is required for general health, thick bones, for making muscle and your immune system, your brain function, and for protecting you from diabetes, heart disease and cancer. Vitamin D also acts to assist your body in absorbing calcium and zinc from your food and supplements. Without Vitamin D3 these vital minerals go through your body without absorption, and you just excrete them without being able to use them.

The vitamin-hormone Vitamin D comes in several forms. The form D2 comes in natural food sources such as salmon, swordfish, egg yolk and fortified foods such as milk, orange juice and other milk products like yogurt. However, Vitamin D2 is not a potent form of Vitamin D. Vitamin D is also produced by your skin in the melanin when you go out on a sunny day, however you would have to be out daily for most of the sunny hours, without sunscreen, at a latitude like where Phoenix and Destin Florida is or further south to absorb enough Vitamin D from the sun.

Your skin absorption in the 21st century is usually minimal since medical science has promoted the use of sunscreen every day all day long which blocks our absorption of Vitamin D.

Your skin tone also alters how much Vitamin D you absorb from the sun. if you have very light skin and burn easily it takes less time in the sun to absorb the same amount of vitamin D than someone who has dark skin. It is a given that most people who do not live in the southern US and have dark skin are not getting enough Vitamin D from the sun even if they work outdoors all day long, so they must take a supplement orally or in a shot of VitaminD3. The recommended oral dose is 5,000 MIUs of Vitamin D3 every day to receive enough Vitamin D in their body.

For all people with all skin types, you should be out in the sun for an hour before you cover yourself in sunscreen. The sun gives you vitamin D, but also has other benefits. Remember no matter what skin type you have, the tanner you get the less vitamin D3 you absorb. It is a protective mechanism to prevent overdosing with D from the sun for those people who have dark skin and live in the sun around the equator.

What does it really do?

For one thing Vitamin D is essential to your immune system. If you want to be immune to viruses and bacteria as well as cancer you must have a normal blood level of vitamin D. The accepted level is 30 from the US government but it is preferable to have a blood level of 40-100 for optimal health. The other jobs of Vitamin D include Building muscle and bone, normalizing blood pressure and Type 2 Diabetes, preventing heart disease, stroke, and dementia. If you want to stay healthy throughout your life you should take oral Vitamin D3 5,000 miu per day.

The Actions of Vitamin D3:

We have already listed the important job of supporting your immune system to prevent infection and cancer. The addition Vitamin D supports Muscle and bone. Without Vitamin D, children get a disease of soft bones that bow their legs and prevent normal height, called Ricketts. It was common in the early industrial age when children were kept inside factories all day long to work instead of playing outside.

Adults we must have Vitamin D to keep our muscles strong, and our bones thick. Muscle and bone are in a state of homeostasis which means they are growing and breaking down all of the time. If breakdown is more rapid than growth the bones become thin and are apt to break. The other necessary elements to keep bone and muscle strong are Calcium, Magnesium Vitamin C, and Vitamin K2.

For optimal skeletal muscle (which includes the heart) you have to have adequate vitamin D levels in your blood. For example, patients in a recent study increased their muscle fiber size by taking 4,000 IUs of Vitamin D3 a day. They also made more Type II muscle fibers which are responsible for rising from a chair or lifting things over your head. Type two muscles are located in your hips, back and shoulders. Another study showed the just 1,000 IUs of Vitamin D3 increased muscle strength by 25%, without any other changes in diet or activity. Muscle training and exercise are also important, but you won’t get the results from just taking Vitamin D, or exercise alone, that you would if you take Vitamin D3 + Exercise + Testosterone. If you are over 50 and don’t exercise while you take Vitamin D and replace Testosterone with pellets.

Type 2 Diabetes also affects 50% of our population, primarily from eating too many carbs, without exercising, but low vitamin D contributes to the development of diabetes and obesity as well. All people who are Insulin Resistant, who have Type 2 Diabetes or Prediabetes should be taking 5,000 MIU of vitamin D3 a day.

Summary: The easiest and cheapest way to prevent heart disease, stroke, osteoporosis, cancer, type 2 diabetes, and dementia, among others because it improves your immune system too. If you are Latino, Black, Italian, Israeli, or Greek, in, fact if your genetics are from any country around the Mediterranean, or just have dark skin, you must take Vitamin D3 to stay healthy! It is over the counter and relatively cheap. You should take Vitamin D3 in oil-capsule form for good absorption.

Remember….Taking Vitamin D3 doesn’t replace going outside for sun absorption. It is in addition to being in the sun! Sunscreen prevents Vitamin D3 absorption.

Vitamin D may cut heart disease risk in dark-skinned adults

A study to be presented at the Experimental Biology 2021 virtual meeting found that taking vitamin D supplements may help people with dark skin, including African Americans, to reduce their risk for heart disease.”Promoting adequate vitamin D status in young, otherwise healthy adults may improve nitric oxide availability and blood vessel function, and thereby serve as a prophylactic to reduce risk of future development of hypertension or cardiovascular disease," says researcher Tony Wolf.

Full Story: Medical Dialogues (4/27)

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Colon Cancer is the third most common malignancy in the US and is something you don’t want to get and there are many ways to test you to see if you have pre-cancer, cancer or polyps which are also risks for cancer. They advertise these tests that you can do yourself by testing your own poop. My family physician daughter advises our patients that those tests do not adequately test for pre-cancer or colon cancer. They might find a cancer, but they will miss more than they find.

90% of Colon cancers are diagnosed after age 50. The incidence of colon cancer in the US is 4.2% and if there is a family history in a close relative before the age of 50, the incidence doubles to 8.4%.

What makes a person high risk other than family history?

Personal history of adenomas (polyps) on colonoscopy
Large adenomas (more than 1 cm)
Multiple adenomas
Flat adenomas that are difficult to remove
Adenomas that have precancerous lesions
Ulcerative colitis increased the risk dramatically

Colon cancer can progress without many signs therefore it is important to get a colonoscopy under sedation when you are 50. After that, depending on your risk factors your doctor will tell you how often you will need surveillance.

Now, as for the other tests that you can do at home in between colonoscopies, my favorite is the stool guaiac test looking for microscopic blood. This blood doesn’t look red and is not visible. I used to do vaginal and rectal exams at the same time during gyn exams and would test the stool on my glove for microscopic blood (the guaiac test) by taking the sample, smearing it on a card and dropping a drop of developer on it. If it turns blue, there is microscopic blood and possibly cancer. I rarely had a positive, but if I did, a referral was made for a colonoscopy, and it was about 50% positive in my testing experience. The same test at home can be done on 3 successive stool samples and this should be a good test to do at home.

They have just come out with a FIT test (fecal immunochemical test) that tests for DNA mutations of colon cells. It is more sensitive and accurate than Guaiac test but not as accurate as a colonoscopy. It was determined that the best frequency was 2 x a year.

As it stands the colonoscopy is the best test, but it requires sedation and an invasive procedure, however low risk. I still recommend a colonoscopy at 50 and every 10 years thereafter. Soon I am sure this FIT do at home test will be recommended frequently to lower the number of Colonoscopies, as a matter of cost saving. High risk individuals should continue with colonoscopies until the recommendations change.

Prevention is my recommendation:

Eat a fresh salad every day
Drink more than 10 -8 oz glasses of water daily
Alcohol and sodas to a minimum.
Probiotics daily
Vitamin D, and Vitamin C
Report changes in your stool to your PCP
Report any obvious blood in your stool to your PCP
Double probiotics whenever you need to take a course of antibiotics.

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Osteoporosis is a side effect of aging and is one of the diseases that affects aging women more than aging men. Osteoporosis can lead to fractures of fragile bones, spinal stenosis, chronic back pain, and inability to walk or take care of ones-self. In the aging population it is one of the diseases that leads to women being admitted to nursing homes.

The disease occurs in women more than men for two reasons. Bone thickness is stimulated by the hormones estradiol and testosterone, and testosterone builds bone better than estradiol. Men have ten times as much of it than women! Therefore, men have stronger bones to begin with, before their testosterone starts to drop, and men never totally lose testosterone like women do! The second reason is that women lose both testosterone and estradiol earlier and more completely than men lose testosterone, so their bones start to thin over a decade before men. Osteoporosis is a women’s disease and the cause of many women’s deaths.

A bit about how bones grow: Your bones are dynamic and always growing and breaking down. When we are young our bones grow at a much more rapid rate than they break down. They are under the stimulation of growth hormone and low doses of sex hormones as well. After age 40 the breakdown process occurs at a faster rate than the building of bone unless testosterone and estradiol are replaced. I bet you thought your bones stopped growing when you reached your adult height, and were static…doing nothing until they started to dissolve?

When I went to medical school, (late 1970s) we knew that hormone loss was the cause of osteoporosis, but it was not such an epidemic as it is today. In the 70’s, women were routinely given estrogens when they went through menopause and stayed on them for years, which counteracted their loss of bone. Result? No osteoporosis!

We didn’t even need to look for a solution for osteoporosis because women didn’t get it! The reason the use of estrogens ended was that they were given without progesterone, and some women got uterine cancer from un-opposed estrogen. It is a generally a very treatable cancer, but the use of estrogen was banned because like all governmental medical decisions, the US government overreacted to a small subset of women getting uterine cancer instead of looking for a way to give estradiol safely. The resultant ban of the use of estrogen resulted in a current epidemic of osteoporosis.

In the 1990’s the people that control medicine in the US realized the danger of osteoporosis to women and the drug companies created drugs to treat it! Instead of using the best treatment for osteoporosis, estrogen and now we know testosterone, they reinvented the wheel and created bisphosphonates, Fosamax an Alendronate. These drugs have many side effects, but we have found over time that the only thing that these drugs do for bones is to make them look denser on Xray, but they are NOT stronger! What a mess! This disease is very slow to cause fractures therefore finding out that bisphosphonates don’t work to prevent fractures! The drugs however did make billions of dollars for the pharmaceutical companies!

Now we are in another century, and we have discovered that treating women with Estradiol and testosterone is the best treatment to prevent fracture! An old trick that should have been found decades ago and saved many lives. My patients can improve their bone density in 2-3 years on E2+ T pellets, from osteopenia (mild thinning of the bones) to normal. It takes a little longer with patients who have overt osteoporosis, but it works.

Some patients depend on Vitamin D3 and Vitamin K2 to treat their osteoporosis after menopause. That is really just fooling yourself! These two nutrients are necessary for bone growth and should be taken with the two hormones, but after menopause without hormones, they don’t make bone. It is like putting plant food in the potted plant and putting the plant in the closet. Hormones are the sun that make bones grow. I know about this problem intimately because my mother the herbalist refused to take estradiol after menopause. She literally died in excruciating pain because her vertebrae collapsed and there was no bone left to repair her. She had to wait for death in hospice because her bones had dissolved.

So, what if you are under the delusion that because you have dark eyes, dark skin, and dark hair you have great bones? Nope….your coloring doesn’t necessarily determine your bone density!

My mother had osteoporosis and was blond with blue eyes, however I look like my dad but have my mom’s bones! Add Lupron for endometriosis, too many diet cokes, and no Vitamin D3 in my diet and you get Osteoporosis in my 40s! At age 47 I was treated with T and E2 pellets and two years after that my hormones built my bones back to normal density! I knew bisphosphonates didn’t work so I never would have taken them…I also didn’t prescribe them unless I couldn’t treat a patient with anything else!

So, if you think that you can use supplements to build bone after age 40, or that you are immune because of what you look like, or your heritage, think again. The only guarantee to prevent osteoporosis and dying like my mom or of a broken hip is to replace the hormones that you had when you were young!

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Testosterone treats many illnesses in addition to sexual dysfunction. Most patients and doctors don’t associate testosterone with the anxiety and depression that occurs after age 40. Depression is a direct side effect of low T. T is a mood elevator and stimulates Seratonin production, improving mood in that way. Many of our patients can decrease the dose of antidepressants or even go off their medications after they have been on T for more than 4 months. I always ask my patients to ask their “depression doctor”, who prescribed the antidepressant, to help them wean off. A side note: I do not recommend decreasing or stopping antidepressants during the fall, because we live in the Midwest and there is very little sunlight at our latitude between September to February, so I ask that they don’t change their antidepressant during those months. Remember testosterone if you develop depression after the age of 40.

Testosterone also treats anxiety in both men and women by lowering FSH and LH, the pituitary hormones that surge after T and Estradiol decrease with age. Many men come in to see me for low T and ED, who have recently been prescribed Xanax or some other antianxiety drug that is not working for their anxiety. However, when I treat them with testosterone pellets, they miraculously are cured of their anxiety! Women generally have hot flashes from elevated FSH/LH, however some of them have anxiety as well. Women are cured of their anxiety attacks, with T pellets plus or minus Estradiol.

Other conditions that are improved when I treat my patients of both sexes with T pellets is Insulin resistance, AODM, and weight gain. T improves insulin resistance and increases the calorie burning in the muscles. You burn most of your calories every day in your muscles and T facilitates the metabolic work in the muscle tissue. With testosterone, you literally burn more calories by jut breathing (your Basal Metabolic Rate). T increases your muscle’s activity by burning more calories of fat and stabilizes your blood sugar. Our patients lose fat, gain muscle mass, and become more insulin sensitive with T pellets. Those with diabetes decrease their medication over time and have a lot more energy…the natural way…by activating their muscles!

Immune dysfunction occurs when you age and is why older people need a higher dosage of immunizations, and why they die of viruses that younger people don’t die of. Your immune system is controlled by your thymus gland which makes white cells called T killer cells, T helper cells that kill cancer cells and viruses. B cells make antibodies. The thymus and its function is growth hormone and testosterone dependent. As growth hormone and T decrease, the gland shrinks and by age 50, and by age 60 it can’t be seen and stops doing its job of protecting us. By taking testosterone, growth hormone is stimulated, and the thymus gland grows and is active making these cells that protect us. There is a peptide that stimulates the thymus for those people who don’t fully respond to Testosterone, called Thymosin alpha-1. This is a communication peptide that stimulates the production of protective immune cells. It has

been around forever as a medication, but no one used it because it doesn’t have a big drug company behind it…so it is available at compounding pharmacies. The FDA has started to stamp it out across the US, for no apparent reason. It improves immunity to all infections. In this time of pandemic, this drug should be applauded and not taken off the market! What are they thinking?

Autoimmune diseases occur when your immune system, your T Cells and B Cells, become confused and instead of killing viruses and bacteria, attack your own healthy tissue. This imbalance occurs secondary to a genetic weakness as well as exposure to infections that “look like” normal tissue. Testosterone deficiency causes an unstable immune system and leaves the door open for autoimmune diseases. I was very surprised when my patients with autoimmune diseases like RA, Lupus, and Sarcoidosis, improved drastically after they got T for completely different indications! I then researched this association between T and Autoimmune diseases and found that there is a lot of research that proves T is an excellent treatment and prevention for autoimmune diseases.

Migraine Headaches response to T replacement, were another surprise for me. As I treated sexual dysfunction in women, they came in to see me and said: “The weirdest thing occurred after I got my pellets…I stopped having the incapacitating migraines I used to get! This is an amazing two-for….I have stopped taking my migraine medicine!” . Once again, I went to the research and found that hormonal migraines can be treated with non-oral testosterone. The migraines that are triggered by food additive and weather changes are usually not improved, but women have hormonal imbalance migraines, and T works for that. Why? Testosterone is a modulating hormone for many systems, but in this circumstance, it is working in the brain to balance the neurotransmitters and the vasodilation chemicals that get “confused” when it is deficient, and the effects of E2 increased and dilated blood vessels.

PMS is another problem that is improved with testosterone. PMS affects every part of a woman’s body…It is the outcome of estrogen dominance with a progesterone deficiency. This era of a woman’s life can occur at any time in her life; however, it is much worse during after age 40. Why is that? Because after 40, testosterone becomes deficient, estrogen is dominant, and ovulation becomes spotty which is the function that produces progesterone.

Weakness and loss of strength occurs after age 40 in women and some men, and this is directly due to the loss of Testosterone and the decrease of T free. This dominos to a less active person, and this results in osteoporosis and frailty. Here is a news flash…Frailty is the one thing that will cause a person to become dependent on others and unable to live independently! Losing muscle is not what you want! Testosterone prevents frailty, by directly stimulating muscle mass and strength, including the heart, which is a muscle, and by stimulating growth hormone which also builds muscle and bone!

You get so much more than a good sex life (Which should be good enough) when you replace your T . Health is a precious commodity, and it should be a priority for you! Life with health is the only way to age…consider replacing your T in the safest way possible— T pellets are my choice, but please replace missing T in any way you can.

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Last week we talked about obesity as the biggest risk to both individual health and to the overall health of Americans. This is not fat shaming…this is a fact! Americans are inundated with advertising which literally makes them hungry for foods that make them fat, which then makes them hungry for more high calories food….we are being fooled into eating what is killing us!

I think the epidemic of Obesity in the US is caused by the following:

Fast food, Junk Food
Sugared and Diet soft drinks
Excessive Alcohol intake (and high calorie mixers they are served in)
Lack of physical movement
Lack of exercise: TV, driving, video games,
Mental vs Physical labor
Sugar substitutes that cause obesity (Splenda (yellow) Saccharin (pink) Equal (blue)
Stress

Fast food= High calories + High Carbohydrates= Weight gain

The only time I have fast food is when I am traveling by car. This summer, I took note of all the calories/carbs in the fast food we were stopping for which made me horrified at the possible total daily calories one meal can generate. By driving I am not exercising so basically, I am fatter when I get somewhere than when I started….next year I’m packing my food!

The basal metabolic rate = the number of calories you burn in a day if you aren’t working out and exercising is generally less than 2,000 calories, and the shorter you are the fewer calories you need. Your weight doesn’t increase the number of calories you need unless your weight is from muscle. Fat doesn’t burn any calories, only muscle does!! This means that if you eat 2,000 calories per day and sit at your job you will stay the same weight. If you eat more you gain if you eat less you lose.

But a calorie isn’t a calorie…in other words all calories aren’t equal. Even though fat contains more calories per oz than protein or carbohydrates, carbohydrates impair your ability to burn calories by making you insulin resistant…carbohydrates are more damaging to your weight loss than any other food and fast food is full of them!

Here is what I found out about fast food.

Big Mac = 540 calories

Burger King Large Fries = 434 calories

Chick Filet Chicken sandwich = 430 cal

Chick Filet sandwich = 440 calories

Chipolte Burrito-Carne = 570 calories

Dairy Queen ½ lb. grilled burger with cheese = 800 calories

Dairy Queen brownie batter Blizzard, medium = 880 calories

KFC Fried Chicken one Chicken breast = 360 calories

McDonald’s French Fries large = 510 calories (all carb and fat)

Panera/STL Bread Co asiago cheese bagel = 320 calories (all carb)

Pizza Hut meat lover’s 1- slice = 410 calories (who eats just one slice?)

Taco Bell soft Taco = 180 cal each

Coffee Calories: Coffee at Starbucks is really just drinking dessert!

Coffee black any size = 0 calories

Starbucks Café mocha Vente = 280 calories

Starbucks Café mocha vente = 330 calories

The Point: Cooking at home with olive oil and other polyunsaturated oils with low carb contents is more conducive to weight loss than eating fast food….No surprise!

Soft Drinks

Soda is just eating a bowl of corn syrup with carbonation---It is deadly because it readjusts your insulin, by increasing your insulin to cause insulin resistance. Insulin resistance is the problem when it comes to weight loss as adults…and some children. These drinks should be removed from the American diet…they provide no nutrition, and they cause obesity.

Obesity can only be treated by and avoided by consciously eating a healthy diet without fast and junk food, without soda and simple sugars. The other side of this is that Americans must sit less and exercise and walk more. Know how many calories you can eat and minimize carbohydrates. If we eat it, big business will continue to sell junk and fast food. We have been a bad example to the rest of the world by exporting all the fast-food franchises to other countries. We must take the lead in following healthy patterns that provide profit for companies that make healthy food and drink instead of the food and drink of obesity and the addiction to sugar!

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WHO: 4 million people dying each year as a result of being overweight or obese in 2017 according to the global burden of disease.

In 2016 1.9 billion adults worldwide were obese.

Right before the pandemic I treated a couple from Copenhagen, Denmark. They were delightful people who had never been to the US before. When they were in my office, they told me that they were in the US because we could treat menopause and low T with compounded medicines which are not available in their country, which is has socialized medicine and very few choices in terms of medication and medical treatment. We found out later that their country won’t even allow the shipping of estrogen cream or any type of hormone into their country. I have no idea what the logic is behind that policy baffled them as well. They were here for medical treatment that they could not obtain at home. They told me that they often must go to France for the treatment they need and now they were in the US seeking help with their hormone deficiency.

Their reflections on our way of life and how they viewed our people jolted me into observing the American people and our way of life differently. While going to the grocery store for some fresh fruit they told me they were shocked by two things: Nearly everyone was obese, and the food in the carts of these people were primarily junk food, processed food, and soda. In their country people eat fresh fruit vegetables, and lean meat, and baked goods, and do not eat processed foods. The people in Denmark have a very low % of obesity. They walk everywhere in their tiny country, exercise is their entertainment like biking, walking, and hiking. The number of obese people shocked them! I opened my eyes and realized what an epidemic we have and how this is affecting our overall health.

Obesity is the new epidemic in the US. In 2010, 30% of US citizens were obese which jumped to 42.4% in 2020. In just ten years we have increased the number of obese people by 12.4% !

Note that this number was calculated before the 2020-2021 pandemic. Worse yet, the rate of severe obesity more than doubled in 10 years and increased by an uncalculated percentage by the quarantine from Covid..

Ok, you’re thinking ……so what? People have the right to choose to eat as much as they want and exercise as little as they choose to…..that is correct, but sadly the number of obese people affects all of us. Obesity is one of the main factors that put people at risk for hospitalized covid patients which has affected each and every one of us, obese of not! If you fly or sit on a bus and are normal weight, your seat is encroached upon by obese people using the space on your seat to accommodate their derriere! The cost of health insurance goes up every year and that increase is affected by the fact that obesity leads to many other diseases such as heart disease, diabetes, depression, infections requiring hospitalization, dementia, elevated cholesterol (which triggers treatment), knee and hip replacements, and increases the risk of all infections becoming severe including viral and bacterial infections. The advances of medicine cannot compete with the obesity epidemic when it comes to eating our way to illness.

This is the problem that you may have become immune to since you are surrounded by the problem, or you are overweight or obese and in denial. yourself. We have become a sick society who site most of the day and drives a car everywhere…we sit and watch our children play sports, sit at pro sport, we hate even walking from the parking lot to the grocery store.

We are unable to prioritize home cooked family meals over fast food in the back seat of the car as we drive our kids from place to place. We don’t have time to exercise because we waste time on things that make us sick. Wake up!….having a normal weight would prevent early death and all the diseases I suggested….. but our mentality only looks toward the next day or week, requiring immediate satisfaction.

Think of this. When I tell a patient that she or he can no longer drink 3-5, or any large corn syrup containing soft drinks a day if they want to be healthy and lose weight. Many of them cry! The sugar is their addiction and their “friend”. Food is meant to be the center of social gathering and familial sharing. It is food like gas you put in your car…would you pump water or soda into the tank of your car? No? Then don’t pump it into yourself and your kids….we are killing ourselves…but worse yet we are setting ourselves and our children up to die a painful slow miserable death from avoidable diseases that start with obesity.

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Situation: over the Covid Quarantine many of my patients became addicted to alcohol. I found that my training was wanting in terms of making my patient aware that I knew they had a problem and that to be healthy and productive they must deal with this problem, addiction.

I would like you to share your experience in treating alcoholics and some important dos and don’ts when it comes to talking to an alcoholic who is in denial about their addiction.

Let’s say an alcoholic is convinced that they have a problem and get into counseling with you, where do you start to untangle this problem so that they can see that they do have a problem?
Once an alcoholic is convinced that something must change as to his or her drinking what is the next step for them?
One of the things I learned during the quarantine was that it is never good medical advice to stop drinking alcohol cold turkey without constant medical treatment and oversight (like they offer in rehab). Most people are afraid of rehab because they don’t know what will happen to them….the fear of the unknown actually prevents them from getting help. Can you give us a thumbnail description of what happens in rehabilitation?
Many of my patients become addicted to sugar in place of alcohol. Can you tell me why that occurs? What can we do about it other than feed them a whole foods diet with low carb?
Are there certain supplements that can be used to treat the side effects of alcoholism, and to replace the vitamins that are used up by drinking alcohol chronically?
The fear of the first 2-3 days of withdrawal is always a deterrent to getting treatment.

It might help to explain the treatment for withdrawal in a medical setting if someone hasn’t stopped drinking by weaning down on the amount of alcohol, they take in. The current medical treatment for withdrawal from alcohol that is recommended by the American College of Family Physicians. I have added some supplements to replenish the body after alcohol addiction and to help clear the liver. In general, Acute and Subacute withdrawal should be monitored and treated in a medical setting with physicians available. It is only necessary for a short period of time.

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2020-2021 has been a huge year for diagnosing my patients with alcohol addiction. It is well known in the psychology, counseling, and medical profession that the recent quarantine caused by Covid 19 created the perfect atmosphere for potential alcoholics to become true alcoholics. I am not a counselor and have no training in diagnosis of alcoholics. More importantly, I have a difficult time confronting patients who show evidence of being an alcoholic, even when it is blatantly obvious that the patient sitting in front of me has been drinking. My nurse practitioners have also asked me how to address this problem when it is obvious that our patients, those who are coming in to have a consult with me to receive hormone pellets to get healthier are negating their own treatment with their addiction to alcohol. I wasn’t taught how to discuss this subject when I was in medical school, so I asked an excellent psychologist with more pages to his CV than mine, to help me and my viewers understand how to help themselves or their loved ones who have a problem with alcohol. My guest is Michael Mahon, Psy.D., who has a weekly podcast called Psych with Mike, and a website of the same name.

Michael Mahon is a Doctor of Psychology, from California Southern University, Irvine, 2011, who spent 20 plus years as a licensed counselor in private practice, and who has years of teaching other counselors at Webster University and two other universities.

Questions to Dr. Mahon:

Would you please Define Alcoholism and help us understand the difference between alcoholism and Social Drinking?
- Alcoholism is defined as an addiction to alcohol that causes tolerance to alcohol and withdrawal symptoms when an alcoholic is not drinking.
- Alcoholism is now viewed as on a continuum with Alcoholism at one end and excessive intake of alcohol without tolerance or withdrawal symptoms.
What are the known symptoms and signs displayed by an alcoholic?
- An alcoholic has the primary symptoms of irritability, a mood change.
- When alcoholics are drinking, they may not be so uptight and are more social and more cheerful. The opposite is true when they are not drinking.
What kinds of social issues do alcoholics have that may be a clue to their problem?
- Irritability and being in denial can cause quite a bit of friction within a couple’s relationship. Being confronted by a spouse put an alcoholic in more denial than ever.
- They tend to have cover stories to hide their drinking
- They black out and must cover their tracks which leads to lying and distrust in the relationship.
Why are alcoholics in such denial about their condition?
- Alcohol provides a modicum of medical therapy for social anxiety and other psychological problems which makes the alcoholic want and need to continue.
- The problem comes in when an alcoholic can’t stop drinking at the point when their social anxiety is improved…they always think that more is better and that is the problem, it isn’t!
How do people act at home to hide their drinking problem?
- They closet drink, take meds to cover up the tremors that occur when they are withdrawing.
- This leads to evasive discussions within the family. Everyone feels out of control.
- Remember you can’t change another person’s behavior, just your own.
- Any ultimatums must be something that you can follow through with.
Alcoholism Is like other addictions, how should it be discussed with a loved one who is obviously an alcoholic?
- Confrontation or asking an alcoholic to stop is not ever going to work until they have already decided to stop drinking. Then it is time to help the alcoholic get into counseling.
What is the best way to get an alcoholic into treatment, counseling?
- The alcoholic must be ready to stop, and family members must be ready to stop being a codependent.
- Counseling is for alcoholics who are trying to decide if they want to quit drinking or after they have gone through rehab to help him or her through withdrawal. No alcoholic who drinks daily should go cold turkey. It could be deadly, so being admitted for medical withdrawal is the only safe method.
Could you please discuss what rehabilitation centers do for the alcoholic?
Rehab centers provide a safe place to withdraw from alcohol. They are also there to arrange outpatient follow up for counseling to help the alcoholic get through the first several months.
This process is called “Stages of Change”. It has been very successful.

Thank you to Dr. Mike for educating us on Alcoholism and the symptoms as well as the steps to recovery. Next week we will talk about Achieving a Lasting Solution to Alcoholism.

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John Behr is the husband of my patient, Marcia Behr, who I interviewed last week about her success with BioBalance® Testosterone and Estradiol Pellets, who told me that her marriage had been positively improved after she had her consultation with me and had her pellets inserted six years ago. John watched the amazing improvement in Marcia in her energy, her beauty and her sex drive and he was impressed with the “fountain of youth” that pellets provided for her, but six years ago he didn’t feel like he was aging or losing energy or sexuality, so he was a bystander continually amazed with her renewed health.

John told us that a year and a half ago he was having trouble with his libido and energy, so he started investigating a variety of sources of information about the benefits of testosterone to the health of aging men. He is a mechanical engineer by training and profession, so he is a man who has to investigate everything before he makes a decision. John told me that the thing that made his decision for him was reading my book, “Got Testosterone?”. He brought his copy to emphasize the importance of reading my book in making his decision to receive testosterone pellets.

John is a very handsome and young looking 62 years old and he is dynamic and has been the Vice President of Engineering, at both Schnucks (a regional supermarket chain) and Hussmann (a major supermarket refrigeration equipment mfr.). He is glib and entertaining in his presentation of his experience with our office. John saw my daughter Dr. Rachel Sullivan, for his initial consultation and had his pellets inserted immediately afterwards.

He said he started to feel the effects of testosterone pellets after 4 weeks. He was back to his energetic active and happy self. He told me that it was as if the clock turned backward.

I was impressed with his understanding of male physiology, and he has had such a wonderful outcome including increased muscle mass, loss of belly fat, increased libido, and faster more effective multi-tasking. He was back! He said it was hard to believe he felt so much better.

In my opinion John has had such a wonderful outcome because he followed my medical advice and changed his diet to whole foods and he exercises daily, and takes his supplements as advised. Even more importantly, he schedules his appointments for his pellets on time and has his pre-consultation blood drawn as recommended. He is the perfect patient and exemplifies what can be achieved through replacement of testosterone with BioBalance® T Pellets as well as lifestyle changes.

John and Marcia are always looking for ways to have fun. They do all the work on their farm themselves and John prepares his land for hunting season all year long. There is always work to be done on their property. For fun they go out to dance and have a glass of wine at a nearby restaurant. Everyone is amazed at how young Marcia and John act and dance! They never guess their ages are 62 (John) and 65 (Marcia). Health is a wonderful thing and can make the rest of your life as good as the first half!

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There are many reasons I treasure Marcia Behr as one of my favorite BioBalance pellet patients: Marcia came to me miserable and desperate to be healthy and get her sex life back as well as her health and body, and she listened to all my advice, and worked hard at all of the tasks that only she could do to make the most of her testosterone and estradiol pellets, so she could get her life back; Marcia did not get results easily, but she never lost her positive spirit to get better; Marcia has a mission in life to help children with music and she put this calling into action by becoming a dedicated Music Therapist for Special ED children. She changed the lives of Special Ed children in Missouri when she proposed and passed legislation to make it required that every special ed child be evaluated to see if music therapy might help them develop; Lastly and most importantly, Marcia has a great sense of humor and hunger for an active life no matter how old she gets!

In our interview, Marcia told us about her life before pellets, when symptoms of aging snuck up on her and her sex drive faded, she was fatigued, and gained 20 pounds and she felt her “light” go out. She told me about how the changes in her caused many problems with her husband even though he is very understanding, since he is quite a bit younger than her, and he couldn’t understand what had happened. When she got her sex life back right before the holidays 6 years ago, they gave that event a pet name for that special Christmas when she came alive again.

I brought up that she was a good example of understanding the relationship between a patient and her doctor: good relationship between a doctor and patient requires that both parties want the patient to get better. The patient must have the intention to get better, to do her part to follow instructions and do as the doctor asks, and the doctor must have the intention to heal the patient. If either piece of these two elements don’t exist, there will not be a successful outcome to the treatment, or cure. These two requirements are what both Marcia and I worked on, and we achieved an excellent result!

Now when Marcia and John go out, no one can believe that she is 65 and he is 62, because they dance like they are 35 and look like it too. If you don’t believe me, tune into my Healthcast # 566 on You Tube and see for yourself!

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BioBalance Health®, Dr. Kathy Maupin and Dr. Rachel Sullivan have a combined total of 42 years of successfully treating hypothyroidism in women and in men. Because we live in an iodine desert in the Midwest (often called the Goiter Belt), we are confronted with a higher-than-average number of hypothyroid patients in our practice. Both Dr. Sullivan and I have been diagnosed and treated for hypothyroidism since we were young adults (17, and 23 yearn old). We understand the importance of replacing thyroid hormone at optimal doses and not the lowest possible dose that keeps people alive, like current medical practice dictates.

The pieces of the puzzle that explain why hypothyroidism is currently inadequately treated is hidden in traditional medical practice that should have been discarded years ago. We train young doctors based on how we were trained years ago whether it makes sense based on current research and information.

Initial Dosage: MDs refuse to use the information from the pharmaceutical companies, choosing incorrect information they learned 30 years ago. For example, the Synthroid and levothyroxine insert in each prescription from the pharmaceutical company list three things that MDs ignore: The initial dose should be based on body weight. The makers of these medications even give us a formula to follow:

Thyroid dose = Weight in pounds/ 2.2. X 1.7= mcg of levothyroxine or Synthroid®.

After the initial dose the following dose can be adjusted based on symptoms and blood work. I rarely see a patient who has been given a proper dose by their MD PCP, yet DO physicians are taught to begin treatment by following this formula.

In either case I adjust the dose based on the blood work and symptom relief. The blood levels can be affected by time the patient takes her last dose, her other medications, her other diseases, level of activity, and liver metabolism (genetics).

Another guideline in the medication inserts from the pharmaceutical company making Levothyroxine and Synthroid state that TSH levels should be suppressed to less than 1.0 if the dose of thyroid is correct.

When I use this guideline as one of the determinants to guide my dosage of thyroid replacement, the current MD physicians tell my patients that I don’t know what I am doing!

Inaccurate Reference Ranges by the big labs (Quest and Labcorp) and followed by the smaller labs.

It is impossible to follow blood levels that are not healthy and based on a group of people who are not picked for youth, lack of thyroid disease or even other diseases that affect thyroid diseases, or medications that lower or raise the thyroid level..basically young healthy people is the group we study to obtain a reference range, but Quest and Labcorp do not use scientifically obtained reference ranges. The reference ranges created by Quest and Labcorp have been dropping with the number of sick people that go to these labs, and the labs use sick, old, and hypothyroid patients to achieve their reference ranges. They use the thyroid tests done in a year and no matter who the patient is and make a bell curve out of it and adjust the reference ranges?

If you use bad numbers, you get inaccurate diagnoses, especially if you ignore the symptoms of your patients.

Correct “reference range” numbers come from gathering blood levels scientifically. Scientists use a group of normal young healthy people who are without thyroid disease, or any other disease for that matter. By using the thyroid tests from patients who have a medical problem they are being evaluated for at Quest, is not scientific and should not be used to determine the blood level we are using to represent a healthy thyroid. The reference range that should be used is the normal range from 20 years ago when the “normals” were obtained scientifically, by testing young healthy people without disease. Diagnosis of thyroid disease based on “bad numbers” is inaccurate and many women are going without thyroid replacement because of it.

As accountants say, “Garbage in, Garbage out!”. The Reference ranges for thyroid disease that doctors follow without thinking are based on blood levels of sick people getting blood tests at Quest or Labcorp over the course of a year, not blood levels of young healthy people. The reference ranges for these tests that doctors go by to represent normal, these have been the same for the last 45 years since I started practicing medicine. Why does the reference range for thyroid blood levels decrease every year, while the ranges of standard tests have been the same for years?

Patients are not directed to take thyroid medication with water only, on an empty stomach, and to wait to eat or drink for 20 minutes after taking Levothyroxine, Synthroid, or Armour Thyroid. Patients are often handed a script without these instructions, so they often take it with their supplements, or other meds and food or coffee which destroys the thyroid medication. All patients should be told these instructions verbally, and it should be written on their script.
Blood tests are often drawn in the morning right after thyroid medication is taken. which makes the blood level l of T4 and T3 look unusually high. Doctors who don’t think about the unusually high blood level of hormones several hours after an oral dose, mistakenly drop the thyroid dose, making patients hypothyroid again. In the care of thyroid, which is taken first thing in the morning, a morning blood draw should be taken before the medication is taken.
Symptoms of hypothyroid patients are often not considered when lowering or raising thyroid dosages. Blood tests obviously don’t always represent the true blood level of a patient and are not the only factor to consider when increasing and decreasing dosage. Symptoms of hypothyroidism must always be considered when adjusting thyroid dose.

We at BioBalance Health® diagnose and treat our patients based on properly obtained lab when a patient is taking her thyroid medication combined with her symptoms of hypothyroidism, and initial thyroid dose should be based on body weight and a trial of thyroid medication.

Other diseases can be caused or worsened by hypothyroidism. These conditions and the lab values that indicate worsening of these diseases are listed below. When thyroid is replaced appropriately these conditions and blood tests normalize.

High total and LDL cholesterol
High Triglycerides
Heart disease
Hypotension
Slow pulse
Lymphadenopathy
Full body swelling
Fatigue

Therefore, when your doctor tells you to decrease your thyroid dose that we have determined is the right dose for you, you have the facts that defend your current thyroid dose. This handout gives you a written basis for your argument and you can hand him/her a copy.

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Two weeks ago we talked about how a vaccination works in your body to create immunity to a virus. Last week we discussed the issues that put people at risk for getting a virus and for not responding to a vaccine.

The third and last section of our series on viruses and vaccines centers on how to boost your immune system so that you are less likely to get a virus, to die from a virus, and more likely to get immunity from a vaccine.

There is a great controversy about vaccines right now, but vaccines have changed the modern world from one where we had a very high death rate from communicable diseases and high childhood death rate to one that is generally protected against communicable viruses, where we now only worry about dying from the diseases of old age. Most vaccines are given a few times in our lives, like MMR (measles mumps and rubella vaccines), usually when we are children and then every 10 years or so, we get a booster. The flu vaccine is different, and we get a different vaccine every year that is created to kill the permutation of the flu virus we think is going to go around the world this winter. Doctors recommend those patients who are not allergic to the flu vaccine to get an immunization against the flu every year, because it is a preventable deadly disease, however we rarely tell our patients how to make their vaccine more effective to provide protection (to decrease the likelihood of immunization failure).

The necessary elements for a human being to be adequately protected from a virus and by an immunization include:

A healthy immune system with adequate numbers of white blood cells of healthy white blood cells.
Good Nutrition
A normal blood sugar --intake of a lot of sugar containing food and drinks and carbohydrates, or the presence of uncontrolled Diabetes decreases the ability of a person’s immune system to function. Viruses LOVE sugar!
Young healthy levels of Testosterone. Testosterone stimulates white blood cell production and modulates the activity of the thymus. Testosterone decreases and becomes deficient as we age, and the activity and effectiveness of the immune system parallels the drop of our testosterone levels in both sexes.
Daily moderate exercise. Sitting all day slows your immune response and can accelerate the drop in hormones and the number of white blood cells. To stay healthy, you must exercise every day.
Control of stress. High stress, and major negative life events (like divorce, loss of family members, money worries, etc.) can cause your hormone, Cortisol from your adrenal gland, to increase over long periods of time. This blunts the effect of White blood cells and decreases your immune function. Taking action to decrease stress with biofeedback, exercise, prayer, or socializing is important to keep your immune function healthy. You can also take a supplement called Endodren Supplement (1 every am) to keep Cortisol from spiking.
Good Gut bacteria—feed the gut biome with probiotics and good basic nutrition including raw veggies and fruit. Your immunity starts in your gut.
Replace declining hormones-- Estradiol, testosterone, and thyroid hormones.

At BioBalance Health our patients who have been taking T pellets for over a year had a better immune response to viral infections during 2020 and 2021 and their T cells and B cells reacted more aggressively to kill viruses.

In addition to the recommendations above we suggest supplementation to your basic nutrition to improve your immune system:

Vitamin D 5,000 IU per day is a must and has been proven to lessen the effects of viruses and improve the response to immunizations.
Vitamin C 1000 mg/day
Zinc 30 mg po q day
Quercetin 250 mg/day

My doctor-daughter primes my grand-daughter before her immunizations with a form of liquid vitamin C each day for 3 days and the day of her immunization at the pediatrician’s office. This improves her chances of obtaining immunity from that one shot.

Special Cases require special immunizations and sometimes boosters:

There are some diseases and conditions that require additional treatment and prevention for viruses and often special immunizations that have a stronger dose of dead virus to create immunity.

Autoimmune diseases: If you take suppressive medications for autoimmune diseases (Biologics) It is very important that you take good care of yourself and try to be as healthy as possible.
Diabetes must be kept in control and your blood sugar and insulin within normal limits.
AIDS Patients
Cancer Patients
Patients over 65 yo
All chronic diseases

If you are a high-risk patient or you can’t lower all of your risk factors, then you may want to check to see if your immunization or recent infection gave you immunity. It will take a blood test to determine your immune status, and to see if you need a booster shot.

The current test can be done at Quest and is an IGG and IGM test for a specific virus. It tells you if you have made antibodies to a specific virus or not. You may be checking to see if your immunization worked or if you still have antibodies to an infection that you had, to confirm your immunity.

If you are at high risk and can’t take an immunization or can’t develop immunity after an immunization or infection, then you will have to

continue to avoid crowds, wear masks and take supplements to fortify your immune system.

These are my suggestions for all viral illnesses like the flu, covid, pneumonia, shingles and other viruses for which we have immunizations. I hope this helps you make proper choices about activity, and immunization and that this talk assists you in improving your immunity as much as possible.

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There are known risks for individuals not responding to a vaccine e.g. Covid. The factors that are key to responding to a vaccine hinge on the health and intact immune system of the patient. The immune system is affected by your lifestyle, genetics, age and current medical conditions. If your immune system is healthy, it will respond as predicted to make antibodies to kill the virus you are immunized against. In one sentence, healthy people respond to vaccines as they should and are protected against that virus from invading your body and causing disease. Immunized people with intact immune systems should not be able to transmit the disease either because they don’t actually get infected by the virus!

Sadly, the very people who need the vaccine the most, because they are at high risk, sick, old or have high risk genetics, are the very people who often do not develop an immune response to immunizations. The immune systems of these people do not respond with adequate immunity, or they only respond minimally, and it is not enough to prevent getting the virus. These are the only people who should be told to get a booster shot!

Because Immunizations are only as effective as your immune system, the factors that prevent a vaccine from working are the same as the factors that put you at risk for getting the virus, and a more severe form of the virus. So, what are the risks for having poor immune response to a virus or an immunization?

Age, Lifestyle, and Genetic Risks:

Age over 60 without Testosterone replacement—Testosterone stimulates your thymus gland to make more T killer and T helper cells as well as to increase antibody response to viruses.
Age under 3 months is a time when babies are using up or losing the antibodies their mothers gave them through the placenta and they have not yet developed a fully competent immune system themselves. Babies 1-3 months should stay at home and limit visitors. Breastfeeding improves their chances of being protected from viruses.
Poor nutrition: Junk food, highly processed food, with high sugar content (viruses LOVE sugar!) suppress the activity of the immune system.
Inadequate Vitamin D blood level. A level under 40 puts everyone at higher risk to get viruses. In light-skinned people the sun can give them enough Vitamin D, but southern European, Polynesian, Hispanics and African Americans cannot absorb much vitamin D from the sun and must take it orally! 5,000 IU per day should be enough to supplement with.
Smoking suppresses the immune system
Alcohol consumption over 10 drinks a week lowers your immunity
Obesity increases inflammation and lowers immunity
Lack of exercise suppresses the immune response
High stress lifestyle
Lack of sleep (optimal sleep is 8-9 hours a night).
Night shifts
Meth, Cocaine and Heroin of course is going suppress your immunity.
Your specific genetic makeup

During the covid pandemic of 2020 scientists and geneticists have been studying the genetics of those people who have gotten severe covid infections and those people who have been exposed and didn’t get it. They also have studied the genetics of people who don’t respond to the vaccine. They have found a group of genetic snips (pieces) that are present in each of these groups. They are publishing their findings in the Journal of Nature: Covid Host Genetics Initiative. Mapping the genetic architecture of Covid 19. Nature https:doi.org/10.1038/s41586-021-3767X(2021).

Medical reasons for Getting viruses and not responding to vaccines.

To treat disease doctors often must suppress the immune system of a patient to control the disease. This type of treatment decreases immunity in general and decreases the effectiveness of an immunization. Some drugs such as corticosteroids or Biologics, suppress the immune system and prevent the immune response necessary to develop antibodies to a virus from a vaccine.

Those people who are chronically ill currently or in the past (heart disease, lung disease, Cancer, Diabetes, COPD, chronic infections etc.) have immune systems that have been overworked and are currently directed toward a different target, so a chronically ill patient may not develop immunity from a vaccine.

If you are on one of these medications or have other chronic illnesses, you should prove that your immunization was successful by get a blood test for antibodies to the virus before you take your mask off.

Medical reasons for non-response to vaccines and for increased risk for getting viruses:

Autoimmune disease on immunosuppressant medication
History of cancer treated with radiation and or chemotherapy can suppress your immune system for a lifetime.
Organ Transplant on immune suppressants
AIDS
Chronic inflammation for any reason
Diabetes and Pre-diabetes
Heart Disease and High Blood Pressure
Having a viral or bacterial infection when you get the immunization
Chronic Medical Illness
Pregnancy
Low testosterone levels in old age

Clearly your best chance of a successful immunization is having robust health, ideal weight, youth, good testosterone levels and lack of disease. These are not reasons to avoid immunization, but they are good reasons to have a test to document that you are immune after you get a vaccine before you go out in public and expose yourself. You can’t change the past, or your genetics, but you can change your habits and check your immunity if you are at high risk!

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The last year and a half, many new words have been introduced into common daily conversations of Americans, and one of these words is immunization, a word that was previously limited to use in the doctor’s office.

Since 2020, TV media and social media has used the word immunization often and in many ways that are not related to an individual’s medical care. Journalists have written and spoken about immunizations in the following ways:

in a positive way as a life-saving treatment to prevent disease and the spread of disease
in a negative way, as a dangerous injection that might cause future disease for those people who receive it
as a political tool which might be used to force individuals to comply with mandates that infringe on their freedom of choice in the US, or conversely to polarize the population instigating fear and distraction from other more calamitous situations in the world (e.g. Afghanistan being taken over by the Taliban, and the disaster at the southern border of the US);
as an entitlement belonging to the citizens of the wealthiest nations used to increase their global power over poor countries who cannot afford to immunize their citizens and therefore will lose population and power due to the attrition of their population.

We have all been witness to these TV, Radio, and social media discussions. I am not a political expert. I am a medical expert and today I will not comment on any of these current definitions or uses of the word immunization. I believe that most of the controversy today involving whether an individual should choose to take an immunization or not is based on lack of understanding of how immunizations work, and how we can make them more effective. Real information by real physicians who take care of individual patients with the patients’ best interest in mind is what citizens need to hear so they can make informed decisions about their own health.

The following three lectures will include a medical definition for the word immunization and explain how immunizations work in the human body. In the second lecture I will discuss who will likely benefit medically from these preventive injections and who will not, and in the third, I will recommend how to improve your immune system which will both decrease your susceptibility to viruses and make your response to an immunization more protective.

Please note that up until 2020 when the two covid vaccines from Pfizer and Moderna were created, all vaccines were formulated from pieces of dead virus, including the Johnson and Johnson Covid vaccine, the flu vaccine, the HPV vaccine, the Shingles vaccine, etc., and a few contained *live viruses which actually gave you a mild case of the disease you were trying to prevent, to stimulate the immune system to make antibodies.

The two new Covid vaccines are different from both types of vaccines I have listed and I will not speak about them as they are completely new to the world of immunizations, and I am not an expert in this type of injection.. Today we will speak of the immunizations available before 2020 plus one covid vaccine by Johnson and Johnson.

First let’s get down to what an immunization really is—the definition of immunization. An immunization is an injection, or a drop of liquid (like the polio immunization that was given as a red drop of liquid on a sugar cube that you took orally), given to an individual to stimulate a person’s own immune system (white blood cells, B cells, T cells, T helper cells, T killer cells) to activate and kill a specific virus. This immune response is done by exposing a person to a piece of dead virus, that cannot infect him, but which looks enough like the whole virus to sensitize and protect the body against succumbing to a future exposure to that particular virus. When a future exposure to that virus does occur in a healthy individual who has been immunized, the circulating antibodies kill the virus before it infects a person’s cells.

The trick to an immunization being effective is the health of your own immune system, which is affected by age, nutrition, other diseases, medications and diet. The immunization itself does not kill a virus! The immunization stimulates your own immune system, to make antibodies and if you are not healthy, then the immunization may not be effective! Being healthy and young is your best defense against getting a disease and also to responding and being protected by an immunization!

The necessary elements for a human being to be adequately protected from a virus by an immunization include:

A healthy immune system with adequate numbers of white blood cells.
Good Nutrition
Lack of chronic inflammation (chronic inflammation is found in obese people, and those people with autoimmune diseases, and chronic joint pain from injury)
As people get older, they get sicker, and their immunizations don’t work as well or last as long. This is true because as people age their thymus gland (the creator of white blood cells) shrinks and becomes hypoactive after age 60. When we are children our thymus gland is very large, and our immunity is excellent. As people get old the thymus gland shrinks and they produce inadequate numbers of white blood cells, and the amount of antibody produced when exposed to a virus is inadequate. This is one of the reasons people over 60 have more communicable diseases like pneumonia, as well other diseases that require large number of healthy immune cells to kill cancer cells.
Normal blood sugar --intake of a lot of sugar containing food and drinks and carbohydrates, or the presence of Diabetes, decreases the ability of a person’s immune system to function.
Young healthy levels of Testosterone and Growth Hormone. Both of these hormones stimulate white blood cell production and modulate the activity of the thymus. These two hormones decrease and become deficient as we age, and the activity and effectiveness of the immune system parallels the drop of these two hormones.
Daily moderate exercise. Sitting all day slows your immune response and can accelerate the drop in hormones and the number of white blood cells. To stay healthy, you must exercise every day.
Control of stress. High stress, and major negative life events (like divorce, loss of family members, money worries, etc.) can cause the hormone, Cortisol from your adrenal gland, to increase over long periods of time. This blunts the effect of White blood cells to kill cancer cells and to make antibodies.

Plainly your best chance of having a successful immunization is if you are healthy, at ideal weight and young (under 60), or over 60 and replacing your testosterone and or stimulating your growth hormone. When immunizations are not effective and an immunized person gets a virus anyway, the person generally has one or more health problems plus some of the listed factors that blunt the effect of an immunization.

We can clean up our lives, eat a healthy diet, and take supplements and testosterone or stimulate growth hormone to improve our response to a vaccine. Of course, we cannot change the past or our age or genetics. Optimizing our health is very important to preventing infection and improving the effect of an immunization. Next week we will talk about more risk factors that you can use to improve your odds of having an excellent protective immunization against any virus.

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Why Most Women Don’t Take Time to Wash Their Face

If you are like most of my patients, washing your face is something that gets lost in your time crunch. I know the routine! Brush your teeth, put on your jammies, go to the bathroom and collapse into bed! The life of a productive woman…but wait! You forgot something vital…you forgot to take care of your most important asset! Your face! It is vital that women take their eye makeup off and cleanse their skin, if nothing else, before bed. The act of washing your face should take only a few minutes and will both clean and exfoliate the dead skin cells from your face. For dry skin, the right product is necessary to moisturize while you cleanse your skin, and for oily skin it is imperative that your remove the oil from your skin so it doesn’t fester and become infected zits that will take weeks to heal!

The first step in cleansing your face is to identify whether your skin is dry or oily, and then pick the appropriate product to use to cleanse and exfoliate your face every night and morning. We will review the best choices in skincare from the lines of products we carry at my med spa, BioBalance Skin, but first, if your mother didn’t teach you or you didn’t listen, then here are the steps straight from the lips of the skin experts, Dermatologists:

Use warm water
Splash your face with warm water to dampen and then soap up your cleanser and massage it into your skin, face first and then your neck.
If you use a mechanical face cleaner like a Clairsonic then use that to massage and exfoliate your facial skin one area at a time, without mechanical help, use your fingers to gently massage the cleanser into your skin.
Splash off the cleanser with warm water
Pat your skin with a soft towel to dry…don’t rub your skin!

Then most of us who are older than 35 should not just go to bed after washing our face but we should use this time to treat our skin with products to improve the health and look of our skin. Just think about it, when we sleep, we can use our sleep-hours without wearing makeup, to “treat” our skin with the necessary products.

OK I’ll do it, but most women aren’t sure what order to apply their products, so here it is!

A recommendation from the College of Dermatologists helps us out:

Step 1: Cleanser. After removing all your makeup, cleanse your face with an oil-based or water-based cleanser—or both if you're doing a double cleanse! ...
Step 2: Toner to remove the last environmental dirt and dead skin.
Step 3: Serum to treat wrinkles, and sagging skin. Think of serum as “feeding” your skin.
Step 4: Spot Treatment. ...for dark spots, or acne, to bleach away brown spots etc.
Step 5: Eye Cream under and above your eyes to ..keep the skin youthful, toned, tight
Step 6: Moisturizer. To replace the water, we lose through our skin through evaporation and prevent wrinkling.
Step 7: Face Oil For very dry skin so your skin will be beautiful in the morning.

Choice of Face Cleanser for You:

Now let’s look at the different kinds of face cleansers that we have chosen at BioBalance Skin for our patients. We Recommend SkinCeuticals and Defenage products for our patients, and we recommend products meant for your skin type.

Let’s start with the Cleanser that I use,

SkinCeuticals Replenishing Cleanser- BEST for ALL SKIN TYPES

For all skin types
Cleans without stripping the skin of moisture
Removes Makeup
Rich, Foamy Lather

-Leaves skin feeling silky

SkinCeuticals LHA Cleanser: BEST for AGING, OILY/ACNE PRONE SKIN

blend of salicylic acids to address breakouts and visible signs of aging
Provides exfoliation to unclog congested pores
removes makeup and excess oils

DefenAge 1-Step Multi-Cleanse: BEST for AGING

melts away surface debris, instantly dissolves heavy makeup and waterproof mascara and helps liquefy impurities in pores and air pollutants
supports the skin's barrier against environmental toxins

TONER: "Toners and astringents aren't necessary for everyone and can sometimes leave skin feeling stripped, but many of our patients love the squeaky clean feel that toners can create, so if you would like to try a toner, we find great success for all skin types, with our ..

SkinCeuticals Equalizing Toner if you feel like you have excess residue or just need a cleansing boost"
- helps refresh and restore skin and exfoliate while removing excess residue
- mixed hydroxy acids and calming botanicals to help regulate the pH of the skin.

MOISTURIZER: Many of us with dry skin and some with oily and combination skin lose moisture while we sleep and need a protective barrier to hold the moisture in which prevents wrinkles and thinning of the skin. We recommend….

SkinCeuticals Daily Moisture

Restores and maintains moisture
Normal to Oily Skin Types
helps reduce the appearance of pore size

Triple Lipid Restore for All Patients and Skin Types
- Ideal for Everyone
- Night time, Daytime if needed (layer with sunscreen)
- Restores essential skin lipids
- Improves the look of skin fullness, texture, and pore appearance
- lightweight and fast-absorbing

Now you have the information you need to make an educated decision about what you are going to do with your skin care, face washing, toning and or moisturizing. Remember if you don’t take care of your skin before bed you are missing the best chance to have 8 hours of skin care every day!

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While you cannot fight your genetics or your past medical history anymore, you must take action as soon as possible to lose belly fat, improve your abdominal strength, and decrease your abdominal girth (measurement around your abdomen).

I hope you watched our last Healthcast that explained the inevitability of belly fat in people over 40 without testosterone pellet replacement. We change all that with testosterone replacement and estradiol replacement with pellets, and a complete preventive medicine plan.

Diet + exercise of the abdominal muscles + aerobic exercise is necessary if you want a flat belly.

First Diet:

Eat a low carb diet (mostly cut out foods made of sugar, flour and all grains), while continuing to eat large amounts of fruit and veggies.
Cut out the lectins that slow down your metabolism by eating according to your own blood type.
Give your body the nutrients that assist in weight loss:Vitamin D3, Iodoral 12.5 mg/day with food, Magnesium 200-800 mg per day based on formulation, Zinc 15-30 mcg per day, DIM (di-indomethane (made from broccoli and cauliflower), Methyl folate 5000mcg/methyl B12 2000 mcg/day, and arginine to increase muscle mass.
Feed your muscles with PROTEINS:
1. You need a lot of protein to make muscle especially if you have a normal testosterone level, so eat enough protein made of whey-ultrafiltered (eg. Phorm Level 1 protein powder) or for vegans, use pea protein. Dose is ½ of your weight in pounds, in grams of protein. For example, if you weigh 200 lbs you should eat at least 100 grams of protein a day to maintain muscle mass. If you are trying to build muscle, then eating between half -100% of your body weight in grams of protein/day. Remember to drink a lot of water to metabolize your protein
2. Eat red meat, eggs and fish: these proteins are excellent sources of protein to build muscle by altering your diet.
3. Take arginine to help make muscle and treat your sexuality
4. Take DIM to lower estrone levels.
AVOID SOY! Soy acts as an estrogen and increases your belly fat and shuts your thyroid down.
Do aerobic exercise every other day one hour a day.
Have your deficient hormones replaced or balanced by a doctor specializing in hormones especially testosterone and thyroid hormones.
Exercise your abdominal muscle daily e.g. Planks, side planks, leg lifts, leg drops, crunches, etc.

The rest of the Healthcast will be dedicated to abdominal exercises: You must know anatomy for you to be able to decide what exercises will strengthen and flatten your stomach.

Your abdominal musculature is made up of 4 muscle groups:

Rectus muscles These two muscles are attached to the rib cage and the pelvic bone and run longitudinally alongside the midline of the abdomen. This muscle group is more commonly referred to as the “six pack.” (picture)
External Obliques muscles run obliquely (at an angle to the rectus muscles) These sit on the sides of the rectus abdominis and allow your trunk to twist. Working on these muscles narrow the waistline. (picture)
Internal ObliquesThese are also located on either side of the rectus abdominis, the run obliquely, but deep to the external 0bliques.They run between the hipbone, the ribs and rectal muscle. They also help with twisting motions. The stronger they are the smaller your waistline.
Transversus Abdominis These muscles sit behind the obliques and help stabilize your trunk. They’re sometimes called the corset muscles.

The abdominal muscles are responsible for curling up, turning sideways, twisting at the waist, and holding in the contents of the abdominal cavity. The abdominal muscles are the anterior or front part of the human body’s muscles of the core. They integrate with the flank and back muscles to complete the core. A strong core brings with it a flat stomach, good balance, good posture, mobility and prevents injury to the body.

We will discuss the simple exercises most patients can do on their own to tighten the abdominal muscles. These exercises are both isometric and active dynamic exercises. Sit ups only exercise your rectus muscles and to have a flat stomach you should work out all of your abdominal muscles!

The exercises should be done in order and should be repeated 3 times. The more in strengthen your abs the more repetitions you should do. Video for each one less than 30 sec each.

PLANK

Get on your hands and knees, then put your elbows on the ground, directly below your shoulders, step your feet backwards until your body is parallel to the floor..like a plank. Tighten your core and hold for 45 seconds, rest for 15 seconds and repeat 2 more times.

SIDE PLANK

Begin in plank position. Place right elbow directly beneath the middle of your chest facing forward, then lift left hand to your waist, and place your left foot on top of your right (so left leg is stacked on top of right, too). Lift your left arm to the sky, keeping hips lifted and glutes squeezed. Hold for up to 45 seconds, then rest for 15 seconds. Repeat two more times, then switch to the other side and repeat.

DEAD BUG

Lie on your back with your arms extended, reaching straight from shoulders to the sky. Bend and raise knees so they form a 90-degree angle. (Shins should be parallel to the floor.) Squeeze abs and press lower back into the floor. hold this position for as long as possible up to 45 seconds, then rest for 15 seconds. Repeat two more times.

BICYCLE

Sit on the floor with your arms supporting you behind you and your knees bent—you will be in a V shape. Bring right elbow toward left knee, keeping chest open and extending right leg out long. Repeat on opposite side with left elbow coming to right knee. Do as many reps as possible while maintaining proper form, up to 20 reps.

HIP TWIST

Forearms resting on the ground supporting your body weight with hips slightly elevated in a piked position. Drop the left hip to the floor twisting at the waist, return to piked hip position, and drop right hip to the floor. Continue alternating to do as many reps as possible, up to 18 reps

LATERAL HIGH KNEE with aerobic action.

Stand with your feet directly under your shoulders. Bring left knee up towards chest and right palm to your ear in a runner’s stance. Quickly switch your arm and leg (as if you were jogging) and move a step to the left. Continue alternating for three steps; that’s one set. Move back the opposite way for three steps; that’s a second set. Do 12 sets total.

While you are doing these exercises think about the abdominal muscles you are exercising. By thinking about them they will work more effectively. The rest of the day think about holding in your stomach, when you are standing, waiting in line, and walking. Abdominals can be done any time, like Kaegles are, without anyone knowing.

Ideally if you need to lose belly fat, you should follow these exercises daily with aerobic exercise for at least 30 minutes. Run, quickly walk, elliptical training, run in place or run up and down your own stairs.

It is not an effort that can be taken in a series, like doing one thing, then stopping and then doing another, this effort is done in concert, all things need to be accomplished at the same time. The many boxes that need to be checked include abdominal strengthening exercises, daily aerobic exercise taking only one day off a week, a high protein, low carb, low lectin diet with appropriate supplements, Testosterone replacement with pellets, medications to treat insulin resistance and even diet pills, all of which were discussed in the last Healthcast, # 559.

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The most frequent question asked by my patients, both women and men, the first time they see me is, “Why is my belly getting bigger? I never had a big belly before, and I can’t get rid of it!”. My answer is individualized to the patient, but there is one change that occurs as the first trigger of aging and ends in a distended and obese abdomen—Low free testosterone, and high estrone blood levels. The cause is loss of the production of the “all important hormone” testosterone, from the ovary or testes, and the result is a slower metabolism and gain of fat in the abdomen.

But why do we crave a thin waistline? Having a thin waist is indicative of a youthful body, and youth in general. It is one of the biggest reasons that we crave, desire, even demand that our bodies revert to a thinner waist to bring back our youth! The aging process takes the thin waist away and deposits fat where we once had a narrow middle!

When we turn 40-50, our body changes from a highly metabolic body that was fertile, into a lower, more efficient metabolism that is slowed even more by carbohydrates in the diet. We can bring our metabolism back to normal by one medical intervention and a healthy lifestyle specifically created for postmenopausal women and aging men. No one escapes the aging process and the deposition of belly fat, without replacing testosterone in a non-oral and bio-identical manner. I explain this to every patient and since I know each of my patient’s medical histories, family histories, medications, diet and exercise programs, I can target my advice to their individual need. At my office at BioBalance Health® we make a plan to get rid of that belly fat for each of our patients and we measure the about of belly fat that they have by measuring their body composition with an INBODY® machine.

What IS Belly Fat, Really?

Let me specify exactly what belly fat really is made of:

A portion of an individual’s belly fat is from the accumulation of fat inside the abdomen around the intestines, in an organ called the omentum. This belly form of belly fat is called Visceral fat, which increases a person’s risk of diabetes and heart disease, and takes a long time to dissolve this form of belly fat, requiring low carb diet and daily aerobic exercise. This is usually a long-term project (a year).

The second type of belly fat, subcutaneous fat, is deposited between your skin and your muscles, most often seen in women who have had pregnancies that stretched their skin and caused the collection of fat under their skin. To lose this type of fat, this fat requires specific abdominal exercises, and or radio wave treatment to melt fat and tighten skin, and sometimes surgery to remove excess skin and liposuction of fat deposits. Generally, this type of fat is the first to respond and decrease when testosterone pellets and lifestyle changes are instituted.

The last type of” belly fat” is really intestinal distention from gas collection in the intestines or from constipation, food allergies or intolerances, diseases like intermittent bowel obstruction after abdominal surgery, or a variety of GI diseases that must be diagnosed and treated by a board certified gastroenterologist. Many people confuse abdominal distention with one of the first two types of fat accumulation. Bowel distension (or abdominal distention sometimes called bloating is generally a GI mobility problem, or an anatomic defect like an abdominal hernia and may require probiotics, fiber, diet changes like avoiding gluten and milk products, getting a low thyroid treated, treating diabetes or prediabetes, or repair of abdominal wall abnormalities surgically. Abdominal distention can also come from very lax abdominal muscles which require dedicated exercises if they are not severe, and sometimes require surgery if they are greatly lengthened and lax.

What causes belly fat to occur as we age? First it is low testosterone that lowers the metabolism in everyone as they age so you burn fewer calories. Second it is lack of exercise and poor diet. You just get more “efficient” and save your calories and make fat out of them instead of energy. Last is the metabolic changes of aging including Insulin resistance or Pre-diabetes that occur at or right before menopause, and the production of more estrone which is made in belly fat from conversion of testosterone into estrone, which both lowers free testosterone levels and makes more belly fat to make more estrone. A viscous cycle ensues!

The triggers that stimulate the production of belly fat: Pick the ones you have working against you and determine your individual issues that make losing belly fat more difficult.

Menopause
Low T in men and women
Aging causing higher estrone levels
Inactivity
History of multiple pregnancies with excessive weight gain which left extra skin hanging
Poor diet
Lack of abdominal wall strength
No abdominal exercises

Lifestyle, Diet and Habits that cause belly fat.

You can assess your personal causes of belly fat on your own, but then you should take the initiative to change your lifestyle to decrease belly fat. The following list include the things you can change to lose belly fat.

Diet High in carbs
Diet High in Lectin foods which interfere with carbohydrate metabolism
Lack of any exercise
Lack of daily targeted abdominal exercise
Lack of aerobic exercise
Poor posture
Sitting all day
Over-eating poor quality food (junk or fast food)
Intestinal issues like constipation, and irritable bowel from lack of good bowel bacteria.
Alcohol consumption
Smoking
Type 2 Diabetes without medication, or following a low carb diet
Alcoholism with liver disease
Fatty liver
Eating foods that are not compatible with your genetics (blood type).

To achieve your goal of a narrow waist and a flat belly, look at the list above and eliminate as many bad habits as possible and foods that you can, and begin an exercise program specifically aimed at working out your abdominal muscles, (Pilates?).

A word about Lectins are proteins in most foods and some are harmless but others many interfere with your health and are considered anti-nutrients that bind to carbs in foods which can cause malnutrition, abdominal pain, GI disease, autoimmune disorders and are in every food. We teach our patients to avoid certain foods with lectins by their blood type. Dr Da Damo MD spent his life researching the foods containing lectins and how they genetically affected people in each blood type. In the future we list foods by blood type that should be eaten and those that should not be based on your genetics. We will dedicate an entire Healthcast to the lectins that are dangerous to your health individualized by your blood type, so you will know what to avoid and what is beneficial for you to eat. Luckily, Lectins can be inactivated by cooking the vegetables, fruits, grains that have lectins! To find the Blood type diets for each blood type look in the back of my book, The Secret Female Hormone®.

Sometimes my patients adjust everything they can on their own and still need medical help. All of my patients have their testosterone replaced if they are over 40 and if their thyroid is low, I replace their thyroid back to normal levels. Both of these treatments will make getting a younger smaller abdomen possible. The following list will provide the possible medical imbalances that can stimulate belly fat growth, and that can only be treated by a doctor.

Factors that can only be treated by your doctor that have a great impact on the loss of belly fat:

Low testosterone—replace T with pellets
Low thyroid hormone—replace women with Armour Thyroid and men with Levothyroxin
High cortisol—suppress with relaxation and or Endodren supplements
Low growth hormone –stimulate production with aerobic exercise and weight training exercise, replace testosterone, and or stimulate GH with a peptide.
Insulin resistance/ Pre-diabetes-treat with Metformin ER, Victoza, Trulicity, or Ozempic
Overall Inflammation throughout the body-Treat with anti-inflammatory drugs
Elevated triglycerides—treat with metformin ER
Low protein intake and low protein in the blood: increase, meat, cheese, milk products as well as eggs and ultra-filtered whey protein shakes
Inadequate vitamin D intake—take 5,000 MIU per day
Inadequate vitamin B intake—increase Methyl B12 + Methyl Folate
Decrease Intake of lectins that (not eating right for your blood type)
For Severe overwhelming hunger-treat with stimulants to suppress hunger

There are some things that will make your journey harder, but we all have genetic challenges. Our past sometimes makes our current work harder such as genetics for adult-onset diabetes, family history of obesity, a history of childhood inactivity and overeating. Unchangeable things in our past can cause roadblocks to losing belly fat, but you can still succeed.

The following are examples of situations that you may have to overcome to lose your belly fat. It is not a race with other people, it is a race with yourself!

An endomorphic body type (pear-shaped build) which is genetic
Obesity as a child
Lack of exercise as a child
Genetically low testosterone
Family history of obesity
Genetics that cause you to be hungry all the time
Genetics that cause you to never feel full no matter how much you eat
Bowel disease that must be treated before your nutrition can be made normal
Inherently bad gut biome you are born with limited gut bacteria that causes us to gain weight from early on.
Lack of a good sleep cycle because of your normal rhythms, or your job or disturbances throughout the night like kids coming in to sleep with you or getting up multiple times because of a very small bladder or a large prostate. If possible, increase your hours of sleep to at the minimum of 7 hours a night.

Follow your progress by measuring your waistline once a week with a tape measure to keep track of your progress.

By taking care of our patients and eliminating all the high-risk factors, changing lifestyle and bringing all hormones back to normal young healthy levels, we are very successful at helping our patients lose their belly fat.

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Do testosterone pellets cause breast cancer?

No. Testosterone pellets improve the immune system function so you can fight all types of cancers more easily than before you started treatment.

I am a breast cancer survivor: Can I take bio-identical testosterone pellets?

Yes. This is the safest form of hormone replacement and can take the place of estrogen to treat symptoms of estrogen deficiency like hot flashes and painful intercourse. Testosterone also improves your immune system so you can fight abnormal cells, pre-cancer and cancer cells, so they don’t grow. Testosterone pellets stimulate the production of T-killer cells that kill cancer cells.

Do BioBalance testosterone pellets cause blood clots?

No.

Do BioBalance Health estradiol pellets cause blood clots?

No. Estrogen that is non-oral does not cause blood clots, however circumstances like long airline flights can cause blood clots in anyone!

If I have used alcohol to excess or drugs like marijuana in the past, will I get the same effect as other women?

No. Both alcohol and marijuana quicken the break-down of testosterone and estradiol. You will likely consume (metabolize) the testosterone pellets more quickly than other people because your liver is hyper-activated to metabolize testosterone with the same enzymes that metabolize alcohol and drugs. In addition, marijuana increases the production of the hormone prolactin, the hormone that increases breast size in men and women. Prolactin not only decreases your testosterone level but decreases your sex drive, and sexual stamina. It is your responsibility to tell us about your medical marijuana and alcohol use so we can adjust your testosterone dose.

Can I take birth control pills with testosterone pellets?

We strongly suggest that you do not take oral birth control pills, because they dampen the effects of the testosterone pellets. Instead of oral contraceptives we encourage our patients to get a Mirena IUD or permanent birth control (like a tubal ligation or have their husbands get a vasectomy) instead of taking the pill. Many women who insist on continuing the pill (we are located in the Show-Me state) are disappointed that their symptom resolution is not complete, and they decide to change to a Mirena IUD or a tubal ligation for birth control. Of course, no birth control is needed after menopause.

What other medications inactivate or interact negatively with estradiol and testosterone pellets?

We suggest you look for alternative medications for the following drugs: All corticosteroids such as prednisone, Medrol dosepak, tamoxifen, progestins (not progesterone) like Provera, DHEA that is not 7-keto DHEA, other hormones given orally like oral contraceptives, as well as anti-depressants and drugs for schizophrenia and bipolar disorder, which suppress the libido.

We do not suggest you avoid or stop taking these medications, but we do help you find alternatives in certain circumstances.

How do cholesterol-lowering drugs affect my testosterone level?

Testosterone is made from cholesterol in the ovaries and testes. When you take cholesterol-lowering drugs, you decrease the substrate that testosterone is made of, and generally decrease the level of testosterone. In your body if you are making it yourself, not if we are giving you testosterone pellets. We have found that testosterone pellet replacement lowers cholesterol blood levels so that statins are often not needed after treatment.

What can I do about my belly fat that started to increase after I turned 40?

First you should replace your estrogen with non-oral estradiol and testosterone in the form of pellets. This is the only form of hormone replacement that brings the level of estrone back to young healthy levels, and lower estrone decreases the amount of belly fat.

If you are having trouble losing belly fat and have already accomplished the above, then take DIM ES 250 mg per day with food, Iodoral (iodine to bump your thyroid activity), eat 6 small meals a day with high protein and low carb, exercise by doing interval training, and always work out your abs by doing sit-ups and core exercises, like Pilates. As a last resort, after you have achieved your ideal weight and that fat won’t budge (small set of cases) from your abdomen, we offer radio frequency treatments called Juvashape and iLipo to dissolve the fat around the waistline.

Under what circumstances would I have to stop BioBalance Health® pellets?

About 5 % of our patients are not “cured” for the problems they came to BioBalance Health ® to treat, or they have a side effect from the pellets that does not fit their lifestyle, such as re-igniting their libido when they are unmarried or do not want a sex drive.

Patients with Chronic Fatigue are helped by testosterone replacement, but they may not feel the complete resolution of symptoms as quickly as women who do not have that illness. These patients may not feel they are completely treated so they cease pellets. Women who have psychiatric illnesses and are on multiple medications may not feel as healthy as women who do not have those illnesses or take these medications. Lastly, if a patient develops breast cancer, then the estradiol pellets are not continued if they have estrogen receptor positive breast cancer, however testosterone pellets are continued because they are safe and improve the immune system that fights all types of cancer.

What if my genetics make me prone to convert testosterone into estrone (old lady estrogen)?

After the first pellets, we find that you are genetically prone to convert testosterone into estrone we prescribe a drug called Arimidex® (anastrazole) which blocks the enzyme that converts testosterone into estrogen (called an aromatase inhibitor). It is used off -label for this indication, however it was originally intended for prevention and treatment of breast cancer. We can use anastrazole/testosterone pellets or prescribe anastrazole orally. As an alternative DIM is a supplement that is weaker than the prescription anastrazole, however it works very well for most women.

I hope these FAQs can help you decide whether you need bio-identical testosterone pellets.

I believe that most women over the age of 40 require testosterone replacement, to lead a healthy and full life, complete with a healthy sex drive and productivity. Fear of the unknown is the greatest threat to your current quality of life and your future health. I hope answering nagging questions help you decide to replace your missing hormones.

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Both men and women have questions about our testosterone and estradiol pellets. I have compiled a group of the most important questions that patients ask before they have gotten BioBalance Pellets.

#1. Can I take testosterone pellets if I am not menopausal (still cycling)?

Yes. Most women begin treatment sometime after they turn 40, or when their ovaries are surgically removed. Testosterone from the ovary disappears before menopause, and it should be replaced when a woman becomes symptomatic.

#2 How is pellet dosage calculated?

We recreate the normal daily production of testosterone and estradiol by young ovary and deliver that dose times the number of days your pellets will last. This dose is then adjusted for body weight, height, exercise frequency, and medications you are taking. We then adjust dose based on symptom resolution.

#3 How long will my pellets last?

It takes about 3-4 weeks to get the full effect from the pellets on the first dose. After reinsertion of the pellets, the pellets effect on symptoms occurs within 1-7 days if they are reinserted at the normal interval, 4 months for women and 6 months for men.

#4 Where are pellets inserted?

In women we place them in the upper outer quadrant of the hip about 1-1.5 centimeters below the skin, in fat where the pellets dissolve and the hormones are picked up by capillaries. In men the pellets can be placed in the same area of the hip or in the “love handles” if they have too little fat in their hips.

#5 What happens to the pellets when they are used up?

The pellets completely dissolve in the body.

#6 Do estradiol or testosterone pellets cause weight gain?

Testosterone increases the thickness of bones and size of muscles, so they increase lean body mass, but testosterone also decreases amount of fat in the body and decreases % body fat, at the same time. In general women taking pellet hormones lose size before they actually lose weight after 9-12 months as long as they follow our directions for lifestyle changes. Remember it is more important to achieve a smaller size than to weigh less.

#7 How long can I take pellets?

You can take pellet hormone replacement as long as you desire to receive the benefits that they have given you: energy, youthful sex drive and mood, treatment for arthritis, osteopenia, weight loss, clear thinking as well as many more healthy benefits that testosterone pellets can provide.

Bio-identical pellet replacement is the closest thing to our natural youthful hormones that one can receive as hormone replacement. By receiving both estradiol and testosterone in the form of pellets, prevents many of the diseases of aging. We treat patients into their 90's at Biobalance Health®. Dr. Maupin and her husband will be receiving pellets as long as they are alive.

#8 What diseases can be delayed or avoided if I take testosterone pellets?

The diseases of aging that testosterone can delay of prevent include Osteoporosis, Arthritis, Auto-immune diseases, Fibromyalgia, Immune Deficiencies, Dementia and Alzheimer's Disease, Parkinson's Disease, Frailty, Heart Disease and Stroke, Type II Diabetes, Obesity, and Insulin Resistance.

#9 If I have Type 2 diabetes will testosterone help me normalize my blood sugar?

Yes. Testosterone is very safe for diabetics and those people who have prediabetes, in fact testosterone generally increases insulin sensitivity which will decrease triglycerides and stabilize blood glucose. It will improve the status of your diabetes and help you lose weight by increasing muscle mass, so you burn more calories each day.

#10 Does testosterone improve depression and anxiety?

Yes. It improves mood and, in some circumstances, can replace anti-depressants (which decrease libido) after only one or two doses of pellets. This is possible if your anxiety and or depression began after age 40, when testosterone began to become deficient.

As you can see the benefits of taking testosterone for both sexes, and testosterone plus estradiol for women can make the quality of life after age 40 much better and delay or avoid disease. The only thing preventing most people who suffer symptoms after 40 is the fatigue and lack of motivation that comes with low testosterone. If you can get past that roadblock then you can reenergize your life by getting the hormones you need in the safest way, with pellets.

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Most of the questions we at BioBalance Health® get about pellets come from our female patients. This is partially because women are more interested in the way hormones work, and we have three hormones to balance instead of just one for men, which is more complicated, and women have a history of caretaking with their children, and they want to understand their symptoms. In general, most of my male patients just want their energy, muscles and erections back….so they usually cut to the chase and ask when will this start working?

The questions from women are often answered on our website and in my book The Secret Female Hormone but often women need quick answers to their questions. In our FAQs that’s what we offer…..just the facts, ma’me!” The following are questions and answers to the frequently asked questions from women.

What is the difference between Estrogen and Testosterone deficiency symptoms? Many of my patients get confused about the difference between testosterone and estrogen deficiency. A patient may say,” I need more estrogen in my pellets because my sex drive isn’t as good as it should be.” Well, she has it backwards, only testosterone can stimulate your sex drive and everything sexual. Estrogen is not the hormone that is in charge of that function.

Because of the many misconceptions and possible misunderstandings between doctors and patients it is important for a woman to know which hormone does what!

Estradiol pellets treat:

Estradiol pellets treat hot flashes, a dry vagina, painful intercourse, dry skin and thinning hair.

Testosterone pellets treat:

Testosterone pellets treat the symptoms of low libido, anorgasmia, insomnia, depression, fatigue, loss of muscle mass, weight gain, belly fat accumulation, immune system abnormality, migraine headaches, autoimmune diseases, dry eyes, mental decline, loss of stamina, loss of motivation, tight skin, and some causes of anemia.

Why should I get Pellets? I thought we were supposed to age “gracefully?

Women are often skeptical about why they just shouldn’t age “gracefully”. It is natural to grow old, frail and pass away, but it is not healthy to do so. Lack of the hormones testosterone and estradiol are the trigger that begins the aging process, and sickness follows.

Replacing the hormones testosterone and estradiol prevent many of the diseases and conditions of aging:

Frailty
Osteoporosis
Heart Disease,
Adult-Onset Diabetes
Dementia, Alzheimer’s Disease
Depression,
Cancer
Autoimmune diseases
Sexual Dysfunction
Poor skin tone
Fatigue
Weakness from Loss of muscle mass

Avoiding these diseases, and these symptoms that go with aging are the reasons that testosterone and estradiol pellets can change the course of a woman’s health-span and save her energy and productivity.

Why are pellets superior to estrogen and testosterone patches, shots and pills?

Or why do you only use estradiol and testosterone pellets?

Pellets are made from yams into pure hormone, and they recreate the hormonal environment that we had when we were young. They are a long-acting form of hormone (2-6 months) so depending on patients irregular dosing is not an issue; They are not oral or transdermal, so they don’t convert into estrone, the dangerous estrogen. They are delivered directly into the bloodstream. Unlike other delivery systems, pellets allow your body to take as much testosterone as you need at a given moment, because they are bio-identical and because of their delivery system, women feel better on pellets than any other form of estrogen and testosterone replacement, and they are the safest form of estradiol and testosterone replacement. Why would I recommend anything else?

We will continue next week with more frequently asked questions that both our female and male patients ask us at BioBalance Health®.

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Q: Why do I have to take Progesterone every night?

Post-menopausal bleeding is one of the side effects of any estrogen replacement therapy, including estradiol pellets. We can prevent break-through or postmenopausal bleeding by treating all women who have a uterus with bio-identical progesterone (BLA Progesterone, or Prometrium®) orally or with sublingual (under the tongue) progesterone. Progesterone prevents overgrowth of the uterine lining, uterine bleeding and uterine (endometrial cancer). You must take progesterone if you want to be treated with estradiol after menopause and you have not had either a hysterectomy, a successful uterine ablation, have a Mirena IUD, or if you can’t take progesterone undergo a uterine ultrasound and biopsy of the uterine endometrium yearly.

Q: What should I do first if I start bleeding? Take AirBorne®, one tablet in water every day for a week. If that doesn’t stop the bleeding add Vitamin K 100 mcg 1-3 pills per day for a week, to the Airborne®. If that doesn’t stop it, then double your progesterone dose for 2 weeks and if that doesn’t stop it then you’ll have to go to your gynecologist for a diagnosis and treatment of this unusual bleeding. Most of our patients stop bleeding.

Q: I’ve bled once or twice in the first 4 months after starting estrogen pellets, what should I do?

Bleeding in the first 4 months after starting your first round of pellets is common and is usually something that will not happen again if you’re taking your progesterone every night before bed.

Q: What should I do If I forget my progesterone?

If you forget your progesterone for one or more nights, take it as soon as you remember, but you may spot or bleed for up to 2 weeks. If your bleeding is heavy then take 2 progesterone pills at bedtime for 2 weeks and then try going back to 1 every night. If the bleeding doesn’t stop, then go off the progesterone for 2 weeks and restart one every night again. If bleeding starts again then we will ask you to see your gynecologist to make sure you don’t have a polyp or fibroid causing the bleeding.

Q: What if I have a thick lining in my uterus, polyps or fibroids? What’s next? Your gynecologist will do an ultrasound and may decide to do a D&C, a uterine biopsy, or a hysteroscopy to remove the lining and the polyp or fibroid. In some circumstances you might have to choose between stopping your estradiol or having a hysterectomy.

Q: I’ve bled over and over during my treatment and have already tried doubling my progesterone but keep bleeding, what should I do?

Recurrent bleeding can be from a thick uterine lining, a very thin lining, or a uterine polyp or fibroid. For us to know how to treat you, we need to know what is making you bleed. This requires an ultrasound of the uterus done through the vagina. We can order a pelvic ultrasound at Metro Imaging, or you can go to your GYN to have it done at his or her office.

Q: I had my ultrasound and I have a (thick lining/or polyp), what do I do now?

Your GYN will have to biopsy the lining of your uterus to make sure it is benign. If you have a polyp then you will need a D&C and a hysteroscopy to remove it. Your GYN will do this because that is their job. Please call them for an appointment and tell their receptionist what the problem is.

Q: I had my ultrasound and I have a very thin lining, what can I do to stop my bleeding?

A thin lining means that your estradiol is low, and you should be given more estradiol, and or less progesterone. We will take care of that by adjusting your dose of Estradiol when we give you your next pellets. In the meantime, if the bleeding is bothering you, we can prescribe an estrogen patch for you to wear until your next pellet insertion.

Q: I have one of the following symptoms: hair loss, swelling, pelvic pain, water retention, high blood pressure, fainting, chest pain, etc., all of which are symptoms that are not from to Estradiol or Testosterone. Should I continue to take my pellets? My doctor said your treatment caused my disease/problem/complications.

There are a few side effects of Testosterone and, or Estradiol pellet therapy but these symptoms are not side effects of our pellet treatment. You should go to your PCP and be evaluated for your symptoms and be diagnosed and treated for the real cause and what the problem really is. Don’t just stop your pellets because your doctor doesn’t understand that this form of hormone replacement doesn’t cause these complaints. Encourage her or him to find the real problem.

Q: What can I do if I cannot take Progesterone in any form because I have (melasma, nausea, swelling, headaches, bleeding) on Progesterone?

There are other options if you cannot tolerate natural progesterone to balance your estradiol. You can ask your GYN for a uterine ablation of the uterus which would burn out the lining of the uterus and stop all bleeding, avoiding any need for progesterone. Or you can get a Mirena IUD placed which will keep the lining thin and avoid bleeding for 5 years. The Mirena takes the place of oral BLA progesterone.

Q: What can I do if neither of these options for not taking progesterone are appropriate for me?

In very few cases a woman has a fibroid or a spongy uterus (Adenomyosis) that bleeds every time it is exposed to progesterone and the IUD or Ablation options are not possible. In these cases, we have a few other options

No progesterone, but receive a vaginal ultrasound yearly and if your uterine lining is thick, you will need a D&C to clean out the uterus or an endometrial biopsy
Get a Mirena IUD that lasts 5 years+
Stop all estrogen, but you can still take testosterone pellets and then there won’t be a need for progesterone
Have a hysterectomy, is the last and most drastic choice

These are the answers to the questions we give our patients when they call or email our RN or Nurse Practitioners. These options for treatment and prevention are effective for most patients. It is our goal at BioBalance Health to stop all bleeding in women on estradiol pellets who are menopausal.

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Q: Why do I need so many tests to replace my testosterone and or estradiol with pellets?

We order these tests for three purposes: We test your general health, kidneys liver and lipids as well as your level of inflammation, and your blood counts. These particular group of tests tell me how healthy you are, what undiagnosed problems you may or may not have, and some of the problems in your health that testosterone will improve. The second group of tests (Hormone Group) is to evaluate every hormone in your body, because they all work together, and to determine if you need replacement of testosterone, estradiol, thyroid or other hormones. The hormone group also assists us in determining your dosage of T and E2 pellets.

The last group of tests are those that test to see if you might have problems taking testosterone or estradiol, so that we do not misdiagnose you or treat you incorrectly. The help us to do no harm with your treatment.

Q: How Often are my labs drawn?

We ask that you get a panel of lab tests before your first visit, before your second visit and once a year. If you have other medical problems that we are treating, we may intermittently order tests to manage these other problems.

Q: Why are your “optimal blood test ranges” different from the labs reference range?

3 kinds of Tests: Health tests, Hormone tests, and Risk preventive tests.

Health tests are the same in general as Labcorp and Quest, except for Insulin fasting levels—We have updated them with the most recent research, but the labs have not.

Hormone tests: At least one hormone test is taken to test each gland in your body. Hormone tests are a little tricky because the lab “reference ranges” are not obtained from the hormone levels of young healthy patients between 20-40 years of age of the same sex as hormone levels have traditionally been determined, but in the past 15 years the labs have used the levels obtained from the “sick” patients who have their blood drawn for any reason by that lab and they don’t represent the optimal blood levels that are the goals of our hormone replacement treatment.

The hormones we replace or stimulate to young healthy levels generally start becoming deficient at age 40-50. Comparing our patients to old and sick patients who generally go to the lab for tests, is not a test of health, but a test to see if that patient is on the average as sick as other people their age, which asks the question, Is the patient tested as sick as other folks their own age?We don’t consider that comparison a test of health! Testosterone, estradiol, thyroid and growth hormones fall drastically as patients age and their health decreases as their hormones drop.

For hormone tests we interpret them based on your circumstances and compare your numbers to those of healthy young adults 20-40 because hormone levels not only decrease with age, but compared to young healthy people of the same sex, their blood levels parallel their symptomology and incidence of the diseases of aging.

It is true that traditional health care compares an individual to the group of people getting blood drawn, but the doctors don’t even know it.. they still think the labs are devising their reference ranges from asymptomatic people who are young and healthy. We had to repetitively ask the largest labs in the US Quest and Labcorp how they got their normal and why they were progressively lower levels each advancing year. It is because when comparing an individual to a random group of Americans who are getting tested because they are sick, the blood level average is dropping as Americans get fatter, more sedentary, stressed and have more and more diabetes and heart disease.

We don’t want our patients to be sick or be average for the “sick, obese and diabetic American” we want them to be in the reference range of healthy, young Americans without symptoms or presence of disease. For an example the clothing industry has changed the measurements that indicate a certain size of women’s dresses as the average American has gotten fatter. If you wore a size 4 dress when you were 25, your waist measurement in the 70s was 24 inches. In 2021 a size 4 waist measurement on a dress is now between 26-32 inches. They have made the average size 4 bigger and bigger to reflect the fattening of Americans because wearing a smaller size makes us feel good!

The labs have taken the cheaper route which is use the statistics you have in your hands—the results from patients whose insurance pays for their blood tests—to make a bell curve and create an average reference range which really means nothing but that if you are in that range, you are probably as sick as your neighbor. In contrast we use the ranges that are used in hormone and medical research that have not changed in the last 50 years. We don’t want you to “feel good “about your lab tests if they are not reflecting health!

Risk Prevention Tests are tests that make sure we are treating the right illness, menopause, low T in women and men or a more serious illness, eg we test a prolactin level (the first pituitary hormone that increases from a pituitary tumor) to make sure we are really treating estradiol or testosterone deficiency, and not a pituitary tumor. If the Prolactin is high (more than 60) a micro-adenoma of the pituitary may be present and you need an Endocrinologist or a Neurosurgeon to diagnose and treat it, not post-menopausal hormones from BioBalance Health! We also check for several genetic diseases that requires special management by us to keep testosterone replacement safe, including Hemochromatosis, Erythrocytosis, and High Homocysteine which can cause stroke or heart attacks. Our goal of improving your health and decreasing your risk of disease means that we find and treat all the diseases that can occur with aging or that are made more severe with testosterone.

On the first blood draw, we test for your blood type to help us advise our patients on the most appropriate diet for their genetic make-up.

At BioBalance Health® we order blood tests to direct our management and preventive medicine recommendations. We advise you to use your insurance to pay for your blood tests and offer you the discount the lab offers us, if you do not have insurance or have high deductibles. We do not use laboratory as a profit center, but as necessary medical information needed to guide us in our treatment plans.

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Welcome to the BioBalance Healthcast, I’m Dr. Kathy Maupin and my partner Dr. Rachel Sullivan, joins me today to discuss a new research finding from Washington University, in St. Louis Missouri.

“Low Testosterone Levels in Men Resulted in More Severe Covid Infections”, according to a research study from Barnes Jewish Hospital in the spring of 2021. The study did not say that low testosterone levels were the cause of severe Covid infections however many of the symptoms of men who have low T levels ARE associated with severe Covid infections: older men, sicker men, men who were obese and had AODM (diabetes). All of these medical conditions improve with testosterone replacement with T pellets, so it is unclear whether the individual risk factors are risks or whether low testosterone that can cause all of these problems and occur in older men are the true risk.

Their study revealed that more men than women were affected by Covid, and men with lower T (around 53 ng/dl) or low T, had most severe Covid infection. Men with more than 151 ng/dl of Total T had less severe Covid infections. They state that they didn’t find women’s hormones associated with severity of Covid, but they didn’t test free- testosterone, which is the only real test of the effect of T in women!

More men died of Covid in the US and in my state of Missouri as well. I’d like to submit another possible cause for this fact. Male humans are more fragile than female humans both in infancy and when they are old. Women are well known. To live longer than men and that is inherent in their DNA. It may be that having one Y chromosome and one X, or being male, makes men less metabolically and immunologically hardy than women who have a matched set of Xs.

For example: We see this in male infant verses female infants at birth. Ask any Neonatal nurse. About the “wimpy boys” verses the girls. They will always confirm that If your baby is born female at the same preterm weeks as a male baby born at the same time, it is much more likely that the female infant will survive better and with fewer disabilities than a male. It is a fact that all prenatal nurses and doctors know, and they manage preterm babies with this in mind. Male babies do not have appreciable levels of testosterone, but the genetics of having only one X chromosome instead of 2, like females have might make men less robust metabolically at the beginning and end of life.

But let’s look at the hormone Testosterone and what it does to prevent infection in both men and women. Testosterone is a hormone that stimulates the Thymus gland which makes the immune cells called T Killer and T helper cells that kill cancer cells, bacteria and viruses. When both women and men age, their testosterone drops and their thymus glands shrinks, producing fewer and less aggressive T killer and Helper cells, which results in a poor immune response in aging people of both sexes. This is one of the hormonal reasons that aging men and women have a high rate of cancer, deadly infections as they age.

In our practice, Dr. Sullivan and I replace Testosterone to people over 40 for women and generally 50 for men, when Testosterone naturally is deficient. When we replace T with pellets, the number and activity of T-white blood cells increase. This means that when we replace both sexes with Testosterone in our practice, we see fewer cancers, and fewer severe infections as our patients age. This may be the reason fewer men with normal/or at least higher T levels did not become as ill when they got Covid.

Testosterone is not a guarantee, but it ups your chance of being healthy while those around you of the same age are getting sicker. We thank Wash U Researchers for confirming our observations and beliefs about the value of normal T levels when it comes to avoiding infections.

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FINASTERIDE is a name of a medication that is commonly used in both dermatology and urology. It is an oral enzyme inhibitor that is used to decrease hair loss and to treat prostate enlargement. Finasteride is called a 5-alpha reductase inhibitor (5-ARI). It inhibits the enzyme that makes DHT out of free- testosterone.

DHT is not a bad hormone, it is only a problem for us if it is too high or too low. DHT is one of the hormones that you need in the right quantity for normal sexuality, normal brain function, normal muscle mass and strength et al, but it is not healthy to have too much which can cause male pattern hair loss, facial hair on women, hair loss at the temples in women, and prostate enlargement and trouble urinating in men.

Because men have a high incidence of hair loss, and prostate enlargement as they age, dermatologists, urologists and family docs start these men on Finasteride/Propecia/Proscar, but don’t think about the side effects or how the drug works. It is sometimes even started for genetic hair loss, which is not successfully treated with Finasteride.

What is the function of 5-alpha reductase inhibitor?

5-alpha reductase is vital to the development of male characteristics such as facial hair, deep voice, muscle growth, prostate enlargement male libido and prevention of ED.

What are finasteride and it’s brother medication, Dutasteride used to treat?

Male Pattern hair loss (Androgenic alopecia) in men and postmenopausal women
Benign Prostate enlargement (BPH)
High DHT causing acne and facial hair in postmenopausal women (off label and only after spironolactone is found to not be enough in women only)

****Women who are of child-bearing age should not take this drug!

What are the names of the two drugs available that are 5-alpha reductase inhibitors?

Finasteride® and Dutasteride®

These medications decrease the amount of circulating DHT by 70-98%. Therefore, when it is used to decrease hair loss and shrink an enlarged prostate, all of the DHT is decreased which results in blocking all the positive actions of DHT such as libido, energy, muscle maintenance,

Penile length, erectile function, and male pattern body hair.

These male characteristics are blunted for the sake of a thick head of hair and to shrink the prostate. It takes a much higher testosterone blood level and free testosterone to maintain male characteristics when on these meds. In some men there is no amount of 5-alpha-reductase inhibitors is safe.

Side Effects of 5-alph-reductase inhibitors:

Loss Sexual Dysfunction (Overall rate of sexual dysfunction 3.7%)

Decreased ejaculatory volume-1.5-3.7%
Ejaculation Disorders-0.2-0.8%

of libido

ED/Impotence 5-8% of the users have this
Infertility
34% decreased sperm count, and 14.5% reduced sperm volume after 26 weeks of use.
Normalization of seminal quality usually returns after discontinuation of finasteride
Depression and Suicide
Breast tissue dysfunction-0.9-2.5% (men)

https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020180s037lbl.pdf, accessed January 25, 2021

POST FINASTERIDE SYNDROME:

SOMETIMES THE SIDE EFFECTS ARE PERMANENT AND CAN ONLY BE TREATED BY TESTOSTERONE REPLACEMENT OVER TIME….THIS IS A LIFE LONG PROCESS OF REGROWING TESTOSTERONE RECEPTOR SITES.

New Study Links Finasteride to Long-Term Sexual Dysfunction

Finasteride users may experience severe sexual side effects for months

or years after they discontinue use of the medication.

Kiguradze T, Temps WH, Yarnold PR, Cashy J, Brannigan RE, Nardone B, Micali G, West DP, Belknap SM. Persistent erectile dysfunction in men exposed to the 5α-reductase

Inhibitors, finasteride, or dutasteride. PeerJ. 2017 Mar 9;5:e3020. doi: 10.7717/peerj.3020. PMID: 28289563; PMCID: PMC5346286.

HOW LONG WILL THIS LAST?

*POST FINASTERIDE SYNDROME CAN LAST 3 MONTHS or PERMANENTLY. Replacing testosterone helps recover the DHT receptors and is the only treatment known.

ARE THE SEXUAL SIDE EFFECTS WORTH THICK HAIR? THE SIDE EFFECTS ARE ….

-DECREASED OR NO LIBIDO

-DECREASED SEMEN VOLUME

--LOSS OF AM ERECTIONS

--ED

-PEYRONIE’S DISEASE (SCAR TISSUE

--LOSS OF PLEASURABLE ORGASMS

--PENILE SHRINKAGE AND SCROTAL SHRINKAGE AND NUMBNESS

OTHER SIDE EFFECTS OF POST FINASTERIDE SYNDROME:

-NO OIL FROM SCALP—DRY BRITTLE HAIR

-MELASMA

APATHY AND CHRONIC FATIGUE

-GYNECOMASTIA

-OBESITY

-MUSCLE SHRINKAGE AND WEAKNESS

-DECREASED BODY TEMPERATURE

--PREDIABETES AND HIGH TRIGLYCERIDES= IR

--INSOMNIA

--DEPRESSION

--DECREASED PROBLEM SOLVING

--EMOTIONAL FLATNESS

What to expect after stopping? 6 weeks of hair loss but that is not a good reason to restart.

Alternative treatments for hair loss and BPD instead of Propecia, Proscar,

Topical finasteride-only if it is not absorbed systemically
Topical Minoxidil
Oral zinc 30 mg/day
Saw Palmetto 500-700 mg day
Pumpkin seed extract
Stinging nettle 200 mg/day

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Saxenda®: is a GLP-1 agonist that normalizes blood sugar and causes decrease in appetite as well as slower emptying of the stomach and which makes people feel full longer. was used for treating Type II Diabetics under the name Victoza® for years. It is now offered in a higher dosage in a larger pen specifically for weight loss. It also reverses the insulin resistance both diabetics and obese people develop by eating too many carbohydrates in their diet.

People who have a significant weight problem, Insulin Resistance, or Type 2 Diabetes responds well to this medication because it works on relieving insulin resistance, normalizing blood sugar and controlling hunger, in addition to helping people get to their ideal weight! For those people who genetically are never full, this is the drug for them to make them feel full, maybe for the first time in their lives!

My experience with never feeling full:

I never understood those kids and adults who had to eat constantly or who could eat 2-3 plates of food at a time. I just had never walked in their shoes…. until I was pregnant. At that time in my life, I was 118 lbs. when I got pregnant, I never could catch up by eating enough in a day to feed both of us, while I was pregnant. I felt full at the beginning of a meal but was really hungry, so I had to eat every 30 or 40 minutes during my waking hours. I was hungry all the time! Eating literally ruled my life and it made me think about food all the time. I felt like I was in the prison of my body, but it was a good experience for me to have because now I understand how terrible a genetic albatross always being hungry or never being full is! If you feel like that it is an inherited trait so there are probably other family members who feel the same way. As people lose weight on Saxenda, they feel less and less hungry and are more satiated by eating.

Back to my experience with feeling hungry all the time, and never full. When I delivered my daughter, I was thrilled to not be manipulated all day and night by my hunger. It was the happiest day of my life to see the beautiful baby that she was, and also to be in control of my eating again. I think those patients who have this problem for a lifetime will be just as grateful to find Saxenda®.

| This medication is one of those that you have to slowly increase over 4 weeks to the maximum dose. The biggest side effect is reflux esophagitis and that means two things…that the patient ate too much out of habit, instead of hunger, or they already have the problem of reflux, and this drug makes it worse. The second most common side effect of Saxenda® is diarrhea. If a patient doesn’t follow a low carb diet this medication causes the carbs to dump into the intestines and that causes diarrhea. The application of this medication is that you take a subcutaneous shot (very small needle) every day in the abdomen like insulin, but it is not an insulin replacement. | | The Saxenda® dosing schedule | | Patients should follow a 4-week dose escalation to reach the clinically efficacious 3-mg dose. | |

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| The Saxenda® starting dose is 0.6 mg per day for 1 week1 |

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| Patients increase the dose by 0.6 mg each week until the full maintenance dose of 3 mg is reached1 |

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| If patients cannot tolerate an increased dose during dose escalation, consider delaying escalation for approximately 1 week1 |

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| If a patient cannot tolerate the 3-mg dose, discontinue treatment1 |

There are people who can’t take either of these drugs (Contraindications): Patients with MEN I and II, Medullary Thyroid Cancer, History of Pancreatitis, and or Pregnancy.

There are so many people who could benefit from Saxenda®. I believe it is the key to normal weight and normal appetite. I regret that the pharmaceutical company finds it necessary to charge a price that only a few people can afford.

If you have obesity as a diagnosis and have high fasting blood sugars or have failed Metformin ER treatment then your insurance company may pay for your Saxenda®, but it will take a precertification by your doctor or Nurse practitioner.

OZEMPIC® is another drug used for weight loss. In many ways Ozempic® is a lot like Saxenda®, however it is only one shot a week. The side effects are not as severe with Ozempic®, and the price is lower. Your insurance may very well pay for Ozempic®, as it has for many of our patients at BioBalance Health®.

Ozempic dosage for obese diabetics is gradually increased as follows:

1st and 2nd injection is 0.25 mg/week x 2 weeks

3rd and 4th injection is 0.5 mg/week x 2 weeks

5th week and thereafter 0.1 mg/week

Dosage for weight loss patients on Ozempic:

1st and second injection is 0.25 mg/week x 2 weeks

Thereafter injection is 0.5 mg/week

Only in resistant cases do nondiabetics have to increase to 1.0 mg/week

Side Effects of both drugs include:

Symptoms of hypoglycemia like headache, fatigue, and insomnia.
Reflux esophagitis and the cough associated with it when you lie down.
Distention of the abdomen from slow bowel peristalsis.

How to put it all together for Weight Loss:

Exercise daily for 45 minutes or more—normal life activity is not enough to be considered exercise! If you walk for exercise, you must walk briskly, and walking briskly means you can’t talk and walk at the same time.
Diet: Eat a low carbohydrate diet (know what that means) which means no sugar and no alcohol while you are working toward your ideal weight. Replace carbohydrates with a high protein diet including meat, cheese, eggs and protein shakes, Whey protein is preferable and tastes the best. You must eat Vegetables and fruits of every color 3 times a day. Snacks can be veggies, nuts, cheese, yogurt, eggs, and or fresh fruit. No baked goods, no crackers, bread, junk food or fast food.
A High protein diet means eating as many grams of protein as your weight in lbs. if you are active. Eat ½ of that in protein if you are not exercising that day.

A delicious protein powder that actually tastes good is Phormula #1 –I like the “mint ice cream sandwich” flavor….I can eat that as a meal substitute alone or blended with frozen fruit 3 meals a day.

Drink filtered water and lots of it! At least 80 fl oz a day.
No alcohol
If you want to lose weight in certain spots like your waist or your thighs, I recommend the Juvashape Ultrasound fat destroyer with Skin Tightening combination. It helps you lose fat where you want to when you have lost enough to be concerned about getting your shape back.
Medications assist in this process and speed weight loss along. Saxenda® and Oxempic® can be prescribed by BioBalance Health in our weight loss program.

If you are interested in coming in for a weight loss program, please go to our website biobalancehealth.com and fill out the history forms and have your blood drawn and we will make an appointment for you as soon as possible.

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There is a silent and UNTREATED, UNTESTED mutation then affects 1/3 of Americans, that causes pulmonary emboli, heart attacks and strokes, and can be treated/prevented by just taking a specific vitamin! No one talks about the MTHFR genetic mutation that can be diagnosed by testing for high Homocysteine and can be treated by simply changing the B vitamins that you take to methyl-B12 and Methyl Folate! Simple and easy, and can prevent a multitude of diseases, for both young and old. There is an abundance of information in journals of medical specialties who still don’t embrace testing for this mutation, therefore they don’t diagnose and treat this very expensive problem with a very inexpensive vitamin. What the heck is going on in American Medicine?

American Medicine treats one symptom or current illness at a time and is completely blind to preventing disease unless a very expensive drug can treat the problem, such as statins to prevent heart attacks. Preventive, individualized medicine is a thing of the future because US medicine is stuck in the past.

I discovered the MTHFR mutation decades ago because as a GYN I treated infertility. MTHFR mutation causes multiple miscarriages and pregnancy losses in fertile women who have the mutation. In the diagnosis of why someone miscarries this is often the answer. Treatment is NOT TAKING plain vitamin B12 called cyanocobalamin, or regular folic acid. The second part of the treatment is TAKING methyl B12 and methyl-folate. When we tested patients for the MTHFR mutation we found it was fairly common, in fact so common, that the FDA should change its recommendations for multivitamin supplements and B complex vitamins, as well as prenatal vitamins to include Methyl folate and methyl cobalamin instead of the non-methylated vitamins that can cause both infertility in the young and heart attack and stroke in the aging population.

Why doesn’t the government change the recommendations for B vitamins in all supplements, and prenatal vitamins to save babies lives? I believe that I have a granddaughter today because my brilliant daughter took methyl B12 and Methyl folate instead of the standard prenatal vitamins! I have this mutation as well and I had 5 miscarriages and I believe that my one gene mutation caused them…and 36 years ago I was not aware of this mutation, or how to fix it.

How do we find this mutation?

MTHFR mutation, discovered by doing a Homocysteine blood level, could prevent infertility and strokes, pulmonary emboli, heart attacks, and vascular disease in older Americans. If doctors do diagnose a high Homocysteine, they recommend giving more B12 (not methylated) and Folic acid and patients get worse and are at higher risk than before.

As for mature adults who have had a whole lifetime of exposure to the wrong type of B12 and folate, the form of the vitamins a third of us cannot metabolize, we have a lifetime of

soft plaque collections in our blood vessels which is just as dangerous as the hard plaque from cholesterol atherosclerosis plaques that statins treat. Soft plaque breaks off as emboli and causes blood clots, pulmonary emboli and emboli to the brain causing strokes and emboli to the heart causing a heart attack. One third of us have this mutation, but few of us know about it. Taking the right kind of B vitamins can stabilize these soft plaques and even reduce them, thereby preventing the embolization they cause.

Why are fewer people diagnosed from an abnormal Homocysteine and tested for MTHFR? Even if your doctor does a Homocysteine blood level, by drawing your blood at the laboratory. the lab companies have a skewed view of the “normal levels” of homocysteine. They give you the “average for the people they test” and call it “in range”, but if 1/3 of the population is abnormal statistically the “normal” is skewed to > 10.4. My normal for patients who don’t have the mutation and are not at risk for collecting soft plaque, is < (less than) 8.0. If you have less or equal to 8 you are probably safe. If you are above 8.0 you are either taking Methyl-B12 and Methyl-folate or you are not carrying a mutation.

How does Homocysteine work to cause soft plaque?

If you are normal, and don’t have this mutation, when you eat food with B vitamins or you take B vitamins in a supplement, the B vitamins go to your liver to be converted into the active form of B12 and folate, methyl B12 and methyl folate, they are then sent to your bloodstream to be used by all of your cells, nerves, brain, blood cells, muscle cells…almost every cell in your body needs these B vitamins.

If you have one or two mutations in the MTHFR, the methylation enzyme that converts plain B12 and Folic acid into methyl B12 and Methyl folate doesn’t work. Your blood test looks like a normal B12 level (between 500-1200), but it isn’t methylated, and it can’t work in your body. What does your body do with something it can’t use? It disposes of the unusable vitamins into the arteries as soft plaque. This is the plaque that is loosely attached to the arteries, which tends to get loose as an emboli, or chunk of this “trash”, which then circulates to your lung, heart or brain and causes a blockage which stops circulation to this tissue, causing a pulmonary embolism, a stroke, or a heart attack. This is all preventable if the diagnosis and right kind of B vitamins were given.

What are the Symptoms of MTHFR mutation?

Generally, patients do not have symptoms that are obviously caused by low B12 or folate until later in life, however there are general symptoms that we should look for as a trigger to test for the MTHFR mutation early on. These symptoms include:

Fatigue
Irritability
Anxiety
Fatigue
Depression
Poor memory
Constipation
Food sensitivities
Hot and cold flashes
Sore muscles
Numbness
Dermatitis
Cognitive impairments
Circadian Rhythm Disturbances
Infertility
Miscarriages

Why are there so many different opinions on what to take to treat the symptoms of B12 and Folate deficiencies and to prevent these medical disasters?

Some doctors don’t understand the way this mutation works. Their advice is to increase taking B12 and folic acid, which I have found makes people worse because it causes more soft plaque.

It is imperative that people with this mutation take already methylated folate and methyl B12, or they will only get worse. The ideal way to treat this is to avoid Cyanocobalamin which will make your condition worse. The ideal treatment for MTHFR mutations and high Homocysteine is methylcobalamin or methyl-B12, or Hydroxocobalamin.

Treatment: For oral Methyl B12 and Methyl folate I prefer Thorne Basic Nutrients 2/day, or Jarrow chewable Methyl B12 1000 micrograms + Methyl folate 400 micrograms daily.

Summary:

I am always amazed when I find easily treated and or prevented illnesses that can lead to severe disease in later life, that is not emphasized by the controllers of medical practice, the “colleges” of cardiology, or gynecology or whatever specialty that concerns the patients who are affected. Without the guidelines being written, most doctors are totally unaware of the real cause of the disease they are treating, so they don’t look for it. If a doctor doesn’t take a temperature, they can’t diagnose a fever! Doctors are generally rule followers who do whatever their specialty society tells them to do, and nothing more. It seems that easily treated preventable diseases are not high on the list of specialty societies in medicine, or on the list of the FDA because it isn’t treated with an expensive medication they can approve, so the agencies that could educate doctors and patients are blind to this cause of the above diseases and therefore doctors have no idea how many diseases they could treat with just one vitamin change.

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Neo 40 Is a new supplement that was created by Dr. Edward Lee to stimulate the production of Nitric Oxide in blood vessels which both dilates arteries and improving blood flow. I also dissolve atherosclerotic plaque at the rate of 6-10% per 6 months of use.

In the Journal of Alternative Therapies Vol 22, NO 52 p 32 stated in the conclusion of the study:

Use of the NO (Nitric Oxide) lozenge supplement without the use of a statin shows reduction of plaque as measured by CIMT by 6.1% on the left carotid (P = .18) and 10.2% on the right carotid (P = .005) in the course of approximately 6 months. Longer term, larger trials are needed to confirm these findings.

We have been using Neo 40, this supplement, with our patients has revealed that it is very effective for reversing ED for patients on Testosterone pellets who still need help with erections, even after taking testosterone. This supplement in the professional strength (What we have at our office) is the most effective dose and is only sold in medical professionals’ offices. In respect to erectile dysfunction, Neo 40 acts much like daily Cialis and may be more effective at reversing plaque in the arteries, which is a real coup for preventing heart disease and stroke! There are other medical conditions that respond to Neo 40.

Neo 40 treats and protects against the following medical conditions:

Hypertension
Erectile Dysfunction
Brain fog and memory problems
Prevents HEART DISEASE AND STROKE
Improves blood vessel’s endothelial function
Renal disease

How Does Neo 40 work?

As people age, we lose the ability to produce Nitric oxide in our blood vessels, which causes “stiff arteries” that are unable to dilate. In young arteries when you are stressed, exercising, having sex, or requiring more oxygen to any part of your body. Your blood vessels produced nitric oxide and your vessels expanded, also called dilation, to get the blood there without damaging blood vessels and without increasing blood pressure.

Until now we only had blood pressure medicines that dilated arteries and lowered blood pressure. The problem with these drugs is that that they didn’t increase nitric oxide, they just opened blood vessels and one of the side effects was the inability to have an erection!

Up until now the only medications we had access to through the FDA to increase Nitric oxide and dilate blood vessels to improve erections was Viagra and Cialis. These were recommended to treat ED with high doses before sex until recently when they were approved to increase endothelial function. These drugs come with a high price and many side effects, as well as a need for a prescription.

Before the production of Neo 40, We have not had a supplement that increased nitric oxide after age has diminished it. Now we have a supplement, Neo 40 which actually increases Nitric Oxide (NO) in your blood vessels, which dilates arteries when your tissues need more oxygen, and which decreases the plaque you have collected in your arteries. This means that there is symptomatic relief of ED as well as treatment of your arterial plaque! All of this without a prescription!

If your vessels are stiff and cannot dilate because they don’t have enough nitric oxide (NO), then when your tissues need oxygen, your heart works harder to pushing against constricted arteries, and your blood pressure rises. This leads to progressive disease of the heart and early death. We now have a non-prescription medication that increases NO production and dilates the arteries which is affordable and can take the place of statins in patients with high cholesterol. This is Neo 40 which cleans up plaque instead of depositing it in arteries.

Never before have we been offered a non-prescription drug that removes plaque from blood vessels that have been damaged by plaque! Neo 40 does that, and the above study proves it!

Where did this supplement come from?

Neo 40 was developed over the last 18 years by Dr. Ed Lee, a famous hormone specialist.

He discovered that the component necessary for arteries to dilate and to improved brain function and sexual function, was Nitric Oxide. This chemical is produced by the endothelium (lining of the artery) and increases oxygenation to all the tissues in the body. Dr Lee also found that this chemical decreases with age and the lack of NO causes lower oxygen delivery to every cell of the body! Neo 40 works to increase NO in the blood vessels and takes the place of the NO your body made when you were young. The drugs that have the same effect as Neo 40 include Viagra, Cialis, and other ED medications. Not only does oxygenation improve by taking Neo 40 or daily low dose Cialis, but this supplement repairs the damaged lining of your arteries (endothelium) that comes with age and deposition of plaque. This treatment benefit will revolutionize vascular disease, heart and carotid disease. Neo 40 does something that Cialis does at a much higher price, and Neo 40 is non-prescription and has no side effects!

Who should take Neo 40?

Patients at high risk for heart disease = High Blood Pressure, High inflammation (CRP), high cholesterol and triglycerides, high Homocysteine, positive family history of heart attack and stroke, patients with atherosclerotic plaque that narrows their arteries.
Patients with current heart disease or who have had a stroke.
Patients with calcium plaque seen on their Cardiac Calcium Scan
Men with Erectile Dysfunction
Any one with Type II Diabetes or Insulin Resistance
Anyone who is overweight with a BMI > 25
Anyone with poor circulation and leg ulcers or neuropathy of the legs
Anyone with trouble thinking and remembering
Anyone who wants to be healthy, and to continue to be healthy as they age

How Do You Take Neo 40?

One box of Neo 40 has 60 lozenges in it
One Neo 40 lozenge should be held in your cheek until it dissolves. It is absorbed directly into the blood stream through your cheek
The first month, you should take one lozenge of Neo 40 twice a day
After the first month, take one Neo 40 per day
Erectile function and Blood Pressure improves in 2-3 months on Neo 40
Mental ability improves over the first month, and in young people it might improve immediately

Risks of Neo 40 supplementation:

If you have LOW BP, Neo 40 can lower it even more and make you dizzy or tired. Make sure you take one half lozenge per day for a month and then increase to one full lozenge per day after a month

Have your Primary Care physician decrease the dose of your blood pressure medication when your blood pressure decreases on Neo 40.
If you have an allergy to beets you should not take it
If you take Viagra, you should only take Neo 40 if you use a single dose of Viagra no more than 100 mg, or daily low dose Cialis
Do not take Viagra and Neo 40 at the same time.
Daily Cialis and Neo 40 can be used together if the daily Cialis is not effective. It can augment the effectiveness of daily Cialis.

Neo 40 is one of the NEW GROUNDBREAKING SUPPLEMENTS that prevents one of the diseases of Aging: Shrinkage of the brain and dementia from atherosclerosis, heart disease, stroke, generalized atherosclerosis, and renal function.

SUMMARY:

NEO 40: Nitric oxide dilates arteries throughout the body, which increases oxygen delivery to muscles, blood vessels, the brain, heart and genitals.

ONLY $47 per month – Purchase at the BioBalance Health Office – It only takes 2-3 months to see improvement!

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There are several types of Hypothyroidism, and Hashimoto’s Disease is one of the types I see quite often in private practice. Hashimoto’s Disease is an autoimmune disease in which your own immune system attacks your thyroid gland. Initially Hashimoto’s Disease causes overactive thyroid hormone production but soon the inflammation caused by the autoimmune attack on the thyroid gland results in an underactive gland as the thyroid is destroyed by white blood cells. The thyroid gland located in the neck right above the collar bone, often swells from the inflammation and causes what is called a “goiter”.

There are many symptoms associated with Hashimoto’s Disease that are listed below, and many of them are the same symptoms as seen in all forms of hypothyroidism, but several are unique to Hashimoto’s Disease.

Symptoms of Hashimoto’s Disease (Those unique to Hashimoto’s Disease are starred*)

Weight Gain
Hair loss
Constipation
Low body temperature
Slow pulse and low blood pressure
High cholesterol
Brittle nails
Enlarged tongue
Fatigue
Muscle pain *
Joint pain and stiffness*
Depression
Memory sluggishness
Abnormal menstrual cycles
Generalized swelling or retention of fluid
Hoarse voice from thyroid enlargement
Trouble swallowing

The initial cause of Hashimoto’s disease is unknown but there are several theories about why some people get this disease. The theories include a bacterial or viral infection that triggers antibodies to kill the virus or bacteria, but the antibodies get “confused” and attack the thyroid gland as well. This is the most popular belief about the origin of Hashimoto’s thyroid disease. There is a consensus that besides the infection that triggers the attack of antibodies, there is a genetic weakness that sets certain people up to be at risk for getting this disease. Patients who get Hashimoto’s also are frequently beset with other autoimmune diseases like Lupus or Rheumatoid Arthritis. The third risk is radiation exposure to the neck and or chest. Lastly, trauma to the neck can cause thyroid cells to be damaged and “leak” the contents of the gland resulting in an autoimmune reaction that begins a domino effect that attacks all the thyroid cells.

What Happens When a Person has untreated Hashimoto’s Thyroid Disease? Not all people go to the doctor when they experience symptoms of low thyroid. Often healthcare is not available, or they are not insured or afraid of doctors. However, it is important to treat Hashimoto’s thyroid disease, or it can cause more severe disease than just hypothyroidism. These diseases include:

Heart disease cardiomyopathy and Heart Failure
Depression
Poor sexual functioning and Low Libido
Myxedema—a severe swelling of the body that results in drowsiness, and finally in unconsciousness.

How do we Diagnose Hashimoto’s Disease?

Blood Tests to diagnose any hypothyroid disease, TSH Free T3 and Free T4
Blood Test called TPO Antibody test, which is the enzyme that is generally contained inside the thyroid but is released from the thyroid gland when it is damaged by trauma, radiation or attacked by antibodies that are misdirected when killing a virus. The test we do measures the level of Antibodies that attack the Thyroid Peroxidase Enzymes.

Blood tests are the way to measure the level of the antibodies that attack the thyroid gland. We test for TPO antibodies as well as the TSH Thyroid Stimulating hormone, Free T4 one of the thyroid hormones, and Free T3. By measuring these tests as well as the antibody test, we can both diagnose and measure the success of our treatment. TPO antibodies are specific for Hashimoto’s Disease and don’t disappear with time but generally stay stable if the disease is adequately treated.

What is the Treatment for Hashimoto’s Disease?

The treatment of Hashimoto’s Disease is to replace the missing thyroid hormone with oral thyroid medication. At BioBalance we treat Hashimoto’s Disease with Armour Thyroid (pig thyroid) the most natural form of thyroid medication. If that is not affective, we adjust the treatment to another type of thyroid medication (NP Thyroid, Levothyroxine, Synthroid or Tirosant) and adjust the dose until the symptoms of hypothyroidism and Hashimoto’s Disease goes away.

It is not enough to give a Hashimoto’s patient a pill form of thyroid, but it is important to make sure the pill is absorbed in the stomach and intestine, and to ensure that it can be absorbed by cells all over the body to truly treat Hashimoto’s. In general, we follow blood levels of Free T3 and T4, after a patient has been on thyroid for a few months, but that doesn’t always tell us if the thyroid medication is attaching to the receptors and stimulating cells to do the job of a person’s normal thyroid.

We make sure the Thyroid replacement is being taken properly Absorbed through the intestines.

To ensure absorption and the activation of receptors we do several things. First, we make sure our patient is taking her thyroid medication on an empty stomach with only water and waiting for 20 minutes, at the minimum, to eat or drink anything. She can’t take other pills or supplements with it either.

Insure the absorption of the thyroid medication through the stomach and intestines

Some patients take medication to lower stomach acid which prevents them from dissolving and absorbing some of their oral thyroid medication. Patients taking thyroid require normal stomach acid to absorb their thyroid meds, and a proton pump medication for reflux will make it impossible for a patient to get her medication into her bloodstream. If it is necessary for my patient to take her Protonix or other drug like it, then our patient must wait 1 hours after taking the thyroid before taking any type of acid reducing medications.

If my patient has low stomach acid naturally, I can tell because she usually has trouble eating dense proteins like steak, then she may also have trouble absorbing her thyroid medication. We advise those patients to take digestive enzymes with the thyroid medication to help them absorb their thyroid medications.

If the beneficial gut bacteria is insufficient or abnormal from GI disease like Crohn’s disease and or Gastric Bypass, then thyroid medication cannot be absorbed. We treat our thyroid patients who have intestinal disease with probiotics and a few months of prebiotics to assist in the GI absorption.

The last step in the effectiveness of thyroid medicine is to make sure once the medication has been absorbed into the blood from the intestines it must penetrate the cells that require thyroid hormone. The cells with receptors for thyroid hormone require Iodine. In my area of the country, the Midwest, we do not have Iodine in the soil or in the water so the lack of Iodine both affects the production of thyroid hormone for which Iodine is required and the receiving and penetration of thyroid hormone by the cells. I advise my patients to take 12.5 mg of Iodoral daily to make up for the lack of iodine in our environment. Without it thyroid may get all the way to the bloodstream only to be blocked from cell absorption because of lack of Iodine.

Iodine is not contraindicated in Hashimoto’s disease when it is given in moderate amounts. Dr. Brownstein has written a book called Iodine, which explains the reason we give Iodine to all our hypothyroid patients, even those with Hashimoto’s disease.

The choice of thyroid medication is critical to treatment goals

I always start women on Armour Thyroid or Nature Thyroid because in my experience during the last 40 years of medical practice, women do better on Armour thyroid than a synthetic like levothyroxine, Synthroid. Armour Thyroid contains combined thyroid hormone, both T3 and T4, and the Endocrinology Society has finally come to that same conclusion. Without taking combined thyroid the only lab test that doctors are trained to test is TSH, and it will look normal, even when it is not making the patient better. This fact is because most women cannot make T4 (what is in Synthroid and levothyroxine), into T3 the active form of the hormone, and doesn’t make patients with Hashimoto’s better.

When I rarely take care of men for this problem, I start them on Synthroid, and they do very well because men can convert their T4 (what Synthroid contains) into the active form of Thyroid (T3). Men respond very well to Synthroid and Levothyroxine and therefore are more effectively treated with what most doctors use.

Hashimoto’s Disease Thyroid Treatment medical maintenance

Once you have been diagnosed with Hashimoto’s disease you cannot stop taking your thyroid medication. Iodine will always be necessary as well. My method of following a Hashimoto’s patient includes following their Free T3 and Free T4 as well as TSH, and reverse T 3 in certain circumstances and always a yearly TPO antibodies. Adjustment of the dose occurs if the labs reveal hyper or hypothyroidism, if the antibodies are increasing, and or if the symptoms of low thyroid come back.

If you have Hashimoto’s disease you may have other autoimmune diseases or symptoms from the Hashimoto’s even if it is sufficiently treated. The most common autoimmune effect of Hashimoto’s disease is hair loss from the antibodies killing hair follicles. In this case we ask our patients to see a dermatologist to prevent future hair loss and we optimize the dose of thyroid and Iodoral as well.

To our patients: Remember, if your symptoms are not improving on the thyroid medication or dose, you are on for Hashimoto’s Disease, you should find a doctor who will manage your thyroid to help you feel normal and ask you if your symptoms are better rather than just looking at the lab values.

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Autoimmune disease is one of the top 10 causes of death for women. The rate of growth of this group of diseases in women over the last 19 years is rapid. I have come to realize since the first 5 years of practicing Bioidentical hormone pellet replacement with testosterone for women that the treatment we offer at BioBalance Health® both helps treat and prevent these devastating autoimmune diseases! If you don’t know what this category of disease includes, it has many permutations, but the most common autoimmune diseases include Systemic Lupus, Rheumatoid arthritis, Scleroderma, MS, and Collagen Vascular diseases to name a few. When I first began offering testosterone pellets to women, I noticed that those women who had autoimmune diseases improved, decreased their medication, or went into remission! It was noticing this effect of Testosterone pellet replacement that caused me to delve into the research articles on Testosterone ‘s effect on autoimmune diseases. This was around 2005 and doctors and researchers had not begun to consider the advantage of testosterone for women at that time or realize how it affects so many diseases that women are at risk for. When I researched this association between autoimmune diseases and testosterone, I found a lot of medical research that confirmed my observations that testosterone is a key player in the treatment of autoimmune diseases!

What are autoimmune diseases?

Autoimmune disease is simply a general label for 100 or more conditions that are caused by a confused immune system that attacks your own cells, instead of attacking bacteria and viruses. It is like “friendly fire” from your immune system. In these diseases your immune response is “confused” and aims at self instead of viruses, bacteria and cancer cells. Autoimmune conditions are increasing in number and currently the only treatments are called “biologics” which is a misnomer for “shutting down your immune system” which leaves patients at risk for cancer, deadly bacterial and viral infections. These biologics decrease the body’s attack toward its own cells and tissues which makes the symptoms of autoimmune diseases better but at the same time it leaves your body defenseless against dangerous infections and cancer, which require a strong immune response to prevent disease, and kill the invading organisms. I have many patients with autoimmune diseases now on Bioidentical testosterone pellets who have regained the health of their immune system so it can redirect the attack toward dangerous diseases and away from their own tissues. Here is an example of one of my patients who took Biologics for years before she started taking testosterone pellets, which cured all her symptoms of low T, and improved, or modulated the action of her own immune system, but it was too late.

Story: My favorite example of autoimmune diseases and the power of testosterone pellets is exemplified by one of my favorite patients. This lovely woman was under 40 when I first met her, and she had young children and a lovely husband. Sadly, she had gotten an aggressive autoimmune disease called Lupus after a viral infection. Her body over-reacted to the virus and attacked her vision. When she came to see me, she considered me her last resort to help her halt the progression of this disease, and to retain some of her sight. She was already on biologics for some time, and she received monthly steroid injections in her eyes. In spite of this she had lost the vision in one eye and was going blind in the other as well. She had read /heard some of my blogs and information about how testosterone “modulates” the immune system and can help control or decrease the damage done by autoimmune disease. When I first saw her, she was well versed in the benefits of Testosterone therapy in autoimmune disease treatment, and she knew that T stimulates the production of T killer and helper cells in those with poor immune systems and normalizes over-reactive immune systems. Both of which improve the lot of patients suffering from Autoimmune diseases.

I told her I had never treated the rare form of Lupus that she had with T pellets yet, but she had other symptoms of low T and had had a Total Hysterectomy and BSO and had no Testosterone blood level. She wanted to try to both get her body back, her sex life with her husband back and to try to slow down the aggressiveness of her lupus blindness, so we began T pellets.

She never had to get another eye injection after her first testosterone pellets, and her condition improved drastically. She lost the 30 lbs that she had gained after her total hysterectomy, and she got her sex life with her husband back! Her Ophthalmologist thought it was his steroid shots that did the work and would not be dissuaded from his victory speech…but she knew what the successful treatment was! It was due to her testosterone! Her Lupus halted its progression after her first treatment, and she could still see out of one eye! Sadly, she does not have a happy ending. The biologics for lupus that she had taken before coming to me as well as during her treatment with T pellets had done their damage and she was diagnosed with an aggressive cancer that took over her health. She came to talk to me to ask me if she could continue to get T pellets while she was treated for cancer because it had brought her life back and she wanted a quality life to the end of her life. We continued treatment…It appears that the cancer was beginning before we started T Pellets and was too far advanced to treated effectively with radiation or other methods. The disease that she got secondary to her suppressed immune system from the Biologics too her life. The only joy I can glean from her treatment was the joy she had for several years of being able to see, as well as maintaining her relationship with her husband. Sometimes the traditional treatments we doctors offer are more dangerous than the disease itself.

After treating this patient, I was more motivated to help more women with their autoimmune diseases by prescribing testosterone pellets. Just to be clear, I do not change a patient’s treatment from her Rheumatologist, I add to it to make it work better against the autoimmune disease, hoping that improvement will allow my patient to lower the dose or get off the “Biologics” eventually. So far I have successfully treated Fibromyalgia, Rheumatoid arthritis, Lupus, and MS. All my patients who were already treated by their Rheumatologists, stopped the progression of their otherwise progressive autoimmune disease and improved the quality of their lives. Testosterone studies about autoimmune disease are available in the Rheumatology literature, but rheumatologist don’t know how to prescribe testosterone, and they are not in the Gynecology journals for doctors who do give women testosterone replacement. Testosterone for women with autoimmune diseases is a treatment without a medical specialty!

Testosterone pellets give women the protective testosterone levels they had in their youth and by adding a very low dose of estradiol they feel “normal” again. Sadly, the advice of most Rheumatologists is to avoid all “hormones”. Their advice is only half right. Patients who have autoimmune diseases should limit the use of estradiol (estrogens) and maximize the use of testosterone. Estrogen given alone in any form, especially oral estrogen can cause a worsening of autoimmune symptoms, so we only use non-oral E2 (pellets) and we use higher than average doses of testosterone in our pellets and our treatment plan works!

We only use the safest testosterone and estradiol delivery system, which is testosterone pellets plus estradiol pellets for women. This treatment plan has worked nicely. For over a decade with my patients. I wish that more women with autoimmune diseases would come for treatment to both help their disease symptoms and to get their quality of life back!

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I will give your PCP the benefit of the doubt that he or she doesn’t know anything about hormones, but that does not excuse him/her from trying to persuade you to stop a treatment that obviously helps you and has brought you back to life! Here are some questions that are brought about by visits to the PCP when they start attempting to scare you into stopping your bioidentical hormone replacement therapy with pellets or your natural thyroid medication (Armour Thyroid).

Is my thyroid being over treated? My PCP says my TSH level is too low:

No, your thyroid is not overtreated if your free T3 is between. 3.0 and 4.5 and your TSH is between 1-2.5. Dr. Maupin has had hypothyroidism since she was 22 and she is an expert on thyroid replacement. Her daughter Dr. Sullivan has been on Armour Thyroid since she was 16. They are treating you with the most bio-identical thyroid possible to normalize your free T3 and Free T4 thyroid hormones. These two thyroids are the active thyroid hormones that enter your cells and turn on your metabolism. TSH is just a stimulating hormone from the pituitary that stimulates the thyroid to make T3 and T4. Looking at these two hormones tells BioBalance doctors and NPs if your body is getting enough thyroid. Thyroid hormone is vital to life and to have it in the proper range is extremely important!

We don’t follow your TSH because it is not indicative of the amount of thyroid hormone you have circulating and does not parallel your symptoms. TSH is only useful for diagnosing hypothyroidism but not for following how successful treatment is. When you take thyroid successfully your TSH decreases to below 1.0. That is a sign that you have enough thyroid hormone, the suppression (lowering) of the stimulating hormone TSH.

Dr. Sullivan and Dr. Maupin both have been successfully treated for their hypothyroidism and know that resolution of symptoms of low thyroid is as important as the lab numbers. Ask yourself do you feel better when our doctors and NPs are managing your thyroid or when your PCP is? If we have wiped away your symptoms, and they don’t, then which one of us is right?

Do I really need all of these supplements?

We prescribe supplements for many reasons. Each supplement is prescribed for your individual problem. We give you a list of the supplements you should take and give you the reason we are prescribing each one. We often use supplements instead of prescription medications because they have fewer side effects, and they quickly supplement our inadequate diets or give us back what our lifestyle or medications take away.

Supplements are prescribed for you to add to the value of the food you eat, to protect you from cancer, treat anxiety, protect you from some medications (Statins use up CoQ 10, and supplementation gives the nutrient COQ 10 back to you to rescue you from abnormal liver function). We only prescribe supplements that treat specific individual deficiencies that you have because of your diet, Medications, genetics and or your medications. PLEASE TAKE THEM!

Other than spironolactone, prostate complex and dermaplane, and laser hair removal... what can I do about my facial hair?

The only rule is don’t shave! Shaving makes it worse thicker and creates stubble. White and light hair can’t be successfully lasered, but dark hair can be painlessly lasered. Hair must be darker than your skin for an Alma laser to remove it. It is a painless process. It must be done every 6 weeks when hair goes into another growth cycle, for 4-6 treatments. For facial hair, waxing, using an epilator and plucking are the most successful hair removal of light hair. Dark hair is removed best with the hair removal laser—it is NOT painful and is effective. We give spironolactone to every patient to prevent facial hair and acne!

These methods are only necessary when a patient can’t take spironolactone for some reason or if they have particularly dense hair.

Is my hair falling out because my testosterone is too high? That is what my PCP says.

The most likely cause of hair loss is low thyroid, followed closely by medications, poor protein intake, familial genetic hair thinning. If hair is thinning only in the frontal area it is due to low estradiol. If it is thinning all over the head it may be an anesthesia side effect, or high cortisol, low thyroid, lack of protein and vitamins in the diet or a side effect of many medications. Only hair loss restricted to the temples and crown in women can be from high DHT, a byproduct of testosterone. (Please see my book The Secret Female Hormone).

Remember to speak up to educate your doctor, and if he or she doesn’t listen or back down from dissuading you from taking your pellet hormone therapy, then vote with your feet and find another doctor. Another option is to say, I will continue to be your patient on the agreement that we won’t talk about hormones or thyroid again, and you will not order testing of these hormones. I get tested by my hormone specialist.

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Primary doctors who practice general medicine, generally don’t know anything about hormones and or worse yet their information is old because they haven’t read anything about hormones in the last 30 years. Medical schools are terrible at hormone education even now. Bio-identical hormones have been prescribed as long as I have been practicing medicine, however medical education only teaches about FDA approved drugs and the FDA only approves drugs that make a massive amount of money for BIG PHARMA. The FDA is hires ex-Big Pharma MEN who only approve of the drugs that are made by big pharma. Bio-identical pellets are as close to your own body’s hormones and are made from yams, so they are not a “new” drug made in a chemistry lab. They can’t be patented. BI hormones will never be FDA approved because they are “natural”, therefore PCPs who are only educated by drug reps who bring medication samples to their office, are trained to hate the competition BI hormones create to the FDA approved drugs. Pellets are mysterious to most doctors and drug reps, so they just tell patients they are “dangerous” or useless to scare patients from using them.

A bigger threat to Big Pharma is that BI Pellets make people healthier, so my patients don’t need as many other drugs. This is a huge threat tp the bottom line of Big Pharma! Health is not the goal of the FDA. Your tax dollars pay for their misinformation and for them to ban good and effective medications…They are not altruistic, and we are not in charge of our health anymore. The FDA has a big voice, and it brainwashes mainstream doctors with lies about BI hormones (the competition) of their previous employers, Big Pharma!

This misinformation is what we are going to combat by arming you with the TRUTH! I am going to tell you what to tell your doctor when he or she tries to dissuade you from using your BI pellets that have healed you, gotten you off many FDA drugs, and are making your lifespan and health-span longer! Please help us with our battle to educate women and doctors by giving you answers to your doctor’s comments meant to make you fearful and control you.

The following questions and answers are examples of how to educate and respond to your PCP if they attempt to scare you off your pellet therapy. If your physician doesn’t listen, then walk away and find another doctor. Close-minded doctors are bad for your health!

1 - Does estrogen cause breast cancer? NO!

It has been proven that estradiol doesn’t cause breast cancer. The WHI revision statement says that estradiol decreases both the incidence and severity of breast cancer. It is Provera (not pure BI progesterone) that causes both breast cancer and heart disease. More research has been done that confirms this. We use Testosterone pellets in combination with Anastrozole (Arimidex® an anti-breast cancer drug that lowers the dangerous type of estrogen ESTRONE!). BioBalance protects our patients by combining testosterone with anastrozole and decreases the risk of getting all types of cancer including breast cancer. Testosterone pellets (not other forms) increase T killer cells and T Helper cells to kill cancer!

Remember, when I say “decreases your risk” it doesn’t mean that no one in our practice gets breast cancer. We don’t wipe out breast cancer with Estradiol and Testosterone pellets, but we prevent many cases of breast cancer and if our patients get breast cancer it is less aggressive than if they were not on pellets.

2 - Does testosterone cause prostate cancer? NO!

Dr. Abraham Morgentaler from Harvard has spent his life studying and researching both animal and human prostate cancer and its relationship to Prostate Cancer. He has proven that Low Testosterone causes prostate cancer, not high or normal levels of pure testosterone. It is now proven and is starting to be accepted by urologists throughout the country. We have been following his research and advice for years! For more information please read. Testosterone for Life, by Dr. Abraham Morgentaler or Got Testosterone? Dr. Kathy Maupin and Brett Newcomb for more detailed information

3 - Is there a certain age that I should stop receiving hormone pellet therapy?

Testosterone pellets make you healthier, cures a multitude of significant symptoms, and as long as you are benefitting from the pellet BI estradiol and testosterone replacement, you should continue receiving it. Testosterone pellets for men and women have been found to prevent many diseases of aging like heart disease, sarcopenia (frailty), dementia, Parkinson’s disease, autoimmune diseases and many others. We have treated patients as old as 93 and as young as 30 (women after total hysterectomies) and men age 18 with a genetic disease called Klinefelter’s syndrome.

Replacing your testosterone and both estradiol and testosterone for women is just giving you back the hormones you had when you were young. It doesn’t cause a risk of getting future diseases, and it helps prevent from cancer. There is absolutely no age or reason to stop taking testosterone or estradiol with pellets. Dr. Maupin and her husband have been on pellet for almost 20 years, and they are not stopping until they die!

4 - My PCP thinks it’s dangerous to take testosterone replacement.

Testosterone is the safest hormone women and men can take if it is prescribed by a knowledgeable anti-aging physician. Women have three times as much testosterone as estradiol when we are young and it gives us beautiful young bodies, and a healthy sex drive, as well as protecting us from cancer as well as the diseases of aging. Women begin to become deficient in their 40s. The Journal of Metabolism and Endocrinology has finally embraced the idea of replacing testosterone for women just last year (2020). They restrict the population who should get it to those women with sexual dysfunction (no sex drive, no orgasms, no fantasies), but I predict that they will come around to the other benefits testosterone has for women.

Doctors who know nothing about testosterone for women. say it is dangerous, but they can’t come up with what will happen if your take it that makes it dangerous! If you ask them what will happen to you, the worst thing they can come up with is facial hair, which is easily preventable.

Instilling fear in women is how old school doctors shut us up so they don’t have to listen to our problems caused by low Testosterone! They try to scare us thinking that will stop us from taking hormones. There is no reason to be fearful of hormones. You made them yourself for 40 years before you needed them. Testosterone and estradiol pellets are just replacing what you lost in the most physiologically similar way to when your body made it. Ask them to read the Journal of Metabolism and Endocrinology Fall of 2020 and winter 2021 or the book, The Secret Female Hormone.

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If you always thought of your age as the number of years you have lived, you may realize that the number of years you have lived doesn’t represent how healthy you are or how young or old you look when you attend your high school reunion where everyone is the same chronologic age. When you go to your reunion you will observe that many friends look much younger or older than their chronologic age! Why do we age so differently? How do we measure your age as how healthy you are which also dictates how long you might live and how healthy you will be until you die? Last week we talked about how you can change the activity of your genes so that you live longer and healthier than your inheritance predicts, and today I would like to discuss how to measure your true health age with just one of two possible lab tests.

How you look is just one way of judging your Health Age. We all reflect our health age in our physical appearance especially our skin hue, texture and tone. Other ways of determining your general HealthAge without a medical test is your family history of diseases, your history of exposure to toxins: environmental, alcohol, drugs, smoking and other lifestyle choices such as your diet, and exercise history and habits. These are indirect methods of measuring health and your Healthage.

Indirect ways to measure Health Age:

· Appearance, and skin quality

· Family History

· Exposure to environmental toxins: environmental, alcohol, drugs, smoking

· Habits: alcohol, smoking, and drugs

· Diet history

· Exercise history

More direct ways of measuring your Health age include blood tests for the hormones that keep you young and healthy, specifically Testosterone, Growth Hormone, Thyroid tests kidney and liver testing, Adrenal Testing with (aldosterone and cortisol levels), as well as lipid and inflammation blood tests and measurement of your body composition. These are other ways I evaluate a patient for their Health Age. They combine to give me a picture of overall health and a low health age.

Direct ways to measure Health Age

Blood tests for hormones that decrease with age: testosterone, estradiol, growth hormone, thyroid, adrenal testing
Blood tests for liver and Kidney health
Blood tests for indicators of unhealthy aging: lipids, inflammation, homocysteine, HBA1C, insulin levels and CBC (blood count)
Body Composition-with InBody machine
Level of stress in your life

The above factors can be tested to evaluate how healthy you are and how long you may live.

Until recently we did not have a test to judge all of these factors together at one time with one test. Now we have two tests to measure your HealthAge with self-administered blood tests to tell us your Health Age, how old you really are. Both the Telomere length test and the test of your epigenetic changes that alter your health are good measures of your Health Age. Armed with this information I can tighten up your lifestyle to inactivate some of your most dangerous mutations that you inherited or advise you on how worrisome your future health looks and to motivate you to change your lifestyle. I can even watch progress in your treatment plan by retesting you!

The Telomere test evaluates the length of the ends of your DNA, the telomeres. The longer the ends of the telomeres, the lower your health age, the healthier you are for your age and most probably the longer you will live without illness. The second way to look at your DNA and how your lifestyle has altered the activity of your DNA is by doing a TruAge® Test which measures the methylations on your genes that turn off your dangerous genes, causing them to be inactivated, and you to be healthier. Methylation of your basic genetic profile is called epigenic modulation of your genes. We talked about this during my last podcast, where I explained that you are not really crippled by your family history of illness and your own genetics, but that you can modify your genetic activity with lifestyle changes. Measuring your Health Age is now being done by a company called Truage®, and you can order the test yourself to see where you stand in terms of your health age.

Knowing your health age gives some of my patients a wakeup call to clean up their diet, exercise, bad habits and improve their general health. It also stops many of my patients from giving up on themselves because they were born with “bad genetics” or a family filled with disease.

For those other patients who have attempted to be healthy throughout their lives, Truage® knowledge gives them the confidence that their efforts have been useful and have resulted in a healthier body and mind. They can stop worrying about “what will get them” later in life. It Is reassuring that we are not merely the sum of our genes with a life determined when we are conceived, but we can adjust the genetic structure of our genes and turn off some dangerous gene by living a healthy life, making you live a healthier and longer life.

What can you do to reverse the genetics you have been given and to make up for poor lifestyle choices in the past?

The things that can do to lower your Health age include:

Replacement of hormones when they become deficient, specifically testosterone and estradiol, in non-oral delivery system
Nutritious whole food diet without junk food
Achieving ideal weight
Daily exercise
Good sleep
Supplements that take the place of a perfect diet
Medications that decrease blood pressure and risks of heart disease
Management of stress
Minimal alcohol, and no tobacco or drugs

My patients are motivated to get better and lengthen their lives, by decreasing their Health Age which increases their life span.

I have been cognizant of these factors my whole life and did a good job of all of the above except good sleep and management of stress because I was an OBGYN for 29 years which is one of the most stressful specialties in medicine. These lapses caused by my chosen profession, finally left me with a heart arrhythmia and I had to quit delivering babies in my mid 60s to become healthier. I now am careful to manage all of the above factors to improve my health and health age and give me the best chance of living a healthy long life.

We all have two ages: Chronologic age and Health age, our True Age. We can’t change one of them, but we can alter our Health or Biologic age through lifestyle changes, replacing hormones excellent diet, supplements and exercise.

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We all know that our genes and chromosomes are given to us at birth, are in each of our cells for our lifetime, and are contributed to by each of our parents. Our Genetic profile is a blueprint for our growth, development, health, talents, esthetic looks for the rest of our lives. Until recently medical science taught us that our genes that determine our future health are unalterable…..that those of us will many ill ancestors may be doomed to a life with the same diseases our parents or grandparents had, and that we cannot change our genetic inheritance. Often the reality of a very ill ancestral tree, called a family history in medicine, caused people to give up on becoming healthy in the face of many genetic illnesses they feel are set in stone. However, that belief is not true! In the recent past the discovery of epigenetics, the study of turning on and off the genes in our genetic blueprint.

In other words, we have learned that our genetic blueprint is not unalterable, and we can improve or worsen our future health through lifestyle changes. Epigenetics is literally the study of how genes can be turned on and off through environmental methods.

You may have noticed that your doctors usually ask you about your family history of diabetes, heart disease, cancer etcetera. They ask because they want to know what your inherited risk of

Diseases, because of the diseases your ancestors had. This method of determining your future risk of disease is a rather “blunt instrument” and not at all reliable, but until when DNA was discovered, it was all we could measure inherited risk. I still ask these questions of my patients for a different reason. I want to know what genes they MAY have been given from their parents so that I can advise them on how to decrease their risk of getting what their genes may or may not predict! How can I be so bold? It is the new findings based on EPIGENETICS that tells me that changing our food, exercise, nutrition, where we work and live, and how we deal with stress and how we control our habits like smoking and drinking can turn off genes we have inherited that can make us sick. This study is one that can save us from our predetermined genetic disease and family history, by turning off “bad genes” to prevent getting the conditions that can make your life miserable and short.

So how does this work? Humans have 22,000 genes in each of their cells that are combinations of the genetic material handed down from our ancestors, but genes can be turned on or off by our living conditions…our lifestyles. This finding in medicine is new and not generally accepted by all of medical science even though it has been proven to be true. We have a genotype and a phenotype. We can alter our genetic code by altering the DNA itself and turning off bad genes, which alters how the genes are expressed. Our genotype is the basic genes we inherited, and our phenotype is how we look and how our metabolism works, which is basically our genotype altered by our environment. We can literally make ourselves sick or well if we start early enough to “improve” our God given genes, by turning off the bad ones and making them work for us!

My personal example of both how we have a chance to get the good genes from our ancestors or our back, I have genes that were given to me by my ancestors that direct me to be obese and have heart disease, yet I am at my ideal weight and my arteries are completely clean. What happened? I had parents who battled obesity all their lives and they cooked in a low carbohydrate way and we did not snack on junk, instead we ate nuts and fruit. When I was in control of my eating in college, I strayed from the way I had been taught and I ate what everyone else did and gained weight, my thyroid stopped working and I felt terrible. A brilliant family doctor in Kansas City Missouri in the late 1970s advised me how to eat—low carb, high protein, no junk or desserts, almost no alcohol, moderate caffeine, and fruit and veggie snacks only. I spent a summer cleansing my body and lost all the weight I had gained and was thin again! I literally turned my obesity gene off! I follow this routine today or I can turn my obesity gene on again, however now I have developed habits for a lifetime that don’t include bad food.

There are many genes that can be turned on or off by living in a healthy manner. When my patients present with a challenging family history, but no obvious problems yet, we discuss lifestyle changes that can help them avoid the future their genes have predicted. This is the time to alter habits and lifestyle…before the damage is done.

A general example of how this works: If a patient has heart disease and stroke on both sides of their family it is important that she change her lifestyle to turn off the genes for heart disease and stroke by exercising daily, replacing lost hormones at menopause and eating a whole food Mediterranean diet with nutritional supplements that prevent inflammation and reverse the deposition of plaque on her blood vessels.

For those of you who have chosen to get a 23 and Me genetic profile, it is the cheapest way to determine the “weak points” in your genetic profile. 23 and me lists the mutations that cause the diseases that you are genetically at risk for. In this way you can concentrate of turning off the genes you did inherit and ignore the diseases that you are not at risk for that may run in your family. …Knowing your genetic soft spots allows you to concentrate on the diseases YOU are at risk for. Knowledge is key to being healthy and 23 and me is an inexpensive way of finding out.

If you have not spent the $99 to get your genetic profile from 23 and me, then you won’t be able to narrow the field of disease you might get in the future. Family history takes a look at your parents, grandparents, aunts and uncles as well as sisters and brothers to determine which diseases you are at risk for and take appropriate action. Family history does not give you the diseases you are at risk for, just a choice of diseases that you may be at risk for.

My own example of diseases I am at risk for was enlightening. 3 out of 4 of my grandparents had adult-onset diabetes, but I did not get the genes for AODM. I did get the gene for obesity, yet I have been overweight when my hormones stopped working but have never been obese. I credit this to the healthy diet my mother trained me on and all the supplements she gave me to help my diet along. She was way ahead of her time. Because I started early with cleaning up my diet and exercise program I could “turn off” the obesity gene!

I also have atherosclerotic heart disease throughout my family history, but I do not have the gene for heart disease. My Cardiologist checked my Cardiac Calcium score at age 47 and at age 63 and he found that my heart vessels were completely clear! My cholesterol has always been high but NO atherosclerotic heart disease! He chalked it up to replacing my estradiol and testosterone with non-oral pellets since I was 47. Hormone replacement given at the right time and the right form of hormone (bio-identical vs synthetic) can turn off the genes and prevent heart disease!

My patients are looking for a way to prevent disease, reverse the changes of aging and lengthen their health span by lowering their health “age”. They embrace the belief that they can change the predetermined blueprint that they have inherited by replacing hormones that are deficient, eating a healthy whole food Mediterranean Diet, regularly exercising, replacing nutrients with supplements, and avoiding alcohol, sugar and inactivity.

You may think this method of regaining health is what your mother told you a long time ago, and maybe it is, but I have the #1 secret weapon, bio-identical testosterone pellets and estradiol pellets which stimulate the epigenetic positive changes in your health. Mom didn’t know about hormones or exactly how her advice worked, but she had the right advice for me that could make positive epigenetic changes in my DNA and turn off bad genes but only if I listened to her!

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There are many roadblocks to fat loss for Americans and the list grows longer every day! It is now wonder that we are an obese society with more than half of our population suffering from pre-diabetes or Type II Diabetes right now. With Diabetes and many other diseases emanating from our obesity, sedentary lifestyles and diets full of carb and devoid of nutrition, we must attack this problem now. It is only getting worse and until we recognize the causes and counteract them, we are doomed to a very sick society.

Today we will discuss the difference between fat loss and weight loss, roadblocks to permanent fat loss, genetic programming of obesity, how to modify the control of your genes and treatment plans that work for my patients.

I do a body composition test on all of my new patients and then follow up with another body composition test 4 months later, even if my patients aren’t coming in for weight loss, I talk to them about the state of their body composition and what they need to do to be healthy. Let me start out by telling you that if you have removed the mirrors from your house to help your denial of your obesity, put them back. Ignoring a problem only makes it worse. My INBODY machine measures a person’s weight, her lbs. of fat, lbs. of muscle, % body fat, amount of retained fluid, and internal omental fat that is the highest risk for heart disease.

The INBODY print out that my patients go home with outlines the amount of fat they should lose and muscle they should gain to be healthy. I use this to explain that muscle burns calories and weighs more than fat for the same volume of tissue. The more fat you have and the less muscle you possess the worse your health is. It is fat and not weight that is a roadblock that prevents you from being healthy and long-lived. One of the reasons that I offer testosterone as the foundation of my treatment plan is because with age and poor lifestyle, we replace muscle with fat and never get it back even if we exercise as we age. It takes T to build muscle and after age 40 we have low T and therefore need to replace it to build muscle. Muscle mass burns calories, and it takes testosterone to optimally burn calories. Many of my patients on T Pellets, diet and aerobic exercise + weight training doesn’t lose weight in the first 4 months after initiation of T pellets, but they lose fat and gain muscle. This sets them up for losing total weight as time goes on, and not lose muscle! I have to re-educate patients every day who believe that losing weight is the goal, when losing fat, and gaining muscle is the only way to sustain your healthy body composition.

So here are a few quick facts:

BMI is a poor way to judge obesity—Height and weight in the BMI computation does not judge good or poor health. It makes people with a lot of healthy muscle and low-fat look like they are unhealthy, and this method of judging health makes the skinny fat folks with low muscle mass and high fat look healthy! The only people it works for are the government agencies and insurance agencies that can compute a BMI easily—it’s an easy math problem! Easy is not necessarily accurate, and the BMI is misleading. It should be thrown out!
If you have a lot of belly fat inside your abdomen (beer gut, or apple shape) you ARE at risk for heart disease and diabetes. The only exercise that helps this problem is aerobic exercise that makes you sweat at least 6 hours a week! PS It only works with a low carb diet!
You can’t get healthy by either eating a low carb fresh diet, OR exercising, or just taking a diet pill, OR taking supplements….You must do all of it and keep it up the rest of your life! (except for the diet pills).
You can overcome your genetics! There are genes that cause people who possess them to be hungry all the time, or to be obese, or to get Type II Diabetes, but the study of Epigenetics tells us that a healthy lifestyle can turn these genes off! Your family history is not the excuse you can use to allow you to be unhealthy and fat!
The last and most important truism is that whatever you did when you were 20 years old DOES NOT work when you are 40! Your metabolism and hormone levels were different when you were young and believe it or not, your self-control over your eating and drinking of alcohol was better when you were young. Please don’t use that excuse for being sick and fat! EG. Starving yourself for a week will only lose muscle when your 40 and you will gain it all back and more after your fast is over!

So, our environment of advertising food at every commercial break and larger and larger plates, portions, cars to fit larger people and larger Barcaloungers is only fooling you. The government in the US advises us about being healthy without a medical degree…they just want you to buy what we are growing. Grains and corn…which make us fat! The BMI is an easy thing to calculate so the government goes for ease over truth, and tells you to look to only your BMI and if you are 25 or less you are healthy even if you don’t’ have a muscle in your body…..Sitting at a computer like I am now, only causes you to lose muscle and gain fat…that is what Covid’s working from home did to us…we don’t even walk to work anymore and most of my patients gained at least 15 lbs. over last year!

So, you have to struggle against advertising brainwashing you, the government we pay our taxes to telling us what is good for us while it only advises us what is good for the economy as a whole, and the misinformation that weight and not fat is the enemy.

My treatment plan is this:

1 Every day make an appointment with yourself to exercise for an hour, both aerobics and weight training.

ONLY eat fresh or frozen veggies and fruit with lean meat, eggs and very little carbohydrate.
Get mirrors back in your house and look at yourself every day
Weigh yourself once a week and measure your waistline once a week
If you can’t eat right, then write down everything you put in your mouth and you have to share it with someone you trust so you stay honest. Figure out what carbohydrates are your problem and don’t buy them.
Turn off the TV and any other form of communication that brainwashes you to eat what commercials tell you to.
Treat your type 2 diabetes to reverse it and get your body and metabolism back to normal.
Replace your Testosterone and thyroid to normal healthy young levels with a doctor who is interested in making you healthier.

Best of luck. It isn’t easy, but if it was. This would not be an issue for any of us!

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Introduction: For many years I have advised my patients to abstain from alcohol while they are working on losing fat and to achieve their ideal weight. There are three reasons behind this advice, first because I have observed the effect alcohol has on the progress of my patient’s weight loss over 30 years of medical practice, second, I have read thousands of research papers that test the different ways people lose fat as well as the studies that reveal the roadblocks to fat loss, and finally I have been taught the basic physiology of the way our metabolism works and what slows it down. Because of my daily experience, medical research and scientific knowledge I can tell you that drinking alcohol while you are attempting to lose weight will block fat loss and sabotage any diet plan!

How the Body Metabolizes Food: Carbohydrates, Fats and Proteins

Let me start by explaining some facts about how humans metabolize foods, the names of hormones involved and what each of them does. Some of our hormones increase fat loss and some slow fat loss.

Hormones of Weight Loss and Weight Gain:

Insulin: This hormone is produced by the pancreas in response to eating. If you produce too much insulin your body becomes resistant to it and it literally can’t get into your cells to burn calories. Insulin is supposed to carry blood sugar through the cell wall of each of your cells and produce energy. If it can’t get in the cell it is carried to the fat tissues and it makes more fat. High insulin is generally because of a high carb diet, lack of exercise and this condition is called Insulin Resistance.

Cortisol: This hormone is produced in the cortex of your adrenal gland and its production follows a diurnal or daily cycle. Cortisol is highest at 8 am and lowest at 3 am. Cortisol is called the stress hormone because when you are anxious, scared or depressed, the stress you are feeling causes cortisol to increase. Cortisol increases blood sugar levels; insulin levels and breaks down muscle tissue to increase the blood sugar available for fight or flight reactions. Cortisol is called a catabolic hormone because it breaks down tissue to produce blood sugar. The only tissue that grows under the influence of cortisol is fat!

Thyroid hormones/iodine speeds up the metabolic process and burns calories, burns fat, causes weight loss and increases energy production, while it speeds the body temperature, blood pressure and pulse. Without Thyroid hormones you don’t burn calories, so you gain weight and swell with extra water weight.

Testosterone: is a hormone made in the ovaries and testes. Testosterone stimulates the growth and strength of muscle tissue, the thickness of bone and connective tissue, and stimulates the maintenance of neurologic tissue, brain and peripheral nerves, and keeps the sexual tissues young and health just as they are when we are young. Testosterone increases muscle tissue while breaking down fat.

These hormones must be sufficient, not too low or too high to facilitate the burning of fat during weight loss. It is not desirable to lose muscle mass while losing weight which is what happens when you fast (not intermittent fasting).

Before embarking on a weight loss program, I always make sure that my patients have normal levels of all of the hormones listed to assist in their metabolism so they can lose fat, not muscle and they can be healthier when they get to their ideal weight.

Roadblocks to Fat loss: Alcohol consumption!

So far, we have talked about how hormones play a key role in the physiology of weight gain and loss. The next step is devising a plan for food or “fuel” intake and exercise. Under the heading of food intake, we always discuss coffee, soda and alcohol intake during the time my patient is attempting to achieve ideal weight.

I have listened to whining, crying and begging when I tell my patients they cannot drink alcohol if they want to successfully lose fat and maintain muscle mass. Remember I didn’t make the rules I am just the coach trying to help my patients reach their own healthy goals!

Why does Alcohol Prevent Weight Loss?

It is true that alcohol of any amount has no place in weight loss. But why? Alcohol is not a carb, a fat or a protein, it is categorized as a “TOXIN” (a poison). By looking at the content of carbohydrates in an alcoholic beverage you cannot calculate the damage it will do to your weight loss progress. Because alcohol is a toxin your body prioritizes it to be broken down in the liver before food or any other type of drink you swallow. The liver is how our food is broken down and metabolized so the liver basically halts the metabolism of all the food you have eaten in the recent past and spends its time getting alcohol out of your system.

Having just one drink can stop all the fat burning your body would normally be doing for days! Your exercise or lack of calories doesn’t cause weight loss after alcohol intake because your body is busy removing a deadly component of alcohol called acetate, not burning fat.

The bottom line when it comes to alcohol while on a diet is “Don’t Do it!”.

How should I socially drink and what type of alcohol can I have after I have achieved my fat-loss goal?

First pick an alcoholic beverage that is low on calories and that is not mixed with a carbohydrate mixer (like sugared soda, or marguerita mix, or bar syrup).
Space out your alcoholic drinks with a glass of water, one for one.
Don’t eat carbohydrate snacks with alcohol of any kind, eat protein snack like nuts, not chips!
Limit your number of drinks per social event to 2. That means 2 half full wine glasses of wine or 2 mixed drinks with one jigger of alcohol each.

I am always asked,” What are the best types of alcohol to consume when it comes to not gaining weight from drinking?” Well, I can tell you that Ale, sweet wine, and drinks mixed with bar syrup are the worst choices. Here is the list of Types of Alcoholic beverages, calories and number of grams of carbohydrate that each drink contains. You can read this and make your own choice.

Before you gain all your fat back after a successful diet by drinking vodka every night remember that any alcohol shuts down your fat burning metabolism and can cause fast and ugly weight gain! Alcohol of any type also increases your appetite and lowers your ability to say no to more and more food and alcohol.

I think the “best” drink for calories and low carb is a greyhound, which is fresh squeezed grapefruit juice plus vodka (no sweetener or bar syrup) or sparking water and vodka or club soda and vodka. Margueritas are usually around 600 or more calories a drink and the larger ones are even more!

In summary if you need to lose fat, replace your testosterone, and if you’re a woman, replace your estradiol as well with pellets. If your thyroid is low replace your thyroid hormone to normal and if you are pre-diabetic/insulin resistant, then take Metformin Extended Release along with abstaining from alcohol while you are losing weight. When you are on maintenance after you have reached your goal, be careful to only drink low calorie, low carb alcohol so you don’t regain it all too quickly. Remember success with fat loss is only success if the fat stays off!

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I am always looking for EFFECTIVE and TRULY DIFFERENT skin care techniques and machines that can offer a better and improved way to make my patients skin beautiful! Last October I attended a conference put on by the largest laser company in the world, Alma Laser, and discovered just such a device!

The OPUS RF+ Pixel machine! This one machine can do the job of several other lasers and RF machines in our office, yet it is one treatment, which makes it superior in terms of efficiency, and cost. One Opus treatment takes the place of a Radio-Frequency treatment to tighten skin, plus a laser Pixel machine for retexturizing and lifting skin, plus the Skin Pen, which injects serums into the skin to promote the production of collagen that smooths the skin and minimizes wrinkles. Therefore, the OPUS treatment delivers the following benefits:

Retexturizing skin making it smoother
Tightening skin
Delivering Hyaluronic acid and other serums to stimulate the production of collagen
Lifting skin around the eyes and mouth
Minimizing the small wrinkles around the skin

When I looked at the OPUS machine and the hefty price that Alma laser attached to it I had to decide whether it would provide real, quality changes in the skin of the face and body for my patients. I watched many treatments of the attendees at the conference to see what it really did, and even though may improvements take weeks and months, I looked for several things:

Pain level
Time for the procedure
Esthetic outcomes immediately
Plumpness of the skin after the treatment
Downtime

The 2 biggest problems with most esthetic procedures are that they create a lot of pain and there is extensive downtime that will prevent my patients from going to work. Knowing these drawbacks to most treatments available, some of which we offer, I was able to decide right there at the conference, because after the 20 minutes of lidocaine gel on the face, there was no pain and there was definitely NO DOWNTIME! This was a miracle to me!

When I describe esthetic treatments to my patients, how they work, what to expect and what problems each of them takes care of, I get to downtime and most people say, “I don’t have time to stay home from work or stay in the house and not go to dinner etc. Forget it!”. OPUS takes care of this problem. There is a little redness like you went out in the sun for an hour and then no evidence that you had an esthetic treatment.

The Opus machine uses a wheel of tiny spikes that contact the skin and make a tiny hole (a pixel) as it crosses your skin in three directions. The holes can be made larger if your skin is thick and we need to “inject” collagen, episomes or other serums. The sizes of the pixels are variable. Each hole stimulates skin repair and act as injection sites for serum. These holes heal and pull skin together, stimulate collagen production, lift and smooth the skin in one treatment.

There is a second tool for above and around the eyes to lift the lids as well as to tighten the upper lip.

Like any other treatment, Opus requires 3 or more treatments a month or two apart to be fully effective. That would be 3 total treatments instead of 9 treatments of various treatments.

I love efficiency! I also love adaptability. OPUS also can treat problems we have no other treatment for such as stretch marks and crepe skin. It can be used on the body as well as the face neck and chest.

Opus outcomes are just as good as the outcomes from laser Plus RF machines…but you pay for one treatment instead of three which also takes less time out of your schedule and no downtime!

When considering your options please consider this cutting-edge therapy, OPUS by Alma Laser!

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When you come to my office, I don’t just weigh you, but I do a full body composition with the InBody machine before treatment begins for a baseline measurement of fat, muscle and body water. After 4-6 months of treatment with T pellets I measure changes in total body weight, fat mass, % body fat, and increase in muscle mass. Even for patients who don’t exercise there is usually a conversion of body fat into skeletal muscle in the first few months even if there is now loss of total weight, however sedentary patients may not have as large an increase in muscle mass until they start working out with weights and doing aerobic exercise daily. Patients who do follow my directions to work out, generally have a larger fat-burn, which uses up calories faster calories, while they build even more muscle.

The benefit of exercise is the most well documented anti-aging activity and treatment to reverse aging available and getting my patients to exercise daily is the hardest compliance issue I confront when managing my patients. “Just do it” is Nike’s catch phrase and I agree…after people just do it, they feel younger and healthier after 2 weeks and they don’t want to stop! I advise my patients who spend their days using their brains instead of their bodies to improve their mentation by working out for 30-60 minutes every morning. Exercise has been proven to greatly improve the quality of an individuals’ mental work output.

Why does Dr Maupin concentrate on growing of Muscle Mass for her anti-aging patients?

Muscle mass is very important in our practice because it is an important way to bring patients back to healthy, normal weight, and reverse their true age. Patients who already have great muscle mass before they start testosterone pellets have the best “fat loss” response. If you think of all the muscles in your body as furnaces that burn calories in your diet as fuel, making heat and energy out of the calories that are eaten. The bigger the furnace the more energy it makes and the more fuel it requires. Muscles make heat, burn calories and create energy. They burn over 80% of our total calories.

What factors cause muscle mass to decrease? Very low muscle mass is called Sarcopenia and Frailty.

Lack of exercise
Poor diet that excludes red meat fish eggs and milk products, or just contains too few calories
Aging
Lack of testosterone, or just low levels of testosterone
Over-exercise—using the same muscles to exhaustion every day makes muscles smaller and they burn fewer
Inflammation breaks down muscles
Low thyroid hormone causes muscles to decrease the numbers of calories they use, which decreases the effective heat production
Low growth hormone causes muscles to literally go to sleep, and they become weak, smaller and burn fewer calories

You can see that many factors in our modern environment can prevent our muscles from burning calories, building muscle and maintaining muscle mass to help us move about throughout our lives.

Your muscles DO MORE than just make you strong, they decrease your “health age”, but how? Healthy Active Muscle Tissue Benefits you by

Decreasing inflammation
Slowing aging by increasing the length of your telomeres on your chromosomes
Decreasing Insulin Resistance
Increasing bone mass
Increasing metabolic rate and weight loss
Increasing neurotransmitters to make you think better and maintain your brain, and improving your mood
Weight loss—your muscles are the largest organ of your body that burns calories. The more muscle you have, the more calories you burn!

The first step in making your muscle mass grow is receiving testosterone replacement after aging begins, after age 45.

Testosterone increases muscle mass that would normally shrink as the years of abnormally low T accumulate. T works to build muscle by directing blood to the muscles to deliver oxygen and decrease lactic acid produced in the muscle that causes pain after exercise. Testosterone thickens your skin, your bones and your connective tissue to make exercise possible and more productive. T tightens your skin and strengthens the attachment of muscle to bone throughout your body causing the pull necessary to make stronger bones. T is also anabolic, which means it directs tissues to “grow” and become stronger and bigger.

How does muscle tissue work?

Your muscles are a dynamic tissue. Your muscle mass decreases every time you exercise and then rebuilds the following day. When you are young this process is balanced. Muscle mass decreases equally to the increase in muscle mass built the next day. When you are young and have excellent testosterone levels, the more exercise and weight-training you do the more muscle you make and the less you lose. When you exercise with weights and adequate T, you can make more muscle than you break down, so you can increase the size and strength of your muscles.

Weight trainers always recommend that their clients alternate their work-out with weights in a certain area of your body (upper body one day and lower body the next) every other day so you can build the most muscle mass. If you work out the same part of your body daily, then the first day you will lose muscle, and the second day you will lose more muscle and not have enough “rest” to build your muscle back. If your exercise program includes daily workouts of the same part of the body, you will notice your muscles getting smaller not bigger! For example, marathon runners generally run daily and only rest one day a week. This causes their legs to lose muscle mass, and their legs become less defined and thinner than the rest of their body. Because they do not rest their legs every other day, they will never get bigger and stronger calves and quadriceps.

Why does muscle mass on the InBody machine often decrease 4 months after my first T pellet insertion?

Another interesting fact about measuring the growth or loss of muscle on the body composition machine is that when we compare muscle mass from before the first T pellet insertion to before the second insertion 4 months later, we find that sometimes in people who have too much fat, even in men and women who work out regularly, their muscle mass seems to decrease in the first 4 months. This usually stops after the second T pellet insertion. The reason for this weird In Body measurement is that when we age and stop working out regularly or we gain weight with a minimal amount of testosterone we store fat within the muscle fibers. Our muscle in this condition looks like a rib eye steak and has marbling of fat in it.

When you get testosterone pellets at my office the metabolism in your muscles turns on, exercise increases your fat loss, which also decreases the fat stored inside the muscle tissue making your muscles seem to shrink. Your muscles are really just becoming more compact, and stronger by losing the fat padding inside the muscle, between muscle fibers. Testosterone makes your muscles more compact without fat striated in it and it looks more like a filet mignon. That is the composition we are shooting for because lack of fat in the muscle means the muscle is stronger, more defined, and can burn more calories, making the owner of these muscle lose overall body fat more efficiently.

How do you read the In Body Composition Evaluation?:

Conclusion:

The overall take away message is that the more muscle you can get naturally through an excellent high protein diet, combined with replacing testosterone with T pellets, and alternating exercise with rest when exercising and weightlifting, the more muscle you will have, which will burn optimal calories, making you leaner and healthier, and able to think better, while reversing the aging process and making it possible for you to be active the rest of your life.

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I have had hypothyroidism since I was 23, so I have had an interest in the thyroid gland, how it works and what treatments work and which ones don’t for my entire adult life. In medical school in the 70s I was told that the thyroid was easy to diagnose, all you had to do was draw one test, the TSH (Thyroid Stimulating Hormone) and if the TSH was high, the thyroid was underactive, and if it was high the thyroid was overactive. Like many medical myths, this myth has been repeated to all medical students for the last 50 years without question, and subsequently millions of women have been under-treated or left untreated secondary to this Medical Lie repeated in every medical school.

The information I reveal in this Healthcast will support the above allegations by way of my 40 years of experience as a physician, 50 years as a hypothyroid patient and the new book Lies My Doctor Told Me, by a physician named Dr. Berry, who uncovers all the outdated and untrue misinformation doctors were taught in medical school and residency. His book confirms what I have been telling patients, contrary to common medical practice, for over 40 years. He quotes and recommends my book, The Secret Female Hormone, to his readers because my book uncovers the lies about what hormones women need and don’t need at menopause.

Today I would like to base our discussion on the information in both of our books and support the true information with my medical experience.

I hope you learn several things about one of the most important glands in your body, the Thyroid:

Thyroid function is complicated and the most direct blood tests are the free T4 and free T3. These two tests are not infallible, but they generally parallel a patient’s symptoms. Free T3 and Free T4 are repeatable which means the test is consistent. However, resolution of hypothyroid symptoms is the best sign that your thyroid is working properly. Following the TSH alone is absolutely the worst way to manage your thyroid!
Thyroid disease predominantly attacks women and therefore is not a priority for medical doctors (DO Doctors of Osteopathy are trained with less sexual inequity than MDs) as most women’s diseases are considered second class, because MDs still instruct their doctors that women are all crazy and that women are always looking for a way to lose weight without effort. These false negative generalizations remain as an undercurrent in medical education even though women are finally almost 50% of the medical school classes. For example, doctors often tell women they are imagining their symptoms if they are still hypothyroid when the doctor has given them inadequate doses of thyroid replacement medicines.
Thyroid replacement must be taken in a specific way to be effective (alone on an empty stomach) and absorption in the intestines require good gut bacteria, adequate iodine, adequate sex hormones and normal cortisol to be completely effective.
Endocrinologists are not your best choice in doctors to manage your thyroid. They are the specialty in charge of the thyroid, but their management hasn’t changed in 50 years. Endocrine Society does the research that confirms and publishes articles that use multiple tests including free T3 and free T4, plus positive hypothyroid symptoms to diagnose hypothyroidism. Endocrine journals teach the opposite: they tell their doctors that the non-specialist order too many tests and criticizing the use of Armour Thyroid® the best replacement for women. Endocrinologists dismiss most female patients with true thyroid disease if their TSH is normal. My advice is to find a doctor who listens to and reviews your hypothyroid symptoms as well as your lab work including free T3 and free T4 tests.
The best thyroid replacement is determined by your gender. Women respond better to Armour Thyroid® (pig thyroid) than Synthroid® or levothyroxine (generic Synthroid). Men respond better to the two synthetic thyroids, Synthroid® and levothyroxine better than natural thyroids.

The thyroid gland is located in the lower third of the neck just above the collar bone. It is shaped like a large butterfly. If healthy, it isn’t obvious when looking at someone except if it is abnormal and swollen which is what we call a goiter. The thyroid gland is essential to life and affects every cell in the body regulating cellular and physiologic rate of metabolism and burning of calories. When the thyroid gland is underactive it causes severe fatigue, weight gain, swelling throughout the body, memory loss, hair loss, dry skin, goiter, lack of the outer third of eyebrows, constipation, feels cold all the time when everyone else is comfortable, and memory loss and confusion. If the thyroid is not working at all it causes a condition called myxedema which results in severe swelling, confusion, and coma. The thyroid gland is the most important gland to human life.

How the thyroid gland works is complicated. The pituitary gland in your brain is the quarterback making “calls” to the glands to stimulate all of the endocrine glands in the body. The pituitary gland produces TSH (Thyroid Stimulating Hormone) which stimulates the thyroid gland to make T3 and T4. There are 4 types of thyroid hormone produced by the thyroid gland, but the most important and plentiful are T3 and T4. These hormones produced by the thyroid gland enter the blood stream and travel to every cell, attach to thyroid receptors on cells, and turn the cells on to burn calories and make energy. T3 and T4 are made from one amino acid (a piece of a protein), called Tyrosine, and three or four Iodine molecules, so the intake of iodine is vital to the normal production of thyroid hormone. Each cell also requires ample iodine to facilitate the cell’s receptor sites to bind and accept the thyroid hormone which stimulates the activity of the many types of cells to activate the production of heat and use of glucose.

Deficient iodine in the diet is one of the reasons thyroid’s fail. When the thyroid is deficient, the TSH increases to stimulate the thyroid gland to make more T4 and T3, but the TSH is not a very accurate or specific test to determine the activity of the thyroid gland. The actual T3 and T4 are much more accurate as long as you test the “free” T3 and T4, which is the active portion of both thyroid hormones.

Measuring the free T3 and free T4 are the obvious ways to test the thyroid, I believe it is the initial however 40 years ago it took weeks to get these tests back, and they were very expensive. I believe it was because of the difficulty running the lab tests for free T3 and T4 in the 70s led to the belief that one test was all you need. This made sense then but not now when. I think of ordering TSH like looking in a mirror instead of looking directly at a person. Now the Free T3 and Free T4 as well as TSH are done by a multi-test machine and are quite affordable. There is no reason to continue the outdated method of diagnosing and managing thyroid with a mere TSH test anymore. However, endocrinologists (the “kings” of non-sex hormones) still teach this outdated method from the dark ages (the 60s and 70s). They generally don’t talk to patients about how they feel and their remaining symptoms because it doesn’t change their treatment plan. They draw only a TSH, while ignoring physical signs (dry skin, goiter, brittle nails, hair loss, swelling, loss of outer eyebrows), symptoms of hypothyroidism (fatigue, constipation, brittle nails, hair loss, depression, poor motivation, slow pulse, low blood pressure causing fainting when patients stand up, and many others.

The obvious blood tests like free T3, Free T4, as well as high lipids (LDL cholesterol and triglycerides) when you have low hypothyroidism, iodine, and thyroid antibodies which can be elevated in the case of autoimmune hypothyroidism like Grave’s disease and Hashimoto’s thyroiditis.

Dr Berry in his book Lies My Doctor Told Me calls the use of only TSH as the “Lie” in the face of new information, more accurate testing and more complete examination. Primary care doctors should complete a symptom history, as well as take BP, pulse and Temperature, all of which in the case of hypothyroidism are low. Many research papers have been published since the 70s which tout the benefit of modern testing to diagnose and maintain patients on thyroid supplementation. It doesn’t seem to be changing anything in the practice of endocrinology.

It almost seems that doctors of endocrinology have closed their minds after medical school and refuse to change how they practice in the face of solid evidence. They are clearly angry when one of my patients sees them after I have diagnosed and treated them, and they are better! I have treated hundreds, thousands of women in my years of OBGYN practice and now replacing postmenopausal hormones with estradiol and testosterone pellets along with their thyroids.

Diagnosis and treatment for hypothyroidism for physicians is relatively simple:

Take an inventory of a patient’s hypothyroidism symptoms,
Ask about or test pulse, blood pressure and basal body temperature
Draw Blood tests for free T3, free T4, TSH, iodine when necessary, thyroid peroxidase antibodies, thyroglobulin antibodies, Cardiac CRP and fasting lipids to diagnose hypothyroidism and determine the cause (low iodine, autoimmune thyroid disease, trauma, or unknown) and then treat the patient with the most effective thyroid replacement for their gender based on body weight.

To manage established hypothyroid patients who are on thyroid replacement, lab should include free T3, free T4, and TSH. If blood is drawn in the am, no thyroid should be taken before the blood draw, skewing the results to high levels. When a patient is on thyroid replacement the TSH should be below 1. If it is over 1.0, then the patient isn’t taking a high enough thyroid medication dose, or they are failing to absorb the medications. The If a patient’s lab looks fairly normal, free T3 (3-4.5). and free T4 (1-2.5) with a TSH below 1, but their symptoms, signs or vital signs are still unchanged or only slightly changed the patient may be resistant to the medication, may be lacking iodine, or may have malabsorption in the intestines. Endocrinologists stop increasing dosage when the TSH is below 4.5 the normal for patients not on thyroid, no matter how the patient feels.

There is yet another problem with receiving a valid diagnosis of hypothyroidism. The thyroid lab tests have been lowering ever since the beginning of the last decade. When I noticed that the range for women’s thyroid free hormones free t3 and free t4 were decreasing every year, I talked to two of the large labs in our area, Labcorp and Quest. They had no answer for me.

It wasn’t until this year (2021) that I discovered how they determine the reference range, which is the “ideal range” of free T3 and Free T4. The labs have changed from the expensive process of testing young healthy women who have no symptoms of hypothyroidism and normal vital signs, to the short cut of using all the results they obtain from all the patients who get their blood drawn in their lab. This isn’t statistically valid because most of the patients getting thyroids tested are sick or have pre-existing diseases that alter the thyroid level. , That is shocking to me and of course the blood levels of ill patient are lower than they should be because when you are sick your thyroid conserves energy by shutting down and becoming hypothyroid during the illness.

My answer to using this abnormal sample of patients to determine desirable thyroid levels I go by the levels of free T3 and Free T4 that were reported by the labs over a decade ago, those listed three paragraphs above. My patients are so grateful that I have diagnosed and treated their lifelong symptoms and fatigue as well as depression and obesity. Many had already developed other diseases because of their thyroid not being replaced, and diagnosis delayed, but they are still grateful that I cared enough to ask about their symptoms and vital signs.

Medical doctors should make a diagnose based on the interview with the patient and obvious physical signs of disease (LIKE GOITER) 90% of the time, and lab work and physical exam the other 10%. Somewhere in the last 50 years we have lost the art of communication in medicine and most doctors have shut their minds off to new information after they left medical school. I am not proud of the disintegration of my profession, but I do wish we would choose inquisitive and creative people to be doctors with good communication and assessment skills in the future, which would greatly improve the profession.

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Title IX is a Federal Civil Rights Law passed as part of the Education Amendment of 1972. It is now in jeopardy of being reversed in practical use and destroyed in the spirit of the amendment. Title IX was passed in 1972 (my junior year in high school) to allow women to receive equal funding with men’s sports so women could compete in sports on an equal basis with men. By requiring equal funding with men’s sports for women’s sports, this amendment allowed women to become respected and adequately coached in high school and college and offered for the first time, scholarships for sports equivalent to what men received. Title IX required schools to allocate equivalent money for women’s sports for uniforms, travel to games, salary to coaches and time on the court or field. This was the first successful step in the women’s movement that allowed women equality since we got the right to vote! Today, 52 years later, the viability of women’s sports and equality of women has been destroyed by one presidential order within days of his entering office and without a vote of the legislature.

I was a young adult when Title IX was passed, and it took years to be practically put in place. The belief that men were the only sex to be able to compete in sports hung on long after the amendment was passed. During Highschool I was only allowed to participate in 2 sports at my very large Kansas City Missouri High school (Center Senior High). The only sports that were offered to women at my high school were tennis and track. We had literally no funding and shared coaches with the men who didn’t pay any attention to us, we were considered second class citizens and had to fund our own travel to meets and uniforms and had minimal court time which was off our high school campus (just for the women).

At that time, before Title IX, when it came to sports, work and professions, women were considered inferior. Title IX raised women to the same level of funding for sports which gave women options to play many types of sports and receive equivalent scholarships and funding for the necessities of athletes. Power flows from funding.

Now I will tell you why biologically this is wrong. In this one pen stroke the President sent the message that women should be put back in our place on the sidelines, and men should be given the money and financial scholarships for higher education.

As a doctor, and a gynecologist, I believe that allowing biologic men who are transexuals to compete against women in sports, will destroy women’s sports by guaranteeing transsexuals and teams with transsexuals on them an easy win in sports every time they compete. It is a physiologic fact that women have 1/10 the testosterone in their blood that men have. This testosterone makes all the difference when it comes to strength, muscle mass, and speed! It is why we disqualify athletes of both sexes who inject testosterone to be stronger and better, because THAT is cheating! The decision to make women compete against biologic men is an uneducated, unscientific decision. This is what his decision to bypass the legislature to sign this executive order says to me.

This executive order should be reversed, but if it isn’t, it should be modified in the following ways:

Biologic males must have a total testosterone level below 60 ng/dl which is the normal total testosterone of women. Men’s normal healthy total testosterone range is 400-1500 ng/dl.
Biologic males who want to compete against women should be completely through their transformation into females which means their genitals must be removed including their testes and penis, and they must be on maximum estradiol replacement that is typical for trans-sexual male to female transformation.
Biologic male transsexuals must have completed the psychological counseling that this transformation requires.

Even with these “rules” there is still a problem with biologic males competing with females. Biologic males even after transformation, for the most part will still be taller than women and still have pre-transformation muscle mass. Both of these un-alterable qualities still give biologic males a great advantage in sports. The other medical outcome for women is in contact sports these biologic males with injure women who cannot be as big or tall as the men.

The locker room is still a problem for the women athletes who must shower with biologic males, especially if the transformation is not completed including surgery and hormone replacement. I would not let my daughter compete in sports with biologic males who did not look physically like a female, because she would be at risk of rape and sexual assault by those “men in sheep’s clothing” who are not truly transformed and use this law as a way to succeed in sports when they cannot win against other men. It leaves the possibility open for fraud in the area of women’s sports, meaning the males who decide they want to win in the Olympics, or in Highschool or college sports, and get a scholarship are free to temporarily decide they identify with being female, but who may revert to being male after competition is no longer a way to success and monetary gain. Until the definitive surgery and hormonal injections have been complete, and the choice of sexual identity is non-reversible, our daughters will not be safe to be in the same locker rooms with biologic male transsexuals.

Currently we ban the use of testosterone in competing athletes of both sexes because it gives both sexes an advantage. By allowing biologic males to compete with ten times the testosterone that females have is just another form of cheating. This will be another way to cheat to “win”. The President is opening up a whole new way to cheat at sports and a new way for men to abuse women. I’m sure he was afraid to let the legislature weigh in on this decision because this law favors 0.2% of the trans-sexual population over 50% of the population. Democracies don’t work like this.

No matter what the modifications of the executive order are, all women should realize what the underlying meaning of this law is: Subjugation of women, yet again! Women are the largest group in America who are routinely discriminated against and we don’t fight back! This is just the beginning of turning back time and making women second class citizens again! Please stand up for half of your voters and half of the US population.

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Did you know that taking Low dose birth control pills can be dangerous to your hair? Many birth control pills are considered healthier because they are “low dose”, meaning low estrogen pills of 10 or 20 mcg estradiol, however are they really healthier than the medium dose BCPs that contain 30, 35 or 50 mcg of estradiol? It is my opinion that they are not only more dangerous to your health and hair, but they also cause women to look and feel like they are in menopause!

If you have been changed to a Low dose birth control pill with 20 mcg of estradiol, or a low-low dose pill with only 10 micrograms of estradiol you may be putting yourself at risk for future heart disease, and osteoporosis as well as hair loss!

Other symptoms of low dose BCPs include:

hair loss,
dry vagina,
painful intercourse,
hot flashes,
dry skin,
poor libido
fatigue

Worse yet, low dose BCPs are less effective than other birth control pills and IUDs in terms of protecting you from pregnancy, especially in women who weigh more than 200 lbs!

This is a huge problem that your OBGYN may not acknowledge or even know because they have been educated by drug salesman who LOVE new forms of BCPs and sell them to doctors under the guise of more safety, without substantial evidence and without describing the risks. Their company makes more money on new doses of pills because they are not generic.

Recently I treated another female physician who was still cycling and on BCPs, who had hair loss, and vaginal dryness after she had her pellets because she was changed to a lo-lo dose pill after her pellets were inserted, and later convinced that her hair loss was due to Testosterone pellets. By the way, it is rarely testosterone replacement with pellets if someone has l hair loss all over her head. I evaluated and treated the other possible causes of hair loss including high cortisol, low thyroid and also found a very low dose of estradiol in this patient’s blood, and then I knew the problem…very low estradiol levels much like menopause which can also cause hair loss. I asked her whether she had changed her BCP script and she had but she didn’t know why her doctor did it. I was keyed in because I was only giving her T and her estradiol after her T pellets became much lower than before her pellets, which is not typical. In retrospect, her hair loss occurred shortly after her BCP had been changed to a low-low dose pill. I switched her back to her original pill, and we reversed the hair loss.

This might be easier to understand if I explain how BCPs work. The estrogen and progesterone in your BCP is taken orally, goes through your liver and is changed into estrone and estradiol which circulates to your pituitary gland where it shuts down your FSH and LH, the two hormones that stimulates the ovary to ovulate, make estradiol, testosterone and progesterone. When LH and FSH are suppressed by the birth control pill, which in turn shuts down the ovary and creates low estrogen, testosterone, and progesterone levels. The pill itself then gives you back a much lower dose of estradiol and progesterone than you would ever make (prior to menopause). The outcome a hormonal environment with low levels of estradiol testosterone and progesterone, and if the pills provide only a tiny amount of estrogen you will have many of the symptoms of menopause including hair loss.

Normal estradiol levels without birth control pills during a menstrual cycle range between 60-250 ng/dl, but on the pill is <5 ng/dl – 12 ng/dl, levels experienced by menopausal women. What young women on the pill feel can include they symptoms of menopause like a dry vagina, low libido, fatigue, dry skin and hair loss (estradiol is needed for thick hair). The lower the “add back” dose of estradiol, the lower the circulating estradiol and progesterone, the more symptoms the BCP taker may have.

If you have been changed to a low-dose or lo-lo dose BCP, and have these symptoms, then ask to be put on a pill with a higher dose of at least 30 micrograms of estradiol so you can preserve your hair and vaginal integrity. You also may need testosterone to support your sex drive so switching to a Mirena or Kyleena IUD can allow you to experience your own hormones, and still have the hormones of a young women, yet not get pregnant!

We are watching out for your health and happiness, so keep listening to stay current and learn what your symptoms mean and how to avoid the problems caused by current medical treatments.

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Doctor lingo is often confusing to those patients who don’t work in the medical profession, and even to some of us who work in medicine, so I believe it is important to translate some of the phrases your doctor uses when explaining why he or she has chosen a particular treatment plan for you. This Blog addresses what your doctor means when he chooses a treatment plan based on the Standard of Care or the Guidelines written by his particular specialty group. These two terms are often misleading and often following guidelines or Standard of Care is an excuse for doing less than excellent care or even out of date care! Read on to understand how to interpret these phrases when choosing the best medical treatments for you or your family.

Over 25 years ago I decided to offer my help to patients who were injured and to doctors who were being sued without merit, by becoming an expert witness. My husband is an attorney and I had always gotten many requests to review medical records for his attorney friends to determine whether a doctor had treated a patient with neglect or had injured a patient secondary to an act of malpractice. Before engaging in this endeavor, I sat down with my husband and asked some necessary questions about what a patient could sue over and what a doctor could use to defend herself if she were sued without merit.

He taught me that doctors are held to a standard that is called the “standard of care” and if he or she fell below that level of care then she (let’s call all doctors “she” for this blog since I am a woman doctor) would be held negligent if there was lasting damage to a patient. To my surprise he defined the medical standard of care as the lowest level of care or the least a doctor could do when caring for a patient. Prior to this time, I had thought “standard of care” meant the best care a doctor or nurse can give a patient; however, the name is misleading and is meant to protect doctors from lawsuits and to defend doctors working in indigent and rural areas where they have very few tools and tests to use to diagnose and treat patients. Needless to say, that day I changed how I used the term “the standard of care!”, and how I viewed the care I gave to my patients.

When planning a procedure or a treatment, If your doctor tells you he is following the standard of care you should let her know that you understand that that is the minimum she can do, and that you want the best care possible for your problem, if it is available the most accurate testing and treatment possible. By letting them know, that you KNOW, you understand the lingo they are using and that you want to receive the best care, you are likely to have a much better outcome than if the bare minimum is done for you.

An example is often seen in the emergency room when a female patient comes in with urinary symptoms: painful urination, trouble passing urine, and back pain. The standard of care is to get a urine specimen and if there is blood in the urine, and white blood cells the standard of care would be to send the urine off for culture and treat the patient with antibiotics. However, these symptoms are often the sign of a kidney stone, or a renal tumor. A simple Xray can usually find kidney stones, or an ultrasound of the kidneys can diagnose dilation of the kidneys that would indicate an obstruction of the ureters like a stone or a tumor. Positive tests would lead to more diagnostic procedures and negative would solidify the diagnosis of a urinary tract infection. The Xray and or Ultrasound would be above the standard of care, but not all hospitals have a radiologist on call to do these tests outside of normal business hours. Another test that is above the standard of care is a culture of the cervix for chlamydia, a sexually transmitted disease that can scar fallopian tubes and cause infertility. An above minimal care test would be to also culture the cervix for chlamydia so that the patient could be made aware of an STD so her partner can be treated as well as receive appropriate treatment for Chlamydia. The chlamydia test would be above the standard of care but is also a necessary test in sexually active women to prevent infertility and should be done!

The term Standard of care is also the phrase used by politicians who want to cut your access to expensive treatments and diagnostic procedures. When politicians who are supported by the wealthy insurance industry, or when political agencies like the CDC and NIH create a standard of care for all of America it is based on spending as little money as possible to serve the greatest number of people, NOT for the health and welfare of individual Americans. Beware when anyone including politicians, lawyers and doctors start using standard of care as a goal of treatment instead of the lowest common denominator of treatment.

You and I want the best care for ourselves and our family that our insurance, or Medicare will pay for and sometimes to get the best doctors or treatments we have to pay out of pocket as well, however the second misleading term that can cause us to be treated inferiorly is the “Medical Guidelines” of our medical specialty groups.

Let me tell a story about being board certified in a specialty such as mine, OBGYN. In 1999 the guidelines from the American College of OBGYN, ACOG, our national organization that sets treatment guidelines for doctors who care for women, gave a national recertification test in Dallas, TX. Hundreds of doctors sat in a large room and took a 6-hour written test that was supposed to test us to see if they were good enough doctors to be board certified in our specialty. All of the practicing OBGYNs had already been certified but a retest was necessary every 10 years at that time. We all studied the guidelines that listed the tests necessary to provide the lowest standard of care to be a member of ACOG, but the problem was the guidelines were at least 10 years out of date, and if a doctor read the research and practiced the way we should, at the most advanced level of practice, then they would fail the test because it was behind the times! For example, I had been treating PMS for women successfully for a decade with natural progesterone nightly during the second half of the menstrual cycle, and the research had come out that said it was a psychiatric disease, but in fact it was a REAL disease! ACOG was so behind the times that they were wrong about the Diagnosis as a disease at all! On the test the question was, “Is PMS a real condition?”. The right answer for the test was NO, but the correct answer was YES! The college of OBGYN was behind in its guidelines and teaching of residents by a decade! PMS had been acknowledged as a disease years before the test and those of us who practiced up to date medicine were marked wrong on this question as many others like it. I was the victim of another outdated “guideline” that ACOG published in 1988 during my oral boards. I was a few years out of residency when a 5 man panel of OBGYNs quizzed me about the surgeries I had done over the past year. I had done quite a few ovarian cyst removals and ovarian removals through the laparoscope, which was the new (about 7 years old at the time) way to remove ovaries and cysts without making a big incision in a woman’s abdomen, and I had been taught in residency and continued to work with general surgeons to hone my skills with the laparoscope when I took this test. I actually was failed because I was “ahead of my time” and used the laparoscope “too much”. When I asked them how much was enough, they had no answer! The guidelines had not changed with the practice of my specialty! Now, most ovaries and ovarian cysts are treated that way! Laparoscopic surgical technique had not been accepted into the guidelines yet, in 1988, but the research and practice had been around almost a decade!

Last but not least is the fact that there are always very old, retired and obstinate men at the top of the medical specialties who do not accept the new way of doing things until they are already being done by everyone! If you are ahead of your time and treat patients with much more than the standard of care you are penalized! I view the medical specialties a large leviathan that can’t turn quickly so is often behind the curve.

When trying to communicate with your doctor please ask for all the options available for your problem..not just medications but procedures too. I had to see a cardiac physiologist because I have had atrial fibrillation for the last decade and it was getting worse. I finally needed a procedure to stop it, an ablation. II did my homework and knew there was a one-day procedure that did not require premedication with a poisonous drug that I am allergic to, so I knew it was possible to have this procedure with one day in the hospital and no premedication. When I saw the first doctor, he told me I would have to be in the hospital on a drug (in the same family as the one I am allergic to) for 3 days ahead of time and 2-3 days after the procedure. I asked him if there was any other way to do this, and he said no. Then I knew he was lying! I asked him if he did the procedure by using a balloon that froze the pulmonary vein in an hour or so, or a radio wave that took 5-7 hours under anesthesia. He told me the only way he did it was the radio wave because it was “safer”. In fact, my extensive research revealed that the less time under anesthesia is the safest way for any procedure and that the balloon freezing method had fewer complications! I left that doctor, never to return and interviewed another doctor who told me the truth and I am scheduled with him soon to have a one- day hospital stay with the balloon procedure. When I asked him which he preferred to perform when ablating the pulmonary vein, he said he does both and I could choose which one I felt most comfortable with! How refreshing.

So, the things I would like you to remember to protect yourself is that you don’t necessarily want a doctor who views the standard of care and medical specialty guidelines as the newest and best way to practice medicine. I would also like you to ask your doctor these questions:

Can you please compare the risks and benefits of the two or three types of treatment or surgeries for me?
How many times have you done this surgery?
How long will I be in the hospital, in recovery, out of work?
Which medication or surgery choice would you have your mother, father, child undergo if they had the same problem as I do?

Run from a doctor who views the standard of care his highest goal and the guidelines to be current and the only way to practice!

Stay healthy and informed! Stay healthy and informed, this is Dr Kathy Maupin Medical director of BioBalance Health.

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Painful intercourse is a common problem that OBGYNs diagnose and treat every day, but it is often a very upsetting problem that women don’t like to talk about with their doctor, so they often live with it, silently. I want to encourage those of you who are experiencing this problem to talk to your doctor about it so you can receive treatment. It is important for women to ask their doctor about their pain with intercourse so they can have a fulfilling sex life.

Most causes of painful intercourse are not “in your head” or psychological. I want to concentrate on the physical causes of painful intercourse and not psychological or couple issues, because frankly the psychological causes are not my area of expertise and I always ask my patients to see a counselor or psychiatrist to manage those causes. There are many physical reasons a woman may experience painful intercourse that prevents them from enjoying the benefits of a good sexual relationship, and today I will discuss the causes and treatments for physical causes of painful intercourse.

At BioBalance Health® I concentrate on the hormonal deficiencies that can cause painful intercourse. For women before and after menopause, having enough testosterone and estrogen is key to lubrication and skin that is thick enough to have comfortable intercourse. Without these hormones the vagina cannot lubricate, the skin “shrinks around the vagina and clitoris and the vagina is no longer stretchy and pliable enough to dilate to accommodate a penis. The outcome of intercourse without enough estrogen and testosterone (called vaginal atrophy) is lack of orgasm, tearing of the vaginal opening, accompanied by pain and bleeding, and the feeling of being rubbed with “sandpaper” when having intercourse. Within 3 weeks of replacing testosterone and estradiol with bio-identical pellets brings women back to health in many ways and relieving the pain and agony of sex from low hormone levels brings the joy of sex back to my patients.

Because of testosterone and estradiol deficiencies many of my patients have stopped having sex because it is too painful. We will talk about menopausal women who have hormone deficiencies first and then we will discuss painful intercourse in pre-menopausal women, what causes this problem and how to remedy this common problem.

A wonderful example of vaginal dryness that caused painful intercourse was embodied in one of my recent patients who looked at the floor while she told me that she just “could not” have sex because her vagina was too small. This woman was 59 and she had been divorced for over 10 years by the time she came to my office for the first time. She had many other symptoms of estrogen and testosterone deficiency, and she had seen her gynecologist to ask for help. She had given her lubricant first and that did nothing for the size or stretchiness of my patient’s vagina. She was still unable to have sex. I don’t know why OBGYNs are afraid of using estrogen cream, estradiol in patch or pellet form or testosterone is any form, but they are! When she got to me the simplest answer was estrogen cream to put on and in her vagina. From experience I know that this doesn’t fully bring a woman back to sexual wholeness, so I also gave her estradiol and testosterone pellets, and she was able to stop the cream after one month. Voila!! She was healed and her new relationship blossomed into marriage! With testosterone and estradiol her vagina was once again back to normal premenopausal shape and her sex life was not only possible, but wonderful!

To summarize the effects one by one of replacing both testosterone and estradiol in women with painful intercourse I will list the post-menopausal effects of testosterone and estradiol attributed to each hormone deficiency.

What Testosterone does for sex:

Improves Libido
Brings blood flow to the pelvis
Makes orgasm possible
Improves the wetness and stretchy ness of the vagina
Lengthens the vagina
Increases the size of the clitoris so it can be stimulated
Allows the vagina to stretch to accommodate a penis of any size
Labia around the vaginal opening enlarge and the skin of the whole vulva thickens
Improves the sensitivity of the vagina, clitoris and G spot

stradiol’s function in sexual health:

Increases wetness in the vagina
Increases the thickness of the vaginal wall and vaginal opening
Improves the sensitivity of the vulva
Helps prevent recurrent bladder infections from having sex

The quality of vaginal wetness and elasticity is vital to a satisfying sex life. The necessary hormones must be replaced to achieve the same level of sexual satisfaction as you had before your hormone loss, menopause In this area of concern, most women are not willing to settle for second best!

There are other causes of painful intercourse that are not from a lack of hormones, but the previous causes and treatments for painful sex treat over 95% of my patients. Vaginal dryness can also be caused by dermatologic and medical disorders such as autoimmune diseases, vaginal infections and dehydration usually from diuretics like Lasix®.

The other causes of a dry vagina, vaginal infections, are listed below. The one cause that will require antibiotic or yeast treatment is vaginal infection. Let me expand on that. Usually, bacteria from the rectum is pushed into the vagina from wiping the wrong way (the right way is front to back), sex, or underwear. This is hard to avoid and is from yeast, the bacteria called Gardnerella, Strep, Staph, or Ecoli. These are NOT necessarily a sexually transmitted disease; however any bacteria can be transmitted through intercourse. The sexually transmitted disease such as Chlamydia and Gonorrhea generally cause a vaginal discharge but create pelvic scarring and infertility and have delayed pain and pain when the infection is active in the pelvis causing adhesions and scarring of the tubes. Both of these sexually transmitted diseases can leave scars and cause pain during and after the infection.

If you want to do a simple and crude test at home to determine whether your vaginal pain is from a yeast or a bacteria, you can use litmus paper and it if turns blue, it is usually Gardnerella and needs an antibiotic cream or oral prescription. If it turns yellow, it is generally yeast and requires over the counter yeast medicine. The discharge for Gardnerella usually smells like “fish” and the discharge for yeast may or may not smell like bread baking. The sexually transmitted disease is not generally those that change the pH so don’t be fooled by a negative litmus test.

To be completely safe you should have a vaginal exam by a gynecologist or family physician or their nurse practitioner who can culture your vagina to find out exactly which bacteria or yeast is the cause, and she will prescribe the right kind of antibiotics for you. Remember if it is rectal bacteria, it will turn the litmus paper blue, but you still need a doctor to prescribe your antibiotic and they will want to see you before writing the script!

In the world of post-menopausal women, pelvic pain can rarely be caused by Pelvic abnormalities. This pain is usually not from the area around and in the vagina itself but deep in the pelvis when the penis thrusts against the vagina or cervix. This is usually cause by one of the following problems, most of which can be seen on ultrasound, with the exception being adhesions.

Pelvic abnormalities causing painful intercourse after menopause

Pelvic masses: fibroids, ovarian cysts, retroflexed uterus,
Old Endometriosis
Adhesions
Colon mass or masses
Cervical scarring from a difficult childbirth
Uterine Prolapse

The anatomy requirements for intercourse are that the vagina must be stretchy and elastic, it must be able to lengthen which means it requires hormones and cannot be tethered by adhesions in the pelvis, and the uterus if you have not had a hysterectomy must also be freely moving and not folded on itself in the front or back which is called anterior flexion or retroflexion. Sometimes the uterus “falls down” (uterine prolapse) into the vagina and the act of intercourse pushing it out of the pelvis is painful.

The diagnosis of these problems must be made by a physician or nurse practitioner who specializes in women’s health. First a physical and vaginal exam can find ovarian, colon and uterine masses like fibroids or ovarian cysts, and uterine prolapse. The vaginal exam can rule out vaginal atrophy and infection. Lastly, a vaginal or abdominal ultrasound or both can be ordered to “see” what is in the pelvis. We require these on every menopausal woman to make sure they don’t get too much estradiol to stimulate their pre-existing problem (like fibroids).

Some problems can only be diagnosed surgically. Uterine and pelvic adhesions can only be seen by doing a laparoscope under anesthesia. Fortunately, they can also be treated by cutting the adhesions and placing an antiadhesion fabric around the uterus or ovaries. Sometimes the adhesions are to the bowel and the treatment requires a hysterectomy only or with the removal of the ovaries.

Fibroids can grow under the influence of estrogen, and endometriosis can be active pre-menopause and make long lasting adhesions, however if the ovaries are removed or a woman has been in menopause it rarely reawakens to cause trouble. The adhesions it made before menopause still remain unless they are surgically removed.

It is important that a GYN or FP Doctor rule out the presence of ovarian, uterine and colon masses because rarely they can be precancer or cancer. Your doctor will usually order the for no other reason than to rule these problems out, but they can see many other things that a patient has in the same test.

We have talked about several causative issues that result in painful intercourse, the diagnosis method and the treatments for them. There are many possible causes and many appropriate treatments. Sexual Pain is a very serious issue which is often under recognized and under treated by gynecologists. In order to be an informed consumer and participate in good medical decision making, a woman must know about their body and the malfunction thereof enough to ask (or even challenge) her physician to help her treat these very fixable problems. It is not “destiny” for a woman to be dry and have painful intercourse. The goal is to have pleasurable sex, it is good medicine and good treatment you can enjoy privately which can restore a happy satisfied mood, and the natural sexual abilities and climaxes you had in your youth!

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Summary: Doctors traditionally divide the female and male orgasms into four stages as though all were the same and progressed identically along the same pathways. After more than three decades of helping women with their sexual issues and a little over one decade of treating men for similar problems, I can tell you that the classic approach could hardly be more incorrect. This underscores one of the deficiencies in medical training. Doctors are taught very little about human sexuality; and, as a consequence, most don’t feel, and maybe aren’t, qualified to diagnose or treat a not uncommon problem – lack of an orgasm.

Unsurprisingly, many real-life women find it difficult to describe an orgasm in objective terms because an orgasm, by its very nature, is explicitly subjective. And they almost never depict any “stages” of their sexual experience. Some women, though, have never had an orgasm. This condition is called anorgasmia. Anorgasmic women often feel incomplete and as if they are only going through the motions when they engage in sex with their partners. In some cases, they become frustrated to the point of giving up on sex because there is no bonus for them.

This podcast is designed to increase your understanding of the female orgasm, to inform you of the hormone that is necessary for an orgasm, and to educate you about anorgasmia.

TRADITIONAL STAGING OF ORGASM

Masters and Johnson conducted years of clinical research of the sexual act, some of it in St. Louis at Washington University School of Medicine, and decided there are four stages of having an orgasm.

Excitation is stimulating the “hot spots” that prepare the brain and body for orgasm. Normal people call this foreplay. It can begin with the mere suggestion that your partner wants to have sex in the near future; or it may be stimulated by you or your partner sexually touching the clitoris, labia, vagina or cervix; or, lastly, sexual visualization and pornography have been known to aid arousal. This phase is accompanied by an increase in heart rate, blood flow to the skin and dopamine secretion in the brain.
Plateau is the stage in which observable physical bodily changes take place. This may include involuntary dilation of the vagina, blood flow to the pelvis, and swelling of the labia. One’s focus is tunneled to the area being stimulated.
Orgasm is the stage where sexual tension is released. Surges of dopamine and serotonin are produced in the brain. Muscles throughout the body may contract or jerk. Kind of the whole point, really.
Resolution is the relaxing stage where blood flow, heart rate and neurotransmitters go back to normal. Women generally enjoy the ability to have shorter resolution periods than men. Women have the potential to have repeated orgasms where the resolution phase is very short and they reenter the excitation phase.

If you have great orgasms, be thankful for yourself and your partner. There is not a better way to enjoy sex and bond. But certainly not all women are alike, and not all orgasms are alike. Various studies have shown the rate of anorgasmia among women of child bearing age to be somewhere between five and ten percent with the degree of the condition ranging from women who have never had an orgasm (primary anorgasmia) to those who only infrequently fail to have one. This rate increases dramatically as women age if they fail to address the hormonal deficiencies that come with aging.

Recently I had two patients on the same day who had never had an orgasm. This coincidence was a little surprising to me given the rather low rate of occurrence for primary anorgasmia. Both women had experienced all the necessary stimulation and had partners who were cooperative and supportive of their efforts. Let me tell you my approach to treating these two patients.

One of the first steps was to take a detailed medical and social history. Psychological problems stemming from past sexual abuse as well as spousal conflict, severe fatigue and medications (antidepressants and some blood pressure meds) can impair a woman’s ability to achieve an orgasm. But these women had no such negative historical experiences and had attentive partners.

Both patients were in menopause and one had had a hysterectomy. But because their anorgasmia predated the hysterectomy and the menopause, I was able to dismiss these as contributing factors.

If you are a patient of our practice, you know that current blood work, appropriately analyzed, is the center point of any treatment plan. The blood work showed that both of these women had very low testosterone and estradiol levels. In talking with them, they both stated they had never had strong desire for sex even when they were in their peak years of ages 16 to 30. Also, they had not had acne or much body hair as young women. This is highly suggestive that they had never had adequate testosterone which is necessary for both libido and orgasm.

Even though testosterone is the primary sexual hormone, women in menopause need estrogen for adequate vaginal wetness; and women experiences better climaxes when they have at least a small amount of estradiol along with their testosterone pellets.

On the day of their visits, I replaced their testosterone with T pellets and an estradiol pellet. Their outcomes were excellent, and both women became orgasmic as the pellets rapidly became effective. They, of course, were thrilled, but their spouses were also understandably ecstatic. I doubt these women would have become completely orgasmic with any other treatment. T pellets bring back sex drive and orgasms better than any other medication or bio-identical hormone delivery system I have ever heard of.

TREATMENT

If you have experienced sexual abuse or suffer from depression or other emotional problems, the best first step is to seek counseling. If these aren’t issues, you should start with your gynecologist to check for physical problems with your anatomy and possibly educate you on where your “hot spots” might be to help you stimulate the proper areas. If this is unavailing, you should find a doctor who follows blood levels of testosterone and estrogen and uses T pellets.

Our practice does regular blood work to evaluate all the sex hormones as well as the other hormones (such as thyroid and adrenal hormones) that affect your general health. We treat all hormone deficiencies to normalize them to the levels you had when you were at your optimal physical state. This generally means supplementation or outright replacement but can also require that some hormones are actually suppressed to achieve the proper balance. We have been extremely successful with helping women become orgasmic for the first time as well as those who develop this problem with age.

I am very aware of other drugs that have been developed to improve orgasms but have found them to be ineffective and expensive. This is not a good combination. Why would someone take an expensive drug with side effects that doesn’t work as well as T pellets? Remember that T pellets provide countless anti-aging benefits in addition to orgasm enhancement.

If you are interested in further information on this topic, I recommend two books by Dr. Beverly Whipple, Orgasm, G-Spot and The Science of Orgasm, and, of course, my own book, The Secret Female Hormone. I’ll give you a hint – the secret is testosterone.

Go to my website at BioBalanceHealth.com to hear more Healthcasts, or you can go to YouTube and search for BioBalance Health or Dr. Kathy Maupin.

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Introduction:

“Hot spots” are the areas of the female body that can bring a woman to orgasm if stimulated, touched licked, sucked or rubbed. Not every woman has the same favorite area, and many women don’t think about it. I always say there are two activities that require you to shut down your mind and go: Sex and Golf! As much as we like to joke about sex, the act of having sex is a serious business and very beneficial to your health and your relationship. As a physician I think having more sex can substitute for sleep drugs, anti-depressants and anti-anxiety drugs.

This discussion will be about the Hot spots located on the female body and the sexual positions that can help stimulated that area. No two people are the same and it is important to examine and touch yourself to find out what areas you like. Figure out what makes you feel good and what brings you to orgasm. Take time to look at your vaginal opening and vulva in the mirror and figure out where the very important clitoris is, touch your own labia and examine your vaginal opening. The most sensitive area of the vulva is the clitoris. If unstimulated it hides behind a “hood that protects it from being injured and from normal daily activity stimulating an orgasm. However, when you are masturbating or having sex, the clitoris is the most sensitive hot spot, and the most common one to bring women to orgasm when stimulated. The clitoris is like a tiny penis and has the same sensitivity. Most women require clitoral stimulation to have an orgasm. The sexual positions that stimulate the clitoris include all face-to-face positions, but if your partner sits behind you or kneels behind you when you on your hands and knees, he can reach around and stimulate your clitoris while he is entering from behind.

Then, when you are familiar with the outside of your vulva, you can enter your vagina with one or two fingers (always wash your hands and trim your nails) and feel the roof of the vagina about an inch in from the vaginal opening, a dime sixed thickness, that is the G spot, an area that can give you a lot of pleasure and the second site of orgasmic excitement, the #2 Hot Spot. This area produces a different feeling orgasm than clitoral simulation and can often stimulate an ejaculation. Once you know where it is, you can show your partner where it can be found and how good it makes you feel. He can then take over massaging it with his fingers or his penis. The best position for this is with you on your hands and knees and him kneeling behind you.

Your vagina is generally about as deep as your longest finger, and at the top of the vagina lies the cervix. This is the organ that provides the third hot spot that can generate a climax, if the cervix is moved in the right way. You can gently move it side to side with the tips of your fingers, one finger on each side of the cervix or gently push it straight up toward your belly button, as if your fingers are a penis thrusting gently into the cervix. With the side-to-side motion or the thrusting motion you can generate a unique and very pleasurable orgasm. The position that reaches the cervix the best is the woman on her back or the side of the bed with her knees up, I call it lithotomy position, and her partner standing at the side of the table or bed trusting slowly. In this position the cervix is accessible to most male penises. That’s number 3!

The outside of the vagina is sensitive to light “slapping” with the palm of your hands or with a penis, which is the fourth way to stimulate an orgasm. Number five is the area around the opening of the anus, and you don’t have to participate in anal sex to be stimulated there. Circling the outside of the anus with a finger can also stimulate the fifth type of orgasm.

Of course, there are other erotic areas of the body that can be stimulated to bring you to orgasm, and some women have areas that are not shared by all women, like toes that are particularly sensitive to being sucked, or massaged and that can bring them to climax. Breasts are another area that can cause an orgasm when they are suckled.

Now, when you have become knowledgeable and comfortable with your own anatomy, then it is time to ask your partner if he or she wants to learn what “really makes you have a great orgasm”!

I think the best part of being female is that we have the ability to have multiple orgasms! This is not generally shared by the opposite sex. With the right stimulation and a generous blood level of testosterone this phenomenon is not unusual.

I think teaching your partner one thing at a time is about all a guy can handle, so go slow, and or masturbate for him to show him how you stimulate yourself to come. Most men think this is a turn on, but it is polite to ask if he is interested in seeing you “perform”, or not.

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Warning: I will be discussing the female anatomy and sexual responses in this healthcast, so you may want to listen to this and the next few healthcasts in a private location. I will use correct anatomical labels for sexual organs and sexual responses Like I do with my patients in my office.

The first step in understanding how your sexual organs work and how you can have an excellent and gratifying sex life is to understand the anatomy of the sexual organs and what each organ works. The pelvis, vagina, and perineum are the primary areas of stimulation to bring a woman to orgasm. There are other areas, primarily the breasts and other erogenous areas that can bring on an orgasm. The sex organs are where the stimulation starts but the brain is where the actual orgasm takes place and the production of neurotransmitters called endorphins is the outcome of the stimulation and the goal of having sex—the feel-good brain hormone that makes women feel warm and attached and excited as well as the chemicals that bring on sleep and can relieve pain and anxiety. The phrase that sex is all in your head is actually true!

The sexual areas meant to be stimulated to bring a woman to orgasm are in the pelvis and breasts. We will address the pelvis in this Health cast. The female reproductive anatomy is divided into three areas of the pelvic area, all located below the belly button. The Perineum, the Vagina and the Internal Pelvic Organs. The perineum is located on the outside of the vagina, that area you can easily see by using a mirror and looking at the area around the outside of the vagina between a woman’s legs. It includes the Mons, clitoris and clitoral hood, urethra, periurethral glands, vaginal opening, labia minora, labia majora and the anus. The Vagina is the area inside the opening of the vaginal, the hymenal ring and includes the cervix, vagina itself, and G-spot. The third area is called the internal pelvic organs and is located inside the abdomen below the belly button, and includes the uterus, ovaries, and fallopian tubes. You can’t see these organs without an invasive procedure like a laparoscope or a radiologic procedure like an ultrasound of the pelvis. Gynecologists use palpation (feeling the organs through the vagina and abdominal wall) to estimate the size and shape of these organs. This particular part of the gyn exam is how we can diagnose uterine fibroids, ovarian cysts and masses and adhesions as well as other pathology without using an ultrasound.

First the external reproductive area, the perineum, is loaded with nerves from many different areas on the lower spinal cord. In other words, different parts of the female perineum have different nerves for sensation that connect with the spine in a variety of areas, that can all transmit information to the brain. All of these nervous connections can stimulate the release of endorphins and produce an orgasm. Different areas of stimulation produce specifically unique orgasmic feelings, and women with a great deal of sexual experience can tell which orgasm comes from which area of stimulation, and they can actually have several types of orgasm at the same time if several areas are stimulated at the same time!

The Perineum:

This is a schematic picture of the perineal anatomy. The most important sexual area is the clitoris, which has many nerves and blood vessels coming to and from it. It is the clitoris that provides the primary orgasm for the majority of women, so it is important that you know where it is, and know that it normally swells with stimulation, either manual or oral, and the hood that normally protects it, pulls back and exposes the clitoris so it is more available to further stimulation. Stimulation causes the clitoris to enlarge and become firm, similar to the male penis. In certain sexual positions the clitoris can be stroked by the penis, otherwise it can be stimulated by tactile stroking, and oral stimulation.

The mons is the fat pad above the clitoris that protects a woman’s pubic bone, and her partner’s from being bruised during long sessions of sexual intimacy. The mons acts as padding during sex and can be sensitive to touch during foreplay and tactile stimulation. On the lateral areas around the vagina are the Labia Majora, or the hairy labia. They swell with sexual stimulation and act as shock absorbers. The labia that do not grow hair are called the labia minora. There is much controversy about these labia. The “sexual-beauty experts” have decided that the labia minora typical for women who are genetically from northern Europe and Asian are the “most beautiful” which is an artificial assessment. This trend made women worry about the size of their labia and many women have had plastic surgery to remove large labia minora. The longer or larger labia minora are characteristic of southern Europe and African genetically. Interestingly, larger labia minora are genetic adaptations to accommodate larger male penises. Larger labia minora lengthen the physical length of the vagina to accommodate larger penises. Your labia minora have many sensory nerves which are beneficial to being orgasmic, so my advice is, don’t “hate” them because they are large, remember that the more sensation, the better the sex!

If a woman is sitting in lithotomy, like at the gyn’s office with her knees up, heels close to her buttocks with her knees spread apart, the mons is toward the ceiling, the clitoris is below the mons, and the urethra, the opening to bladder comes next, below the clitoris. The urethra is very sensitive and can be a source of pleasure, but it must be treated with gentleness. There are two tiny openings on either side of the urethra called the Periurethral glands. They are hard to see, but they are openings to glands that supply lubrication for sex. These glands are one of the producers of ejaculate in women. Some women do ejaculate and some of the fluid comes from the periurethral glands, some comes from the vaginal wall which can secrete al large amount of fluid at orgasm. Both the vagina and the periurethral glands produce female ejaculate, and it is not urine! The ability to ejaculate depends on the amount of testosterone a woman has, how effective sexual stimulation is and how good the orgasm is.

Below the urethra and periurethral gland openings is the vaginal opening. Prior to first intercourse there is usually a tight circular band around the vaginal opening. This band is called the hymeneal ring and is broken at the first intercourse. The vagina itself has very thick lining when women are fertile adults, until they go through menopause when the vaginal skin becomes very thin and fragile from lack of estradiol. Young women’s vaginal tissue is stretchy enough to accommodate any size penis and it can stretch under the influence of pregnancy hormones, enough to deliver a baby! Most vaginas in women of fertile age are 2 fingers wide at rest and wider when stimulated. Childbirth without episiotomy can stretch the vaginal opening much larger, and sometimes surgical repair is needed after childbearing to tighten the vaginal opening enough for intercourse.

The last area we will talk about on the perineum is the anus. The area around the outside the anus had a multitude of nerves that can be stimulated to achieve an orgasm. Aal sex is outside the scope of this healthcast. It takes special techniques and cleansing to successfully embark on this type of sexual activity.

The vagina, the second anatomical area is about 4 inches long (deep), but lengthens with sexual stimulation, and childbearing. The vagina is a cave-like structure. Many of my patients think that at the top of the vagina is their intestines and it opens to the abdominal cavity, but that is not so. There is a tiny cervical canal that allows sperm into the uterus but in general, the vagina is a blind pouch or tunnel that ends in the cervix. Near the opening of the vagina on the wall of the vagina that is toward the ceiling when you are in lithotomy position, is the G-Spot, a thickened mound of vaginal tissue about 1-2 inches inside from the vaginal opening on the “ceiling of the vagina”. The G-spot is a site where stimulation can initiate an orgasm. It can be stimulated manually, or it can be stimulated by the penis from rear entry intercourse in the “doggie position “. It is thought to be a structure with the same nervous innervation as the male prostate.

The research of Beverly Whipple PhD., a research doctor who wrote the book “The G-Spot”, and The Orgasm Answer Guide, outlines in detail the areas of the perineum and vagina that lead to orgasms in specific areas in the brain. She did her orgasm research with Dr. Komasarek, her co-author. They studied women with an MRI machine and watched their brain activity while they masturbated until they achieved an orgasm. Their study revealed that self-stimulation can cause an orgasm that lights up the whole brain on the MRI. The lights represent the secretion of many neurotransmitters in every area of the brain. Before they did the study, they had expected that orgasms would light up one or two areas of the brain and they were surprised when orgasms lit up the whole brain! It confirms the belief that sex may begin in the pelvis, but orgasm is really located in the brain. For those of you who are physicians and want to learn more about orgasm, Dr. Whipple wrote a wonderful book called The Science of Orgasm which explains the details of orgasmic function and the whole neurologic pathway associated with orgasms.

The cervix is at the end of the vagina, and it has nerves that go to a different area of the spinal cord than the perineum, the vagina, the anus and the G-Spot. Stimulation of the Cervix creates a different kind of orgasm than the other areas. when stimulated through manual manipulation (with fingers) or when a penis or vibrator pushes the cervix back and forth or side-to-side. These are called cervical orgasms.

The Cervix has a tiny opening called the Endocervix that leads to the inside of the uterus. The cervix bridges the vagina and the abdominal pelvis. The cervix is actually the lower part of the uterus, but we physicians refer to it as if it is a different organ. It is the cervix that is tested with a pap smear to find cervical cancer.

The Female Abdominal Pelvic Organs inside the abdomen include the Uterus or the “womb” where the baby grows in pregnancy, the Fallopian Tubes which are the tunnel that allows the ovum or egg to travel from the ovary to the inside of the uterus to be fertilized by sperm swimming from the vagina to the uterus, and the ovaries, which produce one or two eggs every month during the fertile years in preparation for pregnancy. The ovaries are producers of hormones Estradiol, Testosterone and Progesterone, and the uterus, vagina, and perineum are receivers of these hormones. The ovaries work from menarche (the first period) to Menopause (the last period) and then they stop working all together and shrink to a small fibrotic nubbin.

A hysterectomy means the removal of the uterus only. A total hysterectomy is removal of the uterus with the cervix. A supracervical hysterectomy is the removal of the uterus, leaving the cervix in place. I preferred the supracervical hysterectomy for my patients because by leaving the cervix in place I could preserve their orgasmic function. There are many women who have their uterus and cervix removed who feel that they are missing the cervical orgasms that they had before surgery, and I did not want that type of surgery for myself or for them.

The role the ovaries play in orgasms is just the production of estradiol and testosterone that together have sex and orgasmic function possible. Most of my patients come to me for replacement of testosterone because they lost their orgasms when they lost their hormones. No amount of stimulation or attention from their spouses can bring them back until they have their testosterone and estradiol replaced with bio-identical pellets.

A note about the uterus. The uterus plays very little part in sexual responsiveness unless the uterus is sick in some way. If the uterus develops fibroids and enlarges to any extent intercourse can cause pain when the penis moves the cervix. It can feel like the penis is slamming against the uterus and the uterus can’t move with the thrust. If there is endometriosis, there is pain with any kind of stimulation that causes blood flow to come to the pelvis. If the uterus is retroflexed which means angled backwards toward the rectum, during intercourse the penis pushes both the cervix and the top of the uterus at the same time. It is folded on itself so there is pain with intercourse. If everything inside the pelvis is healthy the uterus won’t interfere at all with sexual response, but it doesn’t contribute to it either. The good news is that if the uterus must be removed, and the cervix is left in place, there should be no change in sexual activity or sexual response. Orgasms should be the same and to the woman who had the supracervical hysterectomy, it feels like her uterus is still there!

Next week we will discuss the erogenous areas of the body and the most sensitive areas to stimulate to create orgasms. We look forward to a continued discussion on Sex and Women next week.

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Warning: Today and in the next few Healthcast’s I will be discussing the female anatomy and sexual response. I will be speaking as if you are my patient in my office and graphically explaining the anatomy of the female body during sex, e.g., and how orgasms involve many areas of stimulation how the body responds to various stimuli. if you want to put on earphones or move to a private area so others will not hear this discussion, then please do!

Introduction:

I wasn’t an OBGYN very long, in the 1980s, before I realized that many of my patients, both old and young, were unaware of their own sexual anatomy and were appalled at the idea of touching their own vulva or vagina for any reason. When I did their pelvic exam in my office, they rarely understood what the proper names for their own anatomy was, such as what the name vulva (the area around the outside of the vagina), or clitoral hood (the skin that protects the clitoris) meant or where these areas are located. I realize that things have changed a lot in society’s role of women and in an expanded latitude in the sexual freedom of women in the US, however during this time I did not find that my patients became more comfortable talking about their own sexual anatomy! The age of my female patients and their marital status didn’t seem to make a difference in their anatomical knowledge. When I would do their pelvic exam, I always described what I was checking and whether they had normal anatomy or not. I’d point out the G spot, cervix, and clitoris, as I checked them for abnormalities like fibroids and ovarian cysts, and often they would stare blankly at me like I was speaking another language. This discussion today and next week is the result of those repeated interactions with my patients, in order to educate my listeners as to their own female anatomy and why knowledge of your body is necessary to experiencing great sex.

Why can’t we comfortably talk about our sexual organs and how they work?

The reproductive organs are hard to talk about in this country because we are still living in a sexually repressed society that considers sex “dirty” instead of beautiful and healthy, and we learn from very early that “touching ourselves” even in private, is “bad” or a sin. This relegates anything sexual to hiding our sexual feelings, repressing our desires even from our spouse and being embarrassed of our own naked bodies. Other countries don’t have the same inhibitions. For example, we were in Austria at a spa while we experienced a road trip in Europe when I realized that the American standards were not the same in other countries. My husband and I decided to go for a swim at the spa right after we checked in to a hotel-spa in 1999 in Innsbruck, Austria. He and I put our suits on and robe and proceeded to the pool. We were confused when there was just one locker room to change and as we walked in together, we were met with dozens of beautiful naked bodies. We were taken aback as we had not experienced this at home in the US and were uncomfortable with completely disrobing…. everyone at the spa tried to explain to us that that nakedness was required, and I am embarrassed to say we went back to our room…. At that time, I had not progressed to the point of being comfortable naked in public. However live and learn and thankfully I don’t feel that way anymore the human body is beautiful, no matter who you are or what you weigh, and it is a miraculous “machine” that we should be proud of! I admit that the American beliefs seem to be stuck in the Victorian era: The human body should be covered and is nasty or implies loose morals to show too much of your body. This also extends to the belief that “nice” or “good” women should not enjoy sex, and certainly shouldn’t masturbate or use a vibrator to satisfy their sexual desires. What society holds out as its standards and what women do privately are generally different, but the shroud of secrecy that blocks women from sharing information with their girlfriends, spouse or doctors blocks American women from developing a healthy attitude about their own sexual anatomy.

Let me preface the following generalizations with a reassurance that many American women do not have repressed ideas about sex, however there is a silent majority of women who are not comfortable with sex or their own sexuality,

Human beings were built to have sex. The goal of the two sexes in humans is to procreate and to fill the earth with children. Our Creator gave us sex to bond us to another person to form families, but He/She also gave us sex as a beautiful expression of love, and a satisfying and elevating act that brings us pleasure. Sex is healthy and dilates blood vessels, relieves stress, while it also sends blood to the brain and causes every neuron in the brain to be stimulated. There is no reason a healthy person should deny themselves, and often there is not a suitable partner to have sex with so masturbation is the answer to bringing about an orgasm and relieving anxiety.

However, many women still believe masturbation is a “bad” thing and they remain frustrated and unfulfilled if their partner is not available, or they don’t have a partner. One of the important benefits of masturbation is the fact that you must touch yourself and learn where your “pleasure areas” are. A woman also can learn what type of stimulation she likes, and what type of orgasm is her preference. In this way she can “practice” bringing herself to orgasm, and she will inevitably learn about her anatomy and what areas are sensitive to stimulation.

A word about masturbation. Masturbation is not a sin. Babies are born sinless and when babies are in the womb, they touch their genitals and masturbate. We see babies stimulating themselves before birth all the time on ultrasound studies of pregnancies. There is nothing evil about touching your own body, investigating your own sex organs or bringing yourself to orgasm. Orgasm is a natural way to release anxiety and to calm yourself. We can come to orgasm with another person or by ourselves to achieve these goals, and it is normal and healthy.

Some women enter marriage with very little experience, and they expect their husbands to know what to do to make them sexually fulfilled. How can a man know what you want unless you tell him or show him, and how can you do that if you have no knowledge of your own body? I have had a few patients who were so repressed by their religious beliefs that they married and could never consummate their marriage because they could not get over the belief that sex was dirty and it was evil to touch themselves. They could not get it out of their mind that they husband “should know” what to do but these men would have to have ESP to know what to do! If we can use an analogy to the hair care tools, we use every day, our hair dryer and flat iron or curling iron. I doubt many of you have hair care tools that you just ignore and pray that your hair will become beautiful by just wishing it will! Let me reassure you that women cannot take control of their sex lives if they have no working knowledge of their own bodies and how they work! More importantly, believing that your partner has ESP and just knows what to do to make you sexually satisfied is just as much a fantasy as wishing your hair into a beautiful style!

So, if you want more control over your life in general, and sex-life specifically, then I will teach you some basic reproductive anatomy, physiology (how the sexual areas of your body work) and where you should concentrate your efforts when trying to achieve sexual satisfaction. This Healthcast will have some homework that will require investigating your own anatomy if you have not done so before. Next week you may want to have a mirror available to look at your external anatomy.

I am always amazed at how miraculously we are created! We have the ability to have amazingly wonderful sex because of a variety of erogenous areas, located in many areas that are sensitive to touch and friction, and we have the ability to procreate and deliver babies with the very same anatomical organs as those that we need for sex.

Sexual Anatomy is the basic platform from which to build knowledge of how our sex organs work. Our primary sexual organs are in our pelvis and around the outside of the vagina. They are innervated primarily by sensory nerves and organs with clusters of sensory nerve endings that respond to touch, stretch and friction by sending pleasurable messages to the brain and when climax occurs, endorphins (neurotransmitters) are released in special areas of the brain and we feel wonderful…. like we have just taken a drug! Endorphin release is the goal of all sexual activity and is what keeps us coming back! The key to this female sexual system successfully working is very individual. Every woman generally has the same anatomy, but she responds differently than every other woman. Learning exactly what areas in our own sexual anatomy feel good to us is vital to directing your partner or yourself to successfully obtain an orgasm and endorphin release.

Next week we will specifically describe the anatomy of the sexual organs as well as the erogenous zones that women are sensitive to touch and stimulation. Please join us to learn about your sexual self so that you can ask for what you need to be sexually satisfied.

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Today, women are very legitimately concerned about the risk of breast cancer. They regularly ask Drs. Maupin and Sullivan to just give them replacement testosterone and not give them estrogen because of this fear. What these women do not realize is that Estradiol does not cause breast cancer, and that Estradiol provides many benefits that lower their risk of other more common and dangerous diseases. Women should receive both estradiol and testosterone after menopause to receive the healthy benefits of both hormones as long as they live. The fear of breast cancer comes from outdated, faulty studies has been unfounded and has caused many women to miss out on the healthy benefits they could receive from replacing their Estradiol. Medicine has finally accepted that taking estrogen is safe for women, yet many doctors have not updated their recommendations since medical school. There is no need to be in fear of taking estradiol, and it is important to understand why women need Estradiol replaced after menopause.

Estradiol prevents vascular disease: heart disease, stroke and arrhythmias.

An article in Menopause 2017 reviews the importance of estrogen in preventing heart disease. Estradiol is the hormone that keeps the lining of our arteries free of plaque and keeps our arteries supple. Estradiol also stimulates the production of Nitric Oxide (NO) which allows our blood vessels to dilate when we need them to like when our bodies are preparing for sex, or when we exercise. These three actions of estradiol keep our cardiovascular systems healthy and prevent the diseases of aging, stroke, heart disease and heart arrhythmias. Estradiol is one advantage we have over men in regard to lowering our risk of cardio-vascular disease. Women have a lower risk of heart disease than men when we are pre-menopausal, but the risk soars when we become menopausal and do not replace estradiol!

This particular study correlated hot flashes with loss of estrogen. They found that women with the worst hot flashes (and the lowest estradiol levels in menopause), had the highest risk of heart disease after menopause. The underlying science behind this truth is as follows: when a woman loses the ability to make estradiol, her pituitary gland reacts by sending out higher and higher concentrations of FSH (Follicle Stimulating Hormone) which sends the message to the ovary to make more estradiol. After menopause the ovary cannot respond with more estradiol production so the FSH level continues to increase above 23MIU, then the pituitary gland responds to these surges of FSH with an earthquake-like-reaction that surges neurotransmitters through the brain, causing the heat and anxiety centers of the brain to surge with. The lower the estradiol, the higher the FSH level, and the more severely the brain reacts to the FSH surge with heat, sweating and anxiety, and sometimes with a sympathetic surge in heart rate and even arrhythmias.

In short, the more you need estradiol, the more severely you will feel the effects of FSH surges. Hot flashes, anxiety, sweating, sweating, arrhythmias and insomnia. These signs are not to be ignored. They will eventually result in disease and damage to the female body. Should you get these surges and symptoms, recognize that your body is crying for help, and get estradiol replacements appropriately.

Now we know that lack of estrogen causes damage to our bodies beyond just the symptoms from high FSH surges called hot flashes, we also know that it can cause heart disease hardening of arteries and hypertension.

Estradiol depletion also causes pre-diabetes and insulin resistance, atrophy of the vagina and the vulva, make having sex impossible, the drying up of sweat glands in the groin and vagina drying up lubrication, drying and wrinkling of the skin, frontal hair loss, sagging skin, and increases the risk of brain shrinkage causing Alzheimer’s disease and other dementias.

If estradiol is replaced in a high enough dose these outcomes will be averted. The study done on women taking bio-identical estradiol non-orally prolonged the time before women got Dementia by ten years. If you think about it, if your lifestyle and genetics put you at risk for dementia, adding estradiol will give you 10 more years of productive life. For example, if you were designed to have dementia at 80 then the use of estradiol after menopause would defer the onset of dementia until 90. As an aside, the use of T pellets adds another 10 years to the onset of dementia, so you would not get dementia until you were 100.

What is the goal dose and blood level with estradiol after menopause?

Many women come to Dr. Maupin already on oral estrogen, or nothing at all, because their doctors do not “believe in hormone replacement”. Hormone replacement is not something to believe in, it is a fact that before menopause women have estradiol and testosterone circulating in their bodies, and after menopause they have nothing. Replacing estradiol is just giving women back what they once had and what they desperately need all their lives.

The safety of estradiol depends on WHAT KIND of estrogen you take, HOW you take it (oral, patch, vaginal, or pellet) and the metabolism of the woman who takes it. Let’s look at the problems with oral preparations of estrogen. These oral preparations are made from pregnant horse urine (Premarin®) or made in the lab from chemicals. The horse urine estrogen is composed of 17 kinds of estrogen that are specific for horses and are not the same as human estradiol, and they are taken orally so they are converted in the liver into estrone (old lady estrogen) which stimulates the breasts and increases fat and belly fat. Premarin is definitely not bio-identical to human estradiol, so women don’t feel the same as they did when they were young. The conversion of oral estrogens in to estrone leaves less pure E2 to do the work of protecting a woman’s heart, blood vessels, vagina and bladder. The oral preparations also put women at risk for blood clots by stimulating the production of clotting factors from the liver as the estrogens have the first pass effect through the liver.

Non-oral preparations like patches are a better delivery system because they do not cause blood clots, however, the blood level never gets high enough to shut down FSH and LH surges that cause hot flashes. Patches have the additional problem of coming off in the shower or bath or in the pool and it is hard to get replacement patches when that happens and insurance won’t give you more, so women may have to do without, or pay a fortune to get an extra patch. These are just some of the reasons Dr. Maupin stopped prescribing oral Premarin®, Estrace® pills and estrogen patches, and only prescribes chooses bio-identical estradiol pellets to replace the estrogen in her female patients.

When prescribing bio-identical estradiol pellets every 4 months for her patients, her goal for estradiol blood levels is the same range as a woman produces during her fertile years and is individualized to each patient. She adjusts the dose to stop all hot flashes, stop painful intercourse and a dry vagina and create an environment that makes women feel like they did when they were young. Everyone is different so she tries to find the perfect dose for the individual. She looks not just at the numbers but adjust the dose to resolve all symptoms of low estradiol (menopause):

Hot flashes, dry skin, dry vagina, painful intercourse, dry mouth and other mucous membranes, anxiety and poor memory are what she is looking to resolve. She finds the blood level that is associated with the disappearance of all of these symptoms, and the level that corresponds with physiologic blood levels of E2 for the individual and adjusts the dose accordingly. If all of the symptoms and blood levels are normal, the last thing she looks at is if the dose of estradiol is enough to normalize the FSH and LH to <23 and <10 respectively. When all of these goals are met, the maintenance dose of Estradiol that a woman will get every 4 months in her pellets is secured!

Are there women who cannot take Estrogen?

Yes, it is true. Some women who have had blood clots, who have estrogen positive breast cancer and those who have a genetic mutation called COMT2 shouldn’t take certain types of estrogen or any estrogen at all. For those women we often give women testosterone without estrogen, but it is not a frequent occurrence. We prefer to give both hormones in most women because the two hormones combined make women feel “normal” again. We don’t give oral estradiol if a woman has a genetic risk for blood clots that is made worse with estradiol even though this delivery system of estrogen doesn’t increase the risk of having another blood clot. Women who have had E2 receptor positive breast cancer who have had cancer spread outside the breast and have not had a mastectomy are not candidates for estradiol replacement, but we can give testosterone pellets which makes life more livable for those breast cancer patients. Some women don’t have the ability to remove estrogen from their body because of a genetic mutation called COMT2. If these women take any estrogen, they recycle it over and over but can’t remove it. For these women, we only give them testosterone and the small amount of E2 and E1 that is made from their testosterone is enough to prevent the symptoms of menopause.

Are there symptoms of Estrogen depletion that are not typical of Menopause, or any other low estrogen state, but that get better with estrogen replacement?

There are other symptoms of E2 depletion that are rarely recognized and should be discussed with your physician:

Vulvodynia
Bladder incontinence
Chronic bladder infections
Painful intercourse
Chronic vaginal infections.
Very thin vulvar skin the cracks and tears with intercourse
Shrinking of the vaginal opening

These symptoms can also be found in young women who are on low dose birth control pills. Simply increasing the dose of estrogen in the pill or menopausal estrogen in pellets, pills or patches should cure these problems. These symptoms can also be treated with a combination estradiol and testosterone cream that can be directly to the vulvar area if they cannot take any other form of estradiol (like breast cancer patients).

If your doctor doesn’t fix these problems with hormones, then find someone who is expert in estradiol and testosterone replacement to help you. This is not rocket-science, but many doctors don’t understand that these symptoms/conditions can be simply treated with these two essential female hormones.

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Three recent studies have shown a new light on treatments for diabetes. This group of research discoveries teaches us how to improve the severity of diabetes through several changes in diet and medication choices. One study discovered that a simple food addition to your diet can lower the risk of complicating illnesses and death from diabetes. The second study reveals the fact that statins increase the risk of getting Type II Diabetes just by taking a particular cholesterol lowering medication. The third study found that select diabetic medications are effective at preventing heart disease in diabetics. Join us to learn what you can do to help you, or someone you love, avoid diabetes and the complications from diabetes.

Diabetes is a disease that is rapidly becoming the most common and dangerous disease of aging Americans. The increase in obesity, the switch from whole food to junk food and fast-food and lack of active lifestyles, has contributed to the development of Adult-Onset Diabetes in almost half of all Americans. Now that our society is flooded with citizens who have high blood sugars that cause heart disease, stroke, infections and increase the risk of cancer, what are we to do?

The first medical study recommends a simple diet change to those MEN (and possibly women) who already have diabetes, to prevent Adult-Onset Diabetes. A study done at Stratton Veterans Affairs (VA) Medical Center in Albany, NY revealed that just one cup of blueberries daily, fresh, frozen or freeze-dried, significantly decreased triglycerides in the men tested who followed this recommendation. It is widely known that elevated triglycerides increase the risk of cardiovascular disease in diabetic men, and one cup of blueberries daily lowered triglycerides and the risk of cardiovascular disease. I believe that this diet recommendation can work for women as well, but they only tested men.

The previous research gave Diabetics a simple way to lower their risk of getting heart disease by eating one readily available food! Our next study reveals how doctors can prevent their patients from developing diabetes in the first place, beyond the strategies of achieving ideal weight, exercise, and eating a low carbohydrate diet? A study done recently revealed the fact that taking statins for high cholesterol increased the risk for elevated blood sugars, HBA1C and triglycerides in patients who weren’t diabetic and could cause Type II Diabetes! As with most meds, all statins are not the same. The cholesterol medication, Crestor ®, is the least likely to have this side effect, however it is better to take an alternate drug that lowers cholesterol called Zetia® if it is strong enough to lower these blood fats enough. Zetia® is not a statin, and It doesn’t cause any of the side effects that statins do, including raising your blood sugar, because it works in a completely different way than statins.

If you have gotten diabetes since starting your statin then ask your doctor to switch your medication to Crestor®, Zetia®, or try normalizing your sex hormones and triglycerides through diet or by taking diabetic medications like Metformin®., which will lower your LDL cholesterol as well, without a statin! At BioBalance Health® we are able to get patients off statins all the time by replacing testosterone with pellets, lowering body fat, treating patient’s AODM with Metformin, and normalizing thyroid hormones. This is Dr. Maupin’s secret weapon for treating patients with a high risk for vascular disease, who have high LDL cholesterol and or Triglycerides…Testosterone pellet therapy!

Last but not least is a study from the June 2020 Endocrine News that gives us hope for a new classification of diabetic drug that lowers cardiac risk and all vascular causes of morbidity! This class of drug is called SGLT2 Inhibitors, specifically Invocana® and Farxiga®. These two drugs lower glucose by increasing sugar in the urine to get it out of your system. This is how it works to treat the intended disease of Adult-onset Diabetes, but recently it has been found to prevent a common outcome of diabetes, cardiovascular disease! Specifically, it lowered the rate of heart failure by 35% in diabetics.

Dr. Maupin has always started AODM patients on Metformin® for the past 18 years to lower blood sugar, sensitize diabetics to insulin which helps them lose weight and lower their blood sugar, and to make the other diabetic drugs they are taking, more effective. It is inexpensive, generic, very effective, and has few side effects if a patient follows a low carbohydrate diet.

The Endocrine Society guidelines, that rule the actions of Endocrinologists, changed this year:

Pre-diabetes and early noncomplicated diabetes first with Metformin®.
Patients with established AODM and atherosclerotic heart disease and kidney disease should be placed on SGLT2 Inhibitor like Invokana®, or the drugs like Victoza®, a GLP-1 receptor agonist.

The experts in treating Adult-Onset Diabetes, Endocrinologists, are considering the use of Metformin ® for diabetic and non-diabetic patients alike, who have kidney disease, and heart disease without diabetes to improve these diseases as well. If you have these complications to diabetes, or have these diseases but do not have AODM, ask your doctor about these new uses for this old drug.

The most important part of this message is for individuals to prevent diabetes if at all possible, with lifestyle changes low carbohydrate diet and daily exercise, however some people get diabetes anyway because of their genetic makeup. You can easily have a cup of blueberries every day to prevent heart disease if you do have diabetes, and then change your statin to Crestor® or Zetia®, and yes to the appropriate diabetic medications plus Metformin® to save you from having a heart attack, heart failure or stroke. All of these recommendations for medications should be discussed with your doctor, who knows you best. If they have not read these new studies or find that this research is not going to help you then always follow the advice of your diabetes doctor.

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Our bodies are primarily water, sea water specifically, and supplying our bodies with the water (H2O) and the minerals that are necessary, the nearer we get to health. By replenishing our natural nutrients sodium, chloride, calcium and magnesium for example, the better we feel and the healthier we are. It is very easy to get the necessary minerals like sodium and chloride (table salt) and difficult to receive some minerals like Magnesium, by eating a normal American diet.

When we start viewing food as fuel and nutrition and less as “fun” and emotional security, we will all be healthier in every way. There are many nutritional elements necessary to our health, but the mineral that most of us have inadequate amounts of, and need the most, is Magnesium. It is the 4th most plentiful mineral in sea water and should be plentiful in the diet of humans, however we rarely get enough. This leaves us at risk for high blood pressure, stroke, anxiety, Irritability, constipation, muscle cramps, and now it is evident that magnesium is necessary to prevent diabetes!

At BioBalance Health® we recommend several supplements that EVERYONE needs to complete their daily nutrition quotient. These include Magnesium glycinate, Iodine, Vitamin D3, and Methyl B vitamins (Methyl B12 and Methyl folate). I choose these particular nutrients because most people in the US do not get enough of them in their food. Of course, on an individual basis, I prescribe other nutrients to individuals who need them to treat their medical problems.

In general, the role for the mineral magnesium is ubiquitous to the human body’s function. Magnesium is needed for peristalsis of the intestines, the activity that pushes food along the GI track, to relax skeletal muscles and to relax blood vessels, lower blood pressure, the production of antidepressants in the brain, synthesize normal neurotransmitters, and normalize insulin resistance as well as insulin production to prevent diabetes. We are learning more about how important our nutrition is to our health daily. Opposed to the common belief that we can take a supplement for a few days and then we are fine, nutrients must be consumed daily to feed the body, and generally do not build up so that we can go days without consuming them. Once you are prescribed a mineral for your health to supplement your diet you must take it every day! We cannot possibly get enough of every nutrient every day by eating 3 meals per day, so supplying it through supplements to boost our nutrition is a logical and economical intervention.

How do you choose the type of Magnesium to take for what ails you?

In general, magnesium supplementation gives you back what you would possess if you had the perfect diet and no medications or diseases. In fact, if we had all the right nutrients, we would most likely not be sick at all. So, replacing nutrients through supplementation is the most important and most natural recommendation I make every day, other than replacing testosterone deficiency of course). If a patient has a specific condition requiring magnesium, I choose one of the forms of magnesium that is most beneficial to their condition.

First of all, oral Magnesium must be bound to another molecule to be absorbed in the gut. That is why I stated that I usually choose Magnesium Glycinate, instead of just Magnesium alone. The element that magnesium is attached to determines how well they are absorbed and what they can be used to treat.

My favorite, Magnesium Glycinate, is best at calming anxiety, relaxing muscles, and lowering blood pressure. More importantly, for patients who have normal bowel function, Magnesium does not loosen your stools or cause diarrhea. It possesses all the other benefits of the other forms of magnesium supplementation as well, but other forms have different primary results and have different side effects.

Magnesium citrate is another type of magnesium and is used to clean out the intestines for colonoscopies and to treat severe constipation. If you don’t want loose stools or diarrhea, don’t take this form.

Magnesium Taurate is the best type of Magnesium to take to lower the blood pressure and dilate blood vessels. Taurine is an amino acid that is known to feed cardiac muscle and enhance the quality of contractions of the heart so if you need Magnesium for heart function this is probably the best form for you.

Magnesium L-threonate has been found to cross the blood brain barrier and to treat dementia. L-threonate improves learning abilities, working memory and both short, and long -term memory. Additionally, it has the same benefits as any other magnesium including enhancing sleep quality.

How to Take Magnesium? Ideally, take it orally on an empty stomach. Don’t take oral magnesium with calcium or calcium foods because they compete for absorption and you will get less of the magnesium per dose than you think you are getting. If you are interested in the muscle relaxation provided from magnesium, then taking it topically as a cream, gel, or soaking in Epsom salts in the bathtub is preferable. A bath in Epsom Salts actually raises your blood magnesium level and effectively treats muscle spasms and blood pressure.

There are hundreds and possibly thousands of medical articles about the importance of magnesium in the human diet, however the latest research now proves that a lack of magnesium can cause the development of diabetes, the fastest growing non-communicable disease in the US, and taking magnesium every day can help prevent the development of this disease.

I hope this information helps you decide what type of Magnesium would be best for you, and to convince you that the modern American diet is not enough!

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Points to Remember:

Slow heart rate can be from hypothyroidism
Slow heart rate can be caused by an arrhythmia (an irregular heart rate)
Slow heart rate can be because you have conditioned your body through aerobic activity

Primary care doctors check your pulse, your blood pressure and your height and weight when you enter the office before, they even see you. These pieces of information are called your vital signs, and they represent individual signs of health. We have discussed the importance of normal blood pressure and normal body composition in the past, but today we’d like to talk about the importance of having a normal heart rate. Medically a human should have a pulse between above 60 beats per minute and below 100 beats per minute, unless they are well trained athletes, then their heart rate at rest may be 40 beats per minute because their heart has been trained to be very efficient so an athlete can run miles at a time.

However, if you are not a lifelong well-trained athlete and your heatbeat is less than 60, then you may have a medical problem.

This week, we are going to discuss what it means to have a slow heart rate and what should be done if you have this problem.

I decided to discuss this concept with you when one of my new patients who presented to my office for the first time went on and on about how healthy she was because her heart rate was 40 beats per minute. She was over 50, had a sedentary job, and was 20 lbs. overweight, didn’t exercise regularly and was out of breath while she regaled me with how healthy she was! I had evaluated her lab and her medical history and knew before I met her that she had some early medical problems over and above her lack of hormones. I was taken aback by her misinterpretation of her slow heart rate that made her think she was perfectly healthy. I then had to shatter her healthy self-impression by going over the lab that revealed early diabetes, high lipids, fatty liver and obesity. It was only then that I took her pulse myself. In fact, her heart rate was 42, however it was irregular and was clearly not pumping enough blood through her system to adequately oxygenate her. Her skin was sallow and pale, and she was out of breath when speaking. This particular slow heart rate was not healthy. Her slow rate was causing fatigue and stress on all of her organs. I referred her to a good cardiologist who would rule out atrial fibrillation, and other less common abnormal heart rates and give her a diagnosis and treat her, while I replaced her estradiol and testosterone and treated the other metabolic problems that she had. It was this patient who inspired me to set the record straight about the healthiness of a slow heart rate.

So, let me paint a simple picture of what your heart does. Your heart is a muscle that works day and night from the day you are born to the day you die. This muscle has its own stimulation from your pacemaker which sets the basic rate of your heartbeat. There are many other factors that have an effect on your heart rate: medications, drugs like cocaine, stress, and fear increase heart rate by stimulating the adrenal gland which secretes adrenaline and increases the heart rate. Other medications and hormones or the lack of either can slow the heart rate. The rate must be between 60-100 to allow the atria and ventricles to fill with oxygenated blood during the diastolic phase of the heartbeat (the “lub” sound) before the heart squeezes or contracts and pushes the blood out of the heart during systole (“dub” sound). If it’s too fast the heart doesn’t fill with blood completely and then there is not enough blood to push out to provide oxygen to your body. If it’s too slow then the heart expands too much and can’t squeeze hard enough to provide enough force to push enough blood out to oxygenate your body.

Providing oxygenation is one of the essential roles of the circulatory system and a necessary element needed for a healthy body. All of your cells need oxygen to function. The blood flow provided by the heart pump is what delivers this oxygen to those cells. I am not covering every cause of poor oxygenation or all the causes of a slow heart rate but the most common cause of slow heart rate.

If you have hypothyroidism, you will have a slow heart rate, low blood pressure and low body temperature. Thyroid hormone is one of the necessary hormones for a healthy circulation. The thyroid hormone stimulates the strength of the hearts’ muscular strength and stimulates the heart’s pacemaker and supports it to contract normally between 60 and 100. By doing this, thyroid hormone normalizes blood pressure and tone of the arteries. When someone has low thyroid, their lower legs swell because their blood flow is poor, they are fatigued because they aren’t getting efficient oxygen to their brain and the rest of their cells. The body is complex, and it actually does take a medical degree to understand the healthy function of the body, as well as the dysfunctions that can happen during a lifetime. Please listen to your physician when they suspect and issue with one of your complaints because it may be something that can be easily treated, and it may cause a severe problem in the future if you don’t treat it now!

If you have a slow heart rate (< 60 beats per minute) please don’t assume you are healthy and that you don’t need an evaluation by a specialist if you are tired, swollen, have chest pain, or fluttering in your chest. It is only the lifelong athlete who is still actively exercising nearly daily, near ideal weight who has a low heartbeat that indicates physical fitness! If that’s not you and you have a slow heart rate please ask for an evaluation from your primary care doctor who evaluates your heart, your hormones, complete blood work, and your vital signs—blood pressure, heart rate, and weight. It is then your job to follow the recommendations of your doctor and change your lifestyle and take the medications or get the procedure recommended.

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Prostate cancer is a concern for most men as they age. We have culturally been told that if we live long enough and nothing else kills us, we will die from prostate cancer.

Dr. Maupin reminds us that this is a concern but not a prediction made with certainty.

Maupin explains the importance of the Prostate gland to men when it comes to procreation and its impact on the urinary tract whenever it becomes swollen.

We discuss the older treatment for prostate commonly called the “Roter-rooter” surgery. It was really the trans urethral resectioning. It is a treatment that is still used today but there are also now medicines that can work to help this problem without surgery for some men.

The most common new drug is Tamulosin. It can help shrink the prostate as it swells around the urethra without surgery. One negative side effect though for some men is that it will decrease or stop all together their production of ejaculate. For some men, this is a sexual problem that diminishes their desire and their feeling of capacity.

We were relying on a column from Dr. Roach, which appears in the newspaper. He received this question and reported that up to 90% of men on tamulosin notice a reduction in the flow of ejaculate. There are other drugs that can be used if tamulosin is not the drug of choice.

We also discuss whether or not ejaculation is necessary for orgasm and sexually satisfying experiences. There is actually a whole subset of sex education that explains to men and women that there are many ways a man can have satisfying sex without ejaculation. That they should understand (and their wives should know) that this is in no way a statement or message that the man does not find the woman attractive or satisfying. They need to learn that sexual release can and does happen without any visual proof of satisfaction. The ejaculation is necessary for having babies but not for orgasms.

Some men cannot get over the concept that they have to have and see the ejaculate in order to feel satisfied and believe that they had a good sexual experience. There are other experiences men have that can reduce the flow of ejaculate, such as dehydration or a vasectomy. Men need to be educated to understand what that all means so that they can factor the information into their understanding and sense of accomplishment.

If you have concerns or questions about the necessity of a certain volume of sperm and its role in your sense of satisfaction or completion of the sexual act, do your research, learn what it means and how you can recognize that you are sexually satisfied and that you are still able to satisfy your partner without the production of a given amount of fluid!

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Modern medicine is continuing to try to find medicines and treatments for issues and problems that have not been adequately resolved by existing medicines and treatments. There is constant news about speculative new treatments or medicines. When one is found that offers hope or success for treating ailments, diseases, problems then we rejoice. Currently among the hottest items on the event horizon of new treatments and medicines are peptides. The human body functions with communication “chemicals” that it produces to transmit information from one tissue, gland, or organ to another. The communicators that are commonly known include hormones, neurotransmitters, enzymes, vitamins and minerals. The communicator that has not been focused on until lately is the group of chemicals called peptides.

Peptides are pieces of proteins that signal information from one tissue to another or that communicate information within a tissue to keep it healthy, and to help parts of our bodies to remain in balance… to achieve homeostasis. There are thousands of peptides in the human body and some of them decrease with age or illness.

Peptides have come to the forefront because medicine has reached the limit of what chemical cancer drugs, antibiotics, antivirals, and immune suppressants can do, and we have found that these commonly used medications still do not treat or prevent the diseases that occur with aging. The current drug environment is filled with synthetic hormones, synthetic drugs that kill the immune system instead of modulating it, and damage other tissues while killing cancers.

Those of us who strive to improve the human condition with medicine have been looking for MORE…. More natural ways to improve how our body works as it ages, like how it communicated internally when it was younger. This starts with replacing the hormones that are deficient with age. After deficient hormones are replaced, most of the time patients feel all better, but in the situation where they do not, we test and diagnose those imbalances that can be treated with Peptides. In the past we looked to a nutritional solution with diet and supplements, but now that we are looking at peptides, we are finding key peptides that decline with age, and that can be replaced to bring our aging patients back to balance and health. We have discovered how to create peptides for injection or in a nasal spray delivery system that are effective and safe.

There are peptides for almost every disease and condition that plagues modern man, and it might be that peptides become the mainstay of treatment for cardiovascular, metabolic, and endocrine diseases, after individual patients normalize their hormones and diet.

The peptides that BioBalance Health is using are highlighted in the following paragraphs. It is important to note that there are some peptides that treat low growth hormone by stimulating the production needed by aging patients, but there are thousands of other uses and forms of peptides that can be used by patients to treat other illnesses and conditions.

Thymosin Alpha1 is a peptide that stimulates the thymus gland to increase the production of white blood cell t-helpe and killer cells which fight cancer, bacteria and viruses. The use of this peptide can prevent recurrence of cancer, help prevent and treat severe infections with viruses, bacteria, and fungi which are resistant to antibiotics and antivirals.

We use Thymosin Alpha1 for:

Infections

Cancer

Autoimmune disease

Infection prevention

Treatment of immune suppressed individuals

Thymosin Beta 4 is another thymus gland stimulator peptide that heals heal ligaments, muscles, heart damage, and stimulate post-surgical lack of healing. This peptide is short term answer to difficult medical problems that do not have current FDA approved drugs to treat them.

Semax is a peptide that is administered by nasal spray for poor memory, head injuries and degenerative brain diseases. This peptide also works well for the memory issues that occur with age, bringing the brain back to normal.

Selank is a peptide that treats anxiety and calms the nervous system. It is delivered as a nasal spray.

CJC/Ipamorelin growth hormone stimulator is safe and stimulates growth hormone. We treat a variety of problems with this one peptide as it is multipotential in its action. Because it stimulates growth hormone production from the pituitary and the outcome is to provide all the benefits of the hormone GH such as fat loss, muscle growth, energy, improved mental capacity, hair growth, skin turn over for beautiful skin, as well as improving many diseases that come with old age like osteoporosis, diabetes, heart disease, and age induced immune deficiency. Disease, genetic abnormalities and aging cause these conditions.

To receive peptides, you must go through a medical workup and make changes in your lifestyle to prove that your GH will not naturally improve with lifestyle changes. In addition to a complete medical history a blood panel must be done to rule out other causes for these conditions, as well as a low iff-1 test to prove that the gh production is low in any particular patient. After all of that medical work up and informed consent, would I prescribe peptides.

Peptides can be long or short term. You may have to be on them for life so you must consider the cost. My practice works with several quality compounding pharmacies that make the peptides for you. Injectable and nasal peptides must be used right away after receiving or a month after reconstituting them within a few months. We routinely order peptides for our patients 2-3 months at a time to save on shipping fees. The cost for one month is from $150-$300 a month plus shipping and they should be stored in the refrigerator.

It is imperative that you understand that this is not a written prescription you can obtain from any pharmacy, and there is a medical work up necessary that doctors must do before prescribing peptides of any kind: we always go through the steps of treating obvious hormone imbalances first. We follow that with nutritional replacement and exercise counseling, and only then do we add peptides for specific health problems.

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Got Testosterone? The recent book written by Dr. Kathy Maupin and Brett Newcomb, MA LPC, just garnered the prestigious First Place Award for Men’s Health by the Independent Press. Got Testosterone? Explains how all-natural, bioidentical testosterone replacement therapy with long acting subcutaneous pellets can reverse the clock and help lessen the symptoms of age-related diseases such as, diabetes, cancer, Alzheimer’s disease, heart disease, osteoporosis, obesity, high cholesterol among other health issues that occur with aging.

Conducted annually, the IPPY awards honor the year’s best independently published titles from around the world. According to IPPY officials, the award “rewards those who exhibit the courage, innovation, and creativity to bring about change in the world of publishing.”

Brett and I are so thankful to our writing mentor, Nancy Erickson (the Book Professor) for submitting our book for consideration for this award. We were so surprised when our book won first place for this coveted publishing award.

We want to encourage all men to read Got Testosterone? so they can become healthy, virile and satisfied with their health and their lives no matter how old they are.

I believe if healthcare would accept the fact that the majority of men NEED testosterone replacement after age 50, and that those men who receive Testosterone pellets will avoid the diseases of aging (Cardio-vascular disease, diabetes, hypertension, cancer autoimmune diseases, diseases of poor immunity that cause more frequent infections). Why does medicine in the US and Europe concentrate on “fixing” one symptom or disease at a time, and not attend to treating a patient globally by preventing disease, and treating the whole patient?

How medical information is taught and transmitted to patients:

You learn about your condition and the treatment from your doctor, you doctor is guided by guidelines from his specialty’s governing group who certifies specialty physicians like ACOG who certifies OBGYNs , then doctors in that specialty learn new information from drug companies, conferences and journals from his or her specialty organization. When new research is done in multiple specialties and by many drug companies and research organizations, who puts it together across specialty lines? No one! There is no one to develop protocols, or new treatment plans that involve many specialty groups. That is what Brett and I accomplished with this book: we combined research from more than 5 specialties of medicine, as well as American and European medical research and translated it into easy to understand tables and graphs as well as bulleted points that are meant to make important information memorable to our readers.

In the medical world it is difficult to get practical truthful information about new medical treatments that is understandable to lay people. We have translated complicated medical research and practical information about how vital testosterone is to men into entertaining and realistic advice. It is important for lay people to know the truth about who needs testosterone replacement, the most effective and safest way to take it, along with the risks and benefits of T replacement. We have found that bio-identical testosterone pellets are the best form of testosterone for men and women.

Our book, Got Testosterone? Men-Return to the Sexier, Stronger, Smarter You! is easy to find on-line in the Amazon bookstore, and it is available at Dr. Maupin’s office as well. Do yourself and the man in your life a favor and read it!

Please watch for the audio version of our book coming out soon.

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Due to a new trend in medicine that believes that less is more, the Pap Smear has been benched in lieu of a more specific test, the HPV test. The American Cancer Society

now recommends that women with a cervix be tested every 5 years after age 25, until age 65. This is a change from the most recent guidelines that recommended Pap smears for women over 21. In that old recommendation, the HPV test was only done if the Pap smear was abnormal. Both tests are done by a physician or Nurse Practitioner by doing a vaginal swab at the time of the pelvic exam. This test must go to the lab to be processed and there is a lag time for both tests before results come to the physician’s office. There is another lag before patients are notified of an abnormal test. While we used them, pap smears were somewhat inaccurate, and often had to be followed by other tests to document a real problem, and many times women were worried by pap tests that just told them that they needed another test.

Pap smears were a new innovation in 1915 that saved millions of women’s lives from cervical cancer. Cervical cancer is the result of an HPV viral infection which is sexually transmitted, in fact it is the most common sexually transmitted disease in the US. The Pap smear detects abnormal cells that have been infected with HPV virus. The HPV test actually detects the viral infection itself. Thankfully HPV infection often disappears on its own from the immune system killing the virus. The infection with HPV doesn’t just disappear in women who suppress their immune system with smoking, alcohol excess, some medications, environmental toxins and poor diet. The virus can progress and become pre-cancer and then cancer in these patients. Another factor that affects whether HPV can disappear without treatment, is the strain of HPV. Some viral types are more likely to cause cancer than others.

In the past decade, American doctors began recommending a vaccine against HPV to get a head start on wiping out HPV infections all together, and therefore cervical cancer by immunizing children before they become sexually active. This vaccine is also given to female teenagers who are already sexually active. The HPV immunization is a series of three injections that prevent HPV and or prevent the progression of HPV’s progressing into cervical cancer.

After years of preventing HPV infection from being contracted in the first place with the immunization, the American Cancer Society is changing its guidelines for the use of pap smears to decrease the number of cervical tests and to use a more specific test, the HPV test, that reports the presence of HPV as well as the viral type which specifies how aggressive the HPV virus is, and how soon it will cause cancer. The ACC believes that this guideline will reduce cervical cancers by 13%, and 7% of Cervical Cancer deaths.

The ACC thinks this plan will lessen the occurrence of cervical cancer, cervical cancer deaths and also decrease the number of unnecessary cervical biopsies and hysterectomies.

Over the years our treatment has become more specific and less tedious, and diagnosis more specific than ever in the past: we have gone from a Pap smear yearly by the GYN physician visit starting at age 18 every year, to beginning HPV tests at age 25 every 5 years until 65.

It is important to note that a yearly gyn visit is still recommended for adult women because at that visit a breast exam and a pelvic exam is done to detect ovarian cysts and tumors, fibroids, and to evaluate uterine bleeding, birth control, discuss sexual questions and emotional problems. Gynecologists are trained in all types of female diseases and are integral to the health of women of every age.

There is a vaccine for HPV that will prevent you or your daughter from getting HPV and cervical cancer, but only if you get it!. You should also know that men can be carriers but rarely develop cancer of the penis, prostate or bladder themselves. If you get both your sons and daughters immunized with the vaccine, then they will not be at risk for having or transmitting this disease throughout their lives. It is in this way we can wipe out a cancer that has been around since the beginning of time.

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When a person contacts BioBalance Health to determine appropriateness for hormone replacement, Drs’ Maupin and Sullivan order lab tests to be drawn before they come in for their first visit. This is different than the typical hormone practice who see a patient and then order a standard list of hormone tests after the first visit, and then the patient comes back for their second visit to review the lab results and get treatment.

The most important reason Dr. Maupin wants to review the results of a new patient’s blood work and their medical history before they ever pay anything to BioBalance Health® is that it saves that patient the cost of one visit with the doctor, and the second reason is that this protocol speeds up the treatment for the patient by shortening the time between the first visit with the doctor to the testosterone pellet treatment. “Most of my patients have seen 3-10 other doctors trying to get effective relief for their symptoms and it is cruel to cause them to wait longer for symptom resolution.” The pellet insertion is generally provided at the first visit to the BioBalance Health Office immediately after the first physician consultation…patients receive the advice and bio-identical hormone testosterone pellets plus or minus estradiol and start to feel better within 1 and 21 days.

More importantly, those patients who will not benefit from Testosterone and or Estradiol pellet therapy, their protocol of obtaining blood work before a person becomes an established patient, saves many patients money by providing them with the judgement of Dr Maupin and Dr. Sullivan that after reviewing their medical history and blood work, that they will not benefit from hormone replacement. These patients are saved the time and money of a consultation if they cannot be helped, and the doctors can use their time taking care of patients they can help!

An example of this situation is when an 18-year-old adolescent thinks he needs testosterone to be “fit”. First of all, most young men make plenty of testosterone and do not need to replace their testosterone, and by the doctors reviewing their information and avoiding a consultation, is the best way to proceed.

Dr Maupin and Sullivan are not a one-size-fits all medical practitioners. They realize that not everyone is a good candidate for testosterone and estrogen replacement. They also believe that patients should not have to pay for being told they are not good candidates at this time. Their hope is that as their patients’ lives unfold, should they become good candidates for hormone replacement, they will remember their care and return.

One of the most common questions Dr. Maupin gets asked by prospective new clients is the question “what tests do you order and why do you order those?” Dr. Maupin responds that when people find out how many vials of blood that the test requires, they gasp and ask “Why?”. She tells them that she is not just looking for your sex hormone levels but to determine your general state of health, your risk of future heart disease, the balance of all of your glands, and well as diseases that can become worse with the addition of estradiol and testosterone replacement. “We want to provide a foundation of youthful estradiol and testosterone levels that in turn stimulates healthy growth hormone production. After your hormones are optimal, we then treat pre-illness to reverse the diseases that are beginning because of low horomones and aging. Then we work with you to normalize your diet and exercise so that your risk of heart disease, stroke and cancer drops substantially. We identify genetic diseases that no one has tested for and we take action to halt the future damage. BioBalance® is much more than a hormone practice, and we need many tests to discover the source of the many symptoms of aging that patients come to us to treat.

For example, we test for Homocysteine that when elevated causes high risk of stroke, heart attack, and miscarriage. Very few physicians order this blood test, and the treatment is cheap and effective: Take methy-B12 and methyl-folate daily to erase this risk of dangerous diseases! That is a very important test to take that can change your life!

Many of our patients complain that the phlebotomist takes “so much blood”, but it is a tiny fraction of our supply, and our testing can save your life! Our panel of blood tests is created to test for hormone deficiencies and excesses (testosterone, estradiol and estrone, thyroid, parathyroid, adrenal hormones, and pituitary) that are common in people over 40 and are rarely diagnosed and treated. This specific group of blood tests also looks for metabolic diseases and pre-disease like diabetes, hemochromatosis, erythrocytosis, and that takes a lot of blood!

Drs. Maupin and Sullivan use your results to diagnose you and formulate a treatment plan that will both treat your symptoms and prevent disease. The first blood test is also used to obtain YOUR baseline data from which to compare your future tests and mark your improvement. Other tests diagnose conditions that worsen with testosterone, like Erythrocytosis (too many red blood cells in the blood that make it thick) and should be managed while taking testosterone.

Drs. Maupin and Sullivan apply a wholistic and individualized method to their care of your health, with the goal being patients who are well, happy, feel young and are productive throughout their lives.

A last word about cost of blood work. Lab tests are often expensive if you have to pay for them on your own, but we order them in a way that will allow insurance to pay for them or apply them to your deductible. If you do not have insurance or if you have high deductibles for your insurance, we can extend to you the discount we receive from the labs because of the volume we generate. We are happy to pass that discount along to you which is much lower than the cost that the lab changes directly to patients.

Please don’t let the number of blood tests dissuade you from receiving the care you need!

Go to Biobalancehealth.com, touch the New Patient button, choose male or female, and fill out your form and print your lab requisition! That’s it!

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One of the questions I receive from friends and acquaintances who are considering starting testosterone pellets is, “Why do you treat men and women ONLY with testosterone pellets?”.

It launches a brief dissertation on the benefits of Testosterone long acting subcutaneous pellets, compared to Testosterone cyprionate for men, and testosterone compounded vaginal T, creams with T in it and sublingual T compounds.

I have used all of these other types of testosterone replacement and found all of them wanting. In general, these other types of testosterone never brought my patients back to youthful health, with the feeling of exuberant quality of life that T pellets do! And much more.

Specifically, they ask me….

1.1 What type of testosterone is the easiest to use with the least upkeep? In other words, which type must be dosed the fewest times per day, week, or year?

1.2 T pellets are dosed twice a year for men and three times for women. This is better for a lot of reasons…first you don’t have to think about your hormones more than a few times a year instead of daily, or several times a day.

1.3 Next you won’t forget your dose with pellets because we will remind you and make it easy, we make an appointment when you leave after a pellet insertion. When using pellets, you get the dose I want you to get, not the dose you manage to give yourself when you remember. Lastly you don’t have to lug along your temperature sensitive meds with you when you travel (most countries won’t let you bring T in for unknown reasons).

Which testosterone provides the best quality?

Non-micronized testosterone pellets from a reputable compounding pharmacy are pure testosterone without additives, these can be placed under the skin in the fat of the hip by an experienced medical inserter. The results are slow release for 3-6 months and mimics the secretion of the ovaries and testes in young women and men. We call that “physiologic dosing”, and it is much improved over other delivery systems whose dose increases from 0-maximum over 12 or 24 hours which is not what the body does with the hormones it secretes. Other forms of T convert into estrogens at up to 80% of the t dose as it goes through the stomach, or skin, vaginal or mucosa of the mouth. T pellets get to your blood stream as pure T and is not changed into estrogen until it is broken down after it is used by your body.

--3. What kind of testosterone has the fewest problems (side effects)?

The side effects of testosterone shots are secondary to them not being biologically identical to the testosterone humans make in their ovaries and testes. The formulation in shots causes high cholesterol, weight gain, rapid hair loss and excessive hair on the back. They should never be used for women, and only if a man has low cholesterol, and no inflammation should they be used for men.

The gels and creams are used up rapidly by being converted to estrone and estradiol as the topical testosterone passes through the skin. Most men who use creams gels or patches stop using them within 3 months because they make so much estrogen, they develop man-boobs, belly fat, weight gain and generalized swelling.

Pellets do not convert into E2 and E1 in any large amount, and if they do, we add anastrozole to the pellets to block the conversion. T Pellets win the competition for the fewest side effects.

Which one will last the longest?

Drugs of all types have what is called a “half- life”, which means that it is the number of hours, days or months when a particular dose of a drug is gone, and the time when the dose should be re-dosed.

For example, an oral antibiotic that is dosed twice a day has a half -life of 12 hours. The half-life of T gels is between 6 and 8 hours, so must be dosed that often to keep a clinically active blood level. The half-life of Testosterone Cyprionate intramuscular shots is between 1-2 weeks dependent on the dose and the person. Shots must be dosed that often or they are not clinically effective in men.

If Pellets are so wonderful, why don’t more doctors use them for Testosterone replacement?

To dose and care for patients on T pellets takes training and not just a weekend course. It takes months and years to get good at it. Not only do you have to know all the physiology of all hormones that interact with testosterone and Estrogen, but you have to understand how genetic abnormalities such as COMTgenetic enzyme defects change the metabolism of T and E2, and E1.

The medical learning needed to be good at prescribing pellets is different than any other drug treatment doctors learn about in med school, which means that you remember a name of a drug, what it does, a few side effects and one dose that works for everyone, of every race, sex and size.

For T pellets a doctor has to know the physiology of how T interacts with every other hormone and binding protein that is produced in the liver which can affect the free blood level of T. I actually “see” in my mind’s eye, the interactions of all the hormones involved in each patient as I decide on a dose. I have been able to do this since I took my first physiology course in college. It was an inborn talent for me rather than a learned ability.

To make it more of a challenge, Pellets have to be dosed based on height and weight, body fat mass, activity level, diet and stress level. This requires a long visit with the patient and an hour or more before the first visit and more than an hour after to determine the beginnings of the next treatment. Most physicians who don’t specialize in pellet hormone treatment don’t have the time or inclination to spend this much time figuring out the dose and other supplements and meds that the patient needs because they work for HMOs and I don’t and they treat other illnesses and I don’t. It takes immersion of a treating doctor in hormone replacement specialization to do this type of hormone therapy. That is what I do and have taught my Doctor-Daughter to do as well as my Nurse Practitioners and Nurse. Dr Sullivan and I actually have the inborn talent to “see” a patient’s hormones and determine dose to correct the symptoms of both men and women who are experiencing the loss of testosterone.

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My bio-identical testosterone replacement medical practice helps many women and men come back to normal life after aging decreases their testosterone and limits their productivity and joy of living. Most of my patients experience slow negative changes in their quality of life and begin to accumulate medical diseases including heart disease, over the first 10 years after their testosterone level becomes critically low. However, the most severely affected patients are women who have had a hysterectomy before menopause. These women generally have their ovaries removed because they have a gynecological condition or disease that makes removal of the uterus and ovaries necessary. However, women without ovarian removal, with only a hysterectomy, also have a high risk of experiencing the same symptoms and diseases as those women who also have their ovaries removed!

Women are not warned about the symptoms of hormone loss because it is not covered in the medical curriculum of OBGYNs, therefore their doctors are not adequately trained to treat menopause and low testosterone. This lack of knowledge and the incorrect expectation that menopause will not cause severe symptoms, that testosterone is essential to the health and working of the female mind and body, is disastrous for the patients who think they will be “all better” after their hysterectomy!

By the time most post-hysterectomy women get to me for care, they have seen an average of 5 (3-9) specialists and have gone through a myriad of tests and treatments that haven’t worked for their multiple symptoms and complaints. Removal of the ovaries causes women to experience an abrupt loss of hormones after their surgery and the outcome is a whole list of symptoms coming from the abrupt loss of testosterone and estradiol, the two most necessary hormones that are made in the ovary.

Symptoms of Testosterone Loss:

Loss of libido/sexual dysfunction
Fatigue
Insomnia
Weight Gain/Obesity
Lack of ability to remember names and places
Lack of motivation
Arthritis
Generalized pain
Loss of Muscle
Loss of physical stamina
Migraine headaches
Hot flashes
Depression
Anxiety
Rapid aging of the skin
Hair loss
Vaginal dryness and shrinkage
Painful intercourse
Clitoral shrinkage
Osteoporosis at a young age

Symptoms of Estradiol Loss:

Hot flashes/and or night sweats
Anxiety
Dry vagina
Loss of hair in the front of the head
Lack of sexual response=vaginal lubrication
Bladder spasms with urine loss
Stress urinary incontinence
Painful intercourse from a shrinking and dry vagina
Osteoporosis at a young age

My patients who have had hysterectomies and removal of their ovaries fly in from all over the country and the world, because they are desperate to get their lives back! Most of them have been verbally demeaned, dismissed, called crazy, and fat and lazy, and ripped off by charlatans who were the doctors who should have been finding the problem and curing it. Their own doctors usually don’t offer them hormones, or they give them an FDA approved estrogen-only pill that makes their symptoms almost survivable, but they still don’t get completely back to normal better. This leaves them depressed, hopeless and suspicious of the medical profession. Consequently, they are afraid to seek help until they read my experience with hysterectomy and hormone loss on my website.

I have successfully treated all of the patients with this problem who have come to me, and they are the most grateful of all of my patients. It is really a shame that replacement of hormones after hysterectomy should even be an issue! It should be a simple diagnosis based on the fact that the ovaries make testosterone and estradiol, they are removed, and then a woman is left with a deficiency of these hormones, which logically leaves them with various symptoms. These symptoms should resolve when the two hormones are replaced, but for some reason very few gynecologists replace both hormones! This diagnostic exercise should be obvious, even simple, to doctors trained in gynecology, but for some reason they miss the answer because they have been trained for decades that women don’t need testosterone! It is a blatant lie!

Now comes the worst news for women who have not had their T and E2 replaced after their total hysterectomy and ovary removal…not only are they miserable, but they now are at high risk for heart disease, the most frequent killer of aging women!

FACT: Women who have had a hysterectomy are at 300% higher risk for heart disease than women who have NOT had a hysterectomy even if their estrogen was replaced!

Journal of Women’s Health, Dr Susan Rako, April 2009.

It seems that testosterone has a beneficial effect on the heart by protecting the lining of the blood vessels throughout the body (the endothelium) from collecting plaque, improving insulin resistance, preventing diabetes, and in maintaining coronary circulation. It is in these ways that testosterone replacement protects women after a hysterectomy from vascular disease and normalizes their risk of getting heart disease to the level of women who have never had their uterus or ovaries removed.

The benefits don’t stop there. Post hysterectomy women on T replacement are cured of the symptoms that occur after ovary removal (see above), the most frequent of which are: No libido and sexual dysfunction, loss of muscle mass, insomnia, fatigue, loss of quality of life, depression, anxiety, migraine headaches to list a few.

If you have had a hysterectomy with or without removal of your ovaries, and have had any of these symptoms, please seek out a doctor who will replace both your estradiol and testosterone in the most physiologic way possible, preferably with long-acting Testosterone and estradiol pellets! Then have a cardiologist who is accustomed to treating women’s heart disease and have a cardiac calcium scan to see if you already have plaque on your heart arteries or have had any damage to your heart!

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Changing the beliefs of anyone, especially people who believe they are experts in their field, is an amazingly difficult task, especially when the new information clashes with society’s gender ideas. In medicine we battle this truism every time new information comes to light that advances the overall practice of medicine to treat conditions that have not been conquered or ignored up to now.

The last 25 years or more has been the dawn of knowledge about gender differences in medicine. Integrally knitted into the middle of this process is the finding that women make testosterone from their ovaries, like men make testosterone in their testes. This new truth has men worried about their own identity and it flies in the face of the baseless beliefs that Testosterone is a “man’s hormone” , that only men have a sex drive, that only men are stimulated by visual cues, and that testosterone levels determine the level of sex drive in women, not estrogen!

Today we are going to talk “heresy” to those men and women over 40 who have believed throughout their lives that men are superior in every way because they make testosterone, and women don’t. We do make testosterone, and although our genetics cause us to use it differently than men, due to our receptor site programming, we make 3 times as much testosterone as we make estradiol and that means testosterone is women’s dominant sex hormone when we are young and fertile.

For women presenting with androgen (testosterone) deficiency, in contrast, the symptoms are often not pathognomonic solely for hypoandrogenism, but can have diverse etiologies, including psychiatric or psychosocial causes. Another difference between hyperandrogenism and hypoandrogenism states is that the medical community universally accepts hyperandrogenism as a distinct clinical entity, whereas many clinicians question the validity of hypoandrogenism as a specific diagnosis. Instead, it is often believed that other etiologies can explain symptoms of low sexual desire and other sexual dysfunctions, a decline in quality of life, including loss of energy and motivation, and other physical symptoms (e.g.,

reduction in muscle mass). In addition, unlike other hormonal measurements, the sensitivity of testosterone assays has not been consistent in the female. Although, in light of these assay difficulties, controversy also exists regarding the range of normal androgen values for women and, therefore, whether there is an absolute level at which female androgen sufficiency exists.

Bachmann. Pathophysiologic overview of hypoandrogenic woman. Fertil Steril 2002.

Many research papers in the Journal of Fertility and Sterility have the best explanations about the fact that women make testosterone and how they use it. The following list from F&S article on “Androgen Deficiency in Women” reveals the vital role testosterone plays in women’s bodies.

Androgen insufficiency = Reduced

Sex motivation

Sex fantasy

Sex enjoyment

Sex arousal

Vaginal vasocongestion

Pubic hair

Bone mass

Muscle mass

Quality of life

Mood

Affect

Energy

Androgen Insufficiency= More frequent

Vasomotor symptoms

Insomnia

Depression

Headache

Bachmann. Pathophysiologic overview of hypoandrogenic woman. Fertil Steril 2002.

However, one of the “labeling mistakes” medical researchers and doctors make is to refer to testosterone interchangeably with “androgens”. Testosterone is an androgen, but not all androgens are testosterone. Testosterone is only made in the ovaries of women and testes of men, and androgens are from both the ovary and the adrenal gland in humans. When we treat women, we don’t use adrenal steroids to make women better when they have an androgen deficiency, because adrenal androgens have many side effects when given to women, including suppression of all of the other activities of the adrenal gland. We use pure testosterone, which is what the ovary produces until menopause. The ovary shrinks and literally dies and cannot be revived at or before menopause, usually around age 40. I replace what is missing in women over 40—testosterone, and after menopause both testosterone and estradiol, the young woman’s estrogen.

Testosterone literally affects every system in the female body. The loss of testosterone has a global impact on the lives and health of women. The most common alterations associated with low testosterone levels in women include a decline in sexual functioning such as decreased sexual motivation, loss of ability to fantasize, and decreased enjoyment from sex, diminished sexual arousal, and decreased vaginal vaso-congestion (vaginal swelling) in response to erotic stimuli. Testosterone deficiency also causes a loss of pubic hair and underarm hair, increased hot flashes and flushing, insomnia, loss of bone and muscle mass, loss of muscle and increase in fat, increased incidence of depression, anxiety and migraine headaches, and a general testosterone deficiency causes a diminution of quality of life.

Thus, you can see the importance of tracking and replacing testosterone in women, particularly postmenopausal women. At BioBalanceHealth® we are committed to making these distinctions so that we can treat the issues women have and up to now has been ignored by current medical practice. Women face many inequities in medicine and life, and I am determined to bring the need for testosterone replacement to women so they can demand treatment for the core problem they encounter after age 40, instead of getting multiple meds that just treat symptoms.

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The Hormones called the “sex-hormones”, estrogen, testosterone, and progesterone all have effects on the female voice throughout a woman’s lifespan. We have all seen this effect in ourselves and others as we age. Most women’s voices are higher before they start having periods, and lower with the beginning of their periods (and estradiol, testosterone production). The deficiency of hormones after menopause changes a woman’s voice as well, making the voice less full, and vibrant, more thin and thready. These changes after menopause progress slowly during the second half of a woman’s life.

There have been many articles that are written about how much Testosterone replacement causes the voice to lower, but they are not based on objective research. This is another “old wives tale” based on the fact that men have lower voices than women, however men have 10 times the concentration of Testosterone that women have. Until now there has not been an objective study to measure voice changes before and after testosterone replacement, but a study done by Rebecca Glaser MD in 2016 specifically measures the changes in pitch secondary to TESTOSTERONE PELLETS.

The female voice deepens with age, menopause, smoking and trauma (acid reflux, and blunt neck trauma), and a few diseases like vocal cord polyps, or HPV. Despite the popular belief that testosterone therapy after menopause lowers the female voice, all studies have failed to support this belief.

The way we measure the voice is a measure of frequency, or a measure of how high or low a voice sounds to the listener. Factors that affect the pitch of the voice include the size of the larynx (voice box) vocal cord length (the part that vibrates) the amount of fluid in the vocal cord and inflammation of the voice box. There are many factors that change the pitch of the voice, so it is difficult to study just the effect of testosterone pellets.

Because women lose testosterone with age over 40, and T pellets are the most physiologic method of replacement, and the one that I use, the issue of voice change comes up periodically, as a reason a woman might be afraid of replacing her Testosterone. This is more significant for people who make a living with their voice like singers.

In the 2016 study Dr Glaser completed, women who had had breast cancer who were taking only T pellets to relieve the symptoms of menopause were studied. This research measured many characteristics of the voice by recording patients as they read specific excerpts that contained all parameters of speaking the English language. These recordings were then measured by standard tests of pitch and quality of voice. The women were tested before being given T pellets, and again while they were on the treatment, and finally after T pellet treatments were discontinued.

The results of the study showed that women on T pellets, had no measurable change in pitch, and the non-significant changes which were identifiable, were minimally HIGHER, not lower in pitch. The women who had this change to higher pitch were the ones with the highest T blood levels.

The most important finding in the study was that if there was a slight increase of the pitch of the voice, or there was some hoarseness, and the voice change was REVERSIBLE after the T dose was lowered or stopped.

The physiology behind raising the pitch of the voice is based on the properties of testosterone in the body:

There are multiple theories for this, it can be explained by testosterone’s immune-modulating

(anti-inflammatory) properties, and its beneficial effect on muscle strength, bone density, pulmonary function and the health of connective tissue, all of which worsen with age as T decline. We can make these assumptions, but the study was not focusing on this aspect. So, these theories remain assumptions.

If your worry about your voice changing is stopping you from trying Testosterone replacement with pellets then, now you know that you can try T without permanent changes in the pitch of your voice, and you may experience a higher pitch, not lower. There is always a balance between side effects and benefits of a treatment. This study helps shift the balance to the beneficial results of Testosterone Pellet Therapy by reassuring women that their voices will not be adversely changed as a result of choosing pellet therapy as a way of replacing lost testosterone!

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One in eight women in North America are at risk of developing breast cancer during their lifetime. Research has shown that there are genetic factors as well as behavioral factors that can contribute to the risk of breast cancer. This week we are discussing the results of research by Dr. Rebecca Glaser (2019) that confirmed the fact that treatment with testosterone pellets decreases the risk of breast cancer. This research confirms the clinical findings of Dr. Maupin and BioBalance Health®. We want you to know how to decrease your risk of breast cancer by replacing your testosterone with bio-identical subcutaneous pellets.

Dr Glaser uses the same type of testosterone as I do when treating my BioBalance patients. We use two different compounded combinations of testosterone to treat our patients with, one type is pure testosterone plus stearic acid to hold the pellet together, and the second type is composed of non- micronized testosterone, stearic acid plus anastrozole in a ratio of 15:1:1. Anastrozole blocks the conversion of testosterone into estradiol and estrone and is frequently used orally to prevent the recurrence of breast cancer. In the pellet form it works more effectively and has very few side effects.

To prevent breast cancer, the combination of testosterone plus anastrozole implants are effective in preventing breast cancer occurrence. The pellets are inserted into the subcutaneous tissue (fat) of the upper hip or lower abdomen (love handles) through a 2 mm incision using local anesthesia.

Testosterone implants (pellets) are not a new phenomenon.

They “have been used for over 80 years to treat symptoms of hormone deficiency in pre and postmenopausal women.”

Women who are at highest risk of Breast cancer often have a family history of breast cancer, therefore the genetics for developing abnormal cancerous cells in the breast and lack the immune response to kill these cancerous cells. Other risk factors that increase the risk of breast cancer include obesity, women who have suppressed their immune system with daily alcohol intake, lack of exercise and a non-nutritional diet. Dr Glaser’s research found that the incidence of invasive breast cancer is decreased in women treated with testosterone and anastrozole pellets over a 10-year study.

How does Testosterone work to decrease the risk of breast cancer?

Testosterone is an immune stimulator. It increases the action and number of T-cells and T-killer cells that kill cancer cells, so it lowers the risk of all types of cancer. By giving a woman back her testosterone after she has lost it due to aging, gives her a better response to cancer cells, so she can kill them early in their creation like she could when she was younger.
Testosterone competes for the estrogen receptors on breast cancer cells so the cancer cells don’t grow.
Testosterone suppresses the production of estrone, the adrenal estrogen that can also be made in fat, that stimulates breast cancer formation.
Testosterone downregulates (decreases the stimulation) the tissues in the body that are estrogen sensitive and contain estrogen receptors.
Anastrozole added to Testosterone decreases the production of estrone in the fat and stops the conversion of testosterone into estrone in the breast. It is effective in both oral and pellet form and adds to the effectiveness of testosterone pellets.
It is known that T’s direct effect at the androgen receptor is antiproliferative, proapoptotic (stimulates death of the cancer cell) and inhibits Estrogen receptors and breast cancer growth.”

What are estrogen and testosterone receptors?

Some of the tissues in your body are sensitive to estradiol, estrone and/or testosterone hormones. That means that one or all of these hormones can turn on specific cells to make them responsive to the hormone. This works like a light switch on the cell. An estradiol/estrone sensitive cell has receptors on the cell wall that are like light switches and when the estradiol is in the blood around the cell, a molecule of estradiol or estrone attaches to the switch and turns it on. The more hormone, the more receptors are turned on and the cell starts the job it was genetically programmed to do.

There are receptors to testosterone as well on some of the same breast cancer cells as have estrogen receptors. The testosterone does the opposite job of estradiol on the cell and turns the growth of the cell light switch off. The more T and the less E2 causes breast cancer cells to decrease its growth, and testosterone goes as far as causing the cell to die! That is why testosterone is so important to killing breast cancer cells!

The research study by Dr. Glaser: Is important to understanding what we see clinically every day

“This 10- year prospective cohort study was approved in March 2008 and closed in March 2013.” This study was supposed to run for 10 years but it ended early because the results were obvious that testosterone pellets and testosterone plus anastrozole pellets lowered the incidence of breast cancer."

The details of the study showed that “As of March 2018 a total of 11 vs. 18 expected cases of IBC were diagnosed in 1267 patients within 240 days following their last testosterone insertion equating to an incidence rate of 165/100000 people years which is significantly less than the age matched expected incidence rate of 271/100000.”

“Conclusion reveals that long term therapy with subcutaneous testosterone or testosterone combined with anastrozole did not increase the incidence of IBC.” And may decrease the risk,” Testosterone should be further investigated for hormone therapy and breast cancer prevention.”

“1267 patients were evaluated in this study it has shown a 39% lower incidence of invasive breast cancer in T users compared with age matched SEER expected incidence. “

Why other studies have not found the same positive findings about Testosterone pellets decreasing the incidence of breast cancer.

The last important piece of information regarding Testosterone pellets effectiveness against breast cancer is one that many studies testing testosterone’s effectiveness against breast cancer do not address. …these correlated studies do not address the “Obesity-Insulin testosterone connection.” “Obesity and insulin increase inflammation and have direct and indirect causal effects on breast cancer, including increased aromatase activity (the hormone that anastrozole inhibits).” “The more obese you are, the more at risk for breast cancer you are.”

Also, many of these studies that do not find a benefit from testosterone pellet therapy “do not measure the Free Testosterone available, rather they only count the total T levels in women”. The free T is the testosterone that your body “sees” and is the only part of the testosterone that actually can work. The rest of the testosterone is bound and cannot bind to receptors, so is invisible to the body.

Both Dr. Glaser and Dr. Maupin believe that it is important to make a distinction between free Testosterone and total testosterone when doing this research and planning treatment protocols. The critical distinction is to measure the amount of free testosterone because it is more indicative of the real effect of testosterone on the cancer cell.

When evaluating treatments for a particular disease, or to prevent a disease, a doctor always must look at the side effects that can occur secondary to a particular treatment. The side effects of testosterone oral and testosterone transdermal therapy compared to T pellet therapy is quite different. The researchers, with exception of Dr Glazer, do not distinguish between the types of testosterone or the delivery method. This is a huge mistake, because these types of T are as different as they can be. Testosterone pellet side effects are limited to facial hair and acne, which can be prevented by prescribing Spironolactone 100 mg/day. The other types can easily be converted to estrogens and cause weight, anger, body hair, breast stimulation, and many other androgenic and estrogenic side effects.

“Side effects of T (pellets) reported: 85% reported a mild to moderate increase in facial hair, 6% reported a severe increase in facial hair, 11% reported an increase in acne, 50% reported improvement in skin moisture, tone/ texture, and fewer wrinkles, and 1% reported perceived voice changes: cracking, raspy or deeper voice.” The voice change can be reversed by decreasing the dose of T pellets.

Conclusion:

Breast Cancer is being treated now more effectively than it has in the past, but the treatments are often surgical and fraught with side effects and risks of developing other cancers. Breast cancer can still be a deadly disease, so the most prudent course of action is to avoid getting it the first time! Everything that we can learn about avoiding or inhibiting it is important. It is hoped that the information in this Healthcast and in the research article from Dr. Glaser will help you and your physician protect you from the risk of Breast Cancer.

All quotations are from an article in BMC Cancer: Glaser et al BMC Cancer. (2019) 19:1271

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We have only done one other Healthcast about the Coronavirus (COVID-19), concerning protecting yourself by optimizing your immune system recorded at the beginning of the pandemic. Ever since BioBalance Health® has noted that very few of our patients have been infected, and or quarantined for a positive test without symptoms, so today we discuss the reality that research shows that the rapid tests are not reliable, yet they are used to determine if you must quarantine and put a hold on your life for up to 2 weeks even if you have no symptoms. Our concern is for our patients and their families who experience anxiety and fear due to these unreliable tests results, and for the financial burden that these false positive test results impose on hundreds and thousands of people in the US, who cannot go to work because the tests cause them to be quarantined.

The New York Times August 29,2020 caused me to be aware of the opinion of experts in the field of viral testing that states, “The standard tests (for Corona Virus) are diagnosing huge numbers of people who may carry insignificant amounts of the virus and therefore are not contagious”.

The purpose of testing asymptomatic people is to find those patients who are not yet symptomatic and infective, but who will be able to spread the virus to others within a few days.

The experts who develop the PCR Corona Virus Test have come out and revealed that we are calling people “positive” if they have so little virus that they are not really infected, and therefore cannot spread the virus. That is not the purpose of the test.

Three sets of sets of testing data compiled by Massachusetts, New York and Nevada that 90% of the people testing positive don’t carry enough virus to be infective and will not get symptoms themselves.

To understand why this is true, you must understand how viral infections infect us. When you are exposed to a virus of any kind, you have to be exposed to a sufficient amount of that virus to actually become infected. A small amount of virus will be easily killed by your immune system after it is in your bloodstream. The better your immune status the larger amount of virus that can be knocked out by your white blood cells before it actually infects your cells.

Therefore, it is not if you are exposed to the virus, but the AMOUNT of virus that you are exposed to and is circulating in your blood that determines whether you actually get sick. The higher your chance to become sick and to spread the virus to others is associated with the amount of virus in your blood.

Here is the problem with the current PCR test used to diagnose the virus: To find virus, the PCR test must magnify your concentration of virus over 40 times just to find the virus. Experts in medical testing say that multiplying the viral concentration over 35 times over diagnoses people with the virus and labels people who are not contagious or sick, as someone who needs to be quarantined away from others. The PCR test is set up to over-diagnose the Corona virus by 90%! The way the test is set up now they describe as finding a hair in a room a person has been walking through---one hair does not make you bald!

Many of you say well that’s OK, were safer…but that is not true! There is no safety conferred by quarantining healthy people and it damages the financial security of individuals, families and the nation, not to mention the fear and anxiety that causes people not to leave their homes who should be seeing the doctor about other illnesses, and the toll of overwhelming anxiety about dying and being damaged by this virus, that we have created in our population.

I am not proposing not getting tested, I am just proposing that we use a less sensitive test that actually diagnoses people who are going to be or are sick and communicable. The PCR test dilution should be changed to 30 x, and NOT 40 X. Don’t freak out if you are positive please. Please know that test may be wrong.

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This week we are looking at the concept of homeostasis. The question is how we get our bodies (in particular our hormones) to balance properly as we age. Men, in particular are the focus of this week’s conversation. We know that as men age, they lose testosterone which needs to be replaced. What many men do not know, however, is that they also make estrogen and that estrogen too, needs to be replaced in the appropriate amount. The challenge is the balance point. How do we learn just how much of each hormone we need, and how do we obtain them? Those questions are the focus of our conversations this week.

An amazing adjunct to T pellet replacement for men: Anastrozole/Arimidex+T pellets.

Anastrozole is an enzyme blocker, called Aromatase inhibitor (AI). It blocks the aromatase enzyme from converting Testosterone into estrogen. The side effects of oral anastrozole listed are not present in pellet-anastrozole. The dose is uniform and lasts 4-6 months, therefore there are no large swigs in T blood levels with pellet anastrozole. Anastrozole is one of three Estradiol/estrone blockers. It is the only one that is reversable (does not permanently damage the aromatase enzymes) and the only aromatase inhibitor enzyme blocker that causes weight loss rather than gain. This drug was designed to treat and prevent Breast Cancer. We now have expanded the uses for anastrozole and other AIs to treating endometrial cancer, man boobs, endometriosis, obesity, infertility agent for men, and to shrink fibroids in women.

At BioBalance Health, the focus of our work is to determine the appropriate amount of which hormones need to be restored and the appropriate amount so that a man (or woman) is able to live a healthy and independent life as they age. Any preexisting concerns regarding their health need to be addressed and the correct balance of hormones needs to be maintained.

Side Effects of oral anastrozole (Arimidex), not in pellet-anastrozole:

Arthritic pain in small joints

Blood clots

Headaches

Swelling

Patients who take Arimidex orally can have the above side effects but do not experience these side effects of Arimidex if they take it in pellets combined with testosterone. The purpose of using the anastrozole pellets in men is to stop the conversion of testosterone into estrogen.

High Estrogens in Men can be caused by:

A genetic problem where a man has the genes to convert more T into estrone and estradiol than other men
Aging increase T conversion into estrogens
Obesity: fat tissue is where the T is converted into estrogen
High alcohol intake
Insulin resistance
Adult onset diabetes, high carb intake

Men as they age begin to convert more of their testosterone into estrogen and this leads to fat around the belly and breasts and face. A man will get more- plump and less muscular. To avoid this problem, we want to restrict the conversion of testosterone into estrogen to the minimal amount that a man needs to be healthy. The excess leads to vulnerability to other diseases that we want to avoid.

This treatment was originally used on women to help prevent breast cancers. It was a case of serendipity that doctors began to use it in treating men, particularly young men who were suffering from being less masculine in appearance because of the fat tissues from estrogen. Many of these young men develop man boobs and are teased unmercifully as teen -agers. Doctors were trying to find a way to help them avoid this problem.

If either a woman or man are taking arimidex orally they tend to have side effects like headaches that can be avoided entirely if the arimidex is given along with the testosterone in a pellet that is injected in the abdomen. Once the ideal response occurs, then men can be put on a maintenance dose of testosterone and the balance of estrogen conversion is in the correct range, they can sometimes stop taking the arimidex. If the balance is correct, they do not develop side effects and they feel good.

Why are there concerns about high levels of estrogen in men as they age? Estrogen in men causes prostate enlargement. If you are obese and have a lot of fat your prostate will enlarge and increase the likelihood of your getting cancer. Obesity and diabetes can also increase your chances of getting Alzheimer’s and of getting cancer. Men must work on their diet and exercise and take the correct hormone replacement in order to avoid these illnesses and be able to remain muscular and active as they age.

Dr. Maupin has been following the research of Dr. Rebecca Glaser, MD that has supported what she has been doing at BioBalance health for 15 years. In Dr. Gaser’s research she finds that other uses of Anastrozole in men to consider are:

Stimulate the production of testosterone in young men who still produce their own T
Male infertility
Treating man boobs
Weight loss

The more estrogen a man makes the more likely he is to have emotional flooding and cry more easily. High estrogen causes weight gain, prostate enlargement, decreased sex drive, ED. Men who take testosterone by methods other than pellets, often develop side effects that cause them to be miserable and to develop some symptoms of diseases that we are trying to avoid. If you replace your lost testosterone with pellets you will avoid those diseases and feel better as you age! Dr. Maupin will put you on a diet, develop a personalized exercise program and maintain your correct hormone balances and you will be able to lose weight, regain your sexual drive, lose your man boobs, some of your belly fat, and be able to grow muscles to get yourself back into shape. If that sounds too good to be true, you need to make an appointment at BioBalance Health and discuss your options with Dr.’s Sullivan and Maupin. You will be glad you did!

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There are numerous delivery methods for testosterone replacement for women. These methods include oral, sublingual (under the tongue), vaginal tablets and pills, transdermal cream and gels, but at BioBalance Dr. Maupin only prescribes long acting bio-identical testosterone pellets. T Pellets are inserted in the fat of the hip, which creates a long lasting, on demand reservoir that provides a woman’s body with a daily dose of testosterone. Testosterone pellets are replaced every three to four months for women, and are the most effective testosterone replacement available, with the best health profile for anti-aging. Several studies have confirmed what we have witnessed, that testosterone as pellets reduces the occurrence of initial breast cancer in women. Even more exciting is that T pellets prevent the reoccurrence of breast cancer.

Dr. Maupin follows the research of Dr. Rebecca Glaser who researches the benefit of testosterone pellets in the health of aging women. Dr Glaser has written many articles about testosterone pellets and breast cancer, and one of the articles published in the medical journal Maturitas 76, in 2013 focuses on the findings that there are many studies documenting that testosterone for women is protective for the breast and that testosterone therapy treats many symptoms of hormone deficiency in both pre and postmenopausal patients.

After studying these many studies, Dr Glaser designed a study to focus on the incidence of breast cancer in women treated with testosterone pellets alone without estrogen therapy. The women in the study were divided into two groups, those treated either with testosterone pellets alone or those who were given testosterone pellets combined with anastrozole, a medication that prevents the conversion of testosterone into estrogens.

“The study followed a group of women from 2008 to 2013 and found that Testosterone pellets and or Testosterone/anastrozole pellets delivered subcutaneously in women, reduced the incidence of breast cancer in both pre and postmenopausal women. The evidence supports that belief that breast cancer is preventable by using testosterone pellets which inherently maintain a high Testosterone to estrogen ratio. The addition of Anastrozole (Arimidex) to the pellet improved the T:E ratio even more than T pellets alone.

“The women in this study were self- referred or referred by their physicians. They presented with symptoms of relative testosterone deficiency, including hot flashes, sweating, sleep disturbance, heart discomfort, depressive mood, irritability, anxiety, pre-menstrual syndrome, fatigue, memory loss, menstrual or migraine headaches, vaginal dryness, sexual problems, urinary symptoms including incontinence, musculoskeletal pain and bone loss.”

“The testosterone pellets these women received were composed of non-micronized USP testosterone plus stearic acid or non-micronized USP Testosterone plus stearic acid and USP anastrozole, compressed with 2000 pounds of pressure using a standard sized pellet mold, and pressed into 3.1 mm cylinders.” These pellets are created by a compounding pharmacy. A doctor prescribes them, and they are created and dosed individually for you and delivered to your physician’s office. This is the same process used by Drs.’ Maupin and Sullivan at BioBalance Health.

Women who were treated with testosterone pellets who were premenopausal, had symptoms of excess estrogen including migraine headaches, dysfunctional uterine bleeding, endometriosis, uterine fibroids, breast pain or severe PMS, also benefitted from the low dose of testosterone (equivalent to 1mg of T daily) delivered subcutaneously.

Menopausal women who have estrogen receptor positive breast cancers have many severe symptoms of menopause and low T which they cannot treat by taking estrogen replacement. Testosterone fills the breech and lessens hot flashes, treats lack of libido, fatigue, vaginal dryness, painful intercourse, loss of strength, muscle mass and stamina, fat gain, migraines, and anxiety depression. In addition, we now know that for those women who have estrogen receptor positive breast cancer they can now live a normal life by taking testosterone pellets and decrease the risk of recurrence of their breast cancer as well.

“These outcomes indicate a beneficial effect of T pellets and Testosterone + Anastrozole pellets on the breast, were not unexpected. There is sufficient biological and clinical data indicating that androgens(testosterone) have a protective role in breast tissue. Although, some epidemiological studies show an association between increased serum androgen levels and higher breast cancer incidence, those specifically measuring only testosterone (from the ovary) do not. The negative studies also do not address the known insulin-inflammation-cancer connection which would contribute to an increased cancer risk. “

The information from these studies and the experience from 18 years at BioBalance Health support the use of Testosterone in pellet form, and Testosterone with Anastrozole pellets to help women avoid the occurrence of breast cancer and help those who have experienced breast cancers in the past to avoid any recurrence.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC.,

Family Counselor, Presenter and Author. www.BioBalanceHealth.com.

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Women have more testosterone in their blood than they do estradiol. Testosterone is or has been until recently, the “secret” female hormone. It has always been associated with men and considered the male hormone. There have been many stories written in our culture blaming testosterone for the reason that some men become angry and out of control. It is a fact that the most violent men do not have higher free T levels than docile men. Testosterone is not the cause of the difference between men and women. Both sexes have testosterone, and the difference is genetic differences and how society raises boys in a different way from how they raise girls.

Dr. Maupin contends that premenopausal women have three times the amount of testosterone in their blood stream than they do estradiol. Testosterone gives both women and men libido, muscle mass, thick bones, Dr Maupin’s findings are that both sexes need testosterone throughout their lives, and it is not recognized by the medical community that women need testosterone as much as men throughout their lives. The resistance to viewing the needs of women for testosterone has led to many symptoms and diseases that can be treated with one and only one treatment: Testosterone replacement. Instead, women are told in doctors’ offices across the country, in fact the world, that they are lazy or crazy and that they cannot change their condition. They are offered hopelessness instead of comfort compassion and a very effective treatment for a group of symptoms that are currently either not treated or inadequately treated with anti-depressants, anti-seizure medications and anti-anxiety drugs to numb them from their symptoms of aging and illness that they get when they turn 40 something. Dr. Maupin wants to spread the word about women’s need for testosterone and their need for hormone replacement after 40, including the hormone testosterone.

Maupin contends that in medical school, doctors are trained to use the value on a blood test to diagnose and treat patients. That becomes the goal for treatment instead of reviewing the symptoms with the patients and determining if the patient had her symptoms relieved. Sadly, the method of determining success of a treatment by achieving a certain blood lab result is faulty and should not be used in most cases for many reasons. First, blood tests are known for being wrong because of poor handling, inaccurate reference ranges based on a group of people the lab draws blood on instead of young and healthy patients, and because the labs “normal ranges” are really just an average for your age, and not a sign of health.

Dr Maupin’s contention and the focus of her practice at BioBalance Health® is to treat patients to alleviate symptoms of hormone deficiency based on young healthy blood concentration. Whatever symptoms brought you to BioBalance are identified and treated. The goal is to achieve resolution of symptoms, while using lab as the individual patient’s optimal blood level. Because Dr Maupin does not diagnose by using the lab’s average for your age numbers to diagnose and treat hormone deficiency, this sometimes causes her to hear negative comments from other physicians who focus on lab -based treatment even if the patient is not feeling better after treatment.

There is a research physician from Ohio, Dr Rebecca Glaser, who has studied testosterone pellets for hormone replacement in women and has come to the conclusion in her 2013 research article in the medical journal Maturitis (74;179). Her research states that every woman has a perfect blood level of Free Testosterone for her and the numbers do not dictate how well she feels but can be established as a goal for each individual woman on T pellets, because all women do not fit in a specific range. This is proven in Dr. Glaser’s research paper, “Testosterone implants in women: Pharmacological Dosing For Physiologic Effect.” Her name for testosterone deficiency is “ androgen deficiency”.

My hormone replacement practice specializing in testosterone pellets for both sexes, has lasted more than 18 years and I have been successful by treating my patients in accordance with their symptom relief, rather than by a standard lab reference range. My patients live longer and lead a symptom free healthy quality of life. They are not in pain, not weak, not unable to stand and walk, they feel sexual and mentally alert and good as they age. If you would like to experience these benefits, find a doctor who provides T for women, and talk to that doctor about symptom relief as an approach for treatment above and beyond the standard one size fits all policy of current medical practice.

Another example of treating patients based on symptom relief as a sign of optimal hormone replacement is Dr Maupin’s method of thyroid management. Many doctors under manage or fail to manage thyroid replacement by only looking at the blood test numbers instead of talking to their patients and asking which of their symptoms are gone. Currently most doctors base their treatment on what are called “normal” by the labs. But the lab companies don’t test young healthy men and women to determine the reference range, they just lump all the patients together and determine the median and design “normal ranges” from an old or sick population of patients.

In addition, Labs gather their data from the area in which you live from all the thyroid tests they test in the area, and then calculate and average or normal score. In our part of the country, there is a deficit of iodine in our diets. We do not get enough iodine. Our normal level based on our “average” score is low mathematically and our bodies are suffering from that deficit. Dr.’s Maupin and Sullivan at BioBalance Health try to focus on and treat your issues and symptoms and NOT just try to achieve a blood level that is average for a median blood level based on age adjusted cohort of sick individuals getting their blood drawn for other reasons.

The strong belief of the physicians at BioBalance Health is that you should feel better, and that you should not be suffering from the same symptoms that brought you to their office, after treatment is established. Healing is the concept of making you feel better and function better, but not just the act of reaching some arbitrary number on a lab test. We use lab to determine an individual’s optimal blood levels, those blood tests that are taken when the treatment is complete, and symptoms are gone!

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.

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We all have a blood type, either O, A, B or AB. The original blood type was O, and it is the most common blood type in the world. The other types are mutations that we have carried with us through our genetics….but what does blood type really mean? Here is a tiny bit of basic science. Our red blood cells carry a glycoprotein “antigen “ stuck to the outside of the Red blood cell. It is this antigen that provides the “Type” of blood. Antigens include A antigen, B antigen. Those people with O blood type don’t have any antigens on their RBCs, and AB people have 2 antigens.

When it comes to getting sick, we have a very complicated immune system of White blood cells that recognize foreign invaders that can make us sick, like viruses and bacteria, and mobilize special white blood cells from our thymus gland and other lymph nodes to attack and kill the virus before it makes us sick. This is called cellular immunity. Our white blood cells are like an army that provides a pre-emptory strike to kill the invaders it recognizes as foreign. The ability of our body to recognize foreign substances or particles, from “self” is the key to preventing our WBCs from attacking and killing our own red blood cells or attacking our own joints like Rheumatoid arthritis. All living things have the ability to discern “foreign” glycoproteins from their own tissues, to protect themselves from disease, and infection.

When people lose the ability to determine the difference between their own tissue and foreign tissue, they develop disease. An example of diseases where the immune system attacks its own tissues include autoimmune diseases like rheumatoid arthritis and MS. An example of the immune system failing to recognize foreign or abnormal cells is cancer. Cancer cells are not normal and have different proteins on their cell walls and they are produced in everyone all day long, but a normal immune system recognizes them as foreign (abnormal ) and the WBCs attack and destroy them. Disease occurs when a person loses the ability to recognize these cells as foreign, and the cells are left alone, and they grow and become “cancer”. Cancer is in reality an immune problem.

Our blood type is based on antigens that are attached to our RBCs. We recognize our own Blood type as “self” and a different blood type as foreign, and our WBCs attack the “foreign” RBCs. We do not attack our own blood type cells.

So, the antigen A is recognized as self to A blood type people and antigen B is recognized as self to blood type B people. O blood type has no ABO antigens on their cell wall. Our own immune cells, our white blood cells, recognize our own blood type antigens as belonging to our body and do not attack. For example, the A antigen is recognized as “self” to a person with A blood type, and therefore the immune system does not attack our own RBCs that have A antigen. if an A person is given B blood then their WBCs attack the foreign B RBCs, B blood cells are destroyed and the patient can die. When transfusing blood doctors give blood of the same type or O blood. O blood has no ABO antigen on the cell wall, and can be given to any blood type, because they have no antigen to trigger the immune response. This is why O blood type people are called “Universal Donors”.

Your blood type obviously is the determent of how we recognize foreign tissue in our body and therefore determines whether we recognize other cells as “not ours”. In addition, Blood type is also inherited along with other generic susceptibilities to diseases, so it can also be an inexpensive test of genetic susceptibility to diseases.

How does this Blood type work in disease and cancer? If an A person develops a cancer that resembles the A antigen, that person will not kill these cancer cells. B people also will be blind to cancer cells that look like the B antigen. ABs have a double problem, being blind to both A-like and B like cancer cells. However, half the world is blood type O and they kill both the cells that look like A and B cells.

The Diseases that are more common for a particular blood type are listed at the bottom of the page, but a few examples of the association between blood type and disease is based on research from many researchers in the world. There is a lot of research on the subject of diseases and Blood Types. One study in Britain has found that people with the O blood Type peoples are have the highest risk of having a blood clot generally and has a stronger tie to blood clots in women on oral Birth Control Pills. This blood type fact would help doctors especially OBGYNs decide3 whether to use this type of birth control or something else like an IUD.

Heart disease, and atherosclerosis are very common in the US and the O blood type has been found to be protective against this disease, even if a patient has high cholesterol and inflammation. It does NOT mean that NO ONE with O blood type will have a heart attack, but that it is a lower risk for O blood type people.

Our last example of the relationship between blood type and disease is the risk for autoimmune diseases. These include Rheumatoid arthritis, Lupus, MS, fibromyalgia, and sarcoidosis. B Blood type puts a person at higher risk of developing this type of disease.

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This week our focus in on something other than hormone replacement specifically. This topic is often more related to Counseling and Psychology. But it is real, and it does sometimes show itself in Dr. Maupin’s office. It is called a Fugue State.

Fugue State is a diagnosis under Dissociative Disorders in the DSM V. These are the diagnostic and statistical manuals of the American Psychiatric Society. These books (there are five revisions), describe the criterion for diagnosing mental and emotional disorders.

If you experience traumatic events or excessively stressful events, especially early in childhood, you use a defense mechanism called repression. This does not mean that you forget these events or experiences, it means that you block them from your consciousness in order to appear normal and to function without calling attention to yourself in ways that could jeopardize you.

Sometimes when the stress levels are more than your system can handle, you will “lose” some of your awareness. You may forget your name and where you live, and you may forget some event or period of your life.

If you leave home and get in your car and drive somewhere and during the drive have a wreck, and wake up in the hospital and do not know who you are or what you were doing and do not remember the drive at all, you suffer from what we call Amnesia. This amnesia can be limited in duration and will go away and you will recover your memory of the event. If the amnesia is caused by severe brain trauma you may not get the memory back. The type of amnesia that may happen and from which you may recover is the type caused by stress and emotional trauma. There are levels of amnesia and dissociation that are recoverable if your stress levels diminish.

All of us repress things because of our focus of attention. If you break up with a girlfriend and then automatically and unconsciously dial her number on the phone, that is called repression. However, if you have had severe levels of trauma you are not repressing you are dissociating from reality.

This dissociative process can sometimes be beneficial such as when you are doing surgery as a physician, you cannot become preoccupied with your own life problems and concerns. You may hyper-focus in order to do your job. That is a good thing.

Sometimes though the dissociation is so complete that you do not know where you are or who you are and do not remember the flow of your life. If you suffer from this type of amnesia, you may also experience a desire or need to travel and move. This desire is called a fugue state. The compulsion requires you to drive a car or catch a train or plane and go somewhere. You may not know where you need to go you are just going.

The most extreme form of dissociation is called dissociative identity disorder it used to be called Multiple Personality Disorder. Your core identity would fragment into separate and distinct identities, each of which would have its own name and memories.

Each of these disorders can be treated, often with great success. All behaviors are in service of the self. If your self needs to dissociate in order to handle the stress or trauma of your life it will. When you are less stressed, and your life is safer it will often restore your memories and you will be able to function with complete awareness and full memories.

The reason we are talking about these disorders this week is that sometimes a physician will encounter a person with these symptoms and cannot find a physical reason for the symptoms. They must then consider the possibility that the person is suffering from a psychological or psychiatric disorder and make an appropriate referral to a counselor, psychologist or Psychiatrist.

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Our practice (BioBalance Health) is a hormone replacement practice that specializes in the replacement of hormones lost as the body ages. We focus our attention primarily on men and women who are in their forties and fifties and older. However, there are some younger men who need our help because their bodies are not making the appropriate and healthy amount of testosterone. We look carefully at these men and see if we can do something to stimulate the natural production of adequate amounts of testosterone without replacement. We do not want to stop their bodies’ natural processes; we want to enhance them. This is possible in men under 50 but is generally possible in men who are under 50. That is why we replace instead of stimulate T production in aging men.

Currently, there are increasing numbers of men who are experiencing the symptoms of low T at a younger age and the appropriate treatment for them is to stimulate their own production of T, with medication, instead of shutting their own production down and replacing their Testosterone like we do in aging men.

If a man gets replacement testosterone then his own testosterone stops being made, leading to questions about the best way forward when treating the loss of Testosterone. Replacement of T in young men can suppress fertility, can scar the testicles and make it impossible for them to restart their testosterone on their own. Some young men can return to their baseline of T production after T replacement and some cannot. This is why we attempt stimulation in young men before ever replacing their T.

In the last few months the US federal government has ended the ability of men to receive compounded HCG, a medicine with few side effects which mimics the hormones made from the pituitary LH and FSH, and stimulates the testes to make more testosterone, and when compounded is affordable. This drug has mysteriously been banned by governmental agencies by preventing compounding pharmacies from making it. This leaves young men and the doctors taking care of them from treating them in the most conservative manner.

Doctors who take care of these men have lost their most effective tool. The government just banned its use, without public information to explain why. So, for us, it is back to the drawing board. What can we do to appropriately provide the necessary testosterone for these men?

First, let’s look at the symptoms of low Testosterone:

Low libido
Ed
Poor ejaculation
Lack of sexual climax
Fatigue
Insomnia
Loss of muscle mass strength and stamina
Loss of ability to think
Depression/anxiety
Irritability
Belly fat and weight gain
Hair loss
Loss of body hair
Joint pain

It is important to note that the treatment for low T we are talking about is for young men who still have responsive testicles that make more T when exposed to more LH and FSH prom the pituitary. Older men must have their T replaced because stimulatory medications rarely stimulate the testicles as age makes them resistant to stimulatory drugs. Most men over 50 must have their T replaced, since they do not make enough naturally, and stimulation doesn’t work.

Because doctors can no longer acquire HCG to help these young men, we must turn to other medicines which can stimulate the production of testosterone. So now we are using alternate drugs Clomid, Arimidex, Anastrazole and Dutasteride instead. These drugs are much more expensive than HCG, and the side effect profile of them is higher, and the effectiveness is lower than HCG was.

Interestingly, the FDA has just approved a new HCG drug that is meant for infertility and it is very expensive! By eliminating the competition, the very wealthy will be able to afford it! Not fair!

What we know is that we can do some things to encourage the production of testosterone naturally when the body begins to stop making it. But the process is expensive, and we are not allowed to utilize the most efficient and cost -effective drugs. We are not told why, but our patients still need help and we try to find ways to provide that help. The focus of our practice is not on young men in particular, but they do come to us for help, and we will try to find ways to treat them and help them become more healthy and functional, in spite of the efforts of the federal government to prevent our ability to do so. We have to utilize informed consent in order to help them, as they need to know the side effects that are possible if they receive this treatment and they need to know the benefit/cost ratio for living without testosterone or trying to stimulate the body to make an adequate and functional amount.

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This week, we make the distinction between acute inflammation and chronic inflammation. A chronic condition is more enduring and long term. A knuckle, or joint, or your back hurts all the time. just any of the aches and pains that last for long times, even years. Sometimes this is caused by something like arthritis and sometimes it is just the accumulated impact of years of your life.

Sometimes you are hurting from what was an acute injury when you were younger that you healed from. However, it is weak and more likely to be re -injured and cause you chronic pain. Sometimes, you do not heal well, and the pain seems to be just a reminder of the damage you experienced and yet it continues to be a source of irritation and pain all the time. As a result, that tissue will be inflamed most if not all the time and you will have pain from that chronic condition. You may not be able to fix the condition, but you can fix the chronic presentation (pain) through the use of medications.

Fat and sugar from your diet will transport through your blood stream and cause you to feel pain at the site of your injury. There are medicines such as Neo 40 which can help reduce inflammation and limit the constant re- marking of the injury site by the fat and sugar in your blood system.

Here are some of the causes of chronic inflammation:

Untreated causes of infection or injury
Autoimmune diseases
Long term exposure to toxins and irritants
Smoking
Obesity
Alcohol abuse
Chronic Stress
Poor eating with a lot of foods that stimulate inflammation
Celiac disease and leaky gut
Low cortisol or Adrenal fatigue with low cortisol

Test for Inflammation:

HS-CRP
Sedimentation Rate

Treatment for inflammation:

There are things you can do to try to reduce of eliminate chronic inflammation from infection or injury, but you can also get it from a malfunction of the immune system. The body will begin to attack itself when autoimmune diseases begin to flare up. There are medicines for this, but Dr Maupin is not a fan of them. She prefers to do other things to reduce inflammation that is the signal for long term damage of tissue.

One of the problems that develops chronic inflammation is the accumulation of heavy metals in the body like mercury. Those metals build up in the body and you cannot get rid of them. They can cause damage to all the various parts and functioning systems in your body. But there are some things you can do to fight the damage caused by toxins and heavy metals:

Medication and supplements:

NSAIDS:like Motrin, Aleve etc.
Steroids-short term
Supplements: Fish oil, Flaxseed oil, cucumin, alpha lipoic acid
Neo 40
Eat: Ginger, cayenne pepper, garlic
Drink green tea
Drink coffee

Change Lifestyle Habits:

Stop junk food, and high preservative foods
Stop foods made with white sugar and white flour
Stop eating fried foods
Stop eating processed meat like hot dogs
Eat more fresh berries and oranges
Eat more fish—sardines, mackerel,
Eat more nuts, tomatoes, greens with spinach and olive oil
Obesity: lose weight
Smoking: stop
Alcohol: stop!
Illicit drugs-stop
Lack of exercise—begin daily exercise.

Don’t delay treatment of injuries and infections! Such avoidance can lead to chronic inflammation, and that will lead to pain and continuing damage to your system as you age. You will become weaker and be in pain most of the time. It is best to try to avoid chronic inflammatory interactions. Do what you can to stay healthy! Look at your diet, and food preparation habits, avoid toxins as much as you can, try to avoid heavy metals like mercury.

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Inflammation is considered the bad guy in the world of preventive medicine…the condition that causes damage to joints, heart attacks and arrhythmias, aging, and tissue destruction. These issues are at the heart of the diseases that cause us to suffer as we age, and learning what causes it and what prevents inflammation is essential to our quest for healthy aging…

But when is inflammation dangerous and when does it work in our favor? To understand the answer to that question it is vital to understand the role of “good inflammation” .

The GOOD Inflammation:

Inflammation’s role in the body is to attack infection and to heal us. It is the physiologic response to injury and infection. Inflammation signals the immune system to come to the rescue and attack infection and then heal the tissue that was damaged.

Acute inflammation from an injury or infection involves:

-Pain

-Heat

-Redness

-Swelling

-Loss of function

These 5 signs are how doctors diagnose inflammation.

When the body is acting normally, Acute inflammation is a self -limited process—it is short term and takes weeks to resolve.

Examples of inflammation you might recognize:

Acute bronchitis—inflammation of the airways of the lungs
An infected toenail
A Sore throat related to the flu
Skin cuts, scratches and burns
Inflammation after any surgery
After physical trauma like a twisted ankle

In these cases, inflammation is short lived, and helps the body heal.

The Bad Inflammation: When is Inflammation Damaging?

When inflammation is long term it becomes damaging to your whole body. It sends the message that something needs to heal and the inflammatory cells and chemicals the body produces are circulating throughout the body for prolonged periods of time. The antibodies can get redirected to healthy tissue and the result can be an autoimmune disease that rarely is cured, and can only be suppressed with immune suppression, leaving the body at risk for infection and cancer.

Inflammation over time will break down tissue, so continuing to live with an inflamed joint is the dumbest thing someone can do because it causes accelerated damage to the joint and the inflammatory chemicals cause plaque to build up in your arteries and damage is done to the entire body. If you have a red, hot , painful area you should get it treated and avoid chronic inflammation.

Chronic Inflammation has different symptoms from acute inflammation:

Fatigue
Fever
Mouth Sores
Rashes
Abdominal pain
Chest Pain

These symptoms can last from months to years.

This week we have made the case that inflammation is both good and bad. What matters is that we recognize when it is a signal of an acute problem that needs to be resolved and when it is reflective of a chronic issue that may have long term consequences. If you have chronic pain, then the doctor will know and be concerned about what is causing this inflammation in your body and what kind of ongoing damage you are experiencing as a result. Their approach to solving the long-term inflammation issues will be important to the way you are able to age and live independently and with flexibility as you age.

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This week, we are discussing the concept of taking your prescription medicines as they are prescribed. There is ample anecdotal and actual evidence that people often (indeed, too often) do not take their medicines as prescribed. A great example is an antibiotic prescription. Often these medicines are prescribed to be taken once or twice a day for a given number of days. The doctors and the pharmacists will tell you to take them all, even if you begin to feel better before the deadline is reached. What happens, in reality is that people tend to take them for a few days, until they begin to feel better and then they stop taking them. They will save the rest of them for some future anticipated need, either for themselves or for someone they care about.

We talk about the concept known as wishful thinking and how children develop their learning capacities. We all have elements of wishful thinking that remain in our thought processes as we age. This impacts our decision -making capacities and our reality testing abilities. We believe that this process is some of what is going on with regard to the magic of medicines. People rarely take all of a prescription, and then keep the rest in case of some future need. Many people actually forget that the meds are in the storage cabinet and may even forget what they were prescribed for, but they keep them as a magical elixir which will protect someone from some imagined future need or harm.

An example that is particularly relevant to Dr. Maupin’s practice at BioBalance Health is the issue of testosterone administration. There are several ways that the hormone testosterone can be replaced. At Dr. Maupin’s office the only way that the hormone testosterone is replaced for men or women is through the insertion of a pellet under the skin. This insertion creates an on- demand reservoir of testosterone in the body, which the body will then use as it needs it to maintain the metabolic process of the body. The patient does not need to do anything or remember anything or worry about regulating the amount that is absorbed into the system in any kind of consistent way. All of these concerns are dealt with by the insertion process and the reservoir!

An example is a recent article in Medscape, a medical journal for doctors. There was a headline reading: “Fewer Than 1 in 5 Hypogonadic men are Adherent To Prescribed Topical Testosterone Treatment”.

There are many obstacles to medical treatment that prevent improvement of a patient’s symptoms, but the most common and obvious roadblock is the lack of patient compliance.

It seems simplistic, but the fact that you are given a prescription and you fill it at your pharmacy does not mean you will get better unless you actually take your medication as the prescription reads.

This is the one reason I like to treat men and women with testosterone pellets. If they come to my office, they get their medication and I don’t have to depend on patients to remember to take their doses of medication, I know they have it!

This study revealed the severity of this problem with men taking their testosterone gel. A total of 3,184 men were studied and only 17% of these men remembered to take their T gel as prescribed! What a waste. Worse yet 81% of them stopped filling their prescriptions at 1 year.

It is always difficult to remember a new habit. Everyone has to do something to remember a new task like, link it to something you already do, like brush your teeth.

However if the results are obviously beneficial, such as they make you feel good or help you think such as (ADD medicine, thyroid medicine and antidepressants), then I believe the % of patients who comply is better. I think that if the testosterone treatment they studied really made men feel better, then men would remember it! However, there is a flaw in using the gels as a way to administer testosterone. They (the gels), make too much estrogen for men to really feel better, and that is most likely part of why so many men forget to take it.

Another factor in remembering to take chronic medication is the level of fear the thought of what might happen if you forget. The fear of pregnancy is a strong motivation for women to take their birth-control pills. The packaging is also an excellent method that promotes compliance. The pill packs have the day of the week on each dose so you know if you forgot and can catch up. Maybe we should package all medications that way. I have a friend who has a company that packages medicine for Medicaid in that manner. It’s a great idea.

The FDA should consider the following issues when approving drugs and drug packaging when they approve them for consumption. As a doctor I must know if the medications I am prescribing are actually being taken as I asked the patient to, or I will make the wrong assumption and change medications just because a patient won’t or can’t take it regularly.

What makes us follow the directions of our doctors and take our medications:

Patients really want to get better
Medications that let you know if you took it because of how it makes one feel
Medication that doesn’t have side effects
Pills that can be put in a dosing apparatus that hold all the pills or supplements that you take at the same time/day with the day written on it
Pill packs that have a pill for every day on a card that you can pop out for every dose.
Medication that actually works for the reason you are taking it!

Remember, the importance of taking medicines as prescribed cannot be overstated. Doctors and Pharmacists do all that they can to help make this a non- issue when it comes to your health. There are still concerns about the weakest link, which is YOU.

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I evaluate my new patients with a battery of blood tests before I ever see them. This gives me the advantage of the time I need to think about them and how their symptoms fit with their labs. This combination of information gives me clues about their hormone status and other diseases that will affect their hormone replacement and or impair their ability to be healthy as they age.

Recently, both Dr. Sullivan and I had a patient each who had low testosterone but also had symptoms that were not due to low testosterone, and that did not get better after they had testosterone replacement with pellets. This is unusual for us, and we both had waited to see how the testosterone would affect the symptoms of severe fatigue, muscle weakness, bone pain and kidney stones. We put that together with their lab work that showed unusually high blood calcium levels.

Blood calcium can increase a bit when women lose their estradiol with menopause—it is a sign of their bones dissolving faster than they build them back. This is how osteoporosis happens. More bone is removed than is built up because of the lack of estradiol and testosterone in women, and lack of testosterone in men. We both considered this as the cause of their high calcium until we replaced their sex hormones, and it did not get any better!

We decided that a history of kidney stones and muscle weakness as well as bone pain and severe weakness as well as exhaustion and sleepiness were all signs of hyperactive parathyroidism.

So, what are Parathyroid Glands?

There are 4 tiny glands situated behind the thyroid gland in the neck. These tiny glands hold the power to make bones thick or thin depending on how much hormone is secreted from them. If these glands are hyperactive, usually from a benign tumor, then they break bone down and thin the bones, and increase the calcium blood level liberating calcium from the bones. Too much calcium causes muscles to be weak and lax. Too much calcium also makes people tired and sleepy. The calcium dissolved from the bones must get out of the body some way, so the kidneys kick up the excretion in the urine. This results in calcium forming stones in the kidney.

Calcium kidney stones are the most common type of kidney stone and are the only type of stone that can be seen on X-ray.

How do you diagnose a parathyroid tumor? They are small and hard to see on radiologic scans, so the first test is blood work for high Parathyroid hormone and high ionized calcium. If both are elevated, then we look for the gland that is the problem. Often times, surgery to take out 2 of the 4 glands and part of the thyroid is curative. If all of the glands must be removed, and one is healthy, they can transplant the parathyroid gland to a place that can be “followed” easily. This place is usually in the forearm. Parathyroid hormone is absolutely essential to life and calcium balance, bone health, brain and muscular health.

Your symptoms will guide us into checking if you have hyperthyroidism. We check the following

Symptoms of Hyperparathyroidism (High Blood calcium)

Low energy
Feeling tired (fatigue)
Loss of appetite
Muscle weakness
Bone or joint pain
Constipation
Anxiety or depression
Kidney stones
Bone loss
Broken bones
Hypertension

Once we have the information, we need to attempt a diagnosis, we use some or all of the following tests and procedures to Diagnosis.

Diagnosis:

Ct scan of the neck
MRI scan
Ultrasound of the neck
Bone density test
Xray of the kidneys

If we have done these tests and determine that you have an issue with hyperthyroidism the various treatments are:

Treatment is surgical:

Removal of just the parathyroid tumor
Removal of ½ of the thyroid and parathyroids
Radiation

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Heart Disease, Blood Flow, SA node, Right Atrium, Left Atrium, ventricular contraction, neurologic malfunction of the heart

Before I can explain a common neurologic malfunction of the heart, I should explain the way the heart beats and the way the heart increases and decreases how fast it beats.

The heart has an amazing spontaneous electrical generator called the SA node. It is located in the Right atrium and generates the beat of the heart that causes the atrium to contract and send blood to the ventricle through another node of electrical tissue called AV node which then causes the ventricle to contract. This amazing conduction system causes a coordinated contraction that amazingly causes blood to pump from the atria to the ventricles and then out to the lungs or the aorta to the body.

When the heart is working properly you can put a stethoscope on the chest and hear the Lub-Dub that is associated with human and animal life. Lub is the sound of the atrial contraction and Dub is the sound of the ventricular contraction. 99.9% of the time we completely ignore this automatic activity in our chest. Only when the heart becomes sick or develops an electrical short do we have symptoms that cause us to pay attention to the heart’s rhythm.

What speeds up the heart or slows it down?

The heart isn’t an isolated independent pacemaker. It is controlled by the autonomic nervous system, the sympathetic nervous system and the parasympathetic system. When these two systems are balanced the sympathetic system speeds up the heart to accommodate exercise, anxiety and fear, and to respond to the adrenal outpouring of adrenaline. The parasympathetic system is the opposite of the sympathetic system and is the “brakes” of the heart rate, which takes over when we are relaxing , quiet and at rest. The trouble begins when we are under the severe stress of modern life that makes us “sympathetic dominant”. Under the control of the sympathetic system people have a fast heart rate all the time which doesn’t allow the heart to rest and relax its muscle. Over time the heart is overworked and gets faster and faster. The owner of that heart becomes out of breath easily and is unable to exercise for any period of time because the heart cannot fill completely in between beats and therefore cannot deliver oxygen to the muscles.

Today we are talking about the rhythm abnormality called atrial fibrillation. It can be caused by chronic stress, and chronic fast heart rate called tachycardia, combined with a genetic weakness, that progresses from a fast, regular beat to heart beats that are irregular and uncoordinated, making the heart fail to push out enough blood and oxygen to the body. The atria may beat twice and miss a beat to the ventricles which feels like your heart is “falling” out of your chest. Fibrillation means uncoordinated muscle contraction.

The big risk of atrial fibrillation is that the uncoordinated heart activity will literally act as a whirlwind and shake the blood up without moving it through the chambers, which causes a high risk of blood clots, stroke and heart failure. The other and more deadly risk is that the fibrillation will be so uncoordinated that it will prevent oxygenated blood from reaching the vessels that feed the heart muscle, which results in a heart attack and instant death.

Generally, if you have symptoms of AF you will seek evaluation from a doctor and receive medication or other treatment.

The symptoms of AF include:

Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flip-flopping in your chest.
Reduced ability to exercise
Dizziness.
Chest pain
Shortness of breath

Habits and situations that worsen AF include:

Caffeine
Alcohol
Fatty diet
Sugar
Dehydration
Heat
Cold
Hypoglycemia
High altitude and
aerobic exercise
tight neck muscle and headaches
lack of sleep

Even if you avoid these situations and activities, you may still progress from tachycardia to intermittent atrial fib to chronic atrial fib. This is typical if the high stress lifestyle that pushed your body over to AF is continued. I can tell you that you cannot push through this disease…it will only get worse.

What can you do yourself if you have Atrial Fibrillation?

Increase your sleep and avoid alcohol and caffeine

Take up meditation and or yoga

Stop stressful work or activities

Listen to relaxing music

Take the following supplements:

Magnesium glycinate
Replenish your potassium by eating tomatoes, bananas, oranges and avocados
CoQ 10 200-600 mg/day
D-ribose 2-3 times a day
L-Carnitine
The Sinatra foursome is : Co Q 10, D-ribose, L-carnitine, and magnesium

The treatments that doctors can offer patients include medications to slow the heart rate like beta blockers eg: Metaprolol or drugs like digoxn to make each contraction stronger. Other medications that have a normalizing effect on the heart rhythm include NSAIDS and antidepressants at low dose. Antiarrhythmic drugs are reserved for constant AF and is an alternative to ablation directly to the area that is an additional node that has overcome the beat of the SA node or the SA node itself, that is accompanied by placement of a pacemaker.

There are alternative treatments like electrical stimulation of the Vagus nerve which slows the heart. There are more non-medicine treatments being rolled out monthly.

The most amazing things that have come use in the last few years is your very own EKG that you can do yourself in one minute. It works with your iphone and can be sent to your cardiologist. It is helpful in diagnosing how often the abnormal beat occurs. This is important in deciding whether a blood thinner should be instituted to prevent blood clots and strokes.

The name of the EKG I use is Kardia. The latest Applewatch has the ability to count your heart rate and rhythm, so you can always be monitored!

As always, we hope that this information is useful for you when discussing your health concerns with your physician. Remember an informed consumer is more likely to be a healthy consumer. Stay healthy, be healthy.

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We take our muscle mass for granted unless we are body builders. There are five reasons why this happens:

Decrease in testosterone after age 40 for women and 45 for men.
Inactivity is a major cause, remember the old saw, use it or lose it!
Poor nutrition (not enough protein in your diet) taste buds decease and we crave or can only taste sweets so our nutritional balance decreases.
Decrease in the number of muscle fibers especially fast twitch muscles
Increased inflammation throughout your body.

The primary cause of loss of muscle mass is that we create less and less testosterone as we age. These other reasons are outgrowths of that cause. The fact is that the damage is additive, each thing contributes to our having less and less strength and fewer muscles. That is why you see old people hobble and walk slowly with poor balance. It gets harder for us to stand, walk, play golf or anything active as we age. The good news is that there are things we can do to help reduce this damage. Let’s talk about those.

Replace your lost testosterone to the level that was biologically normal for you in your young adult life. Remember the importance of the measure of free testosterone as opposed to total.
As you age you must begin to do resistance training and exercise as well as cardio. You will get the possibility to develop muscles when you get testosterone. You will need to create them through resistance exercises.
Nutrition requires vitamin D, exposure to the sun, curb your hunger for sweets, eat fruits and protein to supplement your diet and satisfy your hunger.
Increase in muscle fibers is a secondary gain to getting your muscle capacity back through the replacement of testosterone.
Inflammation must be addressed In order to resist or avoid the damage of the illnesses of aging. The inflammation is a major sign and a major problem that makes us susceptible to the illnesses of aging. Diabetes and obesity are major causes of this inflammation in your aging body.

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Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

Fibromyalgia is a disease that presents with severe fatigue, poor quality of life, and pain and sensitivity in the muscles (not joints) that make a patient so tender that they can’t stand to be touched.

Main signs and symptoms

fatigue-severe
lack of energy.
trouble sleeping.
depression or anxiety.
memory problems and trouble concentrating (sometimes called “fibro fog”)
muscle twitches or cramps.
numbness or tingling in the hands and feet.
Itching and burning of the skin

40-70 % of people with Fibromyalgia also have GI symptoms like irritable bowel, bloating gas and nausea that comes and goes. 70% of Fibromyalgia patients have tension and migraine headaches.

Many of these symptoms overlap with several other illnesses such as Chronic Fatigue ( a low cortisol condition) that can follow a viral illness, as well as some autoimmune diseases, and the symptoms of low testosterone and low growth hormone, Like autoimmune diseases, fibromyalgia occurs in women more than men, and women over 40 more than younger women.

When diagnosing Fibromyalgia, we must rule out autoimmune diseases, Lyme disease, and other chronic viral infections, and diseases such as depression. Previously we just ruled out other diseases and put our fibromyalgia patients on an antidepressant for both the depression symptoms and the to relieve the pain. Fibromyalgia is a disease of low serotonin levels, so the antidepressant isn’t just for the mood portion of the disease but also to relieve pain.

Because we now know more about Fibromyalgia, we have found that there is usually an incident that caused severe chronic stress that de-regulated the hormones and neurotransmitters in the patient’s brain that later caused her to have fibromyalgia at a later date.

Chronic stress, like being abandoned as a child, or being abused at any age, severe illness including lyme disease, mononucleosis, PTSD, or any other lifestyle choice like drug use, or practicing obstetrics or ER medicine, that stresses the body.

The result of this stress results in chronic elevated cortisol and adrenaline. This wears out the brain and the adrenal gland and the patient can’t respond to stress of any kind anymore. Even being stroked gently feels like pain.

In The Journal of International Immunopharmacology, 2 March 2015, the article,

A novel use for Testosterone to treat central sensitization of chronic pain in fibromyalgia patients, discusses the association of low T and the incidence of Fibromyalgia. Low estradiol, low testosterone and low GH all occur when a patient has FBM. When these hormones are brought back to normal by replacing them, the symptoms go away! I have seen this many times and sleep, pain and pain all become normal as long as we can replace T and E2, an stimulate GH with somatotropin.

Other treatments include anti-inflammatory medications like Celebrex or NSAIDS, SSRIs, Pregabalin, sometimes low dose steroids, Testosterone, GH stimulation in both sexes plus Estradiol in women.

These are the treatments we employ when treating Fibromyalgia, and we watch all the symptoms of fibromyalgia go away when we start with T, E2, oral pregnenolone and GH stimulation. After that, we use the other, non-medical methods of treating Fibromyalgia.

The non-medical methods include:

Set sleep hours at least 8 hours a night every night
Dark sleeping environment
Mediterranean low carb diet avoiding preservatives and chemicals in your food.
Progressive exercise
Nutritional supplementation
Meditation and relaxation exercises

Nutritional Supplementation with:

Vitamin D3, K2 and zinc piccolate
Endodren adrenal supplement q am
Lipo C vitamin
Fish oil and flaxseed oil
Methyl B vitamin
Magnesium Glycinate 40 mg BID
L arginine
GABA
SamE 400mg three times a day
Cucumin 800 mg three times a day

All of these are treatments for FB but the basis of treatment and the most effective is Bio-identical T pellets and E2 pellets + injectable sq sermorelin/ CJC to stimulate growth hormone.

Everything else is in addition to the hormone replacement.

The reason no one seems to have an answer for those of you who have FB “lies in the combination of knowledge (needed to diagnose and treat FB) from diverse fields including reproductive endocrinology related to the gonadal steroid hormones (estradiol, testosterone), nociception, neuro-endocrinology and reproductive immunology.” HD White, TD Robinson, International Immunopharmacology 27 (2015) 244-248.

It is for the very same reason that mainstream medicine has not yet acknowledged the amazing power of testosterone in the non-oral subcutaneous delivery system. It crosses the fields of OBGYN, Urology, Endocrinology, Rheumatology, Neurology, Psychiatry and immunology to see the many ways in which the replacement of Bio-identical T and E2 can treat many illnesses that we are currently using dangerous and ineffective drugs for. Testosterone loss is the first shoe to drop in the loss of homeostasis as we age, and the advent of multiple diseases that we still don’t know how to treat because we are too segmented in our specialties….no experts read the research of another specialty which is the arrogance of the specialists.. in the end we all lose because we only read the papers of what we already know!

Until we humble ourselves to read ALL research about diseases we don’t know how to treat, we will never get the proper treatment for our patients. This is my mission, and my goal…but no one in the many fields that are necessary to understand the many uses of testosterone and estradiol and how to safely treat our patients, so they NO LONGER have the diseases triggered by loss of the sex hormones.

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Everyone responds to fear differently on the outside: they stop eating, or they eat everything in the house, they become immobilized or they act out and yell and scream, so you know what I mean. Unless we are trained to suppress these activities and the emotions, stress and fear cause, we react as our brains and early patterning from our parents dictate.

For example; my mother would get flustered and scream or whimper and my father would lose his temper and yell or stop talking for days on end. I have all of those emotional acting out responses as my first response. But, since I am a Surgeon and an Obstetrician, I have been trained to shut up and do what is necessary to save a life. That requires control and a mantra…mine is: “Nothing has happened to you or your patient at this time that you cannot help, fix or whatever is appropriate”.

Emotions interfere with your ability to think and act logically. Most stressful situations in medicine require “me” (the doctor) to keep her head while those around me are losing theirs!” This is a necessary response for most doctors and therapists. Do not let them see you sweat or get upset or cringe because that affects your patients. For the rest of the world, their response to fear and stress is different. Doctors and therapists seem to them to be emotionless and aloof, while we are just trying to feel unaffected.

Doctors and therapists are not the only ones that have to learn to control their bodies under stress and be able to perform trained tasks. Emergency medical personnel, police, soldiers, pilots. Many professions require a level of performance under stress.

However, what no one can control easily is what is happening inside their bodies when fear or stress occur. These emotions flip a switch with the nerves in your autonomic nervous system that trigger the flight or fight response. A whole cascade of nervous impulses are sent from the brain to our bodies through these nerves and hormones from the adrenal gland flow out and cause us to: sweat, breath harder, makes our heart race, our palms to get damp, we cannot think logically and we regress to reactions we learned when we were little. Whether this is visible to those around you or not, these things always happen…unless you have learned techniques to counteract them.

The autonomic nerves involved are the vagus nerve which is part of the parasympathetic system and puts the brakes on the heart. With fear or stress the brakes are out and the faster and blood flow is concentrated on the heart the brain and the muscles, while the gut stops working. This system was meant to help us with fast and immediate stress that goes away quickly, like the response we have when being chased by an animal.

The stress we are under is long lasting and dangerous. With chronic stress we wear our autonomic system out and over- use our adrenal glands. The adrenaline eventually fails, and we need to add amphetamines to think and act normally. Our cortisol is very high, and it causes us to be obese and not immune to viruses and bacteria. Our heart has no brakes, so we develop tachycardias (fast heart -beat) and eventually this will damage the heart and cause atrial fibrillation.

There are some methods you can learn to use to counter stress reactions and calm your nervous system. They include:

Meditation
Yoga
Deep breathing (slowly and steady)
Massage
Human touch
Music
Thought stopping
Trying to solve a logical puzzle which requires concentration.
Repetitive work
Play card games

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This may save more lives than anything we have talked about in our 500 Healthcasts over the last nine and half years. During this time of quarantine, we all need something to do, that is positive and protective, right?

I think one of the best things you can spend a few hours on is entering your health history into this novel app that comes with every apple phone!

This APP is accessible by emergency personnel if you are in a car wreck, or are in the ER and can’t talk, or if your significant other doesn’t know your health history to tell the people who are caring for you what health problems you have. You can list your meds and your medical problems that can mean life and death to the people caring for you. Your blood type, whether you are an organ donor and your HealthCare Advanced directive can be entered into the information.

Here is how you do it. I’ll use mine as an example.

The icon with the heart
First tap the circle at the top of the page with your initials on it

It will open the screen with your initials or picture on it and Medical Details listed below Health Profile
Medical ID
Organ Donation

First the Health profile—vital info. If you don’t know then don’t fill that part in, you can update this at any time

Go back to Medical ID—set up your medical ID get started

MEDICAL CONDITIONS: Here you list medical conditions like High blood pressure, heart disease, diabetes, menopause, etc.

MEDICAL NOTES
I listed things like:

Medications and dosages
Supplements and dosages
My doctor’s contact information
Blood type
Height and weight
Testing I have had in the past and results—eg. mammograms, Cardiac calcium score
Previous surgeries
Vaccines
Medical Directive/ Durable Power of Attorney for Healthcare: As for your medical directive, if you already have one you can take pictures of the pages and file them on your phone, then indicate where they are on your phone----and also write where they are in your house or who has them in their possession.
If you don’t have one, then you should go to the Missouri Bar Association website MOBAR.org and search for medical directive/durable power of attorney—they are free! You have to fill out and have it notarized.

These are the things your doctor, or any ER Physician needs to care for you, and it is faster than reading your lengthy medical record.

Last, they ask for who you want to be called if you are in an accident: their contact information and their phone numbers and when an SOS call is made, they are automatically called.

The last screen! Go to the back and hit organ donation: you can register with an organ donation company—Donate Life America.

I have always lived by : Be prepared for the worst and Pray for the Best, and you will always have what you need in an emergency!

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Physical Signs of Hypothyroidism: What a doctor or YOU can see or feel on your body:

Low Pulse and Low Blood pressure
Basal Body Temperature below 98 (your oral temperature taken before you get out of bed in the morning).
No sweating when you exercise or are in hot weather
Swelling all over the body
Brittle nails
Loss of, or thinning body hair
Hair problems: poor quality brittle hair, thinning all over the head, slow hair growth and constant shedding
Weight Gain when you eat normally
Swelling, and puffiness around the eyes
Distended and bloated abdomen
Goiter or swelling in the neck
Extremely dry skin, may look like cobblestones
Loss of the lateral Eyebrows (the outer third of the eyebrows)
Heart arrythmias and palpitations
Cold hands and feet

If you have 3 or more of these signs you should be evaluated for hypothyroidism.

There are high risk factors that should alert you and your doctor that you are high risk to get Hypothyroidism:

Being female
Aging over 50
Living in the Midwest
Family history of Hypothyroidism
Family history of Hyperthyroidism, Graves Disease and Hashimotos Thyroiditis.
Allergy to Iodine
Poor diet, lack of vitamin A, vitamin D, Lack of Iodine and Zinc.
Diagnosed with an autoimmune disease already
Diagnosed with Depression
Drink fluorinated water

If the patient is a woman, she is eight times more likely to have hypothyroidism than a man, and if she lives in the northern Midwestern US, the Goiter Belt, she has a very high risk of the hypothyroid epidemic that affects most women in that area. This high rate is the result of a lack of iodine in the ground and water sourced in the Midwest that causes hypothyroidism.

Overall, hypothyroidism causes the human metabolism to slow to a standstill. And slow the production of energy in the cells, and store that energy as fat. Low thyroid slows growth hormone, which thins the hair and makes it frizzy and fall out in large amounts.

Thyroid hormone is meant to keep the body temperature between 98 and 98.6 by stoking the metabolic fire and keeping the body warm enough for enzymes to work, and cells to work as well. We are “warm blooded” for a reason and “warmth” is accomplished by thyroid hormones effect on each cell in our body. When we have hypothyroidism from inability to secrete enough thyroid hormone, or if we aren’t given enough thyroid replacement our body’s enzymes and chemical reactions slow down and stop, causing us to gain weight, feel fatigues and sick. Thyroid is the thermostat and our cells including muscles and other organs make energy out of our food.

Thyroid hormones also stimulate the intestines to work and absorb the food that gives us energy. Without thyroid our intestines come to a standstill and we are constipated! I contend that the great number of drugs on the market to help constipation would be unnecessary, if every person had enough thyroid hormone and iodine to make their gut work!

Fatigue can take many shapes, but hypothyroidism causes a patient to have the feeling of exhaustion that stems from malfunction of the smallest cells throughout the body that cannot turn blood sugar into energy. Lake of thyroid makes organs made of those cells slow down to a virtual stop. It is in that way that the effect of inadequate thyroid hormone on the cellular level, makes the whole mechanism of the human body slow to a virtual stop, and we “feel” exhausted. This is terrible for the human body and we cannot live well without adequate thyroid hormone.

Depressed mood is a very common diagnosis in the US ad often the depressed mood comes from low levels of thyroid, testosterone and or estrogen (in women). Anti-depressants don’t generally completely cure depression in these cases because anti-depressants don’t fix low thyroid.

Inability to think and concentrate is common in 39% of patients with untreated hypothyroidism. Before worrying about having a degenerative disease or “getting old” get your thyroid checked and replace the thyroid with an appropriate amount of thyroid hormone.

I have treated many infertile patients with thyroid replacement in my GYN practice for the first 29 years of my medical practice, and it was unbelievably effective! Normal thyroid is necessary to get pregnant, and infertility doctors rarely look at this very common cause of infertility, when it is very common.

The Bottom Line: If you have 3 or more of the symptoms described above then have your thyroid checked with at least 5 different tests: Free T4, Free T3, TSH, and reverse T 3. If your Free T4 is less than 1.0, your free T3 is less than or equal to 3,0 and your reverse T3 is greater than 20 then you probably have hypothyroidism. You should first take Iodoral 12.5 mg per day with a pinch of salt and find a doctor who will replace your thyroid and listen to your symptoms. Once you are treated then you should find a doctor to increase your dose to the point where all of your symptoms are gone, your lab tests are normal and your basal body temperature is 97.9 degrees F, or greater.

Type of Thyroid Replacement Medication:

Women do much better with a combination of T3 + T4 thyroid replacement called porcine thyroid, or Armour Thyroid, Naturethroid, or WP thyroid. Men are fine on the synthetic thyroid, Synthroid, or levothyroxine most of the time

Post replacement thyroid testing:

After replacement with thyroid, your blood tests should be drawn, on an empty stomach before you take your morning thyroid, and your TSH should be 1.0 or less, your free T3 should be 3.0 or more, and your Free T4 should be 1-2.0. If it is lower, you need more thyroid hormone or a different kind.

Dosage Adjustments of Thyroid hormone replacement changes:

In winter your need an increase in your dose to keep your warm! The dosage should decrease when the weather gets warm. Altitude requires more thyroid hormone replacement, so an increase in dose when you are in the mountains during any season.

Supplements that assist your body in metabolizing thyroid hormone:

Iodoral: 12.5 mg per am with food and a pinch of salt
Magnesium Glycinate 200-400 mg per day to prevent palpitations
Vitamin A 20,000 iu/day
Vitamin C 500-1000/day
Vitamin D 2000-5,000/day
Vitamin E 400 mg/day

Goal of Therapy:

I think that symptoms are the most reliable measure of how adequate your thyroid dose is. If your symptoms are gone and you have no side effects like anxiety or palpitations, then your dose should not be lowered. Lack of symptoms is a sign of success, not a reason to decrease your dose and make you sick again!

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Recently a long-term patient who has taken testosterone and estradiol pellets for over a decade, insisted that her PCP take care of her thyroid medicine, blamed me and her estradiol and testosterone pellets for her hair loss (that she had before pellet therapy), her fatigue and her weight gain. She was confused about what each hormone does, and she was made more confused by her PCP who advised her to take less or no thyroid, based on his own lack of training. He blamed her sex hormone replacement for the symptoms that are obviously from low thyroid, and he only did one test, TSH, to determine whether she needed thyroid hormone instead of the 4-6 blood tests that we do at BioBalance Health®, and he never asked about her symptoms of hypothyroidism..

Doctors, RNs, and Nurse Practitioners at BioBalance Health® follow guidelines to correctly diagnose and treat a patient with Hypothyroidism by personal history and tests.

The things that your doctor or Nurse Practitioner consider when diagnosing a patient with Hypothyroidism:

Symptoms of hypothyroidism (see below)
Presence of a thyroid goiter (visibly enlarged thyroid), full body swelling, very dry skin, thinning and poor- quality hair all over the head, lack of sweating and lack of body hair.
1-6 of the 4-6 blood tests drawn are abnormal: Free T3, Free T4, TSH, Reverse T3, Antibodies to Thyroglobulin and Thyroid Peroxidase
Basal Body temperature less than 98 degrees Fahrenheit, low BP and Pulse
Determine if you are High Risk (see below)

So, you can decide on your own whether you might have hypothyroidism by reviewing the Symptoms, Physical Signs, what follows is a list of Symptoms and Signs of Hypothyroidism. What follows is a list of more than 10 most common signs and symptoms of hypothyroidism, also called low thyroid. These symptoms are not hard to remember, and they are the most physician misinterpreted symptoms in medicine!

13 Symptoms of Hypothyroidism

Fatigue
Weight Gain
Hair loss all over the head
Feeling Cold All the Time = Low Basal Body Temperature below 98 degrees F
Very dry and Itchy Skin
Constipation
Trouble thinking
Infertility, poor ovulation and irregular periods
Difficulty concentrating, poor memory
Swelling all over the Body
Muscle pain after exercise
Poor muscle strength and stamina
Poor immunity

When a patient has 3 or more symptoms, they are very likely to have hypothyroidism and need thyroid replacement. Once a patient is given thyroid, they will always need it unless they had hypothyroidism following a pregnancy which often reverses within a year after delivery.

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For the last several weeks, we have been discussing the various systems of the body which, as we age, begin to function less well and to break down. As each of these systems begin to deteriorate, we become more fragile and more susceptible to illness and death. Dr. Maupin and Brett have been discussing what we know about each of these systems and why they deteriorate and what is currently known about how to anticipate and avoid this break down in capacity and operation of the body systems.

This week we are going to discuss the Anti-Aging Pyramid developed at BioBlance Health by Dr. Maupin. This pyramid explains how she understands where you are on the pyramid and how to help you stay healthier at each stage of the pyramid. Through the use of this model, she has developed treatments which slow down or stop your bodies systems from losing capacity and causing you to be available for opportunistic assaults by disease and injury.

The first of these steps is the replacement of the basic sex hormones Testosterone and Estradiol. Dr. Maupin believes, (and has explained further in both of her books), that these are the first dominoes of the aging cascade of illnesses that we call old age. These two sex hormones are the critical ones for re-energizing a man or woman so that they function more like they did when they were in their thirties and forties. This improved functioning helps shield them from the illnesses of aging, the loss of their libido, the onset of fragility and susceptibility to all kinds of illnesses associated with being old.

After replacing needed testosterone and estradiol, Dr. Maupin looks at replacing other hormones such as thyroid and progesterone and cortisol. This helps prevent adrenal fatigue and helps your body maintain the energy balance at the cellular level that is regulated by the thyroid.

As we go up the pyramid, we look at the prevention of the identified diseases of aging. If we determine that you are more likely to get one of these diseases because of your genetics and your metabolic processes, we apply the best treatments to help you minimize the impact or avoid all together the aging diseases.

Next we will talk with you about personal diet and exercise programs. We find that if we put you on medicine to initially help you avoid the diseases of aging, then encourage you to change the choice matrix of how you live. Eat healthily, exercise regularly both cardio and resistance exercises, you will take control over your destiny and help yourself live longer and more independent lives.

If Dr. Maupin determines that the next best thing to do is help your diet and metabolic control, then she will suggest tailor made supplements for your diet and health.

Once your basic metabolic processes are taken care of as best we can, we want to focus on the reality that if you feel better you want to look better and if you look better, you feel better. To this end, Dr. Maupin has developed BioBalance Skin, a separate business which will help provide full body esthetic care. Skin care, hair, fat, non -surgical procedures that will help you look and feel your best.

A new area of focus is the burgeoning field of peptides. There are specific peptides (amino Acid chains that attack specific harmful processes in the body), peptides can specifically attack imbalances or broken down metabolic processes and help return you to the functionality that you had when you were younger and your system was at full capacity and vigor.

Be sure to listen to this health cast for a fuller understanding of what BioBalance health is and how it works to make your life both longer, and better.

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The brain is complex and is not a static organ. It is always growing new cells and breaking down the old cells. Like the rest of the body the brain is in a state of flux all the time. As we age without our sex hormones and growth hormones, breaking down occurs more rapidly than regrowth and our brain literally shrinks

Another quite rapid symptom is the loss of short -term memory at the time before menopause when testosterone and GH decrease to a critical level. These hormone losses trigger the diverting of the brain blood flow from the area of the brain that holds recent memories. This causes immediate loss of words you are looking for when trying to describe something or someone. Most people forget names of people and places.

There is loss of special ability like the function you need to discern the length or size of something or interpret architectural plans. This immediate memory loss reverses in the first 6 months of testosterone replacement, if it is within the first 10 years after testosterone levels drop.

“An Italian study in 2000 demonstrated that there is a cognitive impairment without dementia which increases with age and is more prevalent in women than men”

“In the same year, Dr. Capurso and researchers at the university of Bari found an age -related decline in cognitive function that causes a mild deterioration in memory performance, executive functioning and speed of cognitive processing”

“The study concludes that the aging associated cognitive decline may be preventable and suggest the following:

Avoidance of cardiovascular and other chronic diseases
Attaining a high -level education
Maintenance of vision and hearing capacities.

Dr. Maupin believes that brain function can be protected from decline by taking testosterone, estradiol (for women), keeping thyroid function and growth hormones optimal. Several studies reveal the truth that replacement of testosterone in the first 10 years after its decline, can delay the onset of Alzheimer’s disease and dementia for 10 years after it would normally occur. Other studies on women showed that replacement of estradiol in any form delayed the onset of these diseases of aging brain by 10 more years if it is taken in the window of 10 years after menopause. This reveals how important the sex hormones are to our brains.

We also want to talk about muscle mass, strength, and stamina and aging.

The amount of muscle mass you maintain depends on how much testosterone and growth hormone you produce or replace, the amount and kind of exercise you do, the genetic composition of your muscle such as do you have 100% slow twitch muscle which gives you the ability for long distance and long lasting strenuous exercise, or 100% fast twitch muscle which makes you good at short spurts of muscle work, lifting weights, and short but powerful muscle work of any kind or were you born with a combo? Diet/Nutrition is also important because you can -not build muscle without the building blocks from animal protein.

When you are given replacement hormone of testosterone, it stimulates your production of growth hormone which you make naturally. This is important because age related reduction in growth hormone is one of the most robust endocrine markers of biological aging. The reduction of GH and IGF-1 impairs reference memory and seems to be reversable with the administration of GHRH. (growth hormone releasing hormones).

“muscle strength is a critical component of the ability to walk and to avoid falls and fractures. Reduced muscle strength as we age is a major cause for an increased prevalence of disability.

If we can prevent the loss of muscle as we age, we will age more slowly and remain independent as we grow older.

Advancing adult age is associated with profound changes in body composition, the principal component of which is a decrease in skeletal muscle This age-related loss of skeletal muscle is referred to as sarcopenia.”

“Studies indicate that age related decline in skeletal muscle may contribute to such age associated changes as reduction in bone density, insulin sensitivity, and aerobic capacity.”

The final component of this week’s conversation references the sensory system. The principal conclusion of the discussion regarding the loss of sense of taste and smell, hearing and sight, suggests that attending to:

Nutrition
Hormones
Lifestyle

May expand your lifespan, while, at the same time, enhance the quality of that human life.

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The entire system from your mouth to the end of the alimentary canal. Food that we eat is a fuel. We ingest it in the mouth and the GI system breaks it down into consumable energy units called BTU’s that are what our food becomes at the cellular level. This level provides our cells with the energy they need to do their job.

We discuss the process from the beginning to the end. The end is where the waste product is eliminated when we go to the bathroom.

One important ingredient in the process is relative to the bacteria in your gut biome. If you have enough bacteria, with enough variety of bacteria, you are better able to digest your food intake and convert it into the energy your cells need. There is even a process available to doctors if you are determined not to have the proper kind and amount, of bacteria in your gut biome. This process is called a fecal transplant. The feces from some other person who has the bacteria you need to make is transplanted into your system so that those bacteria will grow and work within your system. That way, you are able to process and digest your food intake. A less serious option would be to take probiotics which can help you produce the proper bacteria in your gut.

The Gastrointestinal System:

The GI system has a wide variety of changes throughout life. With aging, there is a decline in the actual form of the intestines.

This causes a decline in the absorption of some nutrients, such as fatty acids and cholesterol.

We want to consider the following changes in the GI system as aging happens:

Decreased ability of the intestinal walls to hold and absorb nutrients makes older people highly sensitive to minor body insults;
Drugs appreciably affect taste sensation and thereby appetite
Malabsorption can be caused by low levels of gastric acids, possibly compounded by gastric hypochlorhydria with small bowel bacterial over-growth;
Lowered gastrointestinal movement including incontinence may occur.
GI changers in mucosal immune response also occur.

Our intestines do a lot more for us than we actually give it credit for. The intestines process our food and convert it into blood sugar to feed our cells. The intestines keep toxins out of the blood and filter the food we eat. The GI tract holds all the good bacteria that is necessary for our immune system to function and to process our food. Without bacteria in the gut we would not be “fed” at all!

When the GI system ages, we stop absorbing B12 from the stomach and our acid level and enzymes from the pancreas and liver decreases so we can’t break down meat and fat, which means we are malnourished. Even drugs and vitamins care impossible to absorb when the gut ages. For instance, without the stomach acid and enzymes you can’t break meat and proteins into amino acids to make new muscle. Our GI system is sustained down- stream from our sex hormones but are still made healthy by a combination of fresh balanced diet, probiotics, and sex hormones.

Taking care of our GI system becomes more of a challenge as we age. Because of the resistance that aging effects cause in the GI system, we have to find different ways that our gut and bodies can absorb the proper values of nutrients for good health. As we age, we often stop absorbing various nutrients like B12, a vitamin. Also, out taste sensations change, we get to a point that we can only taste sweets. Fortunately, we now have systems of consumables that allow us to ingest proper balances of the nutrients we need without eating the foods that we used to eat in order to obtain them. There are drinks (usually chocolate flavored or vanilla) that contain all the recommended nutrients for a day’s consumption. We can further give sublingual tablets hat will put those nutrients into our system without having to eat those foods, because our bodies lose the ability to absorb them through the GI system.

As we age, it becomes more important to understand these changes in our GI system and make proper adaptations so our bodies will have enough energy and have the ability to keep us healthy as we age.

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Kathy Maupin, M.D.