What is the controversy surrounding Hormone Replacement Therapy (HRT)?

For years, women going through menopause have been prescribed hormones to reduce hot flashes, vaginal dryness and other perimenopausal and menopausal symptoms. In many cases women continued to take the hormone supplements for the rest of their lives in the belief they also reduced the risk of heart disease. A recent large scale study (11,000 plus women) showed dangerous side effects for a significant percentage of the women in the study. These side effects included risks for stroke, heart disease and breast cancer.

What are the new recommendations arising from the study?

1. Women should be more careful in embarking on the prolonged use of HRT
2. Short term use of HRT for symptomatic relief of hot flashes, insomnia, mood swings, and vaginal dryness may be more appropriate
3. Individual approach with different hormones doses, and types depending on a woman’s age, weight, sensitivity, personal and family medical history should be considered
4. Preventative measures of non-pharmaceutical approaches such as dietary changes, exercise, meditation, natural medicine, herbs and use of supplements may also be indicated.

Are there other treatments for hot flashes and menopausal symptoms other than hormone replacement therapy?

The evaluation and treatment of perimenopause and menopausal symptoms are at the heart of naturopathic medicine. We are the only physicians trained in the art and science of medicine involving prescription medications and hormones as well as natural medicine, herbs, supplements, lifestyle and nutritional counseling. If, as a woman you desire and integrated or natural approach to your health concerns please call our office today. We look forward to serving you.

As an expert in natural medicine, and because so many women are confused about this issue, we have decided to provide a brief summary of the Women’s Health Initiative (WIH) research study for women who are interested in more of the study details. Keep in mind, the clinical implications are complex, and therefore should be evaluated on an individual basis with each woman and her physician.

Specific study findings using both oral conjugated equine estrogens (.625 mg/day CEE) known as Premarin and oral medroxyprogesterone acetate (2.5mg/day MPA) known as Provera compared to a placebo group over an average period of 5.2 years are:

• A 41% increase in strokes
• A 29% increase in heart attacks
• Over 100% increase in venous thromboembolism (blood clots)
• A 22% increase in total cardiovascular disease
• A 26% increase in breast cancer
• A 37% reduction in colorectal cancer
• A 30% reductions in hip fractures
• A 24% reduction in total fractures
• No difference in total mortality

If you would like a more detailed report of the study, please contact our office at (541) 383-3424.

Every day people ask me amongst other things what supplements to take, and what exercise is best. The focus of this newsletter is “Getting back to Basics”.

While I recommend everyone take a high quality multivitamin/mineral supplement, and everyone not only live an active lifestyle, but schedule exercise, I feel our focus must be food. What we are and are not putting in our mouths is at the core of health and wellness.

By now, many of you have seen, or at least heard of the movie “Supersize Me”. Most of us agree, this movie was an example of very poor eating and lifestyle habits.

All of us must eat daily to survive. With every meal, snack and drink we have a choice to make. With every meal we should be asking ourselves “Is what I put in my mouth of high nutritional value, or not.

The quality of food does matter. “Let medicine be thy food and FOOD BE THY MEDICINE”.

Where does one start you may be thinking.

1. It is important to know exactly what in fact you are eating. Pick up a health journal here at the clinic. Record in writing, everything, (YES, EVERYTHING) that you put into your mouth. Quantities are important if the portions you are eating are more than the size of your fist. An analysis is best done on about 4 weeks of data.
2. Record also all medications, and supplements in your journal.
3. Keep track of the liquids throughout the day
4. Record hours of sleep including interruptions

Other helpful factors may also include:
5. Noting any emotions during the days or weeks of recording
6. Keeping track of the type and duration of exercise
7. Any symptoms that come up and/or change i.e.: bloating, pain etc.

Once the record keeping is complete, the analysis and the homework will begin. Schedule an appointment for an evaluation. Many patients have also elected to have a food sensitivity and food additive blood test done as part of their health evaluation. It is a blood test, and the results are specific to you. Other tests important in evaluating and setting up an individualized medication, supplement and wellness program include: annual breast and pap exam and a dexascan, or bone density test (for women), 12 hour fasting blood tests that include cholesterol, glucose, and thyroid levels, PSA (for men), blood pressure, height and weights. In single sexually active men and women who are not monogamous, sexually transmitted disease testing is also recommended. For women an annual review of birth control, and hormone replacement (bioidentical hormones) therapy too is important.

All the resulting information about you is then analyzed and an individualized health program is set up for you. Regular follow-up appointments are then scheduled to follow and monitor progress. For example, high cholesterol and blood pressure is monitored to minimize risk of heart attacks and stroke. Medications are reviewed for efficacy and dosing. As a person becomes healthier changes in medications and supplement doses are required in many cases. Also, monitoring for side effects and interactions has become more important. Advances in science shows us there are more potential interactions between food and drugs and supplements than we may even suspect.

Our life is a journey. And most of us truly believe the journey is a more enjoyable one when we have health. Most of us list health in our top 5 on the list of priorities, and yet most of us do not live a life consistently that reflects this priority. When we are young we take our health for granted. And as we age we do not put our resources, time and money, towards protecting and nurturing our health. And then in the twilight of our lives, we wonder as we are taking handfuls of medications that keep us alive, where is the joy, the ability to enjoy life to the fullest, the inability to drive a car anymore, to travel to other countries, to sleep, to have sexual intimacy, to eat the foods we love?

Currently there is a lot of talk of changing our social security plan, our pension plans, and our retirement accounts. But what are we doing daily for our health IRA’s? Are we investing in our health and wellness? Are you as healthy as you can and choose to be?

Call today for an appointment. We always make room for your referrals of family and friends. We look forward to serving your health care needs.

‘LIFE IS NOT MERELY LIVING BUT LIVING IN HEALTH’ – Martial, Epigrams

Recently the government has recommended a change in the food pyramid. Most people, if asked, do not even know what this is. While I think the pyramid may make for a great outline for a nutrition teacher, from a practical matter my recommendations are to “balance your health account check book daily” by following the below recommendations:

1. Portion size matters. ( do the arithmetic)
The easiest way to remember this is get to know the size of your fist. This equals a serving of protein. Most fruits come in portion sizes, unless the very largest apples, oranges, peaches etc. are picked. A portion of grain usually equals about 1/3 – ½ c. uncooked, and about 1 cup cooked. Vegetables, too, may come in portion sizes, potatoes, corn on the cob, tomatoes, carrots, etc. Most people do not eat enough veggies, so portion size of vegetables in most cases is a mute point. Portion size of nuts, seeds, oils, and other high fat foods due to their high calorie count are significant mostly in the diet of people who want to lose weight. For people who just want to maintain health and wellness think moderation.

2. Food Choices
By having kept a track of the daily food intake (assignment from spring) we can now evaluate how well we did. (more arithmetic)

• How many servings of fruits/vegetables/ proteins did we have daily?
• Did we have at least 5-6 total vegetables & fruits? 3-5 servings of proteins? 3 of the good fats? 3-5 whole grains?
• Were our food choices the best they could be with respect to high quality protein (with every meal)?
• Did we have a little healthy oil/fat daily? (unsaturated, mono/poly unsaturated fats?) (excluding supplements)
• How did we do on the organic, non-hormone, non-preserved, non -colored question?
• Are most of the foods we eat daily, processed, or did we have to wash, prepare and cook them?
• Did we find the organic dairy, poultry and/or meat, actually looks and tastes so much better?
• How about the grains? Have we explored new tastes, quinoa, spelt, or maybe even gotten back to cooking good old fashioned oatmeal again?

3. Balanced Meals
As we get used to keeping track of our food, meal planning becomes easier. For example, if breakfast was fresh fruit, and a bagel with a poached egg, and lunch was a cobb salad, dinner options are very open. If however, breakfast was a muffin on the run, and lunch was a sandwich, a balancing dinner would include a large portion of either fruit, and/or veggies with quality protein. By this example, one can see that each day there are many ways to get the required food groups in. However, planning each meal, or planning a meal based on what one had thus far during the day is actually sort of like “balancing your check book daily” except it is your health account.

4. Exercise
Now part of this “Balancing your health account check book” idea daily also includes exercise. An active lifestyle has been shown to be very effective in the maintenance of health and wellness. Therefore, daily walks, biking to work, and /or walking the first 9 holes all matter. Individualized weight training programs are much more effective than going to the gym unsupervised, and without any specific goals.

5. Liquid consumption
For those of you have stated point blank, “I am not giving up my 2 glasses of wine, beer, martinis/night”….alcohol does affect your health checkbook balance. (in some cases possibly positively, and in others negatively.) Water should be the major component of your daily liquid consumption. Most people are simply not drinking enough water.

6. Sleep
What is your average # hours/night? Are you well rested, and full of energy, with a healthy immune system, emotionally stable, or are crabby and miserable to be around at home and at work (like a young child needing a nap)? Yes, your health check book may be going in the negative here.

7. Medications and Supplements
It is important to take medications and supplements as prescribed. Many people are self-prescribing supplements, and over the counter drugs. This can be very dangerous to one’s health as there may be chemical interactions that may be even life threatening. At a minimum, have a physician specialized in natural medicines (ND) review your natural medicines and supplements. Always tell each of your physicians any and all OTC drugs, (over the counter) supplements, and medications you are taking.

8. Keeping Score
For your convenience a health journal is available here at the clinic. Keeping a written record ensures better outcomes. As you review the above recommendations, some of you may find to only have a minimal challenge before you, while others may have significant hurdles to overcome. To each of you reading this newsletter I would like to extend an invitation and challenge of increasing the balance in our health accounts.

While some of you are very familiar with acupuncture treatments and Chinese medicine, and even have regular treatments, others of you may be unfamiliar with why and when acupuncture and/or Chinese herbs are indicated.

My first response for when acupuncture is recommended would be in any and all pain conditions. This would include acute (sudden onset) and chronic pain, and pre- and post-op. Some more commonly seen conditions here in the clinic are headaches, all musculoskeletal conditions, including neck, knee, shoulder, low back, tendonitis, bursitis, abdominal pain, and menstrual pain.

Acupuncture can be particularly effective in nausea and vomiting, and especially hyper emesis in pregnancy. And in stroke patients, the sooner the acupuncture the initial event, the better their prognosis.

As spring approaches, allergies and sinus symptoms are very often relieved with acupuncture. And a few favorites of mine include insomnia, stress and a lowered immune system.

Chinese medicine refers to the herbs that may be prescribed for the condition. These herbs are usually a Chinese herbal formula. In many cases, herbs may be prescribed concurrently with the acupuncture.

It has been my experience that Chinese herbs and acupuncture are most people’s LAST resort of treatment. Yet, from clinical experience, patients who have acupuncture and Chinese herbs as a first line of treatment, or even regularly, as prevention, may often save themselves from prolonged discomfort and many unnecessary invasive medical procedures.

The theory of how acupuncture works is based on the theory of yin and yang, the balance of energy. From a practical matter, an explanation I use often is that by choosing specific points in the body, and inserting a very fine hair-like needle in these points, a specific response is elicited. For example in pain cases, specific points may help the body produce its own endorphins, others decrease inflammation, and others may relax the muscles etc. It is the clinical expertise of the acupuncturist that determines the combination of points and length of time that are used for a specific patient. Not all acupuncturists’ clinical expertise is equal and results may vary between practitioners.

For those who have tried acupuncture for one symptom and it didn’t work, don’t rule it out as a possible treatment of something else. The body is complex and ever changing. Acupuncture is a most dynamic in the moment type of treatment and has been shown to be very effective in some people for a vast number of disorders. Why not consider acupuncture today for that nagging shoulder, knee, elbow, or low back pain before the golf, hiking, or biking season? They do say “Prevention is a pound of Cure”.

Attention: Parents, Grandparents and Childcare Providers:
As of Spring, 2008, there has been an interesting development in the case of the government looking into a possible link between autism and childhood immunizations.
Apparently the government found a link with autism and childhood immunizations in an infant daughter with a mitochondrial disorder of a John Hopkins neurologist. What are the implications of this information for those of us with infants and children? This is a discussion we all need to be having with our pediatricians and health care providers. To those of you for whom I am your childrens’ primary care physician, please schedule an appointment to discuss this information.

1. Regular age and sex-dependent labs, mammograms, coronary and carotid artery calcium screenings, dexascans, indicated ultrasounds, paps, breast and prostate exams, and x-rays are recommended. The focus of my practice is prevention and anti-ageing. Body chemistry DOES NOT LIE! We might not listen to what our body is telling us, but the most objective evaluation of what is going on inside of us is our chemistry. However, the interpretation of these labs is very significant. This is where all of you, my patients, get my expertise in the area of disease, and disease prevention and anti-ageing.

2. Supplements. No, they are not all created equal. We carry a few very specific, premier quality, highly effective clinically, non-contaminated supplements. These supplements are biochemically active, which means they cause physiological changes in the body. This is the purpose of taking a supplement. If a supplement is prescribed, the desired effect should be manifested. Not everyone needs to have this clinically desired effect. This is why all supplements should be individually dosed and prescribed. In some cases, there may be interactions between supplements and medications. These reactions may in fact be dangerous to one’s health. As a patient of this clinic you will have the expertise of my training and clinical experience in the prescribing and dosing of all natural medicines, which includes supplements, hormones, drugs and herbs.

3. Regular exercise. There isn’t an exercise that is the best for every body. My rule is “GET UP AND MOVE”. For some this is walking, others dancing, biking, hiking, skiing, running, and/or yoga. There are so many benefits of exercise; thousands of books have been written on the subject. Another recommendation is “CHANGE IT UP”. For the first time in my life, I am trying Pilates. I love it. It is very different than anything I have done. Here’s the thing….doing the same thing over and over again can get boring. Also, to keep motivated, exercise with a friend, or co-worker, or partner. Be held accountable.

4. Sleep. For years I was always envious of people who said they could get along on 4 or 5 hours of sleep per night. They seemed to be so productive. Even as a college student, I recall sleeping a lot, especially on winter breaks. Looking back, I am so glad I listened to my body (and my mom) and took the time to sleep. Research has shown study after study quality and quantity sleep is extremely important in disease prevention and overall health and wellness. If you are not getting a minimum 7-8 hours of quality sleep, come in and see me. There may be a metabolic or other reason for your inability to get those quality and oh so important ZZZZZZ’s.

5. Food. There is a saying “Let food be thy medicine and medicine thy food.” This has been proven again and again clinically. Buy organic, unprocessed foods. Start with quality organic, hormone-free protein, organic whole grains, fruit and vegetables. If finances play a role, cut back the alcohol, snacks, and sweets. Please do not compromise your health with buying inexpensive fast food. For those of you who need help in this area, call my office and make an appointment.

6. Prescription drugs. For many this area is very difficult to personally evaluate. If you would like to have me evaluate your prescription drugs with respect to cost and/or other options, please call for an appointment. In some cases, generic drugs are OK. In some, not. The rule is not to discontinue prescribed drugs without the prescribing physician’s permission. These include bio-identical hormones, testosterone, thyroid and blood pressure medications.

7. Meditation, quiet time, prayer. It is very important for all of us to de-stress by doing nothing. I know, I can already hear many of you say, “The day isn’t long enough to even get my to-do list done, let alone schedule some quiet time.” Folks, it is because we are human BEINGS not human DOINGS that we need to learn to JUST BE!!!!! It is in these moments when we consciously connect our mind, body and spirit. Start with one minute per day and just breathe. Yes, time it if you have to. Trust me; you will yearn for more time with yourself. Work up to five minutes/day.

8. Make time for family and friends. Eliminate if you have to obligatory automatic and joyless activities if it takes away from you being and doing things with those you love and hold most dear. Within this last year a number of clinic patients have been diagnosed with some form of cancer. The prognosis varies, however, a few have a very short time to live. I learn many things in being with these patients. Mostly, to live each day prioritizing the people who matter and are important, and of living a daily life of no regrets. Ask yourself, if you knew when you were going to die, what would you be doing now, today, this week, this month, this year. Re-evaluate the path you are on, and make any changes you feel are mandatory in your living a healthy rewarding life.

9. Give back. It seems there is no end to the opportunity to give back. Volunteer, donate, and/or give money. There are truly blessings in helping those who need help.