WHY testosterone optimization in men

Testosterone is known for its role in sexual development, fertility,  and its effects on sexual performance.  However, it is not this issue that brings men in for treatment.   

  1. It contributes to bone density, promoting overall skeletal health and preventing osteoporosis 
  1. It play a role in regulating red blood cell production and muscle contraction and relaxation and post exercise recovery
  1. Testosterone levels impact mood and cognitive function .This is one of the most common reasons men come in. They state symptoms of depression, lack of concentration and inability to make decisions
  1. Lack of energy, and poor sleep.

An imbalance in the level of testosterone may be caused by a number of factors. Lifestyle, diet, exercise, and medications, to name a few.    

While there is a range in testosterone levels, which varies between labs, we have found clinically each individual has an optimal number.

What do you want your level to be?

Testosterone is a controlled substance, a schedule 2 drug,  It must be prescribed by a healthcare provider with qualifying DEA license.

At the Preventative Medicine Clinic we focus on optimizing a patient’s health and wellness and disease prevention.

Call 541-383-3424 today to schedule an appointment

WHY bio-identical hormone replacement in women.

  1. Symptomatic relief of hot flashes, night sweats, vaginal dryness, decreased libido, dry eyes, dry skin, mood disorders,  disturbed sleep
  1. Preventatively:  loss of bone density and a diagnosis of osteoporosis
  1. Preventatively: minimize risk of heart disease
  1. Preventatively: decreased risk of cognitive decline

Recently a number of women have commented that their Gynecologists do not test hormone blood levels because Estrogen, for example,  varies, not only day to day but throughout the day.  Whilst this is true, it does not reflect the whole picture.  For example, Blood pressures vary through the day and day to day and yet we measure and monitor blood pressures to rule out hypertension.  Blood sugars vary throughout the day and day to day, and we still measure blood sugars to rule out diabetes.  Estradiol and other estrogen, progesterone and testosterone  levels in women give information about an individual.  This is important in HRT.

I feel that most physicians don’t run labs they cannot interpret, understand, or know how to treat.

In this clinic, we run lab tests to monitor and optimize health and wellness, and minimize disease and pathology.

There are so many topics I can write about, however I have chosen to write an update on hormone replacement in men and women.

I have been prescribing hormone replacement since I was in medical school  as an intern.  When I went into private practice here in Bend, it was frowned upon and many of the gynecologists told my patients estrogen causes cancer and they want them to go off bHRT. (Bio-identical hormones). I was in family practice. I treated menopause , perimenopause, infertility, thyroid disorders including Hashimoto’s thyroiditis. We had no endocrinologist or fertility specialist in Bend. I worked with OHSU on fertility patients.  I travelled for years across the country and took continuing education in hormone replacement and metabolic optimization from doctors and experts in the field.  The experts included Jonathan Wright MD, founder of bio-identical hormones, Mark Bartiss MD, and Neal Rouzier MD. I worked closely with Lloyd Central pharmacy in Portland to find delivery methods that would optimize delivery and absorption. To date it is the only Oregon compounding pharmacy I use for  my practice . 

I was fortunate to meet and speak with Suzanne Somers who was the only public voice nationally speaking about menopause and perimenopause in women and the treatments with bio-identical hormones at that time.

The WHO women’s study results were published and concluded an increase in thrombolytic  events, increases in heart disease and death in women given hormones. There was no differentiation of conjugated estrogen and progestins, all synthetic hormones, and estradiol and micronized progesterone, bio-identical hormones.  The difference is like saying I’m drinking orange juice daily (Tang, crystal light etc) vs. freshly squeezed organic orange juice. Physicians took their patients off hormones and women suffered.

In my own practice here in Bend I continued on. I tested hormone levels and prescribed.  The national press and local condemnation of HRT continued. I have developed very thick skin when Natural Medicine is put down and we as ND,s and acupuncturists are insulted.  As my practice grew and I continued to run hormone levels on patients. I was shocked when I had 6 men aged 35-40 all test under 300 for testosterone.  I needed answers and to find a way to treat them.  None of the men wanted to do injections, and transdermal testosterone was completely contraindicated as all men were fathers with children and pets at home. I continued my education with experts in hormones with an additional focus on men’s hormones.  

I was able to go to the East coast and train and study testosterone replacement in men with pellets.  I was excited to offer this additional procedure to my patients. Since then I have inserted thousands of pellets in both men and women.

Now, hormone replacement therapy in men and women has become a buzzword and fad in medicine.  Everybody is doing it, nurses, nurse practitioners, the same gynecologist who vehemently opposed  HRT.  Menopausal and  mens clinics focusing on hormones only have opened up everywhere. 

Hormone replacement therapy is not without risks.  I have seen so much clinical incompetence in my years of practice, and  never more  in this area of medicine, hormone replacement therapy.

If you are  looking for a healthcare provider with years of experience and training in this area call  541-383-3424 for an appointment.

At Preventative Medicine Clinic our focus is each individual”s wellness, prevention and optimization of health.

Life is not merely living, but living in Health.

I recently saw a great Netflix documentary titled “Live to 100″ Life in the Blue Zones”. I feel the way those people live, totally embodies the Principles of Naturopathic and Preventative Medicine. The 6 zones or geographical regions in the world the author and researcher investigates, have a number of common threads.

Some are: Active lifestyle, healthy, daily, social, and personal engaging relationships, diet and nutrition based mostly of plant-based foods, a reason for living or “lkigai” (Japanese), and work, whether it be volunteer or otherwise. There was very little incidence of: heart disease, high blood pressure, dementia, cancer, and diabetes. A 90 plus year old physician was interviewed. Now, I’m not sure I will practice into my 90’s but it truly gave.me some thought about when I will “retire”. I encourage all to view this multi part series.

“Functional medicine”. What is it? When I was in medical school, everything we Naturopathic physicians were taught about treatment of disease was Functional medicine.

We, Naturopathic (and Chiropractic) physicians were the experts in functional medicine. Do no harm the motto. We look at the whole body. It is how we treat the cause of a disease once a diagnosis is made. How does it rebalance, harmonize, strengthen the body physically, mentally, emotionally, physiologically. How is digestion, the immune, the endocrine, the musculoskeletal, and the nervous system affected by our treatment plans. Now, it seems everywhere there is “functional medicine.” I don’t believe the principles of functional medicine today are practiced the same way we were taught by our mentors.

Stem cells and exosomes are exciting topics in medicine. The use of these and other biologics are being studied in regenerative, anti-aging, disease prevention and treatment. We here at Preventative Medicine Clinic are using biologics in degenerative joint disease primarily. Patients are reporting decrease in pain and increase in joint mobility.

Another Netflix documentary worth a look is “Haute Route”. As a prescriber of controlled substances, including testosterone (also known as a performance enhancing drug or PED) I found this film to be incredibly captivating. It follows an athlete’s journey through a non-doping and then doping protocol in preparation and execution of a world stage professional cycling race.

As I write this, it is raining out. The moisture is welcome from the dry and smoky summer months. The leaves are turning beautiful reds, yellows, and a hue of other colors. Some of us may feel a loss as summer ends, and fall, and then winter comes. There is a time for every season. Some of you may have had the loss of a loved one. My sister passed away this summer following years of care for post traumatic brain injury. Let us not forget no matter the season:

“Life is not merely living, but living in Health.”

Warmest regards,
Dr. Evelyn Brust

In This Together

It sure had been a tumultuous last couple of years. First and foremost, I would like to thank each of you in supporting my business. I appreciate the patience you all showed as I ventured on alone. I am excited to announce that I have an assistant starting at the beginning of the new year. Most of us have found a rhythm again in our lives with our families, friends, and jobs. Travel is back as well as socializing and entertainment. The research will continue as to what countries (states) with what, and if any restrictions were and were not successful in achieving specific goals for their citizens. I am happy that the last restriction was lifted for travel to Canada as most of our family lives there.

A researcher found that the pandemic for people either slowed down time or sped it up. At first, I felt that time slowed as we were quarantined. People were out and about in the neighborhood with their dogs and kids. Pickle ball appeared on driveways. There were social distancing group gatherings in the park. Looking back, though it feels overall time went fast.

I would like to share some of my observations from the last two years.

1. For a lot of people the vaccines (1,2, with, or without boosters) did not appear to prevent them from getting Covid 19 or any of the variants.

2. There is controversy whether or not those who got vaccinated had less severe symptoms when they got an infection.

3. In my practice those patients who had lingering Covid symptoms and received MAH (ozone and light IV) recovers quickly.

4. In my practice patients who received regular MAH treatments had less infections overall.

5. In my practice patients who were diligent in maximizing their health and immune systems had less infections and recovered quicker.

6. I wrote medical exemptions for patients who were at risk with the vaccine.

Live is not merely living, but living in health, and I feel wellness, health optimization and prevention are key. Our lifestyle includes diet and nutrition, supplements, medications, jobs, exercise, meditation, prayer, relationships, friendships, relaxation and sleep are vitally important.

At the end of February 2020, I got Covid 19. Unfortunately, there were no tests available at the time to confirm the. During the last two and a half years I have had monthly MAH IV treatments. My exposure to any and all of the variants was continual. I feel that without a doubt, looking back, and with the experiences I have had with other patients who also did the MAH IV for Covid 19 and any variant related symptoms, l lost no clinic days because I did the IV treatment.

Now, we physicians and patients need to be aware and on the lookout for long Covid symptoms. Symptoms may be fatigue,

gastrointestinal, heart (Postural tachycardia) respiratory (eg. going cough), dermatological (skin rash), pain (joint, muscle, neurological) just to name a few.

If you have any questions regarding long covid symptoms and or the MAH IV treatment, and/or would like to schedule an MAH IV treatment please contact me.

The election results are not in yet as I write this letter. Practicing medicine has become more difficult in our community. Many of the doctors I have worked with over the years have left and are leaving. Please be patient as new referral patterns with specialists are established. I remain dedicated and committed on providing the best healthcare to each one of you. I am continually humbled by our many conversations and the personal experiences you share. As my practice is referral based, thank you for your continued support by your referrals of family and friends.

During this season of thanksgiving and reflections I am grateful for you all and I felt your understanding and support. A patient of mine makes jewelry and gifted me a necklace she called” in this together”. Yes, it is so true, we truly were in it together. May your holiday season be filled with Love, Joy, and Peace.

Warmest regards, Dr. Brust

CORONAVIRUS PANDEMIC

This is an interesting time to say the least in the health and wellness of US citizens and people around the world. As the information is coming in across the world, you may have many questions and concerns for yourself, and your family and loved ones. From a preventative medicine point of view, there are really some very basic steps to follow as we as citizens OF THE WORLD work together to support each other in preventing ourselves from getting and or spreading this infection. Also, if we have it, or have had it, I feel it is still our individual responsibility to protect the weak and vulnerable.

Governments have placed restrictions of all kinds in many communities, and will continue to do so. We may face a domestic travel ban sooner than later.

This blog is about what we can do for ourselves and our families to maximize our health, and minimize our exposure now.

  1. Follow the SOCIAL DISTANCING guidelines.
  2. HYGIENE: Wash hands often and frequently and avoid touching mucous membranes; eyes, mouth, lips.
  3. If you have children wash their faces regularly with a clean soapy facecloth. Rinse the soap off fully.
  4. Support the IMMUNE system:
  5. STAY HYDRATED with Water
  6. AVOID SUGAR, Including alccohol, soda, etc.
  7. STOP SMOKING, and VAPING. These activities not only decrease the overall health of your body, they decrease specifically the immunity of the respiratory system
  8. Continue to EXERCISE in a healthy environment. Ride on a stationary bike at home, walk in your neighborhood. Use in home exercise equipment eg. treadmills,elliptial machines,, weights.
  9. MEDITATE, yoga, breathing exercises.
  10. SUPPLEMENTS: Vitamin C, Vitamin D3. I am a huge fan of echinacea, and elderberry .
  11. Eat a DIET high in fresh fruits and fresh, steamed, or roasted vegetables, organic whole grains, eggs, organic free range chicken, grass fed and finished meats, fish.
  12. Get quality SLEEP. Recommended minimum of 7 hours for adults. More for cildren and adolescents.
  13. I also recommend getting OUTSIDE daily. Here in Bend it is snowing, and the ski resort is closed. However, playing in the snow, walking in the neighborhhod is still very doable. If you live in a warmer climate, go for a walk, or bike ride daily.
  14. For those of you who are CLINIC patients, IV Ozone treatments are available preventatively. Please call to schedule an apointment.
  15. Show flexibility freely and willingly with a WARM HEART to each other as we navigate through these next everchanging days.

Like many of you, we too are greatly disappointed that as a family we have had to change our spring break travel plans. However, it is more important that strong restrictive steps are taken now at this point in time of this pandemic in the US and the World.

“LIFE IS NOT MERELY LIVING, BUT LIVING IN HEALTH.” Epigrams

DR. BRUST