Headaches? Fatigue? Detoxification Might Be The Solution

“For the first time in the history of the world, every human being is now subjected to contact with dangerous chemicals, from the moment of conception until death.  In the less than two decades of their use, the synthetic pesticides have been so thoroughly distributed throughout the animate and inanimate world that they occur virtually everywhere.”

While this quote sounds like a line from a recent news report, it is actually an excerpt from Rachel Carson’s book Silent Spring published in 1962.

Detoxification seems to be a buzz word these days. Just google detoxification. You will find everything from water detoxification to colon cleanses.

So what is detoxification? The official definition of detoxification is this: the chemical changes of a xenobiotic, a phytochemical, or an endogenous (one your own body makes) compound that renders it less toxic and ready to be excreted. In layman’s terms, detoxification is the way our body protects us from things that we take in that could damage our body.

The ideal situation is toxins in and toxins out, right? If the body is working as designed, then it should be toxins in and toxins out. And how does the body get toxins out? There are many organs that detoxify: the skin (through sweating), kidneys (through urination), and the liver – the most important detox organ. The liver detoxification mechanism involves 2 main processes: Phase I and Phase II detoxification.

Phase I detoxification involves the cytochrome P-450 system in the liver. This is the first line of defense against all toxins. Toxins are tagged and altered for further detoxification, which then occurs in Phase II.  Any break down in this process will result in increased toxin load on the body.

We are what we eat, drink, breath, and touch. But did you ever think that we are what we don’t eliminate? Without elimination of the toxic chemicals we take in and produce every day, our bodies swim in a sludge pool of toxins.

This increased toxic load on the body leads to inflammation, the balance between pro-inflammatory and anti-inflammatory substances. The balance between Omega 6, a pro-inflammatory subtance, and Omega 3, an anti-inflammatory substance, is the perfect example.

It is the chronic imbalance of  pro-inflammatory substances that then leads to disease.

Shouldn’t the aim of all health care be to prevent inflammation and, therefore, disease? It is in fact, one of the main focuses of the Seasons approach to health and wellness.

Ever wonder if you need to detoxify? My first recommendation is look at and listen to your body.  The body will tell you if it is in trouble or imbalanced. How? Physical signs or symptoms are our body’s message that all is not right. Here’s how to know if you body’s signs and symptoms are saying that you might be suffering from toxic build up.

• Headaches
• Muscle aches and pains
• Fatigue
• Asthma
• Allergies
• Skin disorders
• Chronic infections
• Altered mood
• Altered cognition
• Weight gain
• Altered stress tolerance
• Altered libido
• Infertility

Where do toxins in our bodies come from? Toxins are everywhere. The sources can range from toxins like Dioxins to prescription medication.  Adverse reactions to prescription drugs have been ranked as the 4^th to 6^th leading cause of death in the US according to the Journal of American Medical Association. This amounts to over 100,000 deaths per year.  The cause of adverse drug reactions is an overloaded pathway in Phase I of detoxification (CYP3A4), the pathway that detoxifies over 50% of all drugs in your system. The costs associated with adverse drug reactions has been estimated at up to $4 billion. With the rising costs of health care, treating the cause of these adverse drug reactions in addition to decreasing prescription drugs are two excellent ways to prevent complications and lower costs.

The most dangerous sources of toxins are environmental. Organochlorine pesticides, industrial chemicals, and unintended chemical byproducts surround us everyday and expose us to unwanted toxins. Widespread production of  pesticides began less than 80 years ago. Recently, the EPA estimated that more than 4 billion pounds of chemicals were released into the grounds natural water sources in the year 2000.

In addition to pesticides and chemicals, the average American eats, unknowingly I might add, 124 pounds of additives per year. Frightening to think of it, isn’t it? And over 2.5 billion pounds of pesticides are used on crop lands, forests, lawns, and fields. The unfortunate fact is this: we live in a toxic world.

How can you decrease your daily exposure to toxins? Here are some great ways.

1. Avoid processed foods
2. Avoid fats
3. Avoid tap water — use filtered water
4. Avoid excess caffeine
5. Avoid excess alcohol
6. NO tobacco
7. Limit chronic medicine, if possible
8. Daily exercise
9. Avoid exposure in your workplace
10. Avoid living near industrial plants
11. Avoid liver dysfunction
12. Avoid kidney problems
13. Avoid intestinal dysfunction

The first ten suggestions are steps you and I can take every day to decrease our toxin exposure. But the last three require a bigger step: detoxification. By detoxifying your body, the liver, kidney, and intestines can operate more efficiently and effectively.

So, the question is not who needs detoxification, but who does NOT need detoxification?  The answer? EVERYONE will benefit from a periodic detoxification program. For more information on how to detoxify, contact our office at 865-675-WELL(9355).

The Low-T Epidemic: Hormone Receptors Revealed

Male infertility. Decreased sperm count. Did I grab your attention? These are just two of the symptoms of Testosterone Deficiency (TD), more commonly referred to as Low-T.

TD has become such a widespread problem that one study (The 20-Year Public Health Impact and Direct Cost of Testosterone Deficiency in U.S. Men) projects over the next 20 years TD will:

• Be involved in the development of approximately 1.3 million new cases of cardiovascular disease;
• Be involved in the development of 1.1 million new cases of diabetes mellitus;
• Be involved in the development of over 600,000 osteoporosis-related fractures; *create medical-related costs, in the first year, of approximately $8.4 billion;
• And be directly responsible for approximately $190–$525 billion in inflation-adjusted U.S. health care expenditures over the 20-year period.

So if TD is causing such widespread health issues, how will we solve the Low-T problem? As I mentioned in my last post, there are four components necessary for wellness, good physiologic function, and symptom-free living. Let’s take a look at the fourth on the list.

Hormone receptors must appropriately respond to the signal sent by the hormone to your body. To take a closer look at the Low-T problem, let’s look at androgen receptors.

What is a hormone receptor? Hormone receptors are the landing place for hormones inside your cells. Once a receptor receives the hormone and its message, the receptor undergoes a change sending a signal to the cell nucleus and DNA. [Side note: This is one reason that hormone testing via saliva (not just blood) is such an effective way to evaluate hormones in the body. Saliva testing allows a look at hormones at the sight of action, revealing the free, bioactive hormone inside the cell.]

What is an androgen receptor? Androgen receptors play catch to the two most potent androgens, Testosterone and dihydrotestosterone (DHT) which actually compete for the same receptor. These two hormones are present in both males and females but are typically known as male hormones. Both Testosterone and DHT are very important in development, but here’s an unexpected fact – the androgen receptor actually likes DHT better than Testosterone. What?

You heard me correctly. The androgen receptor has an affinity for DHT over Testosterone. So why in the world are we prescribing so much Testosterone to cure the Low-T problem if it’s not the best solution? Here are some DHT facts.

• DHT inhibits estrogen production. Remember estrogen is a major culprit in inflammation, obesity, weight gain, and hormone imbalance.

• DHT is a more potent androgen than Testosterone. DHT is the most potent androgen exceeding that of Testosterone by a ratio of 3:1. Its increased potency is through its greater affinity for the androgen receptor. And that greater affinity is by a ratio of 3:1.

• DHT does not get converted to estrogens. This is a major problem with simply prescribing Testosterone to men…the body is converting much of it to estrogen.

• DHT binds with a higher affinity and longer duration (5 x longer) to the androgen receptor. Testosterone compensates for this by increasing it’s concentration relative to DHT. Only about 5% of testosterone is converted to DHT. So, a smaller amount of androgen (DHT) has a larger signaling effect due to it’s higher affinity and binding time with the receptor.

Pulling Back The Curtains On Dr. Oz: The Truth About IV Nutrition Therapy

Wow! Now that’s scientific (insert sarcasm). We live in day where we have instant access to data and scientific research, and that is his closing statement?

As physicians, we often forget that we are scientists. Our testing and therapies should be based on science, not opinion. Yet, neither Dr. Oz nor his guest presented any scientific data to support their statements in favor or opposition. So, allow me to do the job that Dr. Oz and his guest did not.

Intravenous nutritional therapy has been around since IV vitamin C was first used for treatment of polio in 1949. Is it something everyone needs? Of course not. Should everyone take insulin? You get my point.

At Seasons, we evaluate a client’s needs based on symptoms. The symptoms lead us to extensive metabolic testing to determine the specific presence and severity of deficiencies of amino acids, fatty acids, vitamins, minerals, etc. Only then do we recommend IV nutritional therapies using the metabolic test results combined with the client’s symptoms. That is what medicine is all about – using the art and science of medicine for the patient’s benefit.

Another reason to use IV nutritional therapy is that for most Americans, our guts are a wreck (and that is putting it mildly). Absorption problems are a major concern for Americans. If you can’t absorb a vitamin or nutrient, it doesn’t matter how good the source or the dosage of therapy is, it just won’t be absorbed. If you are dealing with severe deficiencies, then you’ll never catch up.

How about an analogy to paint a clearer picture? A patient seeks help from a physician for severe dehydration. The patient just can’t keep anything down. Is the physician going to give the patient a pat on the back, tell them to just drink more water, and send them on their way? Of course not. The physician knows that the patient cannot tolerate oral therapy at that point. The deficiency is severe. The physician knows that he/she must catch the patient up, and then instruct the client to drink more water. And how does the physician “catch” the patient up? Well, IVs of course.

Does Dr. Oz question the safety, validity, and benefits of this therapy? Of course not. That is because it is standard practice. Standard practice is defined as: whatever everyone else is doing. I remember my mom often asking me, So…if everyone else jumps of a cliff, are you going to do that too?

And the testing to determine dehydration? Very limited. Usually, a urinalysis, complete blood count test (CBC), maybe a general chemistry, and of course a physical exam. From experience and training, I can tell you that the IV fluids are started based on the physical exam, before the test results get back. That is not how we approach IV nutritional therapy at Seasons. Dr Oz gave the impression that people just walk into a Doctor’s office to order IVs as one would a hamburger at a fast food drive-through. We customize therapy to specific needs and match it with their specific metabolic demand.

So, what does the science say about IV nutritional therapy? The science is overwhelmingly in favor of IV nutritional therapy.

The research below looks at surgical patients. It is well known that poor nutritional status of the patient undergoing surgery effects outcome. These studies showed that IV nutritional therapy improved outcomes. This is not total peripheral nutrition (TPN). TPN is therapy to replace all nutrition. Intravenous nutritional therapy is just to replace vitamins, minerals, and maybe some targeted macronutrients.

• Bellantone R, Doglietto G, Bossola M, Pacelli F, Negro F, Sofo L, Crucitti F. Preoperative parenteral nutrition of malnourished surgical patients. Acta Chir Scand. Apr 1988;154(4):249-51.
• Rham D. A guide to perioperative nutrition. Aesthetic Surgery Journal. July-August 2004;24)4):385-390.
• Xu J. Yunshi Z, Li R. Immunonutrition in Surgical Patients. Current Drug Targets. Aug 2009;10(8):771-777.
• Beier-Holgersen R, Boesby S. Influence of postoperative enteral nutrition on postsurgical infections. Gut. 1996;39:833-835.

So, what about the other benefits of IV nutritional therapy?

During Pregnancy

• Wolk RA, Rayburn WF. Parenteral nutrition in obstetric patients. Nutr Clin Pract. Aug 1990;5(4):139-52.
• Rayburn W, Wolk R, Mercer N, Roberts J. Parenteral nutrition in obstetrics and gynecology. Obstet Gynecol Surv. Apr 1986;41(4):200-14.
• Russo-Stieglitz KE, Levine AB, Wagner BA, Armenti VT. Pregnancy outcome in patients requiring parenteral nutrition. J Maternal Fetal Med. 199;8:164-7.
• Zibell-Frisk, Jen KL, Rick J. Use of parenteral Nutrition to maintain adequate nutritional status in hyperemesis gravidarum. J Perinatol. 1990;10:390-5.

First trimester miscarriage

• Acacio B et al. Pregnancy outcome after intralipid infusion among women experiencing recurrent pregnancy loss. Fertility & Sterility. Apr 2008;89(4):S11.
• Roussev RG et al. Duration of intralipid’s suppressive effect on NK cell’s functional activity. Am J Reprod Immunol. Sep 2008;60(3):258-63.

Viral illnesses

• Klenner FR. Massive doses of vitamin C and the virus diseases. J So Med & Surg. April 1951;113(4).
• Schencking M, Vollbracht C, Weiss G, Lebert J, Biller A, Goyvaerts B, Kraft K. Intravenous vitamin C in the treatment of shingles: results of a multicenter prospective cohort study. Med Sci Monit. Apr 2012;18(4):CR215-24.
• Gorton HC, Jarvis K. The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manipulative Physiol Ther. Oct 1999;22(8):530-3.

Critical Illness

• Tanaka H, Takayoshi M et al. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration. Arch Surg 2000;135.326-331.
• Crimi E et al. The beneficial effects of antioxidant supplementation in enteral feeding in critically ill patients: a prospective, randomized, double, blind, placebo- controlled trial. A & A. Sept 2004;99(3):857-863.

Liver Damage

• Dentico P et al. Glutathione in the treatment of chronic fatty liver disease. Recnti Prog Med. Jul-Aug 1995;86(7):7-8):290-3.
• Smith SW, Howland MA, Hoffman RS, Nelson LS. Acetaminophen overdose with altered acetaminophen pharmacokinetics and hepatotoxicity associated with premature cessation of intravenous N-acetylcysteine therapy. Ann Pharmacother. Sep 2008;42(9):1333-1339.
• Mitchell JR et al. Acetaminophen-induced hepatic necrosis. IV protective role of glutathione. JPET. Oct 1973;187(1):211-217.

Pain

• Chen JY, Chu CC, So EC, Hsing CH, Hu ML. Treatment of postherpectic neuralgia with intravenous administration of vitamin C. Anesth Analg. 2006;103:1616-1617.
• Schencking M, Sandholzer H, Frese T. Intravenous administration of vitamin C in the treatment of herpetic neuralgia: two case reports. Med Sci Monit. 2010;16:58-61.
• Chen JY, Chang CY, Feng PH, Chu CC, So EC, Hu ML. Plasma vitamin C is lower in postherpetic neuralgia patients and administration of vitamin C reduces spontaneous pain but not brush-evoked pain. Clin J Pain. Sep 2009;25(7):562-9.

Cancer

• Riordan HD et al. A pilot clinical study of continuous intravenous ascorbate in terminal cancer patients. P R Health Sci J. Dec 2005;24(4):269-76.
• Mikirova N, Casciari J, Rogers A, Taylor P. Effect of high-dose intravenous vitamin C on inflammation in cancer patients
• Ohno S, Ohno Y, Suzuki N, Soma G, Inouse M. High-dose vitamin C (ascorbic acid) therapy in the treatment of patients with advanced cancer. Anticancer Research. Mar 2009;29(3):809-815.
• Chen Q et al. Pharmacologic ascorbic acid concentrations selectively kill cancer cells: Action as a pro-drug to deliver hydrogen peroxide to tissues. PNAS. Sept 20 2005;102(38):13604-13609.

Blood Pressure

• Juraschek SP, Guallar E, Appel LJ, Miller ER III. Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials. Am J Clin Nutr. May 2012;95(5):1079-1088.
• Schneider MP et al. Superoxide scavenging effects of N-actylcysteine and vitamin C in subjects with essential hypertension. Am J Hypertens. 2005;18:1111-1117.

Autoimmune Disease

• Mikirova N, Rogers A, Casciari J, Taylor P, Effect of high dose intravenous ascorbic acid on the level of inflammation in patients with rheumatoid. Modern Research in Inflammation. 2012;1(2):26-32.

Parkinson’s Disease

• Sechi G et al. Reduced intravenous glutathione in the treatment of early parkinson’s disease. Progress in Neuro-Psychopharmacology and Biological Psychiatry. Oct 1996;20(7):1159-1170.
• Hauser RA, Lyons KE, McClain T, Carter S, Perlmutter D. Randomized, double- blind, pilot evaluation of intravenous glutathione in Parkinson’s disease. Mov Disord. May 15 2009;24(7):979-83.

Neuropathy

• Kuwabara S et al. Intravenous methylcobalamin treatment for uremic and diabetic neuropathy in chronic hemodialysis patients. Intern Med. Jun 1999;38(6):472-5.
• Ziegler D et al. Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials. Exp Clin Endocrinol Diabetes. 1999;107(7):421-30.

As you can see, the benefits of IV nutritional therapy are abound. That is not my opinion, but scientific fact.

How safe is IV nutritional therapy? The studies below showed the safety of IV nutritional therapies in all states of health, including pregnancy.

• Greenspoon JS, Rosen DJ, Ault M. Use of peripherally inserted central catheter for parenteral nutrition during pregnancy. Obstet Gynecol. May 1993;81(f (Pt2)):831-4.
• Valencia E, Hardy G. Practicalities of glutathione supplementation in nutritional support. Current Opinion in Clinical Nutrition & Metabolic Care. May 2002;5(3): 321-326.
• Padayatty SJ et al. Vitamin C: Intravenous use by complementary and alternative medicine practitioners and adverse effects. PLos ONE 5(7):e11414.

Just because Dr. Oz (the great and powerful, Dr. Oz) says it is so doesn’t make it so. I hope I’ve helped pull back the curtain and expose the real science supporting IV nutritional therapy.

New Perspectives On Hormone Balance Ahead

Top 5 Reasons for NOT Buying Supplements at Discount Stores: Pharmaceutical-Grade Supplements Explained

Over 75 percent of the world’s population takes some kind of supplement daily. I am a huge advocate of supplements. Everybody should be taking, at the very least, a multi-vitamin. We just don’t get the same nutritional value from our foods that our parents and their parents did.

But will any source do? The quality of most over-the-counter (OTC) supplements just won’t cut it. The old adage “You get what you pay for” still rings true. If it costs $5 for a month’s supply of a particular vitamin, you are getting the quality of that $5, which is not much. So why pay $40 for that same vitamin because it is labeled “pharmaceutical grade?” Let me explain.

As stated by Health*Edge Sciences, there are three grades of raw materials in the U.S.:

• Pharmaceutical Grade
• Food Grade
• Feed Grade

Pharmaceutical grade is defined as greater than 99% purity without binders, fillers, dyes, or other substances. Food grade means it safe for human consumption. And feed grade implies it is safe for animal consumption (which usually ends up as human consumptions…but that is an article for another day). And can the FDA monitor all these supplements in the Unites States? Of course not. It is beyond their scope and ability.

Let’s make break down pharmaceutical grade into a more applicable definition.

1. Quality

Many supplements will only contain 10% of the raw material and 90% of other fillers. 

2. Contamination

Lack of purity or contamination has been a long-standing problem. From news reports, you might already know that Mercury-contaminated fish had been used in many Omega-3 supplements. That’s not the case with pharmaceutical grade supplements as they commonly exceed the definition of “pharmaceutical grade.” For example, Nordic Naturals exceeds both the Norwegian Medicinal and European Pharmacopoeia standards.

How about globally? According to ConsumerLab in 2002, 5-10% of all supplements were contaminated with lead. Lead in any level is toxic to the body. To have any contamination of such toxic substances as Lead and Mercury is simply unacceptable. Lead and Mercury are listed #2 and #3 respectively, in the 2007 Agency for Toxic Substances and Disease Registry‘s toxicity rankings.

3. Bioavailable

All supplements and prescriptions have fillers in them. These fillers are needed, but they can cause many problems with the supplement. First, they can actually inhibit the absorption of the product, leaving the products completely useless. Second, the filler can be toxic to the body. Third, the filler can be a common allergen.

4. Active Form

The key to a good vitamin is not just if the vitamin/supplement is absorbable, but is it absorbable in the active form. Why is this important? One example is the energy required to convert from an inactive to active form. Many of the clients that we see  at Seasons struggle with energy production, ATP. The conversion of inactive to active requires enzymes, which requires energy. We conserve energy by giving the supplements in the active form when at all possible.

The most common prescribed vitamin B12 on the market is cyanocobalamine. The body makes cyanide as a by-product of the break down of cyanocobalamine. Obviously, we want to avoid the introduction of any potentially toxic substance to the body. At Seasons, we choose to give the active form of Vitamin B12, methyl-cobalamine, to avoid this toxic by-product. There is no reason to give the inactive form of Vitamin B12.

5. Third Party Testing

A good test of any product, is not what you say about it, but what third parties say. This is one of the big benefits of pharmaceutical grade supplements. They will be tested by third party companies to assure quality, potency, and absence of contamination. Of course, there are some “pharmaceutical grade” companies that don’t follow these standards, and this is the reason to work with your Integrative Medicine physician to ensure that your supplements are of the highest quality.

Yes, Virginia, There Are Zombies About

Navigate Your Health Journey With Good Reading

 

Because Tennessee ranks 39th in overall health of its citizens [according to America’s Health Rankings], we are passionate about educating the community on how to improve their health. I spend time daily reviewing the latest findings from scientific studies related to health and wellness topics to insure that Seasons is always offering the latest and best solutions for pursuing wellness.

Contrary to the belief of many, good health is not something that can be mandated from government or given to you by a physician. Health is a personal journey acheived only through education and self-awareness. At Seasons, our goal is to provide you with the resources you need to improve the health of you and your family.

Here are five books that are easy reads and are rich in good information for your health journey.

Inflammation Nation by Floyd H. Chilton, PhD

Inflammation Nation was written by Dr. Floyd H. Chilton in 2005. While the book goes back a few years, it is still incredibly relevant. Inflammation is one of the primary problems/obstacles to health today. Inflammation, in the short term, is a necessary part of the healing process. When you are cut, the “inflammation” present through redness, pain, and swelling works to protect the body from invasion and to start the process of healing. But the inflammation subsides quickly. However, in some, inflammation rages on and promotes disease.

It would make sense that if something, certain types of food for example, were causing inflammation in our body and ultimately leading to disease, we would want to eliminate the problem, reduce the inflammation and prevent disease, right? Dr. Chilton discusses the immune system and how our diet affects it. The old adage “you are what you eat” definitely applies here.

Inflammation Nation is an easy read and provides many easy recommendations to incorporate into your daily life.

The Wheat Belly by William Davis

The Wheat Belly is written by William Davis. Very rarely do I encounter clients that have not read or heard of this book. This book touches on a growing problem in America and the world today – an adulterated food supply. Not food supply that is adulterated with parasites or bacteria, but that is adulterated from within. What does that mean? In The Wheat Belly, Dr. Davis touches on the fact that the wheat of today is not the wheat our parents ate. Not only is the nutritional value present in wheat lost, but the genetic modification is likely contributing to inflammatory problems.

The problem with genetically modified foods (GMO) is we have limited knowledge of their impact on the body. And the federal government and its agencies have never done a good job of investigating these items before rushing them to market. Just look at the history of environmental toxins such as phthalates, parabenes, and other volatile solvents, all brought to market labeled as safe only to be removed from the market when revealed as seriously dangerous toxins.

This book is also a very easy read and provides easy dietary recommendations to immediately bring positive changes to your health.

What Your Doctor May Not Tell You About Breast Cancer by John R. Lee, M.D., David Zava, Ph.D., and Virginia Hopkins

This was the very first integrative medicine book I read in 2006. This book goes back to several founding people in the integrative medicine movement like Dr. John Lee, an oncologist who led the movement in bioidentical hormones and saliva testing. Dr. Lee was ostracized by the medical community, but his commitment to his patients and to true scientific evidence is an example for all to follow. In fact, Dr. Zava believed in this movement so much that he started a saliva-testing company.

As it relates to breast cancer, there are few more published than Dr. Lee and Dr. Zava. I have met Dr. Zava personally on several occasions, and there are few that I would put above his in both scientific integrity and commitment to true science.

This book lays out a different approach to breast cancer, one focusing on prevention instead of early detection. Traditional medicine focuses instead on early detection and cancer treatment. Don’t get me wrong. We need that, but true prevention is where we should first focus.

The book is deep at points, but is a good discussion of biochemistry and physiology as it relates to breast cancer. Its focus on more natural ways to prevent breast cancer is based on the scientific research. The book clears up much of the misinformation about hormones and breast cancer and equips the reader to be advocate in the prevention of breast cancer.

The book’s authors were unafraid to take on traditional medicine, but do so with a good foundation of science.

The Blood Sugar Solution by Dr. Mark Hyman

Dr. Hyman is a great proponent of wellness and a pillar in the integrative medicine community. This book, published earlier this year, is an easy weekend read with numerous tools to incorporate into everyday life. The focus of this book is nutrition, sugar, in particular.

Obesity is at epidemic levels in the United States. According to CDC data, 13 states now have an obesity rate greater than 30 percent, while in the year 2000, NO states reported obesity rates greater than 30 percent. This book takes the major culprit head-on: diet.

The Blood Sugar Solution delves into diet, insulin, insulin resistance, and a host of other factors contribute to poor health. The book provides many tools to succeed in the “battle of the bulge,” and even includes recipes to help you succeed in your personal health journey.

What Your Doctor May NOT Tell You About Hypertension by Dr. Mark Houston

If you ever have the chance to meet Dr. Mark Houston, you will surely be impressed. Mark Houston, M.D., is Associate Clinical Professor of Medicine at Vanderbilt University School of Medicine, Director of the Hypertension Institute and Vascular Biology, and Medical Director of the Division of Human Nutrition at Saint Thomas Medical Group, Saint Thomas Hospital in Nashville, Tennessee.

While his list of credentials are a mouth full, to hear him speak will fill your ear! As a cardiologist focused on an integrative approach, there are few that speak so eloquently on the deep biochemical disease found in cardiovascular disease.

While the subject matter might sound intimidating, this book, is a very easy read and focuses on the underlying dynamics of hypertension and associated complications. Dr. Houston defines the problem and lays out solutions with his wildly successful program for treatment of hypertension using an integrative medicine approach.

Dr. Houston also provides a health discussion of hypertension medications, when needed, and the mode of action and side effects of each. This a definite must-read for anyone on hypertension medications. You might just become more informed than your own physician!

While this book is a self-help guide to natural treatments of hypertension, it is based on sound science and the approach has been extremely successful. This book is also heavily referenced, allowing you the option of pursuing deeper learning if desired. This book removes every obstacle to reducing hypertension except you. It’s your job to act on what you read.

The Naturally Healthy Woman: Whole Health for the Whole Woman by Shonda Parker

Yes, I know I said five and this is number six! But this is a very good manual for women and their health. As an OB/Gyn, my first passion was women’s health. The author, Shonda Parker, whom I have met, is a true blessing to know. There are few who have a passion for health that exceeds hers, and she has an ever better spirit. Shonda is a nurse midwife, has authored many books, and speaks nationally on health and other related topics. This book highlights many of the health issues facing women today, and I predict that the edges of this book will become tethered due to your repetitive use after reading it.

As a nurse midwife, the author’s first passion is pregnancy. This book begins by touching and then builds into many other health issues affecting women. The author provides many natural remedies at the end of each section for the different health issues discussed. The book not only provides natural therapies for the mother/wife, but also for the rest of the household.

Every pathway to health is different. Every journey to wellness is unique. At Seasons, our desire for wellness for all begins with education and knowledge for you. I hope that these books will become additions to your library and provide you with the knowledge you need in your personal journey toward wellness.

Evaluating Hormones Requires More Than Just a Blood Test

“I just don’t feel right.” These are frequently the first words I hear a patient say. “I’m so hormonal…I know I’m not balanced. I’m tired, cranky….” and so goes the list of symptoms, all of which indicate hormone imbalance.

It’s amazing to me that most patients know intuitively that they don’t feel good and it has something to do with hormones, but they’ve had a blood test by their physician and everything checked out “okay.” That blood test, however, didn’t change the fact that they still feel terrible.

There is a lot of debate these days regarding the different methods of evaluating hormones: blood, saliva, and urine (oh my). In a few short weeks, school will start. So to get back in the swing of things, today school is “in session” and a science lesson is the order of the day. The topic? How are hormones evaluated and which is the best test for you?

Hormone Delivery and FedEx?

Understanding complicated topics is often made simple with a great analogy. My good friend, Dr. Eldred Taylor, uses the analogy of FedEx trucks to explain hormones and their delivery to the cells of the body. And I especially like this analogy because my dad has been a pilot for FedEx for many years!

FedEx trucks are everywhere during the month of December. It wouldn’t be unusual for a lot of trucks to pass your house during that month. But, if the FedEx trucks don’t stop at your house, it doesn’t really matter how many trucks have driven by your house or how many packages each truck contained. The fact remains that none stopped for delivery. It only takes one FedEx truck to stop at your house and the Christmas tree is full.

I’ll take it one step further. The day after Christmas, the boxes and wrapping paper are piled up at the road-side for pickup. You might comment as you drive by your neighbor’s house “It looks like the Jones’ had a good Christmas” based on the curbside aftermath. You can even make out what the gifts were based on the leftover boxes and debris on the curb.

What does it all mean? The FedEx trucks symbolize hormones in transport in the blood. It doesn’t matter how many hormones are transported through the blood (FedEx trucks), they are inactive (the truck didn’t stop at your house). When the FedEx truck stops at your house, it symbolizes when hormones are dropped off for action inside the cell. One truck can drop off 100 packages or 100 trucks can drive by, dropping off no packages. Finally, the post-Christmas driveway debris represents the hormones after the body has broken them down into metabolites.

Hormones can be evaluated through three different testing methods: blood, saliva and urine. Blood testing evaluates the number of FedEx trucks in your neighborhood. Saliva testing evaluates the number of packages delivered at your house. And urine testing evaluates the post-Christmas driveway debris to identify what packages were delivered and opened.

So what does the science say about the hormone testing methods of blood, saliva, and urine?

Blood Testing

Testing hormones present in the blood has been used to develop the current reference norms that we use in the diagnosis and management of many diseases. It has been around a long time. This kind of testing is effective in the disease model of medicine. However, in the wellness model of medicine, we are looking for dysfunction, not just disease. And this is where the effectiveness of blood testing breaks down.  By identifying physiologic dysfunction, we hope to prevent disease. It is the move into true preventative medicine, not just early detection, the wellness model of medicine has found the blood testing of hormones to be lacking.

There are three main problems with blood hormone testing.

1. First, is the whole idea of a needle. If we can evaluate hormone levels without puncturing the skin, then we should.
2. Blood testing evaluates hormones in transport. This is typically reported as “total” hormone levels and the “free” active levels are calculated. Transported hormones are inactive. Hormones in the blood are bound to proteins (estimated at 95-99%) and inactive. Going back to the FedEx truck analogy, blood testing tells me how many FedEx trucks there are and how many packages they have to deliver. But it doesn’t tell me how many packages were delivered at your house. And that’s a very important piece of information. Are your hormones coming or going? And is your body utilizing the hormones you have?
3. It is not the most accurate form of testing. Saliva testing is proving to be superior to blood testing for measuring hormones (see Saliva below).

Urine Testing

The use of urine to evaluate cortisol has been present for awhile.  And this is a valid method to test cortisol, one of your body’s hormones. The problem with this form of testing is that most people don’t want to carry a jug around collecting urine for 24 hours.

Currently, the interesting research on urinary testing of hormones is in the measurement of metabolites. Think back to our analogy. Urinary testing is best used for looking at the curbside debris to see what presents were opened at Christmas. By measuring metabolites, we can see how effectively your body is metabolizing hormones. If your body is ineffectively metabolizing hormones, the resulting symptoms and conditions can include Chronic Fatigue Syndrome, obesity, fatigue, and increased breast cancer and prostate cancer risk to name a few. These issues are all treatable at Seasons Wellness Clinic with a customized wellness plan based on your test results.

Saliva Testing

Saliva testing for hormones first appeared in the medical research literature in the early 1980′s. Saliva is becoming the testing method of choice for many different reasons. Going back to our analogy, saliva testing measures the number of packages that are delivered by the FedEx truck at your house.

1. Saliva testing evaluates the “free” (active) hormone levels. A hormone has to be unbound to elicit a physiologic action. Saliva testing looks at the active hormone inside the cell, at the site of action. Saliva testing has been validated as a testing method for measuring the hormones cortisol, estradiol, progesterone, DHEA, and testosterone to name a few.
2. Second, saliva testing requires no needles.
3. Saliva testing has been shown to be well validated and superior than blood, with sensitivities and specificities exceeding 100% and 97.4% respectively.  Other than perfection, you can’t get much better than that.
4. According to the National Institute for Health, saliva testing is useful in “detecting various cancers, heart disease, diabetes, periodontal disease…”
5. Saliva testing is also useful in disease evaluation. Saliva testing of cortisol has been recommended as the first-line test for Cushing’s syndrome due to “high diagnostic accuracy.”

Saliva testing gives me the information I need to diagnose what’s going in your body. And while that is my opinion based on my training, it’s also opinion based on scientific fact according to hundreds of research articles (see links to additional articles below). Saliva testing is now considered the “gold standard” for hormone evaluation.

Today you have learned about the three methods physicians use for evaluating hormones: blood, saliva and urine. You’ve also learned that each test is useful for measuring different things. We can evaluate hormones many different ways at Seasons and determine not only the amounts of a specific hormone in your body, but also how effectively your body is actually using (or not using) those hormones with saliva and urinary testing.

Most important is the clinical relevance of each test. Testing the hormones at the site of action provides the best physiologic approach (saliva testing). Testing the hormone metabolites provides the next best approach (urine testing). Through the evaluation of the body’s metabolism of hormones, the physiologic mechanisms of how the body removes hormones can be evaluated.  The evaluation of hormones in transit (blood testing) provides the least physiologic assessment.

While each test provides an appropriate measure, the question is, does that measure provide insight into physiologic dysfunction? And, can an appropriate therapeutic intervention be undertaken to effect a change? At Seasons, we provide answers using those test results, creating a customized wellness plan that will put you on the road to a life with more energy, balance, and, ultimately, happiness.

Cheers to the pursuit of wellness.

Man vs. Estrogen: It’s Not Just A Woman Thing!

Testosterone is the defining hormone of a man. Estrogen is the defining hormone of a woman.

So when we talk about estrogen, it’s that word men whisper in secret when the women in their lives seem a little hormonal, right? When people find out that my wife and I have 3 daughters, the resulting comment is usually, “Wow, that’s a lot of estrogen in your household!” (Thankfully, I have a son, too, who helps balance the estrogen to testosterone ratio at our house!)

I’m sorry to burst your bubble, guys, but estrogen is not exclusive to women. We make estrogen, too. In fact, some of us make a LOT of estrogen. Too much, in fact. And it creates some serious problems.

But before we talk about estrogen, we need to talk about testosterone. Testosterone levels in American men are at an all-time low! There are four major reasons for that: stress, weight, endogenous estrogens, and xenoestrogens. In this post, I’ll address three of those – stress, weight, and endogenous estrogen.

So let’s get started learning four important facts about testosterone, estrogen, and men!

What problems do high estrogen levels create in men?

1. High estrogen = low testosterone. One of the primary causes of low testosterone is a high estrogen level. Estrogens can be endogenous (produced by your body) or exogenous (from the environment, also known as xenoestrogens). Estradiol and Estrone (two of the three kinds of estrogen produced by your body) feed back to the hypothalamus and pituitary and shut off testosterone production.

2. High estrogen = inflammation. Not only do high estrogen levels decrease testosterone in men, they also increase inflammation. And this is VERY significant. Inflammation, just like stress, is a biochemical process.

Inflammation is the natural result of the immune system. Remember the last time you got a paper cut?  It was incredibly painful, probably red, warm and swollen, all cardinal symptoms of inflammation. Inflammation, in the right setting, is actually the body protecting itself.  However, when the immune system becomes imbalanced or chronically activated, the immune system causes damage through inflammation. For example, chronically activated immune cells in the brain (glial cells) play a pivotal role in the development of Alzheimer’s, Parkinson’s, and Multiple Sclerosis.

Inflammation is a SERIOUS issue. Chronic inflammation has been linked to many of the chronic diseases of aging: Type II Diabetes, obesity, hypertension, and cancer. In fact, a new term has been coined to describe inflammation arising from the gut which results in many of the above listed disease states - metabolic endotoxemia.

We’ve established that high estrogen levels are bad for men, shutting down testosterone production and causing chronic inflammation leading to disease.

What causes high estrogen levels in men?

1. High aromatase activity = high estrogen. First, high endogenous estrogen levels in men come from high aromatase activity.  Aromatase is the enzyme that converts androstenedione and testosterone into estrone and estradiol respectively. Aromatase is present in many different tissues. But in men aromatase is highly concentrated in that mid-life bulge.

Unfortunately, aromatase activity in men increases as we age due to stress, weight gain, and inflammation. None of us are going to get away from aging (it’s right there with death and taxes). And who do you know that has NO stress? (Remember, it is estimated that 90% of doctor visits are stress-related.) Typically, as we age we gain weight and have more inflammation.

That “age-related” tire around the mid-section is more than just unsightly. It is a hormone and inflammation-producing organ. Remember metabolic endotoxemia, the disease-producing state I mentioned earlier? Metabolic endotoxemia is inflammation arising from the GI system which causes obesity and then turns right around and produces inflammation. It’s a vicious cycle!  And guess what is concentrated in fat? If you guessed aromatase activity, then you are absolutely correct. Aromatase activity in men accounts for 80% of estrogen production.

Hormones are not just about numbers, but balance and metabolism as well (read my recent post on the topic).

2. Overdosage of testosterone = high estrogen. As mentioned earlier, testosterone levels in men are at an all-time low. And the mass solution for this problem with most physicians is to increase testosterone without evaluating or treating the underlying causes for low testosterone. Unfortunately, this complicates the entire low testosterone problem. Overdosage of testosterone increases estrogen production.

What?  You mean you can dose too high on testosterone? Yes, and most of the patients I see who are being treated with testosterone have been, in fact, overdosed.

In fact, at Seasons Wellness Clinic and Seasons of Farragut, we have seen many men must donate blood due to excess production of hemoglobin and hematocrit, a by-product of testosterone overdosage. A 20-22 year old male normally produces 5-10 mg daily of testosterone. It is during this age range that men are at their physical peak of testosterone production. For me, this was during my college football years.

Does it make sense for 40-and-up men currently taking testosterone, that they did not need to donate blood monthly during their peak years of natural testosterone production, but are currently required to donate blood regularly with their current regimen of testosterone?  Of course not. So, if you didn’t have to donate blood with your peak testosterone production in your 20′s, you shouldn’t have to donate with testosterone therapy in your 40′s and beyond either. Something is wrong here, right?

The starting dosage for one of the most highly-prescribed androgen gels is 1 gram daily. Men, we didn’t need 1 gram of testosterone in our early 20′s, and we don’t need it in our 30′s and beyond.

80% of a man’s testosterone occurs from aromatase activity, and aromatase activity increases as we age. So high doses of testosterone don’t make sense. Doctors are just throwing fuel on the fire with these massive doses. More is not better if it’s too much, even when it is something your body needs.

Then, there is the delivery of testosterone therapy. The body’s natural testosterone secretion follows a normal diurnal rhythm.  Testosterone is known to be greatest in early morning and lowest in the evening.  But with many prescribing testosterone therapy today, it is very common to get weekly testosterone shots or testosterone pellets. This method of delivery does NOT follow the body’s natural rhythm. The shots and pellets delivery method of testosterone produce supra physiologic (abnormal) peaks. If the purpose of hormone therapy is to return the body to normal levels, then that objective can never be reached with this type of testosterone therapy.

The effects of Testosterone to estrogen conversion in men and women are different. That’s certainly no surprise. In men, high aromatase activity and conversion of testosterone to estrogen has been linked to elevated CRP, fibrinogen, and IL-6.

Are these important?  CRP is one of the best indicators of future cardiovascular disease/events (heart attacks and strokes), and is associated with metabolic syndrome. And yes, it is more predictive than even a high cholesterol level. Fibrinogen is another marker of inflammation that has been associated with cardiovascular disease and systemic inflammation. IL-6 is an inflammatory cytokine (immune signal) that has been implicated in increased aromatase activity (conversion of testosterone to estrogen) and at the same time is the result of increased testosterone to estrogen activity.

So, what’s the big deal? The studies are not 100% conclusive, but it is clear that inflammation increases the testosterone to estrogen conversion through increased aromatase activity. And the increased estrogen conversion is associated with increased inflammation in men. It’s a vicious cycle that will lead to disease states such as insulin resistance, hypertension, prostatitis, cardiovascular disease, autoimmune disease, and cancer, to name a few.

You may be thinking, “Is the testosterone I need leading me to disease?”

The answer is, “Yes, it sure can.” If your testosterone therapy includes prescription of supra physiologic levels of testosterone, lack of follow-up on hormone levels, and no effort to balance hormones and metabolism, then yes, it sure can.

Is there a safe and effective way to balance hormones, lower estrogen and increase testosterone for men?

Effectively administering hormone therapy requires the following:

• A physician with extensive training in hormones and body biochemistry.
• The best and most accurate testing possible to determine current hormone levels and to track hormone levels after therapy is administered.
• Hormones that most closely replicate the natural ones produced in your body — bioidentical hormones.
• A therapy plan with the objective of returning your body to normal, not super-charging the body with unnatural levels of testosterone or any other hormone.

At Seasons of Farragut, Nan Sprouse and I are fellowship-trained (or completing fellowship training) specifically in the areas of hormone therapy and wellness-based medicine.

Our patient experience begins with an initial consultation to evaluate symptoms and develop an evaluation plan.

The next step is testing. In the case of hormone imbalance, we evaluate hormones with state-of-the-art hormone testing via saliva, not just blood. As stated in a 2006 article, “plasma levels of estradiol do not necessarily reflect tissue-level activity.”  Saliva has been shown to reveal the active hormone inside the cell at the site of action.

After initial testing and a therapy program, hormone levels are re-evaluated to ensure the progression of treatment and necessary changes are made to the treatment program. Testing and follow-up are key to proper balance of hormones (read my recent post). At Seasons of Farragut, our approach to treatment and therapy is fully supported in the scientific research literature, and we’re happy to share that research with you if you’d like to educate yourself.

The way estrogens are metabolized plays an equally pivotol role in hormone risk and effect. At Seasons of Farragut, our system of testing, evaluating, and monitoring is the only way to ensure that testosterone therapy for men is raising the testosterone and DHT levels instead of all being converted to estrogen. Hormone therapy is safe, but for it to work effectively, it must be properly evaluated, dosed, followed, and re-evaluated.

If you have questions or comments, please post them below and I’ll respond as soon as possible. What is your experience with testosterone therapy? How has your physician tested and re-evaluated your therapy program?

For more information about the Seasons approach to wellness or to schedule an appointment, please contact our office at (865) 675-WELL (9355).

The Top 3 Answers to the Question “Why Should I Take Hormones?”

Recently during a patient’s visit, we were reviewing her most recent OB/GYN appointment. Her physician asked why she was taking hormones. Unable to offer a technical explanation, she simply stated that she felt much better than she did before she began her treatment program.

While the basic question of WHY is a good question by her physician, we actually need to answer three questions.

•  What are my individual hormone levels?
•  Are my hormones in appropriate balance?
•  Is my body metabolizing those hormones in the right way?

The answers to these three questions will answer the one question: “Why should a patient take hormones?”

What are my individual hormone levels?

Contrary to what most think, hormones are not just about individual numbers. Instead, hormones work collectively as a means of communication within the body. I am amazed at the answers I get when I ask postmenopausal women, “Does your body still have or need hormones?”

The answer is a resounding YES, but most people seem to think otherwise. The body must have hormones to survive. For example, those who suffer from Addison’s Disease have a life-threatening deficiency of cortisol (one of the body’s many hormones).

Far too often I hear the comment, “I’ve had a hysterectomy, so I don’t need progesterone.” The truth is having a hysterectomy does not eliminate your body’s use or need for hormones. It just means you are missing your uterus. Hysterectomy or not, millions of cells throughout the body have progesterone receptors and those cells could care less if you’ve had a hysterectomy or what your OB/GYN thinks about progesterone. [Insert laugh here!] These organ systems throughout the body have receptors for progesterone because they need progesterone.

The aforementioned patient’s hormone therapy included progesterone cream and DHEA capsules. Testing results showed her to be deficient in both progesterone and DHEA (read about how we test hormones at Seasons), and thus replacement was needed. In addition to test results, the patient’s clinical symptom history warranted the replacement of these hormones.

So why was DHEA included in her treatment program? Two reasons. The first is that her DHEA levels were low in her testing results. The second reason? This patient had Type II Diabetes and, after some additional testing, was found to have chronic inflammation throughout her body. DHEA has been shown to reduce inflammation, improve insulin function, and reduce obesity, all of which are associated with diabetes. DHEA does this through a complex interaction with the hormones adiponectin and insulin. As insulin levels rise with insulin resistance, adiponectin falls. This hormone imbalance will result in Diabetes for many people.

Additionally, Type II Diabetes has been shown to be the result of chronic inflammation. What does that mean, you ask? Chronic, dysregulated inflammation causes insulin resistance. What is the source of this inflammation, you ask? Fat cells! The obesity epidemic is the root cause of our current healthcare crisis.

Let’s go back to the patient’s hormone therapy. Her test results showed her deficient in progesterone. Becauseprogesterone is a natural anti-inflammatory, it is currently being used in traumatic brain injuries (TBI) to reduce inflammation and improve outcomes. In addition, women with low progesterone tend to have significantly more menstrual cramps, the result of inflammatory signals called prostaglandins. Progesterone therapy has been shown to reduce those prostaglandins and thus reduce menstrual cramps.

Are my hormones in appropriate balance?

Hormones don’t exist in a vacuum, as many seem to think. Hormones exist in a delicate balance. The most well publicized imbalance is that of the estrogens and progesterone.  Imbalance of estrogen and progesterone have been linked to many health problems: fatigue, weight gain, headaches, and increased risk of breast cancer to name a few.

I often tell patients that with every cause there is an effect. You can’t give one hormone without affecting many others. The addition of progesterone to the body when it has been chronically low will not only restore progesterone to an appropriate physiologic level, but will also allow estrogen signals to work better. The balance of hormones allows each hormone to work as it was intended. Mind you, we are NOT talking about using synthetic hormones which are simply not what the body is looking for and contain harmful additives. We only treat with bioidentical hormones (bioidentical hormone replacement therapy, also known as BHRT). 

Is my body metabolizing my hormones in the right way? 

The final key point is looking at how the body processes hormones (metabolism). Hormone metabolism is just as important as the individual hormone levels and the hormone balance. 

Let’s use estrogen metabolism, for example. Estrogens (there are actually three different types of estrogen) can be metabolized three ways: 2-hydroxy estrone, 4-hyroxy estrone, and 16-alpha-hydroxy estrone. Some of the risks associated with estrogen come from the body metabolizing estrogen utilizing the 4-hydoxy estrone pathway. This pathway results in many dangerous metabolites (break down products). Think of it as turning down the wrong road as you’re driving somewhere, and you end up in a briar patch!

Think about it. Many women with breast cancer and men with prostate cancer don’t take bioidentical estrogen nor do they take synthetic estrogen. Their problem, as it relates to hormones, comes from endogenous hormone production (the body’s own hormone overproduction or underproduction), hormone metabolization, and the often undiscussed environmental xenoestrogens (from environmental toxin exposure). In lay terms, the body is metabolizing estrogen using the 4-hydoxy estrone pathway resulting in higher risk of cancer.

It has only been in the last 50 to 60 years that major hormonal imbalances in industrialized countries seem to have come to our attention. Before that, people and their hormones seemed to do just fine for thousands of years. We can attribute much of that to diminishing nutritional value in our foods and continually increasing exposure to toxins. Nutrition and toxins both have profound effects on the body, hormones included.

In conclusion, why should a patient take hormones (BHRT)?

The answer is a summary of the three points we’ve looked at here. By determining current hormone levels, restoring balance, and evaluating the body’s metabolic processes, the body can once again function as God intended it. Should a patient be on hormones? Well, only if you need them. But the truth is few of us have perfectly balanced hormones due to nutrition, toxin exposure, and prescription medication side effects.

At Seasons Wellness Clinic, we use state-of-the-art testing that reveals your body’s biochemistry. With our years of advanced training, we can carefully customize a treatment plan to restore your body, offsetting the damage of poor nutrition, toxins, and prescription drugs. Our goal is to eliminate any need for prescription medication! We want you to be HEALTHY!

WELLNESS IS POSSIBLE! You don’t have to settle for a body that is not working as it should. You can make a conscientious choice towards good health and a longer, happier life.

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