Vitality for the Aging Woman

Hormone replacement is changing the paradigm of normal aging

Teary eyed, my patient relayed to me that she “was tired and depressed, not sleeping well, frustrated with her weight, and had no sex drive”.  Despite being in previously great health, and continuing good diet and exercise habits, her body was in her words “out of control”.  There were also new aches and pains as well as noting her skin looked dry and lifeless. 

Added to this was a host of new medications started in recent years, including Prozac for mood, Xanax for anxiety, Ambien for sleep, and Lipitor for her newly diagnosed high cholesterol.  To make matters worse and behind the scenes, at the young age of 55, silent aging processes such as thinning bones and artery plaque were beginning.

The stress of not feeling well, poor sleep, and medication side effects were pushing her toward adrenal fatigue.  The high stress hormone called cortisol had been on overdrive for many years, causing the secondary effects of high blood sugar and high insulin, which conspire along with cortisol to put weight on especially around the midsection.  In times of additional stressors her “reserves” of cortisol were depleted leaving her emotionally labile and energy drained.

This patient represents thousands of patients that I’ve had the pleasure of successfully helping with all of these issues.  While the sad truth is that most of them had stories that included the majority of the issues in this one example, the good news is that a real solution exists.

Bioidentical Hormone Replacement Therapy (BHRT)

Hormones are chemical messengers that help the entire body function normally.   They work in concert with the nervous system by responding to neuronal commands that regulate everything from growth and development, to reproduction, to the aging process itself.  Hormones control metabolism, mood, energy, sleep, and sex drive.  Put simply, humans are designed to be healthy with optimal levels of hormones.

Bioidentical means identical to our biology.  A bioidentical hormone has 100% exactly the same chemical and molecular structure as the hormone that is normally found in the body.  By contrast, many drugs are similar to natural hormones, and will activate hormone receptors in the body, but are not identical.  Birth control pills, for example, are much stronger than our natural hormones yet not identical.

For women, the natural ovarian hormones include estrogen, progesterone, and testosterone, and these hormones plummet after menopause.  In the world of hormone replacement, there are synthetic “look-alike” drugs that will stimulate the natural hormone receptors, such as brand name Premarin for estrogen, and Provera for progesterone.  Both of these drugs have effects beyond that of their natural hormone equivalent, and as one would expect, numerous side effects not observed with bioidentical hormones.

If the exact replica of a hormone were available for use in humans, then why would we ever use a synthetic drug that was not bioidentical?  Because you can’t patent something that is naturally occurring, and thus if you are a pharmaceutical company you can’t make any money on it.  Enter the invention of a drug that is similar enough to bind and activate hormone receptors but unique enough to warrant a patent.  The patented drug is then worth the hundreds of millions of dollars necessary to get FDA approval, and in the case of hormone replacement for women generate billions of dollars of sales each year, for decades.

Unlike drugs such as Premarin, which contains ten estrogens derived from pregnant horse urine and none of which are the same as the three naturally occurring estrogens in the human body, bioidentical hormones are derived from plant sources and synthesized into the exact same chemical found in the human body.

Evidence of Safety

In 2002 the Women’s Health Initiative (WHI) study shocked doctors and patients alike with the revelation and proclamation that “hormones cause cancer”.  More specifically, the non-bioidentical look-alike to progesterone, called Provera, caused a 26% increase in the rate of invasive breast cancer.  Provera also caused a 200% increase in blood clots, a 41% increase in stroke, and a 29% increase in heart attack or death from heart disease.

It is worth noting in a case of “missing the forest for the trees” that for the treatment group in the WHI, the decreased mortality from hip fractures and colon cancer offset the increase in breast cancer and 97.5% of women on treatment had no adverse events.

Bioidentical progesterone has been studied extensively, in dozens of studies head to head with Provera, and simply stated it does not have the same risks.  For everything bad with Provera, progesterone is the opposite.  As an example, in the largest study involving progesterone, the European EPIC study involving over 50,000 women taking hormones, it was found that progesterone actually lowered the risk of breast cancer by 10%.

Evidence of Efficacy

I recently had a new patient come to me for help with BHRT.  She moved to our area about a year ago, sought treatment from a local gynecologist, was told that BHRT was “voo-doo” and promptly instructed to stop her hormone therapy, which she did.  A year later her health had deteriorated to that point that she could hardly function.  After being back on BHRT she is now recovering her health.  I have thousands of patients who will vouch for the fact that BHRT works very well to support health and harmony.

HRT is not about treating menopausal withdrawal symptoms such as hot flashes, night sweats or mood swings.  Although it does treat those symptoms quite effectively, HRT is really about preventing disease and maintaining quality of life.  It’s about keeping the body operating well.  Not having optimal hormone levels is like letting a fine automobile just run out of oil, then declaring it is “growing old” as the red light comes on and it overheats.

Bioidentical hormones were being used long before drug companies even came into existence.  They are available in a few commercial forms, but mostly we employ the compounding pharmacist to make BHRT formulations that are specific to each patient and uniquely available in either a tablet that dissolves under the tongue or a topical cream that contains just the right mixture of the ovarian hormones.

There isn’t anything “voo-doo” about BHRT.  It is a well researched and proven branch of medicine that is growing rapidly as more and more people discover its health promoting and quality of life benefits.

If you wish to take a proactive approach to health and aging, and maximize the quality as well as the quantity of life, then you should research and consider BHRT.  If you would like to see more evidence supporting the safety and efficacy of BHRT then consider attending my seminar on BHRT for women in which we review more details on the various ovarian hormones, studies showing the safety and efficacy of BHRT, and an outline of treatment protocols.

FREE SEMINARS

“Bioidentical Hormone Replacement for WOMEN

Monday, April 29^th

“Fibromyalgia & Chronic Fatigue Syndrome”

Monday, May 13^th

Seminars are at 6pm, at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com).  Call 245-6911 for an appointment or more information.

Cleanse & Detox

If you want to do something to improve your overall health, consider a simple cleanse and detox program.

Each of us has a continual onslaught of toxic chemicals that build up in the body and especially wreak havoc with our DNA, immune, endocrine and neurologic systems. With thousands of chemicals released every year into the consumer goods market, we are all exposed to and full of toxins. A cleanse is a great way to help our body to eliminate these toxic chemical invaders.

The results of toxin build-up may be symptoms such as fatigue, weakness, muscle or joint aches, brain fog or emotional ups and downs, irritable bowel syndrome or weight gain. Diseases such as cancer, dementia, heart disease, autoimmune disease and hormone imbalances are linked to various chemicals found in our food, air, water and consumer products.

One study showed that the average American has about 100 various chemicals directly measurable in the fat tissue where most toxins like to accumulate. These toxins include normal metabolic end-products, bacteria, both over the counter and prescription drugs, alcohol, insecticides, pesticides, pollutants, contaminants and food additives. 

NATURAL DETOXIFICATION

Our body comes with a marvelous system for eliminating toxins, most of which enter our body through the gut, skin or lungs. The liver is the first and foremost detox organ in the body. All the blood from the stomach and small intestine flows directly to the liver where the various bacteria and toxins are filtered out. The toxins are “deactivated” and made soluble in water so they can be eliminated via the kidneys, skin or gut.

The natural detox system has three main phases that must work in concert to get the job done. Phases one and two occur in the liver and like a “one-two punch” they need to work together to succeed. Phase three is the final “packaging” that allows toxins to be sent on their way out the body.

The first phase of detox involves the “cytochrome P450” enzyme system, in which toxins are transformed into chemical intermediates that are even more toxic and must be immediately acted upon by the phase two system. During phase one detox, adding or removing an electrical charge from toxins creates the dangerous “free radicals” that can cause so much harm in the body. This is one area where anti-oxidants play a key role in health by keeping control of these free radicals.

Phase two detox is called “conjugation” and it picks up where phase one left off, immediately going to work neutralizing the toxic intermediates by attacking various chemical groups. This is where naturally-occurring enzymes such as glutathione, catalase, and super-oxide dismutase rule.

When everything works well, our body does a fine job of taking care of these toxins so that they don't harm the body. However, there are numerous reasons that our detox system fails.

First, the system can only do so much. Our exposure to hundreds of chemical toxins is not part of the evolutionary plan and we are overloading our capacity to detox. Second, the detox systems rely on abundant nutrients to function, which our standard American diet is woefully short on supplying. Third, impaired gut health is common and causes many toxins to build up while impairing phase two detox pathways upstream. Last, we have discovered only in recent years many genetic mutations that cause some people to have a dysfunctional detox system. 

HOW TO CLEANSE AND DETOX

When I say “cleanse” what I'm referring to is cleaning out the stagnant, built up accumulation of toxins and sludge that interfere with a healthy detox. The first stage focuses on the gut by eliminating foods that cause inflammation, while increasing foods that help bind toxins and stimulate bowel motility. Various supplements are usually added to facilitate this process. This stage is done to “prepare” the rest of the system for detox.

The second stage of a cleanse and detox program is the actual detox portion. Foods and nutrients that support the liver are emphasized. Plenty of water helps the kidneys and skin excrete toxins through the final phase three pathways.

There are dozens of diets to cleanse and detox. A loosely structured detox diet simply eliminates sugar, grains, red meat, dairy, and processed or packaged foods, while emphasizing raw, organic fruits and veggies. Most detox diets also eliminate caffeine and alcohol. Fasting is often done to facilitate the cleansing of the gut. We like the “Fast Track Detox Diet” by Ann Louise Gittleman, PhD, CNS, because it is simple and effective.

The third stage of most detox plans involves healing the gut, replenishing the nutrients lost in the aggressive detox, and restoring the beneficial bacteria in the gut. Again, this is usually done through diet and supplements.

Foods that support the liver detox systems include crucifers such as broccoli and cabbage, green leafy veggies and herbs such as kale and parsley, citrus fruits such as lemon and lime, sulfur-rich foods such as garlic and onions, and foods that heal the liver such as artichoke, asparagus and celery. Cleaning out the colon is done with foods high in fiber, including carrots, apples and berries, and supplements such as psyllium or flaxseeds.

There are probably more supplement programs for detox than there are diet plans. I routinely use and highly recommend two products from Douglas Labs. The “metabolic rejuvenation pack” is a 4-week program designed to prepare, detox and repair. The “metabolic cleanse” is a powdered protein drink designed to add extra nutrients and gut-healing compounds into the plan. 

DETOX FOR HEALTH

If you have any significant health problems, it is wise to consult with your doctor and/or a professional that is well versed in detox programs. All medications are processed through the liver detox systems and a detox program may affect the metabolism of drugs. This is usually helpful in the long run by helping the liver process and eliminate drugs; however, it can also change blood levels of drugs such that it could cause problems.

We routinely perform the DetoxiGenomic® Profile from Genova Diagnostics, which evaluates genetic mutations called single nucleotide polymorphisms (SNPs) that are associated with increased risk of impaired detoxification capacity especially when exposed to environmental toxins. It also identifies individuals potentially susceptible to adverse drug reactions.

Doing a cleanse and detox is a simple process that can reap big health rewards. No matter what method you choose, be careful to avoid gimmick detox programs. Be sure the program is founded in good nutrition, quality supplements and overseen by a qualified professional.

For more detailed information, join us for our free “Cleanse and Detox for Great Health” seminar. Nutritionist and colleague Monica Cullinane and I will review the science on cleanses and detox programs. She follows our seminar with a cooking class geared toward detox foods and then a 10-day detox program. Call 970-245-6911 if you are interested in consulting with Monica to plan your own detox program.

Scott Rollins, M.D., is board certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call 970-245-6911 for appointments or more information. 

Dietary Confusion Part 2: Tips for Creating Your Own Diet Plan

In last week’s column I reviewed the pros and cons of 12 diet plans, from the Atkins to the Zone.  Gleaning the best from each I’ll layout what I consider to be a healthy dietary guideline, whether you are trying to lose weight, maximize athletic performance, or simply stay healthy.

Quantity

Super-size meals equal super-size waistlines.  Taking in way more calories than necessary leads to weight gain, and weight loss will not happen unless we limit our intake to a reasonable amount.  Many of us were taught to “clean our plate” and finish what we are served so as to not be wasteful.  Consider serving sizes! 

A proven technique to limit serving sizes is to serve food on a smaller plate – same foods but smaller serving sizes.  Also, remember that it takes about twenty minutes for the brain to “catch-up” to the stomach.  This means we often eat and eat until our brain is satiated, at which point our stomach is stuffed.  Eat half a sandwich or half the entrée, wait a bit, and see if you are still hungry.  Have a cup of tea or coffee after a meal, and wait a bit to see if you are still hungry for that calorie-packed dessert!

Humans are not equipped to “wolf down” large amounts of food every few days or even once per day.  We are designed to be grazers, eating frequent small meals.  Having three meals per day with snacks in between fits well with our physiology. 

While some studies suggest that skipping breakfast does not interfere with weight loss I have to disagree with the notion that skipping breakfast is ok, particularly for those who are overweight and already have impaired hunger hormone signals.  When we awaken from a full night of sleep, the body is ready to “break the fast” and replenish energy supplies.  If we skip breakfast, then the body has to breakdown stored energy supplies into glucose for fuel.

Skipping breakfast is sort of an emergency to the body, calling on the stress hormone cortisol to signal glucose production, and it can lead to wide swings in blood sugar and insulin.  This will often leave people feeling weak, shaky, tired, or anxious feeling.  Excess cortisol also causes fat to accumulate around the midsection. 

Quality

Our ancestors got their carbohydrates from raw, organic fruits and vegetables.  We are designed to get six, eight or even ten servings per day.  Are you there yet?  90% of Americans don’t get five per day, and this is where we are supposed to get many vitamins and nutrients that are vital for proper metabolism and hormone function. 

Sugar and starch are also carbohydrates.  In the year 1900 the average American ate about 3 pounds of refined sugar per year.  Flash forward to a 1994 study that showed we were up to between 50 and 150 pounds per year.  We are not designed for so much sugar!

Starch is a very simple carbohydrate that is digested and broken down so quickly that it may as well be sugar.  Grains, potatoes, pasta and rice are classic examples.  I’m not saying don’t eat these, just eat so much, and when you do, try for whole-grain products that take longer to break down and have more nutrients.  Wheat breaks down to glucose so fast it will actually spike blood sugar quicker than the same amount of table sugar.

Why should fruits and veggies be raw?  Enzymes for digestion and the nutrients for good health are found in raw foods.  Canned foods lose about 50% of the nutrients, while freezing causes a 20-30% loss.  Raw foods also maintain higher levels of healthy fiber.

Why organic?  Aside from avoiding all the crazy chemicals (a whole other matter) our foods get nutrients from soil, and soils that rely on synthetic fertilizers are mineral depleted.  Organic farming practices encourage nutrient rich soil, which means nutrient rich food.  Plus, organic produce usually tastes better.

Proteins and fats typically come together in food.  We are designed for lean protein that is either lower in total fat or higher in the healthy omega-3 fats, such as wild game and fish.  This does not jive with the American sources including grain-fattened red meat, dairy and processed foods such as chips and pastries.  Again, I’m not suggesting to avoid red meat or dairy, but to recognize there are other protein rich foods and we are getting proportionately way too much saturated fat from our typical protein sources. 

For healthy protein, try grass-finished beef, venison, free-range chickens and eggs, wild salmon and tuna, European or Greek style yogurts, fermented soy products such as Tempeh, protein rich grains, nuts and seeds, and legumes including peas and beans.

Fats are perhaps the most misunderstood dietary element.  Since the American Heart Association (AHA) began its ideological low-fat campaign back in the 1980s we have seen obesity rates skyrocket.  It seems trading fat for sugar and starch isn’t working out so well.  The AHA missed the point in that we need “good” fats, for fuel but also for the essential fatty acids, omega-3 and omega-6, which have important roles in metabolism and inflammation. 

Consume healthy oils from fruit (olive), nuts (almonds, pecans, walnuts), or seeds (flax, chia, pumpkin).  Cook with heat stable oils such as coconut oil or butter.  Use the more fragile, lighter oils, such as olive, canola or safflower, in salads or dips.  Stay away from unhealthy adulterated fats including “trans-fats” and “hydrogenated oils” which are found mostly in processed and packaged foods, and margarines.

My Dietary Plan

Eat breakfast.  Have a salad entrée for lunch or dinner including lots of greens with brightly colored red, yellow, orange or purple veggies.  Have a healthy protein with every meal.  Snack on nuts, fruits or veggies.  Enjoy sparkling water or tea with lunch and wine with dinner.  Avoid sugar in all its forms, minimize high-glycemic carbohydrates and use salt sparingly.  Serve meals on small plates with roughly 1 part protein, 2 parts fruit or veggies, and 1 part starch such as bread, pasta or rice.

Take time to sit and enjoy meals – don’t eat on the run or when you are distracted.  Set down the utensils, chew slowly, and savor your food.  Try to make mealtime an important time to visit with co-workers, family or friends.

If you don’t cook, learn to cook.  Make a mess, make mistakes, but learn to cook.  It will open up a world of healthy foods.  If you have to rely on prepared foods, go for healthy versions such as NutriSystems.  If you struggle with portion control or need moral support, join Jenny Craig or Weight Watchers.

If you need to lose weight be certain that hormones such as thyroid, estrogen, and testosterone are optimized.  Get control of high cortisol.  Get tested for delayed food allergies particularly to gluten and dairy that can cause weight gain.  Consider the HCG diet if you need a “catalyst” to get weight under control. 

That’s it for the “Rollins-Paleo-Mediterranean-Colorado Diet” – hey, maybe the world needs another diet book!

FREE SEMINARS

“Cleanse and Detox for Great Health”

Monday, April 15^th

“Bioidentical Hormone Replacement for WOMEN

Monday, April 29^th

Seminars are at 6pm, at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com).  Call 245-6911 for an appointment or more information.