Even though my 60th birthday is a little over 6 months away, I am planning now for better health, mental acuity, energy, and sense of well-being! My goal is to improve all of the test results that I have previously had at Seasons. You may remember that I did a Telomere test several months ago – a fascinating test revealing how rapidly one ages relative to a normal population. Those results showed that I was above average for my age range; however, there was definitely room for improvement!
For my birthday countdown, I have chosen to begin with a detailed cardiac evaluation measuring specific markers in my blood. My total cholesterol has always been slightly elevated; however, over 50 percent of patients hospitalized with acute myocardial infarctions had normal lipid levels as defined by the traditional blood tests. Functional medicine has identified over 400 risk factors, but they are all exacerbated with inflammation, oxidative stress, and immune dysfunction (chronic infections).
Cholesterol is not the villain portrayed in the statin commercials! It is a biological necessity for creating vitamin D, our steroid hormones, estrogen, progesterone, and testosterone, as well as other tasks. High levels are not a sure sign of cardiac disease, nor are low levels a promise of heart health. Our bodies manufacture most of our cholesterol with a smaller amount coming from the food we eat.
Since cholesterol has to travel through the blood which is watery, the body packages it in various “containers” called lipoproteins. Lipoproteins vary according to the amount of protein, fat, and cholesterol they contain. Those with more protein and less fat/cholesterol are called high density lipoproteins or HDL. Those with less protein and more fat/cholesterol are called low density lipoproteins or LDL. A third type carries even more cholesterol and fat with less protein and it is called very low density lipoprotein or VLDL.
The LPP test measures not only the type but also the number and size of all these particles. LDL has at least five types and sizes. The smallest size is the most dangerous while the largest size is least harmful. Obviously the number of these particles is also a risk factor. Lipoprotein (a) or Lp(a) is a type that increases risk of heart disease. Apolipoprotein B (Apo-B) deposits cholesterol in the artery wall which can be a marker for atherosclerosis. HDL is similar in that the larger size is the most protective.
So what did my test reveal and how can I get healthier?
First of all, my inflammatory markers – C (reactive protein, insulin, and homocysteine) were all in the normal ranges; however, the latter was borderline for being too high. My total number of LDL particles was elevated but the sizes were in the normal range. However, my Apo-B was borderline which meant I have a risk for atherosclerosis. My VLDL and my Lp(a) were normal. Whew!
With these results and several inflammatory markers from a recent ION Panel – my plan includes the following:
- Reduce inflammation with Omega 3 fatty acids. Studies have shown that this will also increase my levels of HDL, increase LDL particle size, and decrease LDL particle number.
- Drink more green tea which will decrease oxidation of LDL, decrease Apo-B secretion, and increase HDL
- Increase consumption of Vitamin E (which I get in a customized vitamin mix) to reduce Apo-B and lower LDL and increase HDL.
- Add Niacin (B vitamin) to lower LDL particle number and Apo-B as well as increase HDL.
- Stop smoking (just wanted to see who is still reading this!) I don’t smoke, but I can always improve my diet with less refined carbohydrates.
- Have an occasional glass of red wine which will increase the powerful antioxidant, resveratrol. This has been proven to reduce LDL oxidation, decrease inflammation, and improve the lining of cardiac vessels. Another way to obtain this is with red grapes and purple grape juice (but be careful on the sugar content).
- Exercise during the cold months. I love to be outside. But now that the weather is getting colder, I have made a commitment to go to the gym after work. I’m fine once I get there, but I’ll need some accountability to be consistent. Feel free to ask me!
- Continue with other cardiac tests. Seasons will be getting a Heart Rate Variability Test which every patient will have access to.
- Find joy every day and keep stress levels in balance. Studies have shown that heart disease is linked to depression.
- Retest my cardiac markers in May, 2013!
Helen Keller said “life is either a daring adventure or nothing at all.” May we live this one life with hearts full of gratitude and wonder for the countless blessings our Creator has lavished on us!
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.
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.
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).
Between Valentine’s Day and American Heart Month, there’s no denying that hearts and February go hand-in-hand. This month, as we celebrate the things that make our hearts melt, let’s also think about preventing heart disease with the 4 Pillars of Heart Health: Minerals, CoQ10, Alpha Lipoic Acid, and L-Carnitine.
Not only is Cardiovascular Disease (CVD) one of the most widespread and costly problems in the U.S., it is among the most preventable. Like any other part of the body, the heart requires preventive care to ensure it will operate at its best. These days I see more preventive care for cars than for the heart. Prevention is not early detection. It is identifying those at risk and instituting therapy to actually prevent the disease. And while early detection and treatment is needed and saves lives, we need also to focus on preventing CVD altogether.
Current statistics on Cardiovascular Disease (CVD):
- 33.5% (149 million) of US adults have been diagnosed with high blood pressure
- 8% (18.3 million) of the US adult population has been diagnosed with diabetes
- 67% (34% of which are obese [149.3 million]) of US adults are either obese or overweight
These 2012 statistics tell us that we are not gaining much ground in the battle against heart disease.
So, what is the heart? The heart is complex organ, but essentially it is a big hunk of muscle. The heart is responsible for pumping the blood to the lungs to be oxygenated and then deliver that oxygenated blood throughout the body. To pump that oxygenated blood, the heart needs lots, and lots of energy (ATP). The heart uses the “power house” of the cell, called mitochondria, to generate all this needed energy.
How much energy does the heart make? The heart makes enough energy, everyday, to drive a truck 20 miles. That mileage, over an average lifespan, will get you to the moon and back. The ability of mitochondria within the heart (which is muscle) to generate energy is critical to life. In fact, the result of compromised mitochondria is aging and death. The lack of ability to produce energy, actually triggers apoptosis (cell death). Enough cell death equals organ death, which results in the body’s death. Obviously, this is not what we want. Mitochondria are crucial to the heart’s ability to make energy and avoid all the, well…unintended consequences.
At Seasons Wellness Clinic, we focus on the 4 Pillars of Heart Health which support mitochondrial function.
- Magnesium is a nutrient. Magnesium is needed for more enzyme reactions than any other nutrient, which makes it extremely important.
- B Vitamins give us energy. Why? One reason is B vitamins are co-factors in energy production. Many of the B vitamins are co-factors in the Kreb’s cycle, another very important pathway for energy production.
2. CoQ10 is critical in energy production. CoQ10 is a carrier protein between complex I and complex II of the electron transport chain (ETC). The ETC is where your body makes most of the ATP (energy). CoQ10 is an antioxidant as well.
3. Alpha Lipoic Acid is very important in the pyruvate dehydrogenase enzyme complex. This enzyme complex is very important in the first steps of energy production from glucose, a process called glycolysis. Alpha Lipoic Acid, like CoQ10, is an antioxidant.
4. L-Carnitine is involved in the “fat shuttle.” Carnitine is involved in how the cell shuttles fat into the mitochondria for energy production. You can see how a compromised “fat shuttle” can effect energy production and fat production. L-carnitine, too, is an antioxidant.
Not only do we want to evaluate these critical components (and yes, we can test for these essential molecules), but we want to prevent any compromise to their function. A major cause of component malfunction in the body’s processes is mineral depletion, and the #1 cause of mineral depletion is prescription drugs.
To demonstrate my point, let’s use Metformin and Statin drugs as examples. First, Metformin, a good prescription drug for Diabetes, is known to deplete the body of Magnesium, B12, folic acid, CoQ10. And second, Statin drugs, for cholesterol, are known as disruptors of CoQ10. Ever wonder why those on statin therapies complain of muscle pains/cramps? If you poisoned your muscle’s ability to make energy, you would do the same. I am not opposed to these medications, it is just very important that we understand that a patient with Diabetes and high cholesterol (closely linked) must avoid therapies that actually worsen the problems.
To help the heart live long and strong, remember the 4 Pillars of Heart Health. There are four major vessels of the heart as well as four major obstacles to heart health. For more information about heart health, specialized testing, and medical-grade supplements, contact a Patient Relations Specialist at Seasons Wellness at (865) 675-9355
“If wrinkles must be written on our brows, let them not be written upon the heart. The spirit should never grow old.” — James A. Garfield, 20th President of the United States.
I read that quote by President Garfield the other day and it occurred to me how important his statement was in my practice of medicine. What causes wrinkles? What causes the spirit to grow old? What can damage the heart? The answer is stress. Stress is not something that just exists. Stress is not just a term used to describe forces applied as in engineering. Stress is real and it affects our hearts. Stress kills.
What impact does stress have on the health of our heart?
- 43% of all adults suffer stress related adverse health effects.
- 75-90% of all visits to primary care physicians are stress-related.
- Stress is directly linked to heart disease according to a new study from University College London.
The interesting thing about stress? It’s not just external. Stress is both external and internal. There is stress of day-to-day life. And then there is the silent physiologic stress. The internal stress occurs in the form of obesity, food sensitivity, and inflammation to name a few.
How is stress affecting you? Ask your heart. Focus on keeping your heart healthy by limiting and relieving your stress this Valentine’s Day. While we can’t always eliminate the causes of stress in our life, we can control how we allow it to affect us!
- Make good food choices to give your body the right kind of energy that lasts and helps you work and feel better.
- Get regular exercise. It boosts your metabolism, fights fatigue, and even elevates your mood helping you to cope with stress more effectively.
- Take time to meditate and pray.
- Take a break and relax whether it’s a soak in the tub or a good book.
Take care of your heart. That’s the best gift you can give those you love!
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- Study: Low levels of vitamin D linked to higher rates of asthma in African-American kids (scienceblog.com)
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