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My medical practice, BioBalance® Health, allows me to hear all of the myths about how to lose weight, when I am in consultation with a new patient. All of my female patients and some of the men have at one time, or multiple times been fooled by the false promises of friends, doctors, and advertisers, about quick and easy ways to lose weight.  If you have bounced around trying every diet out there on the internet and failed to lose weight, then I can help you stop the pointless trial and error process, and help you embrace the difficult and time-consuming process of truly losing body fat and keeping it off!

If you thought that all we do at BioBalance Health is replace women and men’s testosterone with long-acting bioidentical pellets, you are partly right!  In addition to treating our patients’ hormone deficiencies we also have the goal of attempting to guide them toward a healthy long life!  This involves treating “pre-diseases” like prediabetes that other doctors don’t treat until damage has been done and guiding our patients as to the right way to achieve their ideal weight.  One of the important roles we have in assisting our patients with “fat-loss” is to disprove all the lies our patients have been told over the years by nearly everyone about how to lose weight.  Some of these myths are actually believable (unless you are a doctor and understand the physiology of weight loss), but still never work. Other diet plans work for some people with specific genetic qualifications, but not for the majority of the population.   Then, there are diet plans that are so bizarre and illogical, that they literally make me giggle when my patients describe the protocol (or advice) they have been following without results.

Why are these myths so prevalent?  It is because we have been programed since childhood to eat in a way and in amounts that are inevitably going to cause us to be obese. It takes a lot of work to turn those lifestyles, habits and food choices around to lead my patients to lasting fat loss and long-lasting health. Hard work never “sells” and a time-consuming diet doesn’t either so businesses make a lot of money keeping you fat!

You may or may not have heard these! I will tell you why they

#1 Myth- If you eat fewer calories, you will lose weight, and all calories are the same.

This is one of the myths that is spoken by doctors every day because they learned it 30 years ago in medical school, and it just isn’t true!  To begin with calories in food are metabolized differently depending on whether they are Protein, Fat or Carbohydrate. It takes more calories to metabolize Protein, and more than fat and the food that burns the least calories to be metabolized are carbohydrates.  So, food calories are different depending on which food group they are from. Eg. There is a vast difference between the weight you might lose, or gain based on the food group your calories came from. For example:  If you eat a steak with 500 calories verses a slice of birthday cake/icing that contains 500 calories, it takes more calories to breakdown protein so you USE calories to make it into blood sugar, while the birthday cake takes almost no energy to make BS and readily makes fat if it is not used in exercise.

Another factor that causes counting calories to be a losing proposition, is that every food stimulates insulin differently, and insulin that is over stimulated over time gives a person insulin resistance which causes them to be so efficient that they can go a day and not eat anything, and still fail to lose weight.  If you have tried a low-calorie diet and that happened, then you are not alone.   Going back to the steak and birthday cake example, steak does not stimulate insulin very much and birthday cake is likely to over stimulate your insulin making insulin resistance worse and doesn’t make energy but is stored as fat!

The third reason limiting calories cannot be the basis of a weight loss diet is that an individual human body has a vast number of factors that influence how you as a unique individual burns calories, therefore any one calorie limiting diet will not work for the majority of humans. We are all different with individual requirements for the types and amounts of food we need which is based on our genetics, our history of healthy or unhealthy diets, our daily exercise, and how obese we are when we start to lose weight.

What that means simply is that there is no easy way to attain your ideal weight and stay there but limiting your calories.  Weight watchers tried this method for years and I never found a person who lost weight by eating a certain number of any type of calories (candy, dessert, or fruit and vegetables with the equivalent number of calories) in one day, who lost weight and kept it off.  If you eat 1200 calories of fruit, veggies, eggs, fish and or meat throughout the day and have an active lifestyle, you will lose fat that day. If you eat 1200 calories you save up all day to eat one dessert you will probably gain weight because it will overstimulate your insulin and make your calories into fat and not energy.  Weight Watchers changed their program several years ago when their clients realized their system didn’t work. Counting calories to lose weight is a myth you should avoid.

Myth #2: The promise:  “If you just  eat _________ (one food like grapefruit/cabbage soup/ salad/juice take your pick)  for ____ weeks you will lose 20 lbs.

The cabbage soup diet is an example of this failed “theory” which invaded the US female population in the early 2000s and my patients embraced it completely believing that they would lose 20 pounds in 4 weeks.  I objected and told them that eating only one food for 4 weeks was unhealthy, a baseless fad which was unlikely to work, but very few of them listened.   It turns out that Cabbage is a food that slows the metabolism of people with   A blood type, and the majority of citizens in my city, St. Louis, have A blood type!  At their next GYN visit my patients were all moaning over the fact that they had GAINED 20 pounds on the cabbage soup diet! Not eating a variety of foods is unhealthy and this proves that even an unhealthy diet doesn’t promise weight loss for everyone.

So please don’t follow fads. they are baseless, and you might gain weight and not lose it!

Myth #3 You can exercise your way to fat loss,  eat whatever you like and still lose weight.

I believe exercise should be part of every human’s healthy lifestyle, and exercise is necessary to speed up the metabolism while you eat a low carb, high protein diet and refrain from bad habits like alcohol consumption. However, eating like you normally do and exercising hours daily will not bring about weight loss for 90% of the population of the US. Lasting weight loss doesn’t occur unless you add eating a healthy diet, stopping bad habits and taking the required supplements necessary to decrease your fat mass, and exercise.  Yes, you have to do it all!    Increasing muscle increases our metabolic rate and exercising muscles increases the loss of fat, but both muscle building and muscle strength require high protein diets, with a moderate amount of fat, and without a lot of carbohydrate.  Eating carbohydrates unchecked can cause the weight loss promised by exercise-based weight loss programs to fail, over and over again. After the age of 45 your muscle will not be preserved while you lose weight if you do not replace your low testosterone and exercise too.  So it is not ONE factor that facilitates weight loss, it is complicated and there is a perfect fat-loss plan for everyone…you just have to find it!

Myth #4 Low fat diets are a good way to lose body fat and prevent heart disease!

Every study has failed to support this idea!  Low fat diets don’t lower cholesterol, but low carb diets do!  We were told by cardiologist for the past 30 years that low fat diets would lower the cholesterol and the atherosclerosis in your arteries…but they lied!  It is now accepted by most doctors that low fat diets leave people hungry which causes them to  eat too many carbs resulting in an increase in cholesterol and weight gain. Re-introducing fats into your diet should include healthy fats (fat from seafood, vegetables like olive oil, milk fat and other omega 3,6, and 9 ) are necessary for brain health and good body composition.

The advice by the US FDA and Medical specialists to eat a low-fat diet has contributed to over 50% obesity, dementia, and diabetes in America. If your cardiologist tells you that a low fat diet is going to prevent heart disease, then look for a more up to date cardiologist.

Myth #5 High protein diets are not effective for weight loss.

High Protein-Low Carb diets are the best diet for the majority of people in the US.  This diet is the most effective type of eating plan for your weight loss.  If you want to know what % of protein, fat and carbohydrates you should eat, then go to our website, BioBalancehealth.com and become a weight loss patient with genetic guidance and you will learn how to distribute your foods based on your unique genetic map.  High protein diets keep you “full” longer after a meal or snack, so your calorie intake is naturally lower.

Reserve your intake of carbs to supply you with physical energy before and after exercise. Otherwise, your diet should consist of high protein and fat, and limited carbs, with plenty of fresh vegetables and fruit (these food are not considered carbohydrate).

Myth #6 Diet soda is a “free food” because there are no calories, so I can drink as much as I want to and lose weight!

 Diet soda contains many chemicals, salt and includes a chemical sweetener called aspartame.  Salt causes swelling, and all chemical sweeteners stimulate insulin and act to make you hungrier than if you drank unsweetened iced tea, water or anything sweetened with stevia.  Stevia is a plant that does not contribute to insulin resistance and diabetes.  The majority of diet sodas stimulate insulin just like carbohydrates do and contribute to weight loss failure.  Every time you drink one you should consider it just like eating a carbohydrate!

Summary:

Following the advice above will prevent so much frustration with future weight loss attempts, and will help you achieve your ideal weight through avoiding these myths about weight loss.

Remember that weight loss fads have been around for a long time without a public refute of the obvious myths above.   Fads should be ignored if you want effective weight loss. Remember that Instagram and Facebook posts are only motivated by profit, even though they spread crazy diets as based on fact. There is no one monitoring the “fads” validity.

Please don’t listen to fads of people who are not doctors or nurses trained in weight loss! More Myths about weight loss next week!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Dave Glover, the most listened to talk radio voice in the Midwest, invited me on his show last week to talk about BioBalance Health Testosterone Pellets for men and women and BioBalance Skin my medical esthetic spa.  His show is on KMOX, the voice of the St. Louis Cardinals.  Dave Glover and I have worked together for 10 years, and he is unabashedly my patient who has experienced the superiority of our medical care that is unique, and preventive, in addition to being the best testosterone pellet therapy in the Midwest. We go far beyond to direct our patients to a healthier life.

Dr. Maupin Radio Interview with Dave GloverWhen patients have their first appointment our doctors have already reviewed their lab amd medical history, and the first appointment is chocked full of information about the meaning of their laboratories, diagnosing medical problems such as insulin resistance and prediabetes to finding diseases they were unaware of.  At the same one-hour long appointment we work with our patients to develop an individualized diet and exercise program for their unique situations.

The secret to our success in bringing 95% of our patients back to health is the foundation of replacing testosterone in the most effective and safest method with replacement non-micronized testosterone estradiol pellets.  We do much more in a short time to direct our patients to reversing the symptoms of aging (the symptoms of testosterone and estradiol loss) while we prevent future illnesses like diabetes and help our patients move to healthier lifestyles.

Dave asked me what is new about BioBalance Heath.  We are always improving our knowledge, based on new medical research, and our newest offering is a simple genetic Diet and Metabolism Test called Nutrigen.  This test is done by simply doing a self-cheek swab and never has to be repeated!  Right now we are offering this test for $300 (a discount of $150).  If you have tried many diets and still don’t know what type of food you should eat, our test is meant to be a ONE-TIME test to tell you everything you genetically need to lose weight.  Or if health is your goal and not weight loss and you want to know how to eat for the rest of your life, this diet is a necessity!  It comes with a 60-page report.

Everyone who elects to take this test will get a 60-page report about every genetic factor that affects their diet, metabolism, exercise and weight loss.  It even includes what genetic factors are working against them and their ability to lose weight. When their test comes back, our Nurse Weight Loss Specialist, Sarah Hooper RN will be ready for them to make an appointment to go over the report and explain a healthy eating plan. We always have used the INBODY machine for following body composition and not just weight for ALL our patients, pellet, weight loss, and non-pellet patients.

Dave then asked about what was new in our BioBalance® Skin Office? We are always looking for ways for our patients to look younger, and healthier as they age. Dr. Maupin and Sullivan’s criteria to adding services is that they are TRULY EFFECTIVE, as well as painless, and the service is affordable compared to other pathways to the same outcome.

This year we have added a painless hair growing ultrasound treatment called TED.  It can treat any form of hair loss, as long as there are some follicles left to stimulate. Women and men come in for 4 to 6 45-minute treatments, that feel like a scalp massage.  There are no necessary serums or vitamins to buy. You just have to keep the areas treated out of the sunlight for the month following the treatment.  This is a real breakthrough and compared to very costly hair transplants and painful PRP treatments this is a game anger!

For women who have lost weight and ask us every time they come in for weight loss or pellets what they can do about sagging and crepey skin, now we have a variety of treatment s  to offer them: Opus treatments for the chin and jowls, Juvashape to tighten areas all over the body. EM Sculpt to build muscle, lose subcutaneous fat and tight skin, and EM Face to take the place of a Facelift!  Our patients are encouraged to come in for a free consultation to help them decide what they can do to “SHAPE UP” after successful weight loss!

We offer episome treatments with our Aqua Gold treatments to rejuvenate tighten, smooth out and lift facial skin….It is a step up from  microneedling for more mature skin.

We literally offer the MOST EFFECTIVE, MOST ECONOMICAL TREATMENTS with the least pain and best results anywhere!  BioBalance Skin Staff will guide you to the appropriate choice of treatments so you can be assured you have the best esthetic treatment for your individual problem.

Our Goal is to help our patients look as good as they feel with their BioBalance Pellet treatments!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

2024 has been the hottest summer of the decade and it is causing many of you to go to the ER with heat related sickness. There are several risk factors that may put you at high risk for illness relating to the heat. I have been present several times when someone collapses from heat stroke which is the most severe heat related illness. The heat can kill you if it progresses this far.  It is interesting, athletes who won’t back off from their outdoor activities, and will work out in the highest heat of the day.

Heat stroke can cause a person to collapse, drop their blood pressure, act out, or pass out, or even seize, all of which are signs to call 911, and start emergency procedures: elevate their legs, if possible, place ice packs under the arm pits, around the sides of the neck, and on their groin.

The highest risk patients:

Ask the heat stroke victim to drink fluids if possible. Of course, make sure they stop the activity they are engaged in outside in the heat. Move them to a cool place while you are waiting for emergency help to arrive. Heat stroke can cause a vascular stroke or death, so emergency treatment is necessary. If possible, offer the victim water with electrolytes in them (NUUN-Sport) and some sugar in case they are also hypoglycemic as well. If they can’t drink, which is a side effect of heat stroke, put a wet washcloth in your mouth to suck water from it slowly.

My husband and I went on a trip to Cinque Terra, Italy with another couple last fall to hike the trails between the 5 towns that line the cliffs over the shores of Liguria.  The hike was supposed to start at 8 am so we could avoid the heat of the day….and it was in the 90s and humid…but as luck would have it the transportation we had arranged for wasn’t able to take us to the starting point and we didn’t get there until  10:30.  We packed several water bottles and a few snacks but we were not prepared for the  4  ½ hour trek high above the mediterranean on a trail that was 3 feet wide and involved thousands of steps up and down…we had drunk most of  our water in the first 2.5 hours and were very hot and sweaty the whole time….about 40 minutes from the town of Vernazza, my husband started stumbing, and talking nonsense…he had stopped sweating and couldn’t walk….There was no place to lay him down without blocking the path and we found a shady spot for him to recline and put his feet up.  I had some Nuun-sport electrolytes which I had put in my water and had been drinking, so I put 2 electolye tablets in ½ bottle of water and tried to get him to drink it…..he was delirious and refused, and I had to force him to drink…he fell asleep and we received water and cold water bottles to put around his neck from passersby.

 Ideally, we would have gotten ER help which he really needed, but there was no way to get emergency care to him and at 6-4 and 230 he was too heavy to carry/drag…and remember we were on the edge of a 200 ft cliff. When he had slept 20 minutes I kept my finger on his pulse and he was thready and fast…..Thankfully he rallied and we got to Vernazza and he walked into the ocean after drinking several glasses of water to cool off and fell asleep on the beach for an hour until he was ready to get on the train back to our hotel….This was one of the scariest times of my life because I knew what to do but didn’t have the IVs, or water or ice or anything to help him.  Remember this and make sure you are always prepared for the worst scenario when you are active in the heat!

So how do you know when you are getting close to heat stroke?

 You feel weak and out of breath. Your pulse rises, you stop urinating, and you STOP sweating.  You are getting close to heatstroke when you start to feel cold even though the ambient temperature is high.  When you feel dizzy and unstable on your feet…the next thing to happen is vascular collapse

See the stages of Heat Related Illnesses below, which we are all at risk for! This is from the NEJM.

Classic heat stroke: most often occurs among older persons with compromised behavioral and physiological compensatory responses to heat exposure

Exertional heat stroke: most often occurs among healthy persons during extreme physical exertion, which results in excessive metabolic heat generation, often but not always with concomitant ambient heat exposure

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

In general, I spend my time defending women and the fact that our problems and sexual physiology is ignored, by the governmental powers and physician organizations in the US, so I try to do my part to bring information to women about their hormones and the aging process. Today I am changing my focus to men and the way men’s normal sexual function is considered a “normal” and rarely discussed outside the men’s locker room and or porn sites. So here goes…The fact is that men’s sexuality isn’t just the act of sex, but men spend a lot of their sexual energy on fantasies and just thinking about having sex.  Men’s ability to have an orgasm is not just a wham- bam—thank you…well you know the phrase…and there are many physiologic factors that must work, in the background to bring a man from thinking about sex or desire, to an orgasm.

Sadly, in the current environment couples don’t talk about sex….they don’t tell their partner what makes them excited or even what they want…. because none of us can read minds, too many of us don’t get what we want when it comes to sex.

With lack of communication between partners, leads couples to trial and error without a map.  Neither sex knows how the other sex “works”.  I decided to describe the normal series of what men go through on their way to orgasm to educate them and their partners.  In addition, the process is not always the same in each person and as men age the time between the first sexual thought to completion gets longer and longer…sometimes these detours include episodes of losing an erection, sometimes getting it back and sometimes not which leads to frustration of both partners.

In youth when a man’s free testosterone is high and his arteries are free of plaque, between puberty and age 35, erections may occur often, and they last a long time if the man is stimulated for a long period of time. At this point sex is automatic and easy to complete to orgasm and ejaculation.

As time goes on, free Testosterone starts to decrease with age, as does the diameter of a man’s arteries…blood flow doesn’t rush to the pelvis to create an erection like it did in youth. The things that lower free testosterone.  What happens with age that cause erections and ejaculation to be less and less automatic and easy?

For men who don’t know all these medical, aging changes that happen to most men, these changes cause fear and anxiety which of course makes it worse.  Men who have this issue (most men) are even reticent to talk to me about it and they haven’t talked to their spouse either.

So here is what I tell them:  You are aging like everyone else, and that fact can’t be changed, however, your lifestyle and your medical health, or poor health is affecting your orgasms and your ability to have sex.  These factors CAN be changed.  You can change your BP medicine to

one that doesn’t impair erections.  You can get your diabetes or obesity under control, and you can improve your erections.  However, to get it all back you will need testosterone replacement if your free T is under 129 ng/dl. The safest way to accomplish this is with my practice BioBalance® Health…we do it better and know all the tricks to making you healthy productive and potent!

What is in the ejaculate? mature sperm are mixed with whitish, protein-rich fluids with prostaglandins are produced by the prostate. These fluids nourish and support the sperm so they can live after ejaculation for a limited time to fertilize an egg.  This mixture of fluid and sperm, known as semen, and is what is moves through the urethra in the form of ejaculate.

Sensory stimulation travels from the skin to the brain and stimulates dopamine and endorphins which are neurotransmitters that make a man fee happily ecstatic during and after an ejaculation.  These neurotransmitters also stimulate the Hypothalamus to make oxytocin, a bonding hormone that binds couples together. Many nerves, vessels and the brain are involved in a successful sexual encounter.

The culmination of a sexual encounter is complex and involves the whole body. I find it interesting that the “medical view” of orgasm is still divided into 4 different steps when, if you are a male (or even a female who has had sex with a male) the divisions seem very arbitrary and is ALWAYS connected to ejaculation.

It is a fact that men and women can have sexual intercourse and orgasm without ejaculation.

The following is how the practice of medicine describes the male sexual act.   In contrast I have educated my patients by comparing sex to a on the fact that men can have orgasms which occur in the brain when endorphins flood the neurons, even without ejaculation.  So I will discuss, the male sexual experience to them, not with the “4 easy steps of male sexual response”, but as a “process” of achieving orgasm in men.  It is more like a recipe, that requires each ingredient to be added in order, but sometimes you can stop in the middle and start again.  It is not always a straight line from sexual desire to orgasm.

In general, all men need testosterone to have sexual desire, and sexual desire to have sex, however both men and women can be physically or visually stimulated to be aroused without true sexual desire. If the man has a long history of having sex often, then the habit of having a sexual response can be achieved without enough testosterone, however the erection will not necessarily last long enough.   Continued physical stimulation can bypass desire, and therefore testosterone, and a man can be stimulated into having an erection of sorts and into having an orgasm with or without ejaculate

An erection requires testosterone to become fully erect, however there is a “work around” now and men without testosterone can have an erection with Viagra, Cialis pills, or prostaglandin injections into the penis itself. Men can also have a penile implant placed so they can have sex without testosterone or Viagra/Cialis. However, let’s talk about sex with testosterone in men who have good pelvic blood flow who don’t require medication to become erect.

The second necessary ingredient after testosterone is stimulation, which can be with touch, visual stimulation, auditory stimulation or even imagination that causes a man to be stimulated. The sexual response to any of these stimulations send messages through the nerves from the brain to the pelvis that dilates his veins and arteries. This sends blood to the penis from the arteries and blocks the veins from draining the blood out.  This creates an erection. Testosterone’s role is to cause the arteries to dilate by stimulating the production of nitric oxide from the arterial walls. Remember the stimulation? The ongoing stimulation (mental, visual, auditory or imaginary) keeps the erection hard with vascular dilation.

At this point stimulation can be changed or paused and other stimulation can prolong this part of the process.  Holding the base of the penis can keep it hard, or any tight encircling toy can keep the erection from proceeding to orgasm for some time or the erection can go away without continued stimulation.

The third step is the preparation for orgasm which can last from as long as 30 minutes and as short as 2 minutes. A clear “pre-ejaculate” is produced that lubricates the penis for intercourse, and if ejaculation is to take place there is a “loading of semen” that takes place from the seminal vesicles readying the man for ejaculation.  At this point the penis contracts the muscles quickly in rapid repeating emissions that shoot the semen out of the urethra. This is the orgasm and ejaculation that occur together, which is typical of normal youthful ejaculation.  As men get older the force at which they ejaculate decreases.

After ejaculation/orgasm the brain is flooded in endorphins, the feel-good neurotransmitters, that make a human feel happy and satisfied.  This is solely the result of the orgasm after a sexual encounter. The feeling of ejaculation does relieve pelvic pressure but is not needed to experience orgasm in most men.

Medical science has been able supply an assist for desire (testosterone) and erectile function (vasodilation and release of nitric oxide but they have not discovered the “pill” to make ejaculations occur or to improve their volume.  It is important for an aging man to accept that orgasm doesn’t require ejaculation since we don’t have an answer to recreating the youthful ejaculation.  Besides age, vasectomy can also limit ejaculation.  dehydration, vasoconstrictors, anti-hypertensive drugs and diuretics can limit the volume of the ejaculate as well.

After the “process of sexual orgasm” the penis loses tumescence, blood leaves the pelvis and overall relaxation occurs throughout the body. Then a period of time must pass before another erection can occur.  Over time some “twice a day men” can turn into once every week…..this can be changed by practicing…..having sex more often.

The sexual response in both men and women is more like a symphony with several movements, than a recipe, but it is definitely not a series of steps that is followed in every human in every circumstance. It is the job of the physician to help patients both understand and live with any variations in the sexual process.  Much of what I do is act as a teacher to my patients who need to understand their own bodies and any dysfunctions thereof.  Understanding becomes treatment over time.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

The medically accepted belief that testosterone is bad for men has finally now been superseded by a huge study from Australia that proves that men with healthy levels of Testosterone live longer and healthier than men with low Testosterone! All you men who have been told that testosterone is bad for you or will cause prostate cancer by your doctor, you can tell you provider that he or she is out of date! 

At BioBalance Health® we have been treating men with testosterone pellets for years and our patients are our evidence that testosterone not only keeps men’s sexuality healthy, but youthful testosterone blood levels keep men healthy in many ways, eg. strong muscles and bones, excellent immune systems, healthy heart and blood vessels, lean muscle mass and it prevents the diseases of aging too!   I have been treating men and women with Testosterone for over 20 years and I concur with how this study plays out in real life, in my own practice. When my patients replace men’s low testosterone levels with testosterone pellets and they follow my recommendations for a low carbohydrate diet and weight training exercise, supplements and treatment of pre-diabetes and pre-cardiac disease, they live more productive, longer and more enjoyable lives.

My goal for my medical practice is to keep both men and women healthy as they age, and testosterone replacement is the most important necessary element to that end.  My intent is to defeat the aging process with interventions that have the potential to delay the onset of age-related diseases and preserve your ability to live life to its fullest, no matter what age you are!  We have based our treatment on hundreds of other studies that literally studied one symptom of testosterone deficiency or disease of aging at a time in relation to testosterone levels and found bioidentical testosterone to be beneficial to the health and longevity of men. However, we treat all the symptoms of aging and low T with testosterone pellets.

Australia’s Men’s Study found that men who continued to produce normal youthful levels of Testosterone or replace their Testosterone to achieve normal youthful levels lived longer, more active lives than men who let aging take its course and drain them of testosterone! We have known this for two decades and we have treated men and women with testosterone pellets, the most effective and safest way to prescribe T.  Many smaller studies have been done that prove the same thing, but none so dramatic as the latest study we are referencing.

At this point I have two questions to answer for most of your inquiring minds: Why did all the experts tell you that testosterone replacement is dangerous? and, why are the experts in the field of men’s medicine, Urologists, still advising men not to replace their low testosterone as they age? Let me explain that why everyone is so negative about testosterone and why most medical doctors still believe that prescribing testosterone to men is evil.  This all started in the 1950s based on the study of only 3 men, who had had prostate cancer. They said they were testing them to find out if testosterone caused prostate cancer recurrence in men after prostate cancer.  During the study one of the men had a recurrence of prostate cancer when he was given testosterone injections.  In the “olden days” that provided the basis for the belief that Testosterone CAUSED prostate cancer!  The doctor even got a Nobel prize.  Based on this minimal and falsely extrapolated information, 50 years of doctors have been taught that prostate cancer is caused by testosterone, when in reality testosterone is only dangerous if a man already has an aggressive cancer already, will testosterone replacement stimulate the growth of prostate cancer.

This misinterpretation of a faulty medical study has prevented generations of men from being treated with testosterone to prevent diabetes, heart disease, loss of muscle mass and the ability to walk and lift, as well as the inability to have sex throughout their lives.  This has been a grave dis-service to American men, because the world follows us with all of our medical protocols, this misinterpretation and lack of preventive care with T has spread around the world.

The second question you should ask is: Why are the experts in the field of men’s medicine, Urologists, still advising men not to replace their low testosterone as they age? Well, this is not just your doctor’s fault.  Other than being trained by generations of doctors who believed the inaccurate information about the danger of testosterone causing prostate cancer and passing it on, there is a problem with how we train the doctors who take care of men. Urologists are surgeons first and not particularly interested in anything that has to do with preventive medical care.  Their training is based on surgery: they go through a general surgery residency after medical school for 5 years and then do a specialty in urologic surgery which doesn’t include treatment of anything medical or preventive.    More than that, their College of Urologic Surgery and their journal has been blinded by supporting the surgical treatment of prostate cancer, so their motivation to prevent prostate cancer is generally opposite their type of practice of medicine. They can only operate on prostate cancer when a man has it.

Now if you have a penchant for conspiracy theories you may then jump to the conclusion that both the practice of medicine, the business of pharmaceuticals and the government have monetary benefit from keeping all of us sick, and limiting our longevity, since we are a drain on the system after we stop working and live off Social Security and Medicare.  In other words, old Americans don’t provide value to the whole of society.  I contend it is only because we don’t help aging Americans stay productive and healthy that they are a drain on the rest of the population…However, that conspiracy theory is just a theory I have heard from my patients.

This study is big news because it is the most important study that has been allowed through the blockade of powers, to the public!  We at BioBalance Health® can now give you men what you need, and when other doctors criticize our treatment, we can defend our treatment plan with this Australian study and the other hundred studies that came before.  You have your ability to ask for what you need from your doctor, based on sound evidence! The second study is below and was in the Journal of Internal Medicine about the same time as the Australian men’s study.

Study links low testosterone to increased mortality

A study published in the journal Annals of Internal Medicine found that men with low testosterone levels had a higher risk of all-cause mortality, and those with very low levels also faced an increased risk of cardiovascular mortality. The findings suggest potential links between testosterone concentrations and health outcomes, emphasizing the need for further investigation into underlying mechanisms and potential therapeutic implications.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

On the last Heath cast #662 we talked about the choice of doing nothing when faced with symptoms of hormone deficiency and symptoms of aging, versus the choice to actively live a healthy life. I believe that concentrating on yourself as you age can save your lifestyle and or your life!  Preventing illness as you age is as important as paying your taxes!

An unhealthy living plan without replacing deficient hormones can lead you on  a road to illness and early death.  If that doesn’t motivate you, then consider yourself warned. Recently I saw a man in his late 70s who I had seen about 7 years before this.  He and his wife entered my office, and I could see that some of my medical predictions had come true.  This man had developed every disease I told him his blood work and physical self-predicted. Despite the treatment plan I gave him, he ignored me on diet, exercise, supplements, stopping smoking and drinking I gave him 7 years earlier.  He admitted that everything I told him would happen, did happen and now he is in constant pain, he is morbidly obese, and has trouble even walking.  He now has diabetes and has had a heart attack and 7 ER admissions for his heart since.  He did not do one thing I told him, except just recently he stopped drinking alcohol. He now is ready to live a healthy lifestyle however since he has so many diseases, he spends an enormous amount of money on medications and medical care.  The cost of care was his reason to ignore hormones, but he ignored my lifestyle advice as well.  Even though now a lifestyle change and testosterone pellets will improve his life, he still has done damage to his blood vessels and heart not to mention his joints and back.  These aging changes I cannot prevent, just stop the rapid progression.

When you become our patient, we ask you a variety of questions that help us design a treatment plan, more accurately named a “longevity plan”. Symptoms of Testosterone, Estradiol and Thyroid deficiency:

A combined list of symptoms of aging for men and women include:

Loss of Testosterone Symptoms:

·      Loss of sex drive

·      Loss of erections, and morning erections

·      Loss of orgasms for women

·      Fatigue

·      Insomnia

·      Depression/anxiety attacks

·      Loss of strength and muscle mass

·      Frailty

·      Can’t think clearly or remember names of things

·      Loss of motivation

·      Loss of efficiency at work

·      Weight gain

·      Belly fat increase

·      Sagging skin

·      Arthritis

·      Osteoporosis

Loss of estradiol (women):

·      Hot flashes

·      Night sweats

·      Anxiety attacks

·      Irritability

·      Dry vagina

·      Painful intercourse

·      Sagging skin

·      Frontal balding

·      Urine loss

·      Dry skin

·      Shrinking vagina

·      Osteoporosis

·      Arthritis

 Thyroid deficiency:

·      Hair loss

·      Fat gain

·      Fatigue

·      Depression

·      Feels cold all the time

·      Very dry skin

·      All body swelling

·      Constipation

·      High cholesterol

·      Low blood pressure and pulse

These symptoms above can be treated and in treating them you will experience not only a lack of symptoms, but a longer healthier life. However, if you also change your lifestyle you can avoid the diseases of aging too!

Through replacing your deficient hormones, add only individually chosen supplements and develop a healthy whole food eating plan, with 3-7 days a week of exercise (1 hour/ session). 

What do I mean? What is a healthy Lifestyle?

·      If you smoke STOP!

·      If you Drink more than 15 alcoholic drinks a week, then stop, If you aren’t addicted to alcohol, you should decrease your drinking to < or = 7 drinks a week.

·      Exercise 30-60 minutes a day (consecutively)

·      Throw out all the simple carbs in your kitchen: all cereals and granola, use olive oil to cook and no vegetable oils, Processed dry food in boxes or cans should be donated to charity.

·      Buy fresh fruit, fresh vegetables, cheese yogurt, fresh or frozen meat, fish chicken, turkey for meals at home.

·      Sourdough bread is the best choice in breads—it has no gluten but still has carbohydrates, so small amounts are advised.

·      Do something you love every day

·      Look for opportunities to have fun

You CAN turn your bad genes off through a healthy lifestyle!  Now we know even your genes can be combatted through healthy living. The diseases of aging can be adjusted or avoided.  When thinking about what your risks might be, remember that Family history is a broad and faulty way to determine your risk, but genetic testing is a better way to determine your risk of disease that is found in in your chromosomes and genes. The combination of your genes are uniquely yours. Knowing what your genes are can guide you to an individual healthy lifestyle for avoiding disease and living a long life.   We offer this service for our patients who want to know what the perfect diet and lifestyle plan is.  It is called the

Nutrigen test is optional but a great idea if you are trying to renovate your life! This saliva test (no needles) can determine the genetics you inherited from your ancestors.  We then share the information with you and develop a lifestyle plan that includes lifetime changes in eating to decrease carbohydrates from grains and sugar, increase protein, and remove as many processed foods as possible. The Nutrigen test tells you what genes you inherited that impacts your health, but it doesn’t tell me whether you have turn any of your bad genes off or your bad genes on!

We offer that test to our patients who are trying to lose fat or just reframe their life so they can live more productively and as much without disease as possible,

Now if you aren’t convinced that you need to replace your hormones with testosterone plus estradiol if you are a postmenopausal woman, or if you figure you will 

 Does a future of having Alzheimer’s disease strike your panic button enough to change what you eat and how much you exercise, and to replace your Testosterone with Pellets?  Or is it losing a limb from diabetes? Being unable to talk from a Stroke?  Would losing your ability to move around as you do today from a Stroke or heart attack make you scared enough to value your health and clean up your lifestyle?  Or would the prospect of never having sex again be the trigger that causes you to be as careful with you own health, body,  and mind, preserving it for the rest of your life?

Medical care is not just about fixing the sick through medications or surgery anymore, although that is the paradigm we have all grown up in.  That dated belief may have dominated our  belief  about what medical care can do for us and how it works because until recently medical experts didn’t understand how diseases sprouted from a bad lifestyle, or because we were taught that our genes determine our health and there is nothing we can do about it…..but we now know that leading a healthy lifestyle, using food as fuel and not entertainment, and being moderate in everything from food, to alcohol to exercise is the key to a long healthy life. New information in the last 20 years has come to light  revealing that an individual can turn off bad genes through a healthy lifestyle…. Your genetics do not  dictate your fate, but it is your behavior that dictates the diseases you will suffer fromwith through the last half of your life  and eventually die from.

Let’s talk about the most dangerous lifestyle choices that you can make. You must think about your body as a luxury car that requires a lot of maintenance, the best quality gas to fuel it, and loving care every day to maintain its value and performance.  Our bodies are a thousand times more complicated than the highest- performance car, and I contend that the most beneficial maintenance you can do is to think about your health every day especially when you are presented with behavioral choices.  For instance, when you wake up you should stretch and make sure your muscles are not spasmed.  YThe you should think about the two most important choices you will make all day, “When will I work out for an hour?” and “What shall I eat today?”. .  Exercise is key to managing your insulin sensitivity and blood sugar, protecting you from diabetes and heart disease.  Why would you avoid this inexpensive protection from these deadly diseases?   Planning what you will eat that day (or for the next week) should include  healthy, non-processed foods and drinks with plenty of water and protein and limited carbohydrates from grains especially from wheat.

But you counter my suggestion ,” Wwhat should I do when everyone around me is overeating processed foods and drinking alcohol and sugared soda?”.  My answer is, “Stop and think! Do you drive over a cliff because the guy in front of you does? No!  Be brave and don’t make a scene., just choose to eat and drink in a healthy manner…if that is not available, leave and find the food and drink your body needs!”  You are no longer a teenager when all the mistakes we make are “forgiven” by our bodies.  That stops working after age 20!

I think you should look at taking care of yourself like being engaged in working toward a goal, whether it be in sports, climbing the corporate ladder, getting a raise or getting your degree.  Health is a goal that will repay you throughout your life.

I no longer work in OBGYN not because I didn’t enjoy it, or it wasn’t profitable enough, I stopped running around with my hair on fire, stressed out and exhausted without adequate sleep or nutrition because it was bad for me!  My medical practice literally made me sick!  I gained weight, felt terrible, looked old, was crabby and depressed, so I made a choice to make my health a priority and a priority for my patients.

In terms of how  my medical practice changed…from doing insurance paid medicine which is paid for the patient by someone else I was daily faced with patients who didn’t value my advice and didn’t follow it!  I now have a medical practice where patients pay for their care themselves.  There is something about paying for something that makes you value it more!

Instead of seeing patients yearly that I gave the same advice I give to my BioBalance patients today and repeating myself year after year without my patients making any progress, I now recommend lifestyle changes and treat my patients with replacement testosterone and estradiol pellets and they immediately feel better and follow my advice!

I am blessed to watch my patients achieve health by changing their hormones, diet, exercise, changing medications and taking supplements to round out the nutrition offered by their food choices.

The one most important health goal should be weight loss so you can achieve your ideal weight while you maintain your muscle mass. That change will take effort and sacrifice and if you are over 40 you will need testosterone to make this happen! 

Here are the diseases that are caused by obesity:

·      CANCER! All kinds!

·      Diabetes-Type II

·      Heart disease, Myocardial infarction and stroke

·      Alzheimer’s disease

·      Autoimmune diseases

·      Endometriosis

·      Arthritis and joint replacement

·      Hypertension and kidney disease

·      Immune deficiency

Are you afraid of getting any of these diseases?  What is your most terrifying disease that keeps you awake at night?  Any of these in the list above?

I have always been fearful of Alzheimer’s Disease and stroke because not being able to think and speak is my biggest fear!  I have gone so far as to have genetic tests for Alzheimer’s Dx and I have 1 of the 2 genes that cause this devastating condition. However, because I have taken estradiol and Testosterone pellets since I was 47, my chance of getting this disease has been delayed 20 years.  Other factors that increase my risk for stroke and dementia are inflammation from being overweight, eating a high carb diet, lack of exercise, hypertension, poor neurotransmitters from a poor diet and bad gut bacteria. 

One by one I have changed my lifestyle to decrease these risk factors.

If I can do this, you can!  You don’t have a harder work schedule than I have had or less time to choose foods to eat.  I choose to turn down more than one alcoholic beverage, to take my own healthy snacks when I travel and at my office. 

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

My goal for BioBalance Health® is to guide my patients to live a healthier life by offering them the newest preventive treatments, and safest hormone treatment available. My patients make an appointment with me and Dr. Sullivan for help with their current symptoms of aging and hormonal treatment to replace their missing hormones.  They also receive a plan for unique preventive lifestyle changes to assist them in continuing their lives in health.

But first, I believe that treating the symptoms of aging is the first thing on the agenda, and those symptoms are treated by replacing the hormones that disappear with age, testosterone, estradiol and often thyroid hormone. These symptoms are classic and appear within a short period of time, together: This is a combined list of symptoms of Testosterone and Estradiol loss for women after age 38, combined with loss of Testosterone in men after age 50.

·      Loss of normal youthful body, muscle and shape

·      Loss of sex drive

·      Loss of balance

·      ED in men (men)

·      Poor or decreased ejaculation (men)

·      Cellulite

·      Dry vagina (women)

·      Painful intercourse (women)

My patients frequently tell me that they feel so good after getting their first testosterone pellets that they wish they would have come to see me years before because they have been suffering and now their symptoms are improved or gone. They also comment on how great their sex life is, their improved stamina to walk, play golf or run and how much younger they look! That is the enjoyable part of my practice.

Replacing these hormones gives my patients their lives back and gives them their energy back so they can make changes in their lives to keep themselves healthy to avoid the diseases of aging.

The Diseases of Aging are these:

We find that we get great results with one or two hormones, but because we are preventive medicine doctors and hormone replacement doctors we are not just interested in your current condition and symptoms, but we are concerned about the diseases you are at risk to get when you get “old”.  We then go over your family history of diseases with you and use it to determine what you are at risk for. Let me say that family history is only ½ of your risk factor because each parent only carries 1/2 of the genes you own. This means that your risk is usually watered down by the relative who has the disease, and your risk usually goes up if two relatives on opposite sides of the family have the same disease. Even though we use family history as an estimate of your risk for diseases in the future it is not very specific or accurate.  The information your family tells you about their history may not be accurate for the real diseases your parents and grandparents had.  My family history is a good example of bad information in an individual’s medical history:

I thought I was at risk for Adult-Onset Diabetes because my grandfather on my father’s side and my grandmother on my mother’s side had Type II Diabetes. I was worried since medical school that I would eventually get AODM too. When I had my genetics done, I found that I had 4/5 genes that foretell obesity, but NO DIABETES genes! This changed my approach to my own health from avoiding carbs totally, to losing weight until I was at ideal weight.

  In case you don’t know it, almost all obese people develop Type II Diabetes eventually. If they don’t change their lifestyle soon enough and lose weight as well as get the proper nutrition it is in their future. Diabetes is a disease that will follow them through their lives, putting them at risk for other diseases like cancer, heart disease, Alzheimer’s disease, dementia of all kinds, arthritis, and joint deterioration needing joint replacements. This list includes the most common causes of death. So the moral of the story is, my family history didn’t tell me what I was going to be at risk for!

 You can plan your healthy living plan based on your family history, or you can get your own genetics done to tell you what you are at risk for based on your genes, OR you can just clean up your lifestyle, receive your hormone replacement using the safest delivery system

(pellets) and begin a healthy lifestyle as soon as possible. Get real information based on your individual situation now with blood work and add your genetics or family history to help motivate you to get healthier. Changing your lifestyle is the hardest thing you can do so getting expert advice from a physician, and then follow it.  Look for a doctor who will help keep you motivated to follow your healthy living plan and do your half of the path to health and healthy aging without disease.

Please join me, Dr. Kathy Maupin, BioBalance Health® next time when we outline a plan for health and longevity to avoid the pain and disability of aging.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

I bet you have heard the idiom, “There is no free lunch”, or  “There is no medication without a side effect”, but did you know that medications that are prescribed by your doctor can have negative effects on your health that are never even discussed with you….so you should protect yourself by replacing the nutrients that your medications  remove from your body, and that must be replaced for you to be healthy.

Statins -→ COQ 10 DEFICIENCY= fatigue and depression

Beta Blockers -→ COQ-10 DEFICIENCY= fatigue and depression

Oral contraceptives and oral estrogen/progestins-→ COQ-10 DEFICIENCY= fatigue and depression

Antidepressants called SSRIs-→ COQ-10 DEFICIENCY= fatigue and depression

Dosage: If you take any of these medications you need to take COQ10 200-400 mg/day every day!

Thiazide Diuretics=HCTZ -→ Magnesium and Zinc Deficiency muscle spasms, prostate issues, constipation

NSAIDS (Motrin, Advil, Aleve, Ibuprofen, Meloxicam, Naproxen, Indomethecin, Daypro, Mefenamic acid, Voltaren)-→ malabsorption, depression, anxiety, and the vitamin and mineral deficiencies listed:

OR change your medication to Celebrex 200-400 BID

 PPIs=Proton Pump Inhibitors (Omeprazole, Prilosec, Pantoprazole, Lansoprazole, Protonix) are taken for stomach ulcers, H. Pylori infection and gastric reflux

PPIs Increase Homocysteine which increases your risk of stroke, MI, and Pulmonary embolism.

 PPIs decrease the absorption of many nutrients.  They actually cause malabsorption of essential nutrients.  

Replace these nutrients with supplements, but much of what you take won’t be absorbed unless you take daily Probiotics: 

Note: PPIs can even cause the growth of dangerous gut bacteria causing chronic Hemophilus. If you have chronic vaginitis that smells fishy, it could be your PPIs!

If you have this stop the PPI, take Pepcid instead (histamine receptor blocker) or nothing and take probiotics to repair the damage the PPIs have caused. These nutrients need to be replaced to keep you healthy, however it is better for most patients to only take PPIs for 2 weeks at a time or substitute a histamine receptor blocker like: Pepcid, Zofran.

Surgery

It is not just the medications doctors prescribe for their patients; sometimes surgical procedures can cause chronic diseases through preventing nutritional nutrients to enter your body.

Removal of the gall bladder must be done, yet patients are not told what they can do to be healthy after the surgery.

The gall bladder provides enzymes that help you breakdown foods, primarily fats and absorb fatty vitamins from your food and supplements.  If you have had your gallbladder removed you can become nutritionally deficient in A, D, E fat soluble vitamins, and you will promote the growth of abnormal gut bacteria and are at risk for leaky gut, Celiac disease, autoimmune diseases and malnutrition. Everyone who has their gallbladder removed should take digestive enzymes with every meal and take Probiotics daily.

Bariatric Surgery for Obesity

The last iatrogenic nutritional deficiency that I will discuss is Bariatric surgeries, all kinds that remove part of the stomach, or band the stomach or in any way physically makes the stomach smaller is related to nutritional deficiencies caused by malabsorption of vitamins and minerals.  The way to combat these deficiencies include taking:

 In Conclusion:

Remember I am a physician, and my job is to promote wellness in my patients.  It is sometimes more important and lifesaving to take the above medications or have these surgeries, than to prevent a nutritional deficiency in the future.  We must follow those medical decisions with trouble shooting addition of nutritional supplementation to replace what these necessary medications and surgeries remove.  That is preventive medicine and why supplementation is often needed for our health.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

You are what you eat, and you use what food and drink you eat based on your genetics.

Weight loss requires professional advice, direction and oversight.  Combining receiving the best advice on what you should eat and drink as well as tailoring it to your metabolism and medical condition is what you should receive from your weight loss program.

 Before you embark on a weight loss program you need to know the following lessons.

Lesson #1: All Calories Do Not Create the Same Energy/Heat/Weight Loss in All People.

You can put a gallon of gas into a Maserati and Ford Fusion and they do not provide the same performance (different acceleration or speed, pick up and ride) different MPG or speed because these two engines are not the same.  The Maserati burns fuel (calories) faster than the Fusion; it operates at a higher level of speed and performance, and it uses more gallons of gas per distance.  Just like the difference in cars, the difference in our bodies is VAST!

I explain this truism every day in my office.  One of my female testosterone replacement patients returned for her first follow up consultation. The blood levels were ideal and all the symptoms relating to testosterone deficiency were gone!  However, the only thing she could think about was the fact that she did not lose weight (although she did gain muscle and lost fat) and her friend lost 15 lbs in the first 4 months! 

Even though she and her friend were the same age their metabolisms were very different AND the fact that her friend did everything I told her to in regard to diet, limiting alcohol, taking supplements  and exercise, but she did not,  tipped the scales to cause her not to get the same result as her friend…in other words, her friend had a genetically faster metabolism, AND she put Premium “gas” into her metabolic car, changed the oil and took care of her car so it ran faster and better than the patient sitting in front of me who used regular gas, didn’t care for her car

and drove too fast and hard.  Two people the same age with different metabolisms, diet, exercise, supplementation, and stress level have widely different responses to weight loss.

 Therefore, medical weight loss advice must be individualized to fit just you!

The individual variables include:

 Fad Weight Loss diets are a fraud to sell books or to get attention.  If it takes a 300-page book or a Social Media fad to sell a diet that is supposed to be good for everyone…it is a lie and may backfire!

When the cabbage soup diet was a fad many of my GYN patients did it.  I had access to their blood types and knew that cabbage was bad for A blood types and slowed their metabolism. Despite my advice they still did the diet, and you know what happened?  They gained an average of 10 lbs!!!! Their blood type determined whether this particular diet would work for them. This is an example of how important your genetics are to weight loss.

 What are the genetic variables that affect your approach to weight loss?

 Inheritance how our body burns calories—are you a Fusion or a Maserati?: there are many genetic variables that make you as an individual require specific foods and exercise programs to get to your ideal weight and be healthy. It is the job of your medical advisor to determine what these are for you and tailor your diet accordingly.

Your ideal % of Protein, Carbohydrates and fat are genetically determined. Many of us have discovered our ideal food chart through trial and error, but a weight loss genetic test can tell you as well!

Your Age: The older you get the lower your sex hormone testosterone is. As you age testosterone, growth hormone decreases while estrone increases all of which cause and cause weight gain.

Lifestyle impacts your ability to lose weight:

Diseases that you currently have affects your ability to lose weight.

I will talk about Medications that cause weight gain—beta blockers, blood pressure medications, Statins, and others in a future blog.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

If you have hypothyroidism (Low thyroid), fibrocystic breasts, fatigue, metabolic syndrome, diabetes, hair loss, obesity, or high cholesterol then taking supplemental Iodoral can improve these diseases.  These conditions have become an epidemic in the United States due to Iodine deficiency.

My longevity medical practice is all about keeping my patients healthy so they can live not only a longer life but one with quality. In the last 20 years of my BioBalance® Health practice, I have seen a flood of new patients with conditions that are in part secondary to iodine deficiency.  Today in America, the majority of people need iodine and other supplements to their diet for many reasons:

Today I am going to address the symptoms and diseases of Iodine deficiency. This blog about Iodine is to inform you about the need for Iodine and what it does.  I hope to never have to remind my patients about taking this supplement again after listening to the associated podcast or reading this blog!

Iodine is a micronutrient necessary for life. In a research article in the Journal, Frontiers of Nutrition, March 2024, a very succinct review of the illnesses that occur because of iodine deficiency and that can be treated (partially) with iodine supplementation. I recommend all of my patients who live in my area which has no iodine in the soil or ground water and where all the drinking water is fluorinated.  The Iodine supplement, Iodoral, is not a drug, but a nutritional supplement that is sold over the counter. The Iodoral 12.5 mg bottle of 90 is $14.50 for 3-6 months supply.  You can’t afford NOT to take it!

Why do we need this supplement at this time in America and many first world countries?  Governmental intervention in our basic need for water caused most of our deficiencies.  Iodine is produced naturally in the ocean by seaweed, and it is contained in the soil and ground water in areas of the country that are near the ocean and those areas that were covered by ocean water millions of years ago. So, if you think geographically, most of the US is in that “map”, except the Midwest.  However, man and government has intervened and caused our population to be iodine deprived by adding Fluoride to our water.

The government and the FDA make decisions for us without looking at the subsequent damage that might be done by those decisions. In the 1949 the US government decided that EVERYONE needed to be protected from dental cavities so 75 years ago we fluorinated our water and that decision led to the epidemic of iodine deficiency. Fluoride in your drinking and cooking water literally replaces iodine, and takes its place molecularly, leading to generations of people with 25% fewer cavities and 100% increase in the list of diseases I have listed in the first paragraph!   Fluoride is the biggest cause of thyroid disease. Wouldn’t it be better to use fluoride toothpaste once a day than drink it?

In some areas of the country, called the “Goiter Belt”, we don’t have any iodine in the natural ground water, so locally grown food does not contain Iodine.  These regions have had a history of high percentage of the population with low thyroid, and goiters, even before we added fluoride to drinking water.  This compounds the problem and the diseases from Iodine deficiency. I live in that area!

Before the 1970s iodine was required to be added to bread, salt and a few other foods. Ever since I have been seeing more Eating designer salt has caused people to not even get iodine in the salt they eat,  Now we use all kinds of salt most of which don’t have iodine in them,.

So now you know what the problem is today as well as the answer, Iodine supplementation with Iodoral® every day!

How do you know if you have low Iodine and or Hypothyroidism?

Symptoms of low iodine mirror those of low thyroid:

So what will taking Iodoral® do for you beyond reversing the symptoms above?

Improved thyroid function which decreases fatigue, weight gain, hair loss, brittle nails, swelling, and slow metabolism….

The benefits to you and your thyroid gland are immense! Your thyroid hormones control your metabolism and control your thermostat. Every cell in your body requires thyroid, and therefore require Iodine.  If your body doesn’t have enough heat, then your enzymes can’t work and our cells can’t do their jobs, heal themselves and skin, muscles and all our tissues suffer.

How does that work? Thyroid hormones T1, T2, T3, and T4  are made from one amino acid, Tyrosine, an 1-4 Iodine molecules!  The molecular structure of Iodine calls for plenty of iodine nutrient in the blood stream to make thyroid hormones and  to attach to iodine receptors on each cell that uses thyroid in your body.

Preserve the health and function of your thyroid gland. You will feel warmer, your pulse and blood pressure will normalize. You will lose weight.

Your thyroid hormone keeps your body warm by stimulating mitochondria to burn calories.  In this way thyroid hormone controls your weight, how fast you burn calories, how energetic you are, how well you think, how your hair and nails grow just to name a few benefits of thyroid. You need to add iodine to your diet to produce thyroid hormones to maintain all these vital functions for you!

For both sexes Iodine is needed to maintain blood sugar control and the control of obesity.  It is one of the necessary nutrients when it comes to weight loss.  More importantly it can prevent Metabolic syndrome which is a combination of high blood sugar (diabetes/prediabetes), obesity, hypertension, and high cholesterol. If you have Metabolic Syndrome, you are at higher risk for Cancer, Heart Disease, Stroke, and early Death.  It doesn’t take just iodine to treat this syndrome once you have it, but Iodine is key to making your medical treatments, diet, and exercise work to decrease your medical risks of disease and early death.

Hypothyroidism causes an increase in LDL Cholesterol; therefore it may increase the incidence of heart disease.

Organ Systems Other than the Thyroid Need Iodoral:

As you can see by the list above, vital organs other than the thyroid accumulate/store Iodine: salivary glands, stomach, pancreas, ovary and testes, which has led to the new realization that Iodine has effects outside of the thyroid.

Other Results of Replacing Iodine to what is clinically considered a high level in the US.

How could supplementing Iodine, removing Fluoride, from our drinking water do for us individually and our country? Japan is an example of high Iodine levels that benefit health.

 What happens in other countries with adequate iodine levels?  Japan has the highest level of iodine in the blood because they consume seaweed in their diet and most of their water and food has iodine in it. Of course, Japan is an island surrounded by iodized seawater! They consume 7 x the average amount of Iodine as Americans with healthy consequences. Japan has one of the lowest incidences of Metabolic syndrome and the diseases included in it.  A study on Iodine consumption revealed that obese women had a significant weight loss when eating food in Japan.

Summary:

We all need iodine in our food and water or if we can’t get it, we must supplement it with an over the counter supplement, Iodoral ½-1 tablet a day (12.5 mg tablet). The “normal” reference ranges are skewed to the low iodine level, so many people stop taking iodine when they follow the reference ranges, however in this research paper the ideal blood levels were considered healthy up to 100- 399mcg/L while the Quest and Labcorps reference ranges are 52-109, much lower than what is considered healthy by research studies.

Iodine does not cause hyperthyroidism, however if someone has hyperthyroidism there is controversy as to whether Iodine should be supplemented. Make your choice: Health with an inexpensive supplement (Iodoral) or illness with fluoride and without Iodine.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

There is a lot of New Medical Information that is important for patients to make healthy decisions about their care or the care of their loved ones that you won’t hear about on the news.

For new research to reach you, the public, a researcher or a drug company has to spend a great deal of money for the public relations people to push information into the light.  I compiled the research I thought you might want to know about that has been discovered during the past 6 months. I always use these studies to educate my patients and to change my protocols for treatment, although many of them have been part of my practice for quite a while, because they just confirm what I have been seeing in my Integrative and preventive medical practice for years.

The First Group of Discoveries Relate to Menopause,  and the Risks of Being Menopausal

The most recent article in Lancet confirmed what has been obvious to me in my GYN practice for years. I am not sure why this actually required a study to prove that Menopause is tied to a higher rate of depression and anxiety, in conjunction with insomnia, higher stress perception, and hot flashes.  This study documented what the loss of estradiol, progesterone and testosterone can do to women in menopause.  The sad fact is that this article doesn’t tell the reader what they need to know, how to treat these symptoms.

However, I will let you in on a self-discovered fact:  The replacement of the hormones that disappear before and during menopause can be replaced in a non-oral delivery system to treat these symptoms.  I have 40 years of medical practice that proves my findings that agree with the problem, and my treatment with hormones.

The Lancet:

Menopause tied to mental health issues in certain women

A study found that when certain women are menopausal, they increase their risk of Depression, anxiety, bipolar disorder who experienced stressful life events, had poor sleep related to hot flashes, or had previous depressive symptoms of depression were more likely to develop menopause-related mental health problems. Researchers wrote in the journal The Lancet that some women escape the mental health effects of menopause altogether.

HealthDay News (3/6)

Another recent study about menopause discovers that a lack of estradiol in the post menopause causes women to have trouble thinking. I agree with that revelation, but why doesn’t the research take the next step and suggest a treatment to prevent this result of hormone loss?  Why doesn’t the research tell us how to help women think by replacing their estradiol? Many other studies confirm that replacing estradiol will delay the onset of dementia by 10 years.  Another study reveals that the replacement of testosterone will delay dementia it 10 more years. These studies occurred over 20 years ago, but this study doesn’t cite them.

Poor and worsening cognitive function is one of the most frequent complaints of my new patients coming to BioBalance Health® for treatment of menopause and low testosterone with bioidentical hormone pellets.

Dr Maupin:

I am continually reminded of the importance of testosterone and estradiol replacement is to aging men and women when they come back for their second pellet insertion and review their list of the symptoms they complained of before they started E and T pellets The most frequent response I witness when I ask if a woman’s ability to think, do her job and stay organized is completely better after 3 months of Estradiol and Testosterone pellets, is crying with relief!   Many patients are deeply worried that they are developing dementia, specifically Alzheimer’s Disease when they first come to me, but are able to go back to work and or experience a renewed quality of life because their ability to think, they can now feel confident in their professions and careers. Dr M

Estradiol associations with brain functional connectivity in postmenopausal women

Testo, Abigail A. BS1; Makarewicz, Jenna BS1; McGee, Elizabeth MD2; Dumas, Julie A. PhD1

Author Information

From the 1Department of Psychiatry 2Department of Obstetrics, Gynecology, and Reproductive Sciences, Larner College of Medicine, University of Vermont, Burlington, VT.

 The results illustrate the relationship between estradiol level and functional connectivity in postmenopausal women. They have implications for understanding how the functioning of the brain changes for individuals after menopause that may eventually lead to changes in cognition and behavior in older ages.

© 2024 by The Menopause Society

I have another problem with studies that should be shared with patients is that they often imply that menopausal women are “crazy” instead of saying that women after menopause develop mental health issues that can be treated with hormone replacement. Women who are menopausal are not mentally ill they are hormone deprived!

I view this as a “slam” and divisive attack on aging women. The fact that if we gave women what they need …hormonal replacement ….they would not suffer the symptoms of mental health disorders.

Menopause tied to mental health issues in some women

A study found that women who experienced stressful life events, who had poor sleep due to nighttime hot flashes, or who had previous depressive symptoms or depression were more likely to have menopause-related mental health problems. Researchers wrote in the journal The Lancet that some women escape the mental health effects of menopause altogether.

Full Story: HealthDay News (3/6)

The Second Group of Articles Is About The Loss Of Estrogen In Menopause Causes Heart Failure and Atrial Fibrillation.

 This article from the European Society of Cardiology reveals that the longer women live without estrogen (e.g. is menopausal), the higher risk of developing heart failure and atrial fibrillation. Once again, there is no mention about how to prevent this disease!  Why can’t they study the women who replaced their hormones and compare them to the women who didn’t?

March 18, 2024

Hormone therapy may boost weight loss for postmenopausal women on Semaglutides.

Healio (3/18, Welsh) reports, “Hormone therapy was associated with an improved weight-loss response for postmenopausal women with overweight or obesity treated with Semaglutides, according to cohort study results published in Menopause.” In the study, “postmenopausal women on hormone therapy had a higher percentage of total body weight loss at 3 (7% vs. 5%; P = .01), 6 (13% vs. 9%; P = .01), 9 (15% vs. 10%; P = .02) and 12 (16% vs. 12%; P = .04) months of semaglutide treatment compared with no hormone therapy.”

How and Why to Treat Metabolic Syndrome

 Metabolic Syndrome is a combination of hypertension, high lipids, insulin resistance, obesity, prediabetes or diabetes, large abdominal measurement.  This combination puts patients at risk for heart disease and early death.  Many conditions and outcomes have been associated with metabolic syndrome, but now we have a treatment that can prevent one of the outcomes of this syndrome, the generic drug Metformin ER.

Metformin, Cognitive Function, and Changes in the Gut Microbiome Endocrine Reviews, Volume 45, Issue 2, April 2024, Pages 210–226, Published: 21 August 2023 Article history

Abstract

The decline in cognitive function and the prevalence of neurodegenerative disorders are among the most serious threats to health in old age. Metformin can preserve cognitive function by treating metabolic syndrome and improving the gut biome that produces neurotransmitters.

I am not naive enough to believe that the only thing that your brain needs to perform well is two sex hormones (E2 and T).  This new research from the Endocrine Society describes how the generic, inexpensive medication Metformin ER, can help preserve an aging patient’s ability to think.  That is primarily because the brain has insulin receptors, and when a patient has insulin resistance brain cells don’t receive enough blood-sugar to be able to think!  By taking metformin ER (extended release) plus replacing estradiol plus testosterone in pellet form, the brain gets what it needs (blood sugar) and patients can think again!

The second factor the researchers found to be important to brain health and problem solving, is healthy gut bacteria in the intestines.  This requires eating whole foods, especially fruits and vegetables every day, and not eating fast food, alcohol, simple sugars, and preservatives that kill good bacteria. We recommend a daily probiotic by Mega + the lifestyle changes above.

If you want to keep your ability to think for your whole life then you need E2 and T in pellet form if you are a woman and T if you are an aging male, plus Metformin ER daily and the above lifestyle changes.

Metabolic Syndrome, Obesity, is the Biggest Risk for Cancer

Metabolic syndrome may increase cancer risk by 30%

People with metabolic syndrome had a 30% higher chance of developing cancer over the course of a decade after diagnosis, according to a study published in the journal Cancer. The researchers also studied inflammation by tracking C-reactive protein, concluding that elevated levels of the protein along with metabolic syndrome were “significantly associated with subsequent breast, endometrial, colorectal and liver cancers.”

Full Story: National Public Radio (3/11)

The struggle to stay young and healthy is a difficult fight but the most important battle that you will wage as an adult.  If people knew the whole truth, would they stop overeating, drinking, smoking, avoiding exercise, or stop taking illicit drugs?  I can only hope that if we convince people to take care of themselves better and replace the hormones that are missing as soon as they are clinically deficient, then they will also listen to the truth about the various ways to support their health and prevent disease.  I also hope that the doctors who write articles and do research stop treating women like crazy people instead of the gender that actually runs the world and not only nurtures the children but also organizes homes and businesses.  We are NOT crazy when we need hormones to be replaced (PMS, MENOPAUSE), we are experiencing symptoms of hormone-deprivation, and we just need to be treated with the hormones that are missing!

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Last week one of my pellet patients asked me to see her daughter, even though I don’t see young women anymore since I began BioBalance Health for people over 40.  I asked her why she couldn’t see her gynecologist and she told me that she was told that she had PMS and that was a condition that was treated by a psychiatrist!  I have treated PMS successfully by replacing one hormone that is missing, Progesterone, two weeks a month, the same two weeks that women experience the symptoms of PMS.  I agreed to see her although I wish my fellow gynecologists would learn how easily this can be treated and not make young women feel like they are crazy, because they aren’t!

NOTE: Before I give you the impression that I treat PMS currently at BioBalance® Health, I want to clear that up: I only treat PMS in my younger cycling patients (36yo. to menopause) who take testosterone pellets for other symptoms.  My recommendation for finding a doctor who treats PMS in your area is to contact a local compounding pharmacy and ask the pharmacist which GYNs treat PMS, or contact one of the large compounding pharmacies, eg. College Pharmacy in Colorado Springs, or Belmar Pharmacy in Colorado as well to find a doctor in your area who can treat you.  There are many good compounding pharmacies who have pharmacists who can tell you which doctors prescribe progesterone for PMS.

What is PMS?

PMS symptoms are only present 2 weeks a month, the 2 weeks before menstruation. This condition causes patients to feel different, not like themselves in the ways listed below, and also caused menstrual changes in the menstrual periods that follow the PMS symptoms.

The Emotional and physical Symptoms of PMS:  All occur monthly, for 14 days

The Menstrual Symptoms associated with PMS:

The GYN Symptoms that can occur secondary to PMS (poor progesterone production) include:

1)irregular periods, spotting for a week before the period starts

2) heavy bleeding, sometimes uncontrollable bleeding,

3) infertility,

4) multiple miscarriages

5) lack of ovulation, and lack of periods for months at a time like with PCO Polycystic ovaries

My History Treating PMS (skip if you already know this)

I have been a gynecologist in private practice in St. Louis County since 1985 when I graduated from my OBGYN residency at Mercy Hospital. My training gave me an excellent knowledge of GYN Surgery and Obstetrics, but a very minimal understanding of the hormonal cycles of women, including Premenstrual Tension (PMS). Since the 1980s when PMS was recognized as a condition of women, OBGYNs have been taught that PMS is a psychiatric disease that must be treated with psychiatric medicines, primarily anti-depressants. Most OBGYNs today still believe that women who have PMS are “crazy”, and either give them an antidepressant which rarely work to treat the symptoms or refer their PMS patients to a psychiatrist.  In my case, I do not do either because PMS is a hormonal imbalance that causes emotional symptoms, and because psychiatric diseases are not cyclic every 28 days lasting 2 weeks, followed by 2 weeks of normalcy.

The Cause of PMS

Since 1988 I have studied the cause of PMS and with the help of a very intelligent compounding pharmacist, Pete Hueseman, I found the answer to the cause and treatment for PMS.  I began to treat PMS hormonally and now have successfully treated hundreds of PMS patients with bio-identical Progesterone.  It is a simple answer. PMS is caused by a deficiency of the hormone Progesterone during the two weeks after ovulation, from around days 14-28!  This is not a complicated diagnostic discovery, and the treatment should be obvious to all doctors who treat young, fertile women. More about that in a minute…

From 1980- the present there has been no effective treatment for PMS approved by the FDA         (just ineffective anti-depressants) because it is still  categorized as a psychiatric disease.   When I took my second American Board of OBGYN test in 1999, a question on my test was: “Is PMS a Psychiatric Disease that should be treated with antidepressants?”  And the correct answer according to the American College of OBGYN was that that statement was TRUE, they believed and still do in 2024 that PMS is a psychiatric disease!  In 1999 I had been treating PMS successfully with bio-identical compounded progesterone for over a decade with bioidentical progesterone in non-oral form (suppositories, vaginal tablets, vaginal cream, and transdermal creams), given only during the second half of the menstrual cycle, from ovulation until the onset of the period.

To understand PMS you have to understand how the three sex hormones work during a woman’s 28 day cycle.  We count the days of a cycle starting at the first day of bleeding, which is day 1.  While we have a period our estradiol, progesterone and testosterone are all at their lowest level in the blood, but by the end of our period estradiol (estrogen) and testosterone start being produced by the ovary. They increase and both peak at ovulation, usually day 14, giving a woman a viable egg and a surge in her sex drive to motivate her to have sex and fertilize the egg. On day 14 the egg is released from the ovary and the corpus luteum (where the egg came from on the ovary) starts secreting progesterone.  This hormone increases and plateaus during the next 14 days, while estradiol and testosterone level out.  The day before bleeding, when the egg is not fertilized, all three hormones drop precipitously and that causes the uterine lining that was growing under the control of estrogen, to shed and bleed.

PMS occurs during the second half of the menstrual cycle when the developing egg is not ovulated or is immature and ovulated but is not “ripe” enough to stimulate a decent progesterone blood level.  In the case of PCO, many eggs develop but are trapped and don’t ovulate at all so no progesterone is produced.  In all these cases, women with PMS are symptomatic both in the symptoms above and the menstrual abnormalities listed earlier.

All of the physiologic changes that take place in the PMS patient indicate an inability to conceive, or to conceive but have multiple miscarriages.

The Treatment for PMS:

The Treatment is bio-identical Progesterone, but the FDA didn’t have a form of bioidentical Progesterone that worked until the last 10 years, when Prometrium was produced. Prometrium is an oral pill containing natural progesterone in peanut oil.  This works well for some women, but not for others. For those women we prescribe bio-identical compounded progesterone in sublingual, vaginal, transdermal and BLA Progesterone oral forms.

The most important fact about diagnosing PMS is to remember that the symptoms of PMS only occur 2 weeks a “menstrual” month (28 days of the cycle).  The most important fact about treatment is that PMS should be treated with Progesterone the second two weeks of the menstrual cycle at bedtime.

Now my patients ask me to treat their daughters who are cycling and whose OBGYN follow the guidelines of ACOG blindly even if the suggested treatment (anti-depressants don’t work or make them worse).  I can only hope that the method of treating PMS as a hormone deficiency, instead of a psychiatric disease, will be accepted by American College of Gynecology and that you can find doctors you can be treated by, by finding a compounding pharmacy who will refer you.

Compounding pharmacies in St. Louis: Neels’s Pharmacy, and Medical Arts Pharmacy (ask for Brock) in Clayton MO, Jennifer’s Pharmacy in Clayton, MO.

neelspharmacy.com

Phone number

(314) 849-3123

Medical Arts Clayton Pharmacy

https://www.medicalartsrx.com › compounding

jenniferswholehealthpharmacy.c…

(314) 862-7400

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The Problem: I see women and men every day who are deficient in their own production of testosterone because of age, testicular trauma, removal of their ovaries, chemotherapy, chronic illness, and medications.  The cause of testosterone deficiency is as varied as the side effects and benefits of every different type of testosterone. This means that when you hear or read a headline like the one that came out last week:

“Testosterone Treatment Fails to Offer Protection Against Fractures in Men with Hypogonadism, Research Indicates”

You cannot take It at face value.   This headline should read Testosterone replacement in the form of testosterone cream given at a low dose given at a low dose to men who already had osteoporosis doesn’t offer protection against osteoporosis.

The headlines that read the way this one is an example of the reality that everyone loves to hate testosterone. This makes informed decision making by a patient very difficult because of the jaundiced view by physicians and drug companies about replacement of one to the hormones that men and women both make when they are young, but which becomes deficient in most of my patient population as they age.

Why is there all this subterfuge and confusion about testosterone replacement? I believe it is the fact that allowing American’s to age out of jobs and make room for the younger workers; many people cannot afford testosterone on their own so they are jealous of those people who can and do afford it; The insurance companies don’t want to pay for anything they don’t have to; keeping people youthful and healthy is not a priority for American medicine based on acute care in the ER and operating room;

The group of naturalists who think aging is great, are people who either are out of touch or are very young; the use of testosterone by both sexes often makes the use of other medications unnecessary (anti-hypertensives, statins, autoimmune medications, etc, and also prevents patients from getting communicable diseases so the largest industry in the US, pharamaceutical companies cannot make more and more drugs to treat each symptom and disease individually; and lastly the government has made a very safe and natural hormone scheduled like amphetamines and pain killers by the DEA.

Now why are these tests misleading?  All research studied are manipulated to have a desired outcome.  You can do a lot with statistics…you can make a blue sky look black!

By given too little of a medication or vitamin, or by treating a disease for too short a time, or by picking the age group such that they won’t respond you can make any drug look ineffective!

So when you look at the studies on testosterone, you must look for the type of testosterone: is it a cream (which turns into estrogen as it passes through the skin? Or is it an injection of testosterone cyprionate which is not equivalent to natural testosterone and lasts 2 weeks because it keeps circulating through the liver and making more and more of the byproduct DHT than pellets or pure T injection?

Simply if the type of T is not the type that you are taking or are contemplating taking then you should ignore the studies conclusions because each type of T and each delivery system of T has a variety of effects, each different from one another.

“One testosterone is not equal to another form of testosterone. Therefore, a study that tests one type of testosterone does not apply to other forms of testosterone.” Dr Kathy Maupin MD

The factors that matter as to how much improvement you will get when you choose a form of T replacement are:

I see research articles every day in the many journals I read that are shared with the public, that denigrate testosterone replacement in general, while in my practice, with the most effective form of T I have found, that T pellets literally transform  men and women who have T deficiency, most of whom are recently menopausal or over 55.

The successful studies that recommend testosterone seem never to make the front of journals, but this recent study about bone density made all the title pages of the digital version of journals. The result will be that doctors and patients everywhere who should treat their osteoporosis with the safest treatment available, testosterone, will be the victims of VERY expensive drugs that have more side effects and less effectiveness. Research trials no longer look for the truth.  They look for “how do we get the answer we want to , so our drug that is not testosterone, will sell?”.

These headlines deceive patients and scares them from asking for testosterone treatment, which can relieve their symptoms with one hormone, Testosterone, instead of many drugs. An even greater benefit of testosterone given at the dose that relieves testosterone deficiency symptoms, this one hormone gives my patients back their quality of life.

In 2002 the WHI study scared menopausal women from taking their menopausal hormone therapy (ERT and HRT) which caused these women to develop anxiety, depression, frailty, osteoporosis, dementia, poor critical thinking, fatigue and many other symptoms that required treated multiple drugs to relieve just a portion of them. Women also developed marital problems because sex was so painful that they stopped having sex with their life partners.  An unproven fear of breast cancer led to the loss of these women’s quality of life!

An example of one of my most severely affected patients went off her ERT (estrogen only hormone replacement) that she had been on for decades since her hysterectomy because her doctor refused to prescribe it for her.  By the time she came to me she had developed depression, suicidal thoughts, agoraphobia, frailty and osteoporosis and she refused to leave her home.  It took her months for her son, a doctor friend of mine, was able to bring her to my office to restart her treatment. Today she is still traveling all over the globe and fully enjoying her well-deserved retirement!

It has been estimated that in the 5 years after the WHI demonized estrogen replacement, more than 100,000 women died of diseases related to a lack of estrogen, and more experienced a loss of quality of life.   Even now over 20 years later, many doctors have not restarted giving estrogen to their women patients.

Medical Thinking and rapidly changing standards of medical care when it comes to sex hormones has affected how we live, if we live, and how many drugs and diseases we get in our lifetime.  We have effective inexpensive treatments for loss of hormones, why are we always looking for expensive and non-hormonal answers to the symptoms of menopause.  In the last year pharmaceutical companies have developed a new drug with many side effects to treat hot flashes (fezolinetant/ Veozah, another new drug for osteoporosis (Tymlos 1pen, 1 injection/day = $2,134) and even a new drug for waning sex drive (Vylessi injection 2 times a week prn 1 month is $3,066/month) , also exorbitantly expensive!  Instead of recommending replacement of relatively inexpensive hormone replacement with estradiol and testosterone (with pellets for women approximately $140/month, and for men $200/month), the Big Pharma companies try to strike it rich with multiple piece meal treatments for the symptoms of menopause and low T.   I did not even mention medication for insomnia, migraine headaches, Viagra for men, lubricants for women and many other symptoms and treatments that T and E2 completely resolve.

Back to the research article in question about testosterone for men, which employed testosterone as a transdermal gel, at a low dose, and determined testosterone (over-generalization) was not effective, for building bone in osteoporotic elderly men!  This was a defective study in every way, but the most important way was that it used T gel which turns most of the T into estrogen, so the effects are really from E2, E1 in men who do not respond well to E2.  The abstract is at the bottom of this page for your reading pleasure.

I hope you are more selective in the future about what you believe and question the research that criticizes testosterone treatment, estradiol treatment especially the safest delivery system, pellets, when the research is short term, and generalizes the results from one form of Testosterone or estrogen to all forms.

Testosterone Treatment Fails to Offer Protection Against Fractures In Men With Hypogonadism, Research Indicates

MedPage Today (1/17, Monaco) reports “testosterone treatment didn’t offer protection against fractures in men with hypogonadism, a” subtrial indicated. The research found that “compared with placebo, men who were on a testosterone gel actually had a significantly higher risk for fracture.” The findings were published in the New England Journal of Medicine.

HCPlive (1/17, Iapoce) reports “the findings showed the 3-year cumulative incidence of all clinical fractures was nearly 4% among those treated with testosterone, compared with 2.8% in the placebo group.” Additional “data revealed the fracture incidence was also numerically greater in the testosterone group for all other fracture endpoints.”

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T.E.D.  a NEW painless high intensity ultrasound treatment that actually regrows 65% or more of your hair.  It is the most effective treatment overall and really the most economic treatment with the least amount of time investment, no pain and best results.  Unlike hair implants, you can’t tell you have had a treatment to make your “lost hair” grow again!

The Problem of Hair Loss:

Many of my patients (most of whom are over 40) complain that they have thinning or balding hair-loss before we even start our hormone treatment with hormone pellets. Testosterone treatments with Testosterone pellets rarely increase the DHT blood level enough to increase hair loss.  DHT is the metabolite of Testosterone which is responsible for “male pattern balding” also called hair loss associated with aging in men. Most of my patients have genetic hair thinning or balding, hypothyroid hair loss, or loss from a medication that they take.  We treat these metabolic causes, but we can’t make hair grow back metabolically, we can just stop the loss!  NOW WE CAN MAKE LOST-HAIR GROW BACK with TED!

Features of Alma TED:

TED is a FOCUSED high intensity ultrasound that drives serums into the scalp to the level of the hair follicle. Alma has worked 17 years on a serum for hair loss and they have achieved their goal!  Only with TED will the serum get to the hair follicles that are “sleeping” and make them grown again!  This pairing of ultrasound and specific serums are key to the unique success of TED.

Comparison OF TED with other treatments for hair loss:

#1 TED is the only FDA approved treatment for regrowing hair!

Six months ago, I was looking at various options to help my patients, and my husband, grow back their beautiful hair. After a comparison of multiple available treatment types for hair loss, I chose Alma Laser’s high intensity ultrasound treatment, T.E.D. that combines a unique hair growth serum delivered deep in the scalp to awaken sleeping hair follicles, stimulating growth, even in follicles that are dormant.

In 4 treatments that each last 45 minutes or less, TED brings hair follicles back to life without pain… I finally found the “holy grail” of hair restoration!  It is affordable and PAINLESS.  My medical skin care practice, BioBalance Skin®, offers free consultations to those men and women who want to have TED treatments to bring reverse hair thinning and balding.

TED this works for men and women with all causes of hair loss!

Who is a candidate for this treatment>

Who is not a candidate/ or will have a less than optimal result:

Information on Hair Loss: All these types of hair loss, except the most extreme will obtain a good result from TED Hair treatments.

 Hair loss that occurs with age has typical patterns of loss. The examples shown below are examples of male and female age-related hair loss.  The same patterns occur from elevated androgens in some people.

Some types of age-related genetic hair loss are merely thinning of the hair, where individual hairs are spaced out making hair look “see through”.

PATTERN OF HAIR LOSS

NORMAL———– STAGE 1———STAGE 2————STAGE 3

TED HAIR GROWTH TREATMENT WILL WORK WELL WITH STAGE 1 AND 2 HAIRLOSS,

IT  IS ONLY PARTIALLY EFFECTIVE  FOR STAGE 3 hair loss

THE CONDITION OF THE SCALP IS IMPORTANT IN PREDICTING YOUR SUCCESS:

PROGRESSION OF FEMALE HAIRLOSS PATTERN

BOTH PATTERN AND CONDITION OF SCALP DETERMINES THE EFFECTIVENESS OF TED TREATMENTS

WOMEN’S HAIR LOSS—In general women lose hair all over the head or at the temples and crown of the head. The stages of female hair loss above all respond to TED except the most severe-long term loss.

COMPARISON OF OTHER TREATMENTS TO TED

I am asked by my patients, “How do I get thicker hair?”…or for the most common questions from those men who have been experiencing their hairline creeping backward every year, “How do I make this stop, I look like my dad!”.  Over the years my Medical Health Spa, BioBalance Skin® has attempted to help my aging  hormone replacement patients regain their thick and healthy hair and hairline with scalp injections with PRP and  Aqua gold injections of serum and PRP, however effective these treatments are in stopping the loss for a period of time, none of our patients were able to tolerate the pain of the injections in their head for an hour, even after topical pain relief.

These invasive treatments really hurt not matter how we tried to remedy the pain.  It turned out that our patients couldn’t tolerate one hour session, much less a series of treatments necessary to make a visible difference.

Hair implants take so much time and money (>$15,000) that it is like taking on another job and is really only effective for receding hairlines, not thinning hair.  Patients have to have multiple treatments.

There are other options that do not regrow hair but mask the process.  These all require ongoing treatment such as hair extensions, hair implants Hans Weiman hair restoration, all of which are prohibitively expensive, and are also painful and time-consuming.

The one drug therapy to slow hair loss that is used by men, Propecia® finasteride is minimally effective at stopping the loss of hair, and it does not grow hair where it no longer grows. This drug also has significant side effects that many men can’t tolerate including loss of muscle mass and erectile dysfunction.  Our patients who receive T pellets tell me that finasteride decreases all the sexual and muscle improvement they have gained from T pellets.

Other new options for hair loss I investigated the required lifetime ongoing supplements (many of them) and ongoing treatment. The other option was significantly painful and not as successful as TED.

When I find a new and unique treatment to solve the problems of my patients as they age, I am compelled to find an answer!

For hair loss, TED is it! If you have thinning, receding, or balding hair don’t wait, the sooner the better for bringing back hair follicles permanently!

If you need visual documentation, please go to the Alma TED results page with this link to see picture proof of the results from TED treatments:

Link to example pictures of the results from TED. https://almainc.com/products/almated

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Last time I talked about the ways you can keep your skin healthy and the products I have found that medical grade products are effective to keep skin looking young and healthy.  My last Healthcast/Blog was about what you can do at home to improve your skin and look younger.

This week we are going to talk about how to get the treatment you need to improve your skin if it is damaged and aging at the medical spa, and you may not have been able to be out of the sun or been able to follow the lifestyle changes I recommended that are necessary to avoid skin and sun damage.  The problem is bigger, and the treatments are more drastic, and expensive.

When you have finally decided to do something to help your skin look younger, you must   do an introspective survey of your face and prioritize the problems that you see, placing what bothers you the most as your first priority.  I think writing this on a list and taking it to your consultation is the best way to proceed. When nothing is getting better with your own self-care, It is then time to get a consult from an expert who can tell you what you need to reverse your skin problems. Bring your list to the office consultation and decide on how much you can spend a month/or a year, on your own “renovation”.

What to know when you have your consultation:

When you have your consultation, you should be aware that there are at least 3 different treatments to treat any problem that you have. They have different levels of effectiveness and cost.  At our spa you will be able to choose between three levels of treatment, but often, the consultant will weigh in on what the best procedure is for you.

The least expensive treatments take the longest time to reach your goal and are usually the least effective. There is generally a medium level treatment, which is a little more expensive and more effective than the least expensive but will take more time to get the results, and finally the most dramatic results and faster outcomes cost the most.  If you need fast results and can afford the procedures, then tell your consultant at the beginning of your interview.  On the other hand, if you have a limited budget but have an open time frame then tell her that too. This will help you get to the desired treatment fastest and make your consultation the most profitable for you.

In case this doesn’t make sense, here is an example:  The treatment of age spots or brown spots has three possible solutions. The least expensive treatment is achieved by the use of topical serums at home and a series of facials in the spa. The outcome takes time and is not as effective as the other two options.  The medium level of treatment (medium cost and effectiveness) is a VI or TCA Peel that has more immediate results and has some down time, but is less expensive than the most effective treatment, and more effective than the least expensive. The Laser IPL or Pixel treatments are the most expensive outside the operating room, they have some pain involved, but it takes only a couple treatments to rid yourself of the brown age spots that are on your face and decollate. In addition to the excellent results, these two treatments also tighten skin, and diminish wrinkles, while they remove the precancerous skin spots that make us look old.  This is the highest price treatment but is faster and more complete than other available treatments.

Choosing the Treatment that is right for you: Your Goal, Time to get to Goal, Effectiveness of treatment, Downtime, Pain, and Cost.

I think it is best to inform your Skin Consultant about how much time you have before you reach your skin goal, if you can have some downtime or not, and how much money do you want to invest in your skin “re-birth”. In terms of choice of treatments at a med spa, you will get what you pay for.  On our BiobalanceSkin.com website we have the three or four options for each skin problem (wrinkles, brown spots, sagging skin, eye lid droop, poor texture) that our patients present with.  I like that method of comparing treatments for each skin care problem.

It should be transparent as to what your choices are, and what you get from a particular series of treatments. You should make your opinions known as to your priorities. That means what bothers you most about your skin. Think about it before your consultation and give her a list of priorities in writing which will keep her on track.

BTW, none of these treatments work if you don’t follow the instructions given to you for aftercare and follow-up treatments. Ask about before and after care at your consultation.

For example, If a patient has chosen a pixel laser resurfacing to remove her brown spots, and after 2 weeks all of her brown spots have come to the surface and peeled off, and she doesn’t use effective skin care products and doesn’t wear sunscreen and stay out of the sun for the appropriate time, then there is no guarantee that her results will remain excellent. You must take control of your own self-care because it is 50% of the treatment, and 50% of the outcome of our treatment.  Please don’t use products from Walgreens if we told you to use something else after or before the treatment!

Price of each treatment series is usually critical to decision making…..each of us has a budget. However, you should understand that the least expensive treatments generally have a lower cost to the spa and are least expensive.  For example, what follows is a comparison between the three choices for improving texture and tone of facial skin are as follows:

Least expensive: a series of Hydro-facials (30-45 minutes) one per month for three months, and three months of products, followed by a 3-month maintenance:  This is the least expensive and doesn’t transform skin texture and tone as much, and doesn’t last as long as other available methods of treatment.  If you have very little damage, are young and healthy, or you just want to maintain what you have, this is ideal for your needs. There is no downtime.

Medium price: For example, Micro-needling treatments, are a medium cost and effectiveness treatment. This treatment uses a pen that contains a tiny needle that makes tiny “holes” in the skin’s dermis all over the facial skin, neck and decollate, which then stimulates collagen production over the next 4-6 weeks, tightening and lifting the skin.  In general, this treatment is done in a series to achieve the results you are looking for.  2-4 treatments done every 4-6 weeks is the typical number of treatments needed.  Maintenance requires a few of these treatments a year. Down time is minimal, there is a redness that occurs for 24-36 hours and peeling of the superficial dead skin for up to a week, but it is not severe and can be covered with makeup.

Micro needling is ideal for younger patients to prevent the sagging and loose skin that comes with aging.  It also makes the skin look fresh and glowing. Micro needling offers an Add-On of PRP to be applied and “injected” with the needles into facial skin to stimulate collagen production faster and more efficiently. Of course, this increases the price of the treatment.

Highest price: The highest price treatments are generally appropriate for older patients, or impatient patients: those women who have a timeline for improving their skin ( a wedding or event), and those who have the most sun damage. You also get extra goodies when you get Laser Pixel treatments. The Pixel resurfacing not only improves texture and tightness of skin, nut it also removes brown spots and helps fill in wrinkles!  Lots of extras which makes the price worth it! There are several choices for the top-of-the-line procedures to improve texture and tightness and they are not all lasers.

One non-laser treatment is called Aqua Gold treatment which has three choices for what is injected and three prices. It uses a small disposable applicator that has many short gold needles to deliver a serum by “stamping it into the skin”.  The injectables are hyaluronic acid injected below the epidermis and which combines the micro-needling technique with filler (very expensive) and Botox (very expensive) with an option to add activated platelets (a blood draw, spinning with an expensive activating compound). This treatment is expensive, but it is immediately effective, and the change is great.  There is no real downtime, and the changes are immediate. A series of these treatments can revolutionize the quality of your skin.

The last component of getting the most out of your facial treatments includes buying the right products to help you maintain the beautiful results you have achieved through any of the above treatments.  It is a waste of your money to buy inferior products that may reverse the improvements you have paid for.   This is essential for preserving the improvements you have received from any of the esthetic treatments discussed in this blog.

Now if you think you need a facelift, you should see an injector consultant to ask if she can help with a much less expensive injection of Botox, filler, or both.  Another treatment which is done without needles is the EmFace which uses magnetic energy to stimulate lift and muscle tone to literally do what a facelift does without a knife.

Facelifts total cost is $75,000-$150,000 and has down time of months, and includes drains, and pain.  A series of EmFace series of treatments (4) is about $3500, without pain and without downtime.  When faced with surgery, always look for another way to do the same thing!

Now you know what is ahead of you when you talk to a Skin Care Expert about how to achieve your beauty goals.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

You may be like I am, and you took your “young skin” for granted, because it had always looked good, healthy, and glowing. Sadly, the damage that causes wrinkles brown spots, age spots, and sagging jowls occurs years before the damage shows on your face!  At age 40 I woke up, looked in the mirror and realized what I had been doing to my skin with baby oil and iodine plus 8 hours of sun a day, every summer, without sunscreen and moisturizer for the 30 years before and I realized I had to do something to reverse that process. I then began my study of skin, skin damage and how to heal it! I still and studying the new advances in skin care, nutrition for skin, and skin-care products.

But why is our skin so important? I have two answers, one as a doctor and another as an esthetic specialist.   My “doctor answer” is that our skin is the largest organ in the human body, and it provides many benefits for us.  The skin not only protects the more delicate organs of the body, but the skin excretes toxins for us from sweat glands, it cools us with perspiration, and protects our muscles and internal organs from trauma and the sun’s rays.  Our skin also protects us from cold with hair that grows on our head and body.

The condition of the skin also acts as a reflection of our health.  It is possible to look in the mirror and determine if you are healthy or not.  The skin is also a window for others to judge our general health.  This is a double-edged sword.  It helps us self-diagnose medical problems or at least determine that something is wrong so we can make changes to our lifestyle or seek medical attention.  Our skin also reflects fatigue (dark circles under our eyes, sallow color and lack of glow or shine), BUT it also allows others to discover our age, health status and whether we have cared for our skin or not!  Our skin is a window to our internal health, so if you want to appear rested, healthy, and desirable, then you MUST take care of your skin!

I am not saying that nonphysicians consciously look at you and say to themselves, “that person’s skin looks sick”, but the condition of your skin determines unconscious judgements of the state of your health.   It is for this unconscious knowledge that we have about the appearance of our skin, that drives women to seek out ways to make their skin beautiful and young.   When we notice signs of aging, fatigue, and over-indulgence in our own skin we should take action if we want to reflect the impression of health and youth.

Very perceptive people can tell what our age is by looking at our skin….that is why women spend time trying to fool them by improving the natural condition of our skin!  Our instinct to be and feel young motivates us to seek help.   No one wants to look their age!  Everyday Instagram and Facebook show ads that say…”Buy this and you will look #—- years younger” are barraging us. Those advertisers know our instinctive drive to turn back the clock and they use it to sell…but in general those “one answer ad campaigns” help the seller make money but won’t do a thing for your skin….Don’t be sucked into their sales job.

If you are over 40 you will require a multipronged approach to get your youthful skin back. This process requires a change in your routine, your lifestyle….the very hardest thing for humans to achieve!

As a doctor one of my observational skills that helps me diagnose patients before I even interview them Is my  first impression of their face and skin—if the color of their skin is dusky,  they probably don’t have good blood flow (atherosclerosis, alcohol consumption or illnesses like Diabetes) and if the texture of their skin is thick and “piled up” I know they have poor skin care habits and often are not healthy.  I also look at the creases or wrinkles as well as brown spots that give away a patient’s age and sun damage history.  There are many more signs of illness that I look for, but skin is like having Hercule Poirot (famous detective) sitting next to me whispering in my ear.”

For non-doctors the appearance of your skin gives strangers an impression of your age, and how healthier you are.  Think of speed dating….you  are introduced to Mr. Right and he immediately is not interested.  He doesn’t even care to talk to you.  His instincts say to him that you are not healthy and that you are older than you say you are, because of the condition of your skin.  The same thing can happen at job interviews….you don’t want to look sick and old when you are going for a job.  No one even consciously knows they are judging you…they just know instinctively get the message that you aren’t a candidate for whatever you are trying out for because of perceived old age and poor health….it is an unconscious reason for not choosing you!

So why not consider the simple steps it will take to transform your skin, and yourself, from looking old and sick to young and healthy?  To get great skin, we must BE HEALTHY, in other words we must develop healthy habits as well as give our skin the attention and care it needs.  Here is a list of what is required to heal you skin and begin to look younger and healthier.

Ok. so you think, you can do this, but here is the kicker—you also need to make harder lifestyle changes, and stop your bad habits:

Now I hear the typical negative response coming through the computer…as if I am spoiling your party…I KNOW you don’t want to change your habits….or stop excessive drinking, smoking, and staying out late, so you are already finding excuses why this obvious, simple answer  won’t work for you!  If that is you, then stop worrying about your skin, because it won’t be any better than it is today….and it will get WORSE with age!

But if you will spend an extra 7-10 minutes a day on the health of your skin and you realize that it is time you clean up your act, then continue to listen to the things that you should do to have a beautiful body covered with glowing skin!  A little work and change of habits will get lots of compliments and people may ask you how you got beautiful skin!  The “happy” side-effect of taking care of your skin is that you are concurrently building a healthier body that will live longer without disease.

The above changes are a start but protecting and feeding your skin is important too! In the list below I will share what products and   I use, but I have skin concerns that you might not have (I’m 69 and had a lot of sun damage as a teenager). These are examples, however if you are serious about having beautiful young and glowing skin, then using the medical grade skin products (those bought at your spa or dermatologist) are the most effective.

Taking care of your skin at home is fairly simple and for the most part can be integrated into your daily routine.   Here are the basic skin care steps:

Step #1 Cleansing your skin in the AM and before bed when you with a non-drying face wash.

(Skinceuticals Gentle Face Wash or LHA face wash). Follow this with a serum specific to the needs of your skin to repair sun damage, to fade age spots, or to improve the texture of your skin. For example, Skinceuticals CE Ferulic— It lasts all day and assists in maintaining hydration and improving the condition of your skin.

Step#2 Moisturize and Protect your skin from drying out during the day and while you are sleeping and not drinking water.  The 8 hours you sleep is the longest time you go without oral hydration, so your skin needs protection to hold the moisture in.  Moisturizers are generally a shield to prevent drying out.  The best of these moisturizers both feed your skin and protect it from drying, like Skinceutical’s Triple Lipid Moisturizer before bed. Your morning routine is just like your bedtime steps, except after you moisturize, you should use a sunscreen that is equal to or greater than SPF 30, ideally with a tint instead of foundation.

Hint: If you brush your teeth twice a day, then add 5 minutes to your morning and evening self-care you can clean and apply your skin care routine to your dental care.  Of course, there are many other types of topical products that preserve the beauty of your skin, but they are directed at specific problems such as acne, rosacea, deep wrinkles and discoloration, but it requires an expert in skin care to help you choose the most effective product for you.

My patients ask me what skin care routine I follow, and I give them the following list of products and vitamins I use because I know that skin requires nutrition from my diet as well as topical products.

If you have taken excellent care of your skin with medical grade skin care products throughout your life, then all you have to do as you age is continue the care you already established and add some serums. Serums treat the skin with needed vitamins, minerals and peptides that are applied externally. medical grade products cost more because they actually penetrate the epidermis penetrate the epidermis and provide building blocks to repair and supply your dermis with needed “supplies” for healthy “daily reconstruction”.  So healthy diet with varied healthy and unprocessed foods, plenty of water, healthy fat and protein to “feed” your skin is a required step toward beautiful skin as you age.

In the end most of us have not been aware of the needs of our skin until our skin starts to show aging and damage.  Because that is a common occurrence,  BioBalance Skin  offers a variety of treatments that you can receive at our Medical Spa that are all aimed at reversing the aging process by tightening sagging skin, removing age spots and wrinkles, elevating facial skin, fillers to inject to fill lost fat in our face as well as treating sagging upper arms and skin around our knees just to name a few.  Next week we will be talking about the more aggressive methods of improving aging and damaged skin available currently available in our Medical Skin Care Spa and other spas like it.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Every day in my office I hear horror stories about how my female patients are dismissed by the doctors they trusted to help them resolve their problems such as:

·      Hot Flashes and night sweats

·      Loss of libido

·      Rapid weight gain

·      Brain Fog

·      Insomnia

·      Arthritis associated with lack of hormones

·      Anxiety/Depression starting in their late 30s

·      New irritability

·      New Migraine headaches

·      Lack of motivation

·      Fatigue

There doctors dismissed them, telling them they were just getting old, or they were “babies” because they can’t stand a few hot flashes, the doctor changed the subject, or my most unfavorite response to a plea for help, “It is just in your head”. Many other demeaning responses have been recorded, but I am appalled at these responses.  For a patient it takes so much strength to ask these questions, and patients are literally at the doctor’s mercy.  In case you didn’t get it, the doctor who says these things is covering up for his/her own ignorance.  These are methods used by a person in charge who is challenged to answer a question he or she doesn’t have an answer for.  In general, these doctors are men and women, however women have been trained by men and they taught women to do what they had been doing for years.  These “medical” responses are used to belittle the patient to hide their own lack of knowledge. If you are dismissed in this way you should not put up with it.  You can just never schedule with that doctor or practice again or you can find a new doctor who will hear your distress and treat you or tell you they don’t know how to help and refer you to someone who does. You shouldn’t put up with dismissive doctors. 

Another dismissive phrase used by many doctors since the inaccurate WHI study is you’re your doctor tells you that he doesn’t BELIEVE in hormone replacement. You should respond that hormone replacement is not a religion, it is a medically necessary treatment for menopause! Board certified OBGYNs and Family Doctors should be trained in this treatment. 

We women have not only been dismissed by doctors, but also by the Colleges (eg. American College of Obstetrics and Gynecology) that tell doctors how to practice.  In my OBGYN training I was taught that most of women’s complaints were because they were depressed so they told us to put women on anti-depressants that just make them numb, but that did not treat our symptoms.   Misogyny is alive and well in the practice of medicine, even in the group of doctors who are supposed to dedicate their lives to the health of women, Obstetricians/Gynecologists.

Discrimination CAN be taught, and I believe medical training still teaches these male oriented beliefs to new doctors who are almost 50% women. Medical schools allow women to become doctors because we are qualified, and they can’t discriminate anymore.  When I was trained and for a few decades after I became a doctor, you would think I was a second-class citizen. I was left out of resident training run by the residents (almost all men).  Those older male doctors treated me like and. Interloper and some even told me I was not supposed to be a doctor because of my sex. …I was never treated as if I was an equal from the minute, I started medical training and women now practicing over the age of 50-something were all trail blazers and were told all women were hysterical and complainers.   I never accepted this view but now know that women complain because we are not believed and not treated with a treatment that really relieves our symptoms.

 After my hysterectomy 2002 I was in private practice with like-minded women in Balanced Care for Women, and they tried to help me but admitted they didn’t have the knowledge. I had terrible symptoms that I now know was from lack of testosterone.  The endocrinologists and primary doctors I sought help from belittled me and treated me like I was making the symptoms up!  The worst experience I had was with endocrinologists who were women just saying what their male counterparts had taught them without really thinking.  They “drank the Kool-Aid “from their male teachers and treated me like I was crazy because they were unwilling to admit they didn’t know what was wrong with me!  I grew up in medicine (1977-now) under a cloud of sex discrimination and when I needed them most at the age of 47 my sister-doctors failed me…I know intimately how my patients feel when seeing doctors that demean them.

There has been a Federal Law to protect women since 1972, when the US government passed Title IX a Federal Civil Rights Law amendment, but in my experience the law was violated all the time.

Title IX 1972 (my interpretation is simplified and not the actual word for word amendment)

Sex discrimination is unlawful in choosing an employee, a medical student, funding for sports at the collegiate level.

I am a champion for women and women’s rights. We should require every medical student to be taught about this so the teaching from one generation to another doesn’t contaminate young doctors.  Without this action the misogyny in medical care will continue. Recently The DEA required doctors to take an 8-hour course to help them learn to communicate with substance users in a more kind and sympathetic manner. The course’s direction to be compassionate and supportive to substance users should be taken for treating women as well. That would be a giant step for all of us.  Wiping out discrimination takes generations but must start somewhere and that should be taught at the beginning of medical training.

After we conquer the minds of physicians then we will have to work toward equity in drug development (all drugs are tested on men, but women were not tested on new drugs until 2014), the FDA, the DEA, and Pharmaceutical companies.  To make this happen patients will have to take part and not accept dismissive and discriminatory behavior by their treating doctors.

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That is a strong statement, however I am confident in saying that belly fat can put you at risk for Alzheimer’s disease, because it is a fact supported by medical research. These studies reveal that obesity, especially abdominal obesity (Beer belly, Gut, “Dunlap’s disease”…..), increases the onset and rate of Alzheimer’s dementia! Another reason to change your lifestyle to benefit your longevity.

Abdominal obesity can come from fat accumulation right underneath your skin (the fat you can pinch between 2 fingers) OR the fat that grows inside your abdomen like an apron draped over the intestines. It is called “visceral fat”, and this type of fat is what places you in the crosshairs for several diseases of aging including Alzheimer’s Disease, heart disease, stroke, diabetes, and rapid aging.  A large belly is more common in men, but it is still a risk for women if they develop an apple shaped body.

Below is a picture of visceral fat, and a diagram of what it looks like in an artist’s sketch of a normal weight person. When the yellow fat doubles and triples in thickness the abdomen pushes out to look like a “beer belly”.  

Visceral fat extends from your stomach over the transverse colon and your small intestines like an apron.  This fat pad thickens with alcohol abuse (beer belly), high carbohydrate diet, overeating, junk food, under exercise and creates a large pad of fat that secretes inflammatory cells.  The resulting inflammation is the vehicle that damages your brain leading to Alzheimer’s disease and damages your arteries leading to heart disease and stroke.

In my office we use INBODY machines that measure your Visceral fat, BMI, and percent body fat.  Normal visceral fat is below #10 on our machine, BMI less than or equal to 25, and fat % for men < 19% and for women < 26%.

The Research: A recent study correlated the size of patient’s belly (visceral belly fat), and obesity with the amount of amyloid plaque (the cause of Alzheimer’s disease) in their brain. This was measured by MRI in the study subjects’ brains.  The age of the patients studied was between 40-60.

The study found that the amount of visceral fat (fat inside your abdomen) is directly correlated with the amount of amyloid plaque and inflammation in the brain!  That causes Alzheimer’s Disease.

If that doesn’t motivate you to lose your belly fat, then you are making a choice to eventually suffer from Alzheimer’s disease, a heart attack, a stroke or arthritis.  If you are thinking that you will just wait for “something to happen”, then not making a decision to change your lifestyle is making a decision to take on illness in the future.

We have new medications to help you lose that belly fat and they really work. You should ask your doctor to help you and if they don’t understand the importance of arriving at ideal weight then look for a different doctor who will help you.

Even with medication you will have to put in the work and self-control to turn down unhealthy foods when others are being unhealthy.  You will also have to add daily exercise to your schedule if you really want to avoid Alzheimer’s Disease, heart attack, stroke and early death.

The possible meds and habits that can help you lose your “belly”:

·     Limit calories and or carbohydrates

·     Increase daily exercise

·     Diet pills (amphetamines that older patients usually can’t take)

·     Xenical (Orlistat)-Side effect is fatty diarrhea

·     Qsymia (topiramate/Phentermine) can increase BP

·     Contrave for craving (naltrexone/bupropion) can decrease sex-drive

·     Semelanotide (Imcivree-new), darkens the skin, expensive

·     Metformin ER an oral, effective medication to treat insulin resistance, and promote weight-loss

·     Victoza and Saxenda injections are diabetic treatments, that can cause GI reflux, however they work well for patients who have Type II Diabetes who need to lose weight.

Even though many patients lost weight with these medications, many could not tolerate the drugs listed above because of the side effects.  These side effects limited our ability to help all patients lose weight…until now!

Now, for the first time we have an effective way to help most people lose their dangerous visceral (belly fat). If you have a big belly you are at high risk for inflammatory diseases like Alzheimer’s dementia, obesity, heart disease, diabetes, cancer and stroke.

The new weight loss drug’s generic name is Semaglutide, and has been marketed under several names: Wegovy, Ozempic, and Rybelsus. A second generic drug that is in the same family of drugs is called Tirzepetide, includes Mounjaro (for diabetics) and Zepbound (for weight loss). All of these drug’s work for weight loss, pre-diabetes and Type 2 Diabetes.  Most insurance companies do not cover weight loss and they require a precertification for you to get the medication covered by insurance.  This precertification process is time consuming for the doctor and her staff, which costs the doctor an increase in her overhead to employ a nurse to provide this service for the patient. In general people with a BMI under 30 will not be covered for Semaglutide or Tirzapeptide, however if their BMI is over 30, there is a chance insurance will pay for one of these drugs for a period of time.

The market price at the pharmacy is between $900/$1200 per month if you pay out of pocket to your pharmacy. Because of this fact and because we have so many patients whose pellets are not paid for by insurance, we provide access to the generic form of these drugs through a compounding pharmacy. The cost is a fraction of the normal out of pocket cost, about $560 for 3 months supply. In this way we have been able to treat many people who cannot afford to pay the exorbitant going rate for this medication.

Because it is costly for a patient to receive the medication no matter how they are able to get it, It is very important for weight loss patients to be compliant and follow a low carbohydrate diet, exercise daily and to refrain from alcohol consumption while they are taking weight loss medications.  We require our patients who request these drugs to be seen at least every 2 months by one of our NPs or our weight loss specialist to help them get the best results possible.

These drugs work for weight loss and diabetes by multitasking.  The ways the medication actually works are listed below: Semaglutide and Terzapeptide,

·      decrease hunger between meals  

·     you feel full faster than normal so you eat less

·     decrease sugar and alcohol-craving

·     decrease the release of sugar from the liver when you are fasting, which turns into fat

·     Prevent hypoglycemia which causes hunger and fat gain

·     Makes patients more insulin sensitive.

Obesity is not just a lifestyle problem; it is a disease that should be treated with medicine PLUS lifestyle changes. These drug actions take place in the brain, stomach hormones, pancreas and liver, as well as in all the cells in your body.

At Bio Balance Health® have years of experience in treating patients with bio-identical testosterone pellets and we have observed that weight loss plus testosterone pellets for patients over 40 allows patients to lose fat without losing muscle. Now we add these weight loss medications to T pellets, and we have the perfect combo for safe weight-loss (really fat loss).

The biggest worry for patients is that they may not be able to get off this drug after they achieve ideal weight.  I have found that the longer you have been overweight and the more overweight you are, the higher the risk of needing maintenance medications to maintain your ideal weight. We try to wean our patients off injectable meds by switching them to Metformin ER, a drug that insurance will pay for.

With these effective meds we finally, we have an effective preventive treatment to add to our testosterone and estradiol pellets for those people who view Alzheimer’s as their worst nightmare, and for those patients who are worried about heart disease, diabetes and stroke  we can prevent the diseases that can ruin our “golden years”.  

KCM

Research:

People with large amounts of visceral fat as they age may have higher risk of Alzheimer’s disease.

NBC News (11/20, Carroll) reports, “People who have large amounts of” visceral fat “as they age may be at higher risk of developing Alzheimer’s disease, a new study suggests.” The findings were presented at the Radiological Society of North America’s annual meeting.

HealthDay (11/20, Thompson) reports that investigators “compared brain scans of 54 people between the ages of 40 and 60 with their levels of belly fat, BMI, obesity and insulin resistance.” The investigators “found that people who had more visceral fat compared with fat found just under their skin tended to have higher amyloid levels in the precuneus cortex.” The “relationship was worse in men than in women, and higher visceral fat measurements also were related to increased inflammation in the brain.”

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At Bio Balance Health I order blood tests to evaluate my future patients before I even have my first appointment with them.  I use them to find a baseline for an individual patient, and to see if hormones will help them with their symptoms.  Blood tests work well for establishing a diagnosis but are not the only factor in determining an ideal dose of hormone that works for that patient.  Symptoms and medical history supply most of the information for determining dosage as well as help me find other medical problems to treat at the same visit. Many diseases in the early stages are not treated by primary care doctors because they are overwhelmed with their number of patients and the short-time they are allowed to see them.  Our goal is to prevent disease that have been missed or treat conditions at an early stage before they become severe.

Blood tests establish and confirm both hormone deficiencies and provide a baseline level before treatment and the optimal level for each individual patient.   That blood level may or may not be within the range that is expected for a treatment success (written on the lab report). You are an individual and it is my job to find the ideal blood level of hormones for you.

Why would the blood level not tell the whole story?

Your body is genetically programed to both PRODUCE hormones from your endocrine glands and ACCEPT those same hormones in each cell.  Every person is an individual and each person makes hormones based on their genetic map and environment. Everyone is programed genetically to accept hormones into their cells in an individual manner. This is the key to understanding the differences between patients’ responses to an equivalent dose of hormones, either excreted from their own glands or absorbed through their chosen delivery system (oral, vaginal, transdermal or subdermal pellets) after their glands have aged and don’t produce enough hormone, like estradiol and testosterone.

I was in Cambridge in 2014 for the release of my first book, The Secret Female Hormone, when I visited a medical bookstore.  I discovered a large red book that weighed no less than 10 lbs was titled Testosterone.  I looked through this book and found that there was information that I had not discovered in my research of the American medical journals and books, so I bought it and read some of it on the long flight home to St. Louis, MO. I found that this book had answers to questions I had uncovered in my then,13 years of hormone medical practice. My biggest question at that time was why 2 people of the same sex having the equivalent blood level of free testosterone often feel completely different. For example, I was trained that if a man had a blood level of free testosterone that was above 129 pg/ml and under 350 pg/ml (using Quest Diagnostics lab), then he should feel normal, like he did when he was in his thirties (barring any other illnesses interfering). However, I observed that some men felt great at 110 pg/ml while others at 130 continued to have the symptoms of low T. This puzzled me, but at that time I had no answer. Then I read the first chapter of Testosterone.

The answer is found in the individual differences in the receptors on each cell for that hormone, the receiving end of the hormone physiology.  It informed me that receptor sites are genetically created differently in each individual and that one-size-does-not-fit-all!

You can bathe a person’s cells with what is considered an adequate blood concentration of testosterone for most people, let’s say men since that was the subject of the first chapter, of the book Testsosterone, but some men would receive and use only a small portion of the circulating hormone. Their cells were “resistant”, therefore they required a higher concentration of hormone, to activate their cells. This very important fact in endocrinology has been ignored until recently when we began to use genetics to find the differences between individuals’ receptor sites for all hormones and all peptide communicators. In the last 10 years we have found that receptor sites are the missing link in determining a person’s required dose of a hormone, and they are genetically determined.

Here is an example from the book in a very simplified translation. Think of a key and lock. Each cell has “locks” or receptor sites all over it, and the keys are the testosterone molecules.  Some people’s cells have locks that are easy to open and turn on a cell. They are “sensitive” to that hormone.  Some cells have difficult “locks” and they must be bombarded with a hormone “keys” to turn the cells on. This led the researchers to look for the snips of DNA that were responsible for the difference. They found them and then tested men from all over the world to see if there were regional groups, genetic groups, that contained more sensitive receptor sites or more resistant.

The results are quite telling and explain the differences between races and peoples in terms of how their bodies use the testosterone hormones available.  The men with the most sensitive receptor sites live closer to the equator: Mediterranean, African, Brazilian, and those men with more resistant receptors had DNA from ancestors who came from closer to both North and South poles: Scandinavia, Canada, Europe, South Africa, Southern Argentina etc.  The results mean that if you have a clear genetic line from one of these groups, we can predict whether you need a higher dose or lower dose to get the same resolution of symptoms. Most people in America are mixtures of genes so most patients don’t give me any information from their ancestry.

However, there are two catches to this system of determining an individual’s receptor site sensitivity; 1) In this century we are able to travel and find a mate on the other side of the globe and have been able to do so for generations, therefore we are “mutts”, or people who have multiple genetic sources in our DNA and therefore how we look or where we are from is not a good predictable factor for how we will accept our testosterone. 2) There is no commercially available test to evaluate the sensitivity of our receptors. Currently, the best science has found is to test DNA for the snips that predict sensitivity or resistance to testosterone!

This too will come to the practice of medicine, but “medicine” moves slowly and the government and people in control are always looking for a one-size-fits-all approach to illness and or aging, which makes me think this type of test will not be embraced by general American medicine.

At this point all I can tell you about dosing and blood levels is that you have an individual level that is good for you, so I try to figure out what that is, and “mark it” with your “perfect blood level”.  I proceed with is the knowledge that there are many other factors that affect the blood level of free-testosterone (active form) and the effect it has on individual patients.  This leads me to practice individualized medicine like a tailor makes a dress or suit that fits one person only. I have a lot of experience to recognize resistant or sensitive T receptor patients and I now know how to approach their care.  It is NOT by trying to adjust their hormones into the very inaccurate free T levels printed on the blood lab sheet, however I do look at those numbers to establish a baseline for that person, and I do listen to my patients when they tell me whether their symptoms are resolved or not. Resolving all SYMPTOMS is the real sign of a successful replacement of testosterone in both men and women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

When I tell my patients that they need a high protein diet, all they can think of is meat…but protein sources are found in many parts of our diet and eating a variety of protein sources is the key to health, we should find out what we should eat and why?

Protein contains amino acids that are the major building blocks to make our muscles, skin, connective tissue, tendons, ligaments and bones.  It also supplies the components of our skin, hair and nails, and carries with it calcium (the major component of bones and connective tissue).  Protein is found in cheese, milk, all milk products, whey for protein shakes, pea protein, fish, all seafood, chicken, lamb, eggs, Quinoa and beans for building muscle. Pieces of proteins make up every fluid the body makes, including hormones, enzymes, peptide communicators, the immune globulins, semen, breast milk, and vaginal discharge….is it any wonder that I tell my patients to increase protein in their diets!

Despite the need for amino acids and short chains of amino acids called peptides, we also need a variety of foods, all colors at every meal to provide the other building blocks of our body.  For example, fat is a very necessary food for every person, at every meal.  When I was pregnant, I wanted to feed my baby everything she needed to build a healthy beautiful brain, so I ate Braun Schweiger every day (made from liver) for lunch with a salad.  The Braun Schweiger provided Rachel, my daughter, with the building blocks for an amazing brain. Our brains are almost all fat.  That is the type of tissue that nerves are made of, but nerves also need B12 to work properly and B12 is primarily from animal products. It is relatively easy to include fat in our diets, but it is truly difficult to get enough protein to build muscle on a vegan diet. My vegan patients must be experts in obtaining protein from their diet and must be aware of the components in all the food they eat to get the proper nutrition.

Carbohydrates are made for “action”.   Carbohydrates are required for exercise, walking and brains also burn carbohydrates when you are doing “brain work”. Carbohydrates are stored as fat if we eat them but don’t exercise!  Think before you eat carbohydrates about your next 12 hours and whether you are going to exercise to burn the carbohydrates in your diet.

So How Much Protein Do We Need?

Growing teenagers, people who lift weights and try to gain muscle, pregnant women (need a minimum of 100 grams a day) and patients like mine on testosterone need more protein in their diet than the average sedentary, adult.

To quantitate the number of grams of protein you need to sustain your body with a high percentage of muscle, a person needs more than ½ their weight in grams of protein. For example, a 125 lb. woman with average to high muscle mass will need more than 62.5 grams of protein a day. A person with higher muscle mass will need more than that.

For athletes, weight lifters, patients trying to lose weight and sustain their current muscle mass, they need to eat the equivalent number of grams of protein to their weight, every day. 

To do this a person will have to know how many grams are in each serving of their current foods and if they aren’t eating enough, they should add high protein, low carb protein shakes times before or after they work out or exercise.  A typical protein shake will have 15 to 20 grams per serving and less than 5-10 grams of carbohydrate.

An average size  hamburger has about 20 grams of protein.  Add beans, peas, cheese, yogurt, butter, ricotta cheese, milk, eggs, custard, chicken, fish fillets, shrimp, and protein bars.  Be careful not to overeat carbohydrate with your protein which can cause you to gain fat, while you make muscle.

Why do we need more protein on the days we work out, especially with weights?  Weight training is a great muscle builder, in fact it is the best form of exercise for increasing your muscle mass.  But why do people who engage in this type of activity require more protein than those who walk?  The answer is in the physiology of human muscle when stressed by weight training exercises. 

When you work out with weights you put specific stress on your muscles, and during the hour or hours you engage in this type of exercise your muscles are broken down. That’s right, initially you LOSE MUSCLE! The act of physical labor on the human body that uses weights against gravity causes stress on the muscle fibers and they are broken down, their components (all made of protein) are then excreted from the body.  We don’t recycle much of the broken-down muscle! Instead, we must provide new building blocks, or amino acids that are circulated to the muscles from our diet, tp build back the muscle and even build more than was there the day before your exercised! This is the reason weight-lifters work out the top half of their body one day and let it rest (to build muscle) the next day while they exercise the bottom half of their body!

Now let’s talk about protein necessary for aerobic exercise like running or fast walking.  Distance running does not build muscles in the legs (or anywhere else), because this type of aerobic activity breaks down muscles that are working hard, but they are not stressed against gravity enough to build muscle, unless the runner is obese. Obese people who do or do not exercise have huge calves not because they work out, but because their legs have to hold up more weight than it is designed to support so their lower legs lift a fat body every day!  Runners, however, are usually slender, and their calves, quads, and hamstrings are slender too.  They do not build muscles while running.  The purpose of running is the production of endorphins for enjoyment, and the aerobic benefit to the cardiovascular system.  Running also burns alot calories so carbohydrates are needed to give the current muscles energy to run.  If you have ever looked at runners’ legs, they are not “cut” like lifters legs, that show the muscle bellies of the legs, but they are narrow long and smooth. These people don’t need as much protein as a lifter even though they are running every day, because they don’t require as much protein to build back what they already have plus more protein to make the muscles bigger! They just must sustain the muscle mass that is being used.  Their need is in carbohydrates that give them energy to feed the muscle fibers.

As people age, they lose muscle mass unless they take testosterone and eat a high protein diet. Left to nature their muscle mass decreases by 3-8 % EVERY YEAR between the ages of 40 and 90, unless you take a healthy dose of testosterone.  Aging adults are advised to eat more protein to prevent this catabolism but truly it doesn’t work if you don’t replace the hormone that signals muscles to grow which is testosterone.

Remember that protein comes primarily from animal products but can also be found in many kinds of beans and peas, but not in any fruit. Remember to grow muscle you need.

·      Protein in grams per day equal to your weight

·      Varied colorful diet with enough fat and carbohydrates.

·      Testosterone

·      Weight bearing exercise

Another reason supplements might not be necessary: “Protein is in every food group except fruit,” Dr Webb says.

Every human was born to eat a variety of foods to satisfy all their daily nutritional needs. The benefits of variety include the types of protein sources. Meat is an obvious source of protein, but “thankfully we can find protein in a multitude of plant-based sources, including lentils, tempeh, tofu, and beans,” Corwin says.

Barkoukis, a researcher on protein and nutrition, advises that "Variety in diet is the best plan,” she says. “Beans are an amazing powerhouse," however they do not have all the amino acids the body needs to sustain life. “Not all protein sources are alike, or equivalent. Animal proteins are “complete” in that they contain all nine essential amino acids, while most plant proteins often have some—but not all—of those aminos that we cannot make in our bodies, so we must get them from a food source.” Quinoa has all the essential proteins; beans are incomplete and should be combined with other sources.

For those who always ask how food work, here it is taken from a book called Human How do the proteins from foods, denatured or not, get processed into amino acids that cells can use to make new proteins? When you eat food the body’s digestive system breaks down the protein into the individual amino acids, which are absorbed and used by cells to build other proteins and a few other macromolecules, such as DNA. Nutrition.

1.    In the mouth your saliva begins the metabolism of proteins with amylase that is produced in your salivary glands. Your chewing breaks protein down into small pieces to help digestion.

2.    In the stomach acids (Hydrochloric acid from gastric juices and an enzyme pepsin to break down protein. Proteins take longer in the stomach to break- down so you feel full longer when you eat proteins.

3.    The small intestine is the major player in protein digestion. Here the Pancreas secretes trypsin and chymotrypsin These enzymes break food protein into amino acids.

4.    At the end of your small intestine there are specialized cells that transport protein into the bloodstream, and it circulates to where it is stored to make vital enzymes and building blocks for when you haven’t been eating.

5.    Amino acids are recycled to make new proteins (muscle, enzymes, skin hair, etc. Amino acids to build other biological molecules containing nitrogen.

“It is critical to maintain amino acid levels by consuming high-quality proteins in the diet, or the amino acids needed for building new proteins will be obtained by increasing protein destruction from other tissues (stealing protein from your muscles) within the body, especially muscle. This amino acid pool is less than one percent of total body-protein content. Thus, the body does not store protein as it does with carbohydrates (as glycogen in the muscles and liver) and lipids (as triglycerides in adipose tissue). such as DNA, RNA, and to some extent to produce energy.”  Eating protein is vital to life!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

There are almost as many different human metabolic variations as there are people in the world.  Our genetics make us all unique in ways that vary the way we can lose weight or even gain weight. On the other hand, we all had to descend from humans who survived famine, lack of water and lack of nutrition sources, so in one way we are all the same…we have genes that helped us survive times that required of us the ability to maintain our weight even without eating!  The people who genetically were unable to gain fat and keep it to hold them over during famine just didn’t make it to an age they could procreate. The rest of us whose ancestors survived, have given the majority of us the genes to maintain body fat.

Unfortunately, we have been blindly unaware of what man’s evolution and progress has led us to physically, and most of us are over-fat, and have trouble losing it!  The very genes that allowed us to survive the beginning of man’s existence, are the same ones that make it hard to become slender. In addition, in our current societies in the western world, food is plentiful and inexpensive.  Our genes have not changed, but our environment has, and we are becoming sick because of our obesity…how do we survive this “new world”?

You may hear a lot about insulin resistance, and I talk about it a lot on my Healthcasts, but it is insulin resistance that has allowed us to survive and has also led us to obesity today.  The humans who were insulin resistant who also held on to their fat in times of starvation are also the humans who have become obese in the face of plenty. We can’t change our genes, but we can turn some of the obesity genes off through lifestyle and sometimes with the help of medication.

Despite our basic sameness, we are also each individual, and genetically programed so that some of us lose weight if we restrict calories, others lose weight only if they exercise; Some of us don’t lose weight with exercise; some people don’t lose weight with carbohydrate restriction or fat restriction, and some do.  This is the ugly truth that lies behind the millions of books on diet, none of which work for more than a small number of us, and because it is a diet we can’t maintain it...what we need is to determine is the best weight loss program for each of us, by using trial and error, or by using genetic testing that tells us what our best pathway to a normal weight looks like.

To begin we must take baby steps and learn about food and what the words mean that we use when referring to food.  Because there are many people who may have several hurdles to jump before they can live at their healthy weight, we need to all speak the same language of weight loss.

So let’s start with a bit of education about food.

WHAT IS A SIMPLE SUGAR?

A simple sugar is a nutrient meant to give you energy for physical activity. Eating a small amount of a simple or a complex sugar before exercise is a good idea. However, if you sit most of your day, working with your brain instead of your body, simple sugars can increase your fat storage because you aren’t physically working. This is true whether restricting sugar is your genetic method of weight loss or not. Too many simple sugars make you hungry and cause everyone to overeat.….causing weight gain and fat gain. So what are simple sugars?

Examples of simple sugars:

·      Sugar, white, cane  and brown

·      Molasses

·      Regular Soda

·      Agave

·      Honey

·      Syrup-maple or any

·      Rice, white and brown

·      Cereals-all

·      Oatmeal

·      Donuts

·      White potatoes

·      Bread

·      Pancakes/waffles

·      Noodles

·      All Grains: wheat, oats, rice, corn and anything made from them including flour

·      Sweet tea

·      All Cakes, brownies, candy, chips, and many energy bars

·      All bagged snacks like pretzels, chips, cookies, and fruit with sugar added

·      Pies and most desserts, except fresh or frozen fruit.

·      Dried Fruit (has sugar added eat frozen fruit instead.)

·      All non-milk-based salad dressings except plain Olive oil and vinegar.

Note: All diet sodas have chemicals that stimulate insulin like sugar.  There are a few brands that use Stevia (an herb that is sweet, and not a chemical) and they are the exception so you can drink those without stimulating fat production.  Other options are unsweetened bubble water or plain water.

Eventually eating a diet filled with simple sugars leads to obesity, and diabetes no matter who you are, therefore if you are in not working physically with your body all day, every day ( machinists, farmers -in the summer, factory workers, outdoor laborers) you should not eat these foods except in small amounts with a protein to lengthen the time until you feel hungry again.

The rest of us should rarely eat these foods. They should be considered foods for “special events”.

If you exercise aerobically and/or with weights for more than an hour at a time, then you may eat a small amount of simple sugars but eating small amount of complex sugars is healthier to help you maintain your muscle mass and your exercise stamina while losing fat.

COMPLEX CARBOHYDRATES: EAT INSTEAD OF SIMPLE SUGARS

SWEET POTATOES

Sweet potatoes taste sweet and have complex Carbohydrates so it takes longer for them to be digested which means they do not stimulate the secretion of insulin as fast or as high as white potatoes. They are a complex sugar.

Sweet Potatoes also have several health benefits including antioxidant healing role and anti-inflammatory properties.

CHICKPEAS (GARBANZO BEANS, BLACK BEANS AND LENTILS)

Legumes like chickpeas, black beans, and lentils are not only complex carbohydrates buy are a great source of dietary fiber, making them wise choices for a filling you up and satisfying the pre-workout carbohydrate requirement.

QUINOA

Quinoa is a good source of plant protein. It can be a substitute for bread or pasta.

WHOLE GRAIN BREADS LIKE DAVE’S LOW CARB & HIGH PROTEIN BREAD

Whole grain bread like Dave’s Bread has enough fiber and nut protein to prevent excessive stimulation of your insulin. Too much insulin leads to insulin resistance and causes fat gain instead of giving your cells energy.

One piece of bread per meal is all you should eat if you are overweight and or have Type II diabetes in your family. Make sure you are not eating more than 25 grams of carb in any meal.

WILD RICE- is a seed and not a “rice”

You should eat wild rice instead of any other type of rice and only in small amounts.  All complex carbs should be eaten in small portions because in large portions they act just like simple carbs and increase weight gain.

NUTS: Cashews, Almonds, Walnuts, Chestnuts,

Nuts of all kinds can be a substitute for carbs in any form.  A handful of nuts should be enough to decrease your hunger and increase your protein as well as decrease insulin response to eating.

The Combination of foods that you eat is also important.  If you are going to eat any carbohydrate it should be paired with a protein and or a fat.

For example: If you are going to eat a piece of bread, then you can eat it with butter and or peanut butter or cheese or eggs.  This slows the absorption of the carbohydrate from the bread and prevents your blood sugar from surging and plummeting after you eat, leaving you fatigued and sleepy.

In The Dr. Maupin’s Diet in my book the Secret Female Hormone, I recommend eating multiple times a day and controlling simple carbs and carbs from sugar and grains.  Scientifically it is a fact that if you eat 25 grams or less of carbohydrate foods from sugar or grains per meal then you can prevent Insulin resistance and the additional fat that follows insulin resistance.  It is also a good way to lose fat.  In my diet a person can eat as much fruit and veggies as they desire, except white potatoes and bananas.

WHAT YOU EAT, IS AS IMPORTANT

AS HOW MUCH YOU EAT!

Other Strategies for weight loss include eating a protein with each carb which decreases the total volume of food you eat and increases satiety.

·      Saving your carbs to be eaten before exercise.

·      Portion Control of all food.

·      Limit alcohol.  0- 4 drinks a week

·      Daily exercise for over an hour/day.

·      Drink a glass of water before you eat.

·      Skip dessert

·      Eat a salad daily

·      Eat more than half your weight in grams of protein (Meat, cheese, eggs, milk products, whey protein and more)

 The basic information was from my over 45 years of practice and Information provided by Inbody.

 If you know by experience or you have had your genetics tested to reveal that limiting carbohydrates is needed for you to lose fat, then I hope this blog helped you understand what I mean when I tell you to limit your carbohydrate intake to less than 25 grams per meal.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

This subject is for men who have had a high PSA and who have been advised that they need a prostate biopsy to determine if they have cancer. Many men go into the doctor for the biopsy necessary for diagnosis without expecting the “blind biopsy” procedure that is done through the rectum and is extremely painful when the doctor blindly takes pieces of the prostate…over and over again.   Blindly, means he is randomly picking a place to biopsy without a real target….with the urologist biopsying everywhere in the prostate 10 or more times. Finding a small cancer with this random or “blind” biopsy method is a less than effective way to find a small area of prostate cancer. Men who have had this procedure done rarely agree to a second round, under any circumstances and I agree with them.

I always do a PSA test before I treat a man with testosterone so I often am faced with the question of what advice I should give him in this situation before I feel it is safe to give him testosterone. Of course, if he has prostate cancer, even a high PSA, I will not give a man testosterone until his urologist says he is safe to receive it.

 Until recently there was no radiologic way to screen a for prostate cancer. Now urologists use Ultrasound or MRIs to find an abnormality in the prostate that they can biopsy.  This makes the procedure both more accurate and less painful.

The way this procedure was done in the past, and is still done throughout the US, always caused me to wonder why urologists hadn’t figured out a way to do it in a way that accurately biopsied a high risk area of the prostate, with one or two biopsies.  Now Urologists use rectal ultrasound or MRI, like Gynecologists use vaginal ultrasounds to find and drain or biopsy ovarian masses, or to harvest eggs in IVF. The urologists have even borrowed the idea to use numbing medicine as well to make it comfortable.  In the last 2 years I have found a few Urologists who have embraced the new, accurate biopsy procedure that used the MRI to find high risk areas and ultrasound to locate suspicious areas for biopsy, then used the same radiologic method to locate and  treat discrete focal areas of abnormality with cryotherapy (freezing) or focused ultrasound. 

Finally in August of 2023,  a research article titled, “Focal Therapy for Localized Prostate Cancer in Older Men”, was published in the Journal of Urology.

This article describes a much more accurate method of treating prostate cancer that resulted in the diagnosis and treatment of  low grade prostate cancer without recurrence and without complications, allowing men to have a conservative treatment for low grade prostate cancer, following a less painful and invasive diagnostic procedure. Compassion has finally come to diagnosis and  treatment of prostate cancer. We applaud the authors.

August 22, 2023

Focal Therapy for Localized Prostate Cancer in Older Men

Allan S. Brett, MD, reviewing Habashy D et al. J Urol 2023 Jul Lomas DJ and Frendl DM. J Urol 2023 Jul

In an observational study, focal therapy was compared with radical treatment.

At some centers, focal ablative therapy (generally with high-intensity focused ultrasound or cryotherapy) is a treatment option for selected patients with localized prostate cancer. This option could be attractive for some older patients with comorbidities who might be candidates for radical prostatectomy or radiotherapy (according to tumor grade) but who wish to avoid complications from radical intervention.

Using data from national registries, U.K. researchers compared 262 patients (age, ≥70; median age, 74) who underwent focal ablative therapy with 262 propensity-score–matched patients who underwent radical treatment (mostly radiotherapy with androgen-deprivation therapy). At baseline, nearly all patients had intermediate- or high-risk disease. Estimated 5-year failure-free survival (the composite primary outcome, which included absence of salvage radical treatment, systemic treatment, distant metastases, or prostate cancer–specific death) was significantly higher in the radically treated group than in the focal-therapy group (96% vs. 82%). Estimated 5-year overall survival with focal therapy was 96%.

COMMENT

The better failure-free survival with radical treatment than with focal therapy (a 14 percentage-point difference) is not surprising. The challenge for individual decision making is to balance that difference against the higher rate of complications with radical treatment in older men — especially men with substantial comorbidities. We don't have long-term data from randomized trials to compare focal therapy versus radical treatment, active surveillance, or watchful waiting. But in the meantime, editorialists from Mayo Clinic conclude that focal therapy is “a reasonable strategy in older patients.”

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They insert a needle through the wall of your rectum and into the prostate to extract the cells for testing. This is a “transrectal biopsy.” Doctors usually take a dozen samples from various parts of the prostate. In some cases, they do the biopsy by inserting a needle through the skin between the scrotum and the anus.May 29, 2023

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Are you menopausal and have any of the following symptoms?

·      Hot Flashes

·      Night Sweats

·      Dry Vagina

·      Painful intercourse

·      Dry skin

·      Lack of sex drive

·      Lack of motivation

·      Fatigue

·      Depression and or anxiety

·      Change in body composition, with fat collection in the abdomen

·      Loss of Muscle Mass and strength

·      Irritability

·      Inability to remember names and places

·      Decreased ability to problem solve

·      Insomnia

·      Arthritis

·      Body pain

These are all symptoms we currently are aware of associated with menopause and low testosterone.  These symptoms can be treated and reversed with bioidentical estradiol and testosterone pellets.  

Menopause should be treated like an illness that is universal but more severe in some women compared with others.  If your symptoms affect your lifestyle, relationships and work then you should see a doctor who treats hormone deficiency and accept treatment!  

However, if you allow yourself to be manipulated by a male-dominated medical system that teaches all doctors to believe that menopause is normal as women age and don’t seek out hormone replacement, then you just may be setting yourself up for years of symptoms that are treated with handfuls of medications, but never get you back to normal. 

Just think about this for a minute: Men develop erectile dysfunction and experience muscle loss as they age, but medicine doesn’t consider ED or Sarcopenia a natural aging process for men, they advocate and endorse treatment with testosterone, ED medications, injections for ED and therapy for ED, and in most cases pay for it!  If the male mentality would include women we would all be treated with estrogen and testosterone when we got to age 50 (or menopause).

It is not just about the symptoms that E-T replacement can cure, but the diseases that you can avoid by taking estrogen and testosterone after menopause.  These avoidable diseases of aging include:

·      Osteoporosis leading to broken bones and spinal stenosis.

·      Heart disease and stroke

·      Diabetes

·      Alzheimer’s Dx and dementia

·      Obesity

·      Low muscle mass and inability to walk or move independently.

·      Autoimmune diseases

·      Loss of blood flow to Lower extremity, resulting in amputations and inhibiting walking and running

·      Severe arthritis

·      Gout

·      Worsening depression and anxiety

·      Frailty which is what causes most older people to be placed in a nursing home.

Just think it is not fate that gives you these conditions.  It is genetics plus lifestyle plus whether you replace your sex hormones or not! This decision is in your control.  If you really want a life free of debilitating disease and symptoms that are require constant medical care, then you must buck the system (that was designed to keep us from maintaining our mind and body) and look for a doctor to replace your testosterone and estradiol in a non-oral delivery system and maintain it for life.

By stopping ERT or Testosterone like the ACOG doctors tell you to, you will start the symptoms all over again.  My job is to offer you the right type of help to reverse the effects of menopause…both symptoms and diseases. Your job is to decide whether you want to get help and become healthy by taking nonoral estrogen and testosterone for the rest of your life.

Think of menopause as a disease and you will be more prepared to fight for your right to be treated by the medical system. 

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Even though all women eventually stop having periods and stop making estrogen, testosterone, and progesterone we all have symptoms of menopause, even if you don’t recognize them as symptoms relating to loss of estrogen, testosterone, and progesterone after menopause.  However, every woman experiences menopause differently. Some of us are devastated in every way by the multitude of symptoms that loss of our sex-hormones can create, on the other hand some women merely endure painful intercourse, hot flashes, headaches, and fatigue…or are told by their doctors that their

symptoms are “getting older” and they have to live with it!  Aren’t your symptoms enough for you to demand treatment?

What I See:

Every day in the office and even in my private life I run into women who complain about their symptoms of hormone loss. When I offer a solution for their symptoms of menopause and low T, I am often shot down by my patient’s “fear” of hormones. For example, I was at a 70th birthday party recently and a flood of women came up to me and told me how young and heathy I looked.  When they asked me what I do to achieve that, and I explain that I have taken hormone pellets with T and E2 since I was 47 and they can get the same results, they immediately say, “I’m not doing that!  I don’t want breast cancer!  Or “that will cause heart disease or gain weight! “. The media and their doctors who are not up to date in their reading of research have frightened them away from treatment for their symptoms!  The doctors should read more and not depend on 40-year-old information (med school and residency).  They just told me I was doing something right, but then the fear that society has instilled in them shuts the door on a chance to be healthy, mobile and at ideal weight forever.  The opposition to us is strong and this is really brainwashing women away from taking care of themselves!

 The recent (last 10-15 years) research has revealed that medicine has been wrong about much of the advice that we give patients based on flawed research and the need for the media to scare women into dangerous action (not taking hormones).  These groups are literally making women suffer, take too many medications, and literally to be ill during the second half of their lives!  The power of the press causes women to comply.

Here are the “facts” doctors were taught over the last 4 decades: that are lies!

Genetics hold your future. The new study of Epigenetics has revealed that we can turn off our “bad” genes with a healthy lifestyle. Diet—the Food pyramid lied to the American people to make money for America. They advised us to eat grains and sugar, and now we know that that caused Americans to be obese and diabetic. Exercise—Jogging long distances is healthy. Lie!  Exercise helps weight loss in a percentage of patients however most patients who exercise to extreme are less healthy than other people who are moderate in their exercise.  Moderation prevents the need for knee and hip replacements, the stress on the heart and kidneys causes early circulatory and renal disease. “Hormones” –cause Breast Cancer. Estrogen doesn’t cause breast cancer however it can increase growth in estrogen receptor positive women. Not a cause, in fact women on ERT (without provera) had fewer breast cancers and less aggressive ones than women who took nothing! Testosterone is a MALE hormone, and we can’t have any! Lie! We make three times as much testosterone in our ovaries as we do estradiol when we are fertile!

 Do you see that we are manipulated into following false truths because our doctors are too busy to keep up and fear sells newspapers, magazines, and other news agencies. This is how we are discouraged from treatment by our gynecologists, our friends and society. Women are continually barraged with misleading information that makes us think that menopause is no big deal and we just have to live with it and get old gracefully, like our mothers did!  However, our mothers did get estrogen and other treatments for menopause!  Medicine has been completely revamped in the last 50 years, so we should be healthier, happier and have a better quality of life, yet we are prevented from achieving that through instilling fear in women.

While we are dissuaded from treating the symptoms of menopause that take away our productivity and quality of life, we are put in an untenable position. We are discriminated against because we are menopausal.  The most recent example of this mission to cripple women’s success was on national TV when Former Governor Nikki Hayley, the 52 yr. old female Senator who is running for president, was described as inadequate because she was  “past her Prime”, by a male politician who is in a party that touts the ability of an 81 year old man in that position to act as president of the US.   This is one example of millions of examples as to how we are denied treatment to give us powerful and productive lives while we are denied the medicines to make that possible!

The powers that control us, Congress, Senate, the President, the FDA, and the NIH are for by our tax dollars, but they aren’t working for us.  They perpetuate the myth that women are addled and inadequate because of our menopausal status, and then make it come true by lying to women about the risks of taking the hormone replacement that can make the second half of our lives productive.  The people who make decisions about this subject use fear to “manage” us. Headlines and Titles of articles are the weapons they use.

The second hormone women need is testosterone, however testosterone is still claimed by men and they won’t share!  Men have over 20 forms of FDA approved forms of testosterone while women have none!  Testosterone deficiency causes many of the symptoms women experience but don’t associate with testosterone loss.  Fatigue, lack of sex drive, loss of muscle, weight gain, belly fat, arthritis, inability to think, depression and anxiety that begins before 40.  Doctors answer women’s questions about these symptoms by saying, “You are just getting old”, and then refuse to treat or help except with an easy but ineffective treatment, anti-depressants!  That’s how doctors are trained.  It’s disgusting that doctors just ignore our symptoms.

The facts:

Women make 3 times as much testosterone before menopause as we do estradiol, yet testosterone is still referred to by “experts”, including the American College of OBGYN who teaches doctors taking care of women’s menopause. So women are “held down” and discriminated against by the majority of men, who still run everything :  the FDA  who won’t approve Testosterone replacement for women; the government who won’t pay for testosterone replacement or non-oral bioidentical hormone replacement (which is how we receive our T); and the group that I will discuss today—the journalists who title research articles to scare us, not  to educate us, and write them like we are children who need to be placated and brainwashed instead of  just treating  a uniquely female disease….MENOPAUSE!,,,with estradiol and testosterone.

We have allowed ourselves to be manipulated and we repeat the rhetoric men have initiated. Why aren’t we asking questions and making our doctors listen to us?  They should be helping us.  We are half the problem.  We find it easier to buy into the lies and do nothing rather than treat our symptoms.  We ignore the fact that doing nothing for ourselves is doing something negative for ourselves, one of their tactics used against us, is to scare us from seeking treatment for menopause with the current headlines (Like Hormone Replacement Therapy Causes Cancer and Heart Diseases). and messages barraging us to scare us away from treatment of our painful symptoms, while our decisions destroy our power to continue what we are still accomplishing after age 50.

Here are the titles of the medical and public articles recently in the news that scare women into thinking that they are damaged after menopause and have no safe treatment.

NEWS 7.2023 Ovarian cancer risk among women with

PCOS doubles after menopause

HealthDay (6/27, Murez) reports,

MedPage Today (9/13, Robertson) reports

Gout risk higher for postmenopausal women Full Story: Healio (free registration) (8/14)

___________________________-

The association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women

Michopoulos, Vasiliki PhD; Huibregtse, Megan E. PhD; Chahine, E. Britton MD, NCMP; Smith, Alicia K. PhD; Fonkoue, Ida T. MD, PhD; Maples-Keller, Jessica PhD; Murphy, Amy BA; Taylor, Linzie BS; Powers, Abigail PhD; Stevens, Jennifer S. PhD

You get the idea. The underlying message of all of these articles is “Menopause causes illness and death”, yet what it doesn’t say is that treating menopause can treat and reverse everything about menopause except fertility. It is true that the symptoms of lack of estradiol and testosterone and the diseases that follow menopause can be treated with hormonal replacement, and risk of diseases of aging and the symptoms of estradiol and testosterone deficiency can be treated with Bioidentical E2 and T pellets!  I see it every day in my BioBalance® Practice!

This describes the past, only you and other women can change the future!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Often in medicine, doctors discover a new use for an old treatment or a treatment that is approved for one use and serendipitously doctors find a new use for a drug or medical device.

I have used a specific type of IUD in menopausal women on estradiol to prevent postmenopausal bleeding. The Mirena or Kyla IUD produces progesterone into the uterus to suppress the effects of estrogen on the endometrium, preventing post-menopausal bleeding and growth of fibroids.

In the May 2023 Journal of OBG Management the experts have discovered that these special IUDs can be used for more than just birth control.  They don’t contain any estrogen, but they deliver the progesterone (progestin) where it is needed to the lining of the uterus for 8 years!

The cost of one IUD/8 years vs that of daily progesterone reveals a great cost savings by using a Mirena or Lyetta or Kyla (for uteruses that have not been pregnant) and a time savings for patients who are having difficulty with post-menopausal bleeding while on estradiol pellets, or any form of estrogen after menopause.

The way these IUDs work is that the soft plastic material of the IUD has a packet of progestin attached to it that slowly dissolves over 8 years. In general, I don’t advise the use of Progestins orally as it increases risk of breast cancer and heart disease ONLY when it is taken orally.  The small dose that circulates locally in the uterus is only beneficial and is not circulated throughout the bloodstream.

The Mirena (I will use “Mirena” to represent all IUDs of the same genre because it was the first one FDA approved) is placed in the uterus in the GYN office, and a short string is left to stick out of the cervix to be palpable by the patient or the doctor to show that the IUD has not exited the uterus (which is rare in women not having periods, menopause).

Generally the patient is given a week of progesterone to cause her to evacuate the remaining lining of the uterus before the IUD is placed. This will decrease the spotting and bleeding after the procedure. If it is a difficult insertion of the IUD, the GYN will often do a post insertion Ultrasound of the uterus to make sure the IUD is in place. 

There are a few menopausal women who cannot have an IUD after menopause.  Those patients who have had an ablation of the lining of the uterus usually has scarring of the uterine lining so that an IUD would not be inserted easily or at all.  A patient with a uterine septum is not a cancidate for an IUD. Patients who have had a perforation of the uterus in the past are not a candidate for this treatment either. Patients with fibroids on the inside of the uterine cavity are not a candidate either, because the IUD may rub against the fibroid and cause it to bleed.

However if you have a uterus and are on estradiol or oral estrogen and take progesterone or progestin with it to protect your uterus, and have trouble remembering the progestin or progesterone dose every night or you continue to bleed even on progesterone/progestin, then a Mirena would be a good solution for you!

There is a novel treatment for those women who we have been unable to give estrogen to because of uterine bleeding, and the Mirena IUD or one of its sisters is the answer!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

My medical practice at BioBalance® Health brings me many interesting issues that my patients have had to struggle with, before they finally come to me for T Pellets. The latest complaint that men bring to me on their first visit is their reticence to try T pellets because they already tried T cream, or T gel or T patches and they did not get the results that they expected and needed, so they believe T Pellets won’t help them either.  Another problem the other forms of T can pose for men is that they try non-pellet forms of T and tell me that they felt a little bit better and they tell me that is all they thought they would get from any form of T replacement….they settle for feeling slightly better instead of feeling Completely Well!

Compared to FDA approved Testosterone Creams, Gels, and Patches, Testosterone Pellets at BioBalance Health are superior in every way!  When deciding on a treatment or even when buying an important item for your home you should do your homework!  I am going to tell you today why men should switch to long-acting Bio-identical testosterone pellets instead of the other forms.

Deciding between various forms of Testosterone

#1 Effectiveness of each form of Testosterone

When making a decision about which treatment to employ, you should look at whether the treatment will completely treat my symptoms, or just some of them/ and what are the side effects (what is the downside)? Below is a comparison from my book for men, “Got Testosterone?” that compares T pellets to other forms. Note that Creams/Gels/patches are all “Transdermal”, or delivered through the skin:

The reasons for why the quality of the treatment is different for trans-dermals and pellets is because the up to 80% of testosterone converts into estrogen as it is absorbed by the skin. Men don’t need or tolerate estrogens like women do, in fact estrogen binds up testosterone so it can’t be used by the body.  So, gels, creams and patches give a man a small amount of T, but soon it inactivates the testosterone, and doctors think the dose is too low, so they raise the dose. The same thing happens over again and finally both doctor and patient give up and generalize the treatment failure and assume the man cannot take Testosterone (in any form).

Pellet testosterone dissolves under the skin in a layer of fat and goes directly into the bloodstream where it goes to work and attached to Testosterone receptor sights. A small amount is converted into estrogen, but it is not enough to inactivate the testosterone from the pellet, so the effectiveness of Pellet Testosterone is quite different from transdermal forms of testosterone, and is greatly superior.

#2 Side Effects/Risks

The flipside of whether a medical treatment of any kind is right for you, is the risks of the treatment and the likelihood of side effects.  Knowing the effectiveness of a treatment and the risks, helps you decide whether it will work for you.  Knowing these two most important factors help a patient make a decision on which treatment he wants to try.

There are risks that may not apply to you, however you should look to the side effects or risks that apply to you, to make your decision.  In the table the highest risk is noted with three Xs, and the lowest risk is one X. The side effects of T in Pellets are much lower than other forms of Testosterone. You must review whether these are risks for you individually or not.

For example, if you are still of childbearing age or you still want more children than the lowest risk of infertility is offered by T Pellets, however there is still a risk. For those men who don’t have hemochromatosis then this risk is not a risk at all. This really means that risks must be individualized for each man just like dosage.

#3 Ease of Complying with Dosage and #4 Cost

Whether you can actually continue treatment for a long period of time is pivotal to determine whether you should take a type of Testosterone replacement. You should look at these factors:

·      Can I realistically follow the dosing schedule?

·      How many times a year do I have to go to the doctor’s office for this treatment?

·      How much time will I waste a month waiting in a doctor’s office to get the treatment?

·      Is it administered at home or at the doctor’s office?

The next part of this equation is the cost of treatment.  Most testosterone medications are not paid for by insurance.  If they are paid for, they have a high copay for most insurance. If you get your testosterone from a pharmacy, then to compute your fee you should multiply the copay by 11 months. If you have to go to the doctor to get the script, you should add the doctor’s fee as well.

I have compiled the cost of each kind of treatment based on the initial dose, which might not be adequate for people who use trans-dermal testosterone and need to increase the dose multiple times.

As for dosing, If you can’t remember your vitamins, your medicine or to brush your teeth before you go to bed I can guarantee that you won’t be able to remember your testosterone cream or gel, or pill.

In the End it is Your decision

Everyone must make their own decision about what type of Testosterone to use.  Only you know whether you can be compliant with a daily regimen or would be better to come to an office to get your testosterone twice a year.  Only you know whether an effective form of T like pellets is worth the cost of treatment, however, to make a good decision you should compute the daily or monthly cost of the pellets to compare apples to apples.

I see many men who have tried T shots, gels and patches, and come to me as a last chance to treat their low T symptoms with pellets.  98% of them are extremely happy and continue treatment, noting the difference between pellets and their previous T treatment.  If you continue to use gels and creams because the FDA approves of it, or because your PCP orders it, but you don’t feel better, then you should try T pellets!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Your Consultations with Dr. Sullivan or Dr. Maupin last one hour! No other medical practices schedule an hour for consultations with each patient.

You will see a doctor and have time to discuss your issues!!! Drs Maupin and Sullivan spend hours preparing for your first appointment.  They know what medical problems you have, your medications and allergies, and based on your medial history they determine your treatment plan.  This plan includes your pellet dose, treatment of other conditions or diseases that are out of control, a diet and eating plan, exercise advice, individualized supplement advice, and prescriptions for medications. Your health will benefit from the expert advice given by Dr. Sullivan and Dr Maupin and their team of Nurse Practitioners and Registered Nurses.

BioBalance® Testosterone Pellets are the most effective, lowest risk Testosterone Replacement: We exclusively use Testosterone and Estradiol Pellets made from Non-Micronized Bio-identical Testosterone powder, from two compounding pharmacies who have been our providers for two decades.

BioBalance® Health has the most experience in providing Testosterone and Estradiol Pellets in the Midwest We have been practicing anti-aging medicine and treating patients with bioidentical testosterone pellets longer than any other practice in the Midwest, over 20 years!

BioBalance® Health doctors and NPs provide such a unique and successful level of care that patients fly from all over the world to see them. We are innovators and we have learned how to trouble shoot side effects and treat them before they happen. We have such a unique treatment method that we have doctors who request training with us, and patients who spread the word of our success to their doctors and their friends.

BioBalance® Health Has the Highest Success Rate of any other provider of T and E2 pellets. We not only offer quality and service to the practice of Anti-Aging Medicine/ Functional Medicine, we also have the highest success rate of any other BI hormone practice anywhere.  We encounter the fewest side effects and complaints of any other hormone practice, and we are 95% effective at resolving the symptoms of hormone deficiency.

We Treat Much More than Just Your Sex Hormone Deficiency! When replacing hormones and treating the symptoms of hormone deficiency is not enough, we treat our patients for other hormone deficiencies and diseases of aging: hypothyroidism, and Pre-diseases like pre-diabetes, obesity, fatty liver disease, and nutritional deficiencies. Our doctors and NPs often diagnose illnesses that your primary hasn’t found yet!

We apply cutting edge medical and nutritional treatments to keep you healthy as you age. Our goal for you is much more than giving you testosterone, it is lasting health. We combat the sickness and symptoms of aging with a foundation of bioidentical hormones (testosterone and estradiol pellets) plus nutrition, weight loss, exercise advice, esthetic procedures and genetic evaluations to determine your health risks and to diagnose cancer early.  We add new novel and effective ways to help our patients live healthier, longer, and more productive lives like the Gallery test for 99 types of cancer that finds cancer before traditional tests can (this test is for those patients who chose to have it and it is an additional fee).

You are Not Just a Number! We are not a practice built on volume.  We learn your history and know who you are when you see us.  We make sure we keep your health history in mind when we make decisions for your treatment!  Our staff is family to the doctors and to each other.  When you enter our office, you will feel special and cared for!

Our results are remarkable!  BioBalance Health receives most of our referrals from existing patients and doctors. Our Patients tell us that they have never had such a complete evaluation of their symptoms and that no other hormonal therapy has made them feel completely well as the treatment they receive in our office.  We are excellent Doctors and Nurse Practitioners who are determined to bring our patients back to health with the latest treatments and the most natural testosterone for both women and men.  We individualize your care because we know that one size medicine doesn’t fit all!  Before you come to our office, we study your medical history and your blood lab results, to create a treatment plan that we adjust during your initial visit based on your needs.

We offer the best Education for Patients available anywhere from Any Anti-aging, Integrative Practice in the US, and possibly the world. Dr Maupin has written 2 books for patients over age 36 that have been distributed in 6 countries, The Secret Female Hormone is for aging women and   Got Testosterone?  is for aging men.  The Secret Female Hormone is the first book about testosterone for women was the first book of its kind published anywhere!  Her book for men received the International Independent Publisher’s Men’s Health Award in 2019. Dr Maupin’s biweekly Health casts and blogs has grown in number to over 650, 20-minute episodes.  found on You tube (www.youtube.com/@BioBalanceHealthcast) and our website, wwwBioBalancehealth.com. Dr Maupin is dedicated to educating her patients and the aging public with REAL information to help them make good decisions to keep them healthy and productive for a very long time. While traditional medicine has continued to concentrate only on the very sick, young, and fertile women and chronic diseases of the young, Dr Maupin fills in the gap providing advice for aging women and men with preventive medicine, hormone replacement, weight management and sexual dysfunction that mainstream medicine ignores!

We offer the most effective weight loss program for our patients, that allows you to buy real food to eat with the help of prescription weight loss medications chosen for your situation! If our patients need help with weight loss after Testosterone Pellets, diet and exercise have been employed, we offer additional appointments with a Nurse Practioner (NP)/ RN team to help you lose the weight you have always wanted to lose.  Our NP/RNs chose the right medication for you and monitor your weight loss with our body composition machine, In Body® to help you see the fat you are losing.

We combine “fat-loss” treatments with muscle preservation with testosterone pellets. Preserving Muscle mass is critical to stimulating the metabolism and to anti-aging progress. As you reach your weight loss goal, BioBalance® offers esthetic body sculpting treatments, when you have lost enough weight to shape your body without pain or lost time at work.  We acquired the most effective body sculpting EM Sculpt machine to sculpt your body with increased muscle, fat loss and tighter skin; EMsella for treating urinary incontinence and EM face for a non-surgical face lift.

We review your Medical History, Symptoms and Lab before making an appointment for you, to determine if you need our treatment. We realize that you don’t want to pay for something you don’t need, so we review your medical history and blood work before you pay us anything or waste your time on an appointment that doesn’t lead to treatment.  If we cannot treat your particular medical problem, we will give you your lab test results to take to your PCP and you will not have paid anything.  We only make an appointment for you if we believe we can help treat your symptoms, medical problems and/or help you lose weight if needed. Unlike any other practice we offer hour-long consultations with our doctors for your first, follow up, and problem consultations.

Dr Maupin has created a medical practice dedicated to truly bringing her patients back to health: sexually, metabolically, nutritionally, and to help them look as good as they feel with her Esthetic practice, BioBalance® Skin. BioBalance Heath is the fourth medical practice Dr Maupin created/managed over more than 38 years of practicing medicine. Bio Balance Health® is the culmination of all she learned from organizing the three OBGYN practices. She decided that the only way to be the best doctor she could be was to surround herself with the most intelligent Doctors, Nurses and Nurse Practitioners, the most skilled staff possible and to treat them and pay them well, like family. Through her experience, combined with Dr Sullivan’s business training and Family medicine background, she has created what she views as the finest type of preventive, hormonal medical practice.

We want our patients to feel healthy, and to be productive as long as they live! Dr Maupin, Dr Sullivan, their husbands, and Dr Sullivans in-laws are all BioBalance® patients. Bio Balance® knows that the health we have as we age is primarily due to replacement and management of our hormones, nutrition, exercise and attaining ideal weight. Her plan behind the scenes is to create a medical practice that patients enjoy coming to, where staff is happy and well paid, and where doctors and NPs are encouraged to treat patients with cutting edge medical care for the benefit of their patients. Twenty-one years later, her dream is a reality and there is no other medical practice like it!

You only pay for what you get! Your cost is based on what you receive, not on a large yearly fee that some other practices require. We are a cash practice because insurance companies don’t pay for preventive medicine or bio-identical hormone replacement for women. They also generally won’t pay for weight loss. For the services they do pay for we understand that many of our patients pay for insurance, and we try to use it when we can. Most of our prescriptions and labs we order are covered by health insurance directly. we will give you copies of your invoice to submit for your reimbursement from your insurance if your insurance allows. If you don’t have insurance or have a high deductible, we will pass along the discount the lab companies give us, so your lab cost will be much lower than if you paid them directly!

We live by the belief that we can offer medical treatment to our patients based on what we would want if we were the patient:

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

BioBalance® Health uses other forms of measurement to determine body composition, and to diagnose healthy weight, versus overweight and obesity. BMI is a calculation of healthy weight, overweight, and obesity using just two parameters: Height and Weight. The US government endorses and uses this measurement in many ways to manage citizens, categorize them and even pay their salaries.  The AMA has been using this as a measurement of body health for decades. As of July 2023, the AMA is rejecting this measurement of health and illness. Calculate your BMI

Go to https://www.calculator.net/bmi-calculator.html and you can calculate your own BMI. Below is a chart that many types of companies and people use as a reliable measurement to use for many purposes.  Below is the NIH explanation of BMI.  You can find your BMI and corollate it with how lean your body is. The Body Mass Index (BMI) Calculator can be used to calculate BMI value and corresponding weight status while taking age into consideration. Use the “Metric Units” tab for the International System of Units or the “Other Units” tab to convert units into either US or metric units. Note that the calculator also computes the Ponderal Index in addition to BMI, both of which are discussed below in detail.

BMI introduction

BMI is a measurement of a person’s leanness or corpulence based on their height and weight and is intended to quantify tissue mass. It is widely used as a general indicator of whether a person has a healthy body weight for their height. Specifically, the value obtained from the calculation of BMI is used to categorize whether a person is underweight, normal weight, overweight, or obese depending on what range the value falls between. These ranges of BMI vary based on factors such as region and age and are sometimes further divided into subcategories such as severely underweight or very severely obese. Being overweight or underweight can have significant health effects, so while BMI is an imperfect measure of healthy body weight, it is a useful indicator of whether any additional testing or action is required. Refer to the table below to see the different categories based on BMI that are used by the calculator.

Nurses have understood the fallacy of using BMI to judge whether a patient is overweight or not for decades, but the AMA and medical specialty societies have defended its use for as long as I have been in medical practice.  However, BMI is a crude way to evaluate patients for obesity and we use a more accurate measure, a true body composition from an InBody® machine to determine exactly how much fat, muscle, and water our patients are made of and if they need to lose fat for their health. This true measurement of body composition gives us an accurate measurement of your percent body fat, weight of your muscle and your visceral fat (belly fat) measurement. You may say, “so what?”, but I’ll give you a few examples of how BMI is an INACCURATE measurement to follow for healthcare and for insurance, and other agencies that require employees to be a certain weight for their height.

In my practice I take care of two men whose height is exactly the same, 5-10 (70 inches), both weigh 200 lbs., and they both have a BMI of 28.69 which is considered overweight (normal is < 25). However, the two men are very different in their body compositions and therefore their health risks:  Man number one has very little muscle and 30% body fat and is overweight and therefore is at risk for diseases that accompany obesity, high blood pressure, diabetes and heart disease.  Man number two has a very muscular build with heavy bones and has a body fat of 19% and looks lean and is healthy and is not at risk for hypertension, heart disease and diabetes. The BMI makes them the same, and therefore their doctors and employers consider them the same for insurance, treatment of their illnesses and categorization in medical studies that determine the qualities that put patients at risk for diseases.  Therefore, BMI is a very bad measurement to judge whether a person is at risk for diseases of obesity. The medical industry is big and slow, and this measurement will not be replaced with something else in the near future, however this gives you a basis for challenging the measurement as a basis for promotion, or a reason to deny you insurance or charge you more for insurance.

 At Bio balance® Health we have used % body fat and abdominal visceral fat determined by a body composition machine (InBody) as our only measurements to determine future risk, and to determine whether someone requires weight loss treatment or not. BMI is very unfair to those people who are required to maintain a healthy weight for their jobs.  Those men and women who are in the armed forces cannot be promoted in rank unless they have a BMI of 25 or less, however the training that is required and the strength and stamina to be in the active military means that they must work out and exercise to build muscle, which then disqualifies them from promotion because it causes them to gain weight, but healthy weight. Using the BMI as a measurement, can cause a person to be disqualified for promotion because they are well muscled!

Not only the US military discriminates against people with high BMI due to high percentage of muscle mass, the life insurance and health insurance industry does as well! A person is labeled obese and therefore “high risk” for illness and death just because they have a high percentage of muscle mass which is healthy, and not a risk. This makes some fit people uninsurable or increases what their life and health insurance costs.

The worst discrimination by BMI discriminates against genetically highly muscled groups of people. The BMI was created using white males and white females making them the standard, however some genetic groups from African, Hispanics, Italians and other groups of people from Mediterranean and middle eastern heritage are discriminated against because they have a higher percentage of muscle and bone mass normally, compared with Caucasians, eastern Indians, and Asians, therefore using the BMI causes these groups to look “fatter” when they are really more muscled with thicker bones, which is healthier, not a higher risk for illness.

Obviously, people with high muscle mass can still be obese, but it should not be determined by height and weight alone. This decision by the AMA has been a long time coming, and the number of people who have been harmed by this method of determining obesity is incalculable. BMI is just a measurement based on height and weight.  For some average height and weight people, it is an accurate evaluation of normal body weight vs obesity. However, most people have various degrees of muscle mass, and it is the amount of muscle mass that skews the BMI measurement and judges some people as “obese” when they are at a healthy weight, and others are considered normal weight and composition even when they have a high body fat content and very little muscle.

AMA urges physicians to rethink use of BMI calculation

The American Medical Association voted this week to recommend that physicians not rely solely on body mass index as a way to evaluate whether a person is at a healthy weight, as there may be biases and inaccuracies inherent in the method. The AMA recommended that physicians also take into account visceral fat, body adiposity index, metabolic and genetic factors, and fat, bone and muscle percentage. Dr. Scott Hagan of the University of Washington termed BMI “a very poor measure of general health,” adding, “Someone with an elevated BMI may be perfectly healthy.” Full Story: The New York Times (6/15)

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Every physician and every overweight patient have struggled with achieving effective weight loss that was effective for most people, until now!  Almost simultaneously 6 weight loss drugs hit the market approved by the FDA for different uses.  The only drug approved for just weight loss is called Wegovy, a once-a-week injection that causes loss of appetite as well as a feeling of fullness when only a fraction of volume of an American meal is eaten.  It also works by limiting the hormone glucagon that dumps stored blood sugar into the blood when blood sugar levels get low, and it decreases the craving that many overweight patients complain of. The majority of overweight people have been eating a high carbohydrate diet filled with sugared soda, bread, pasta, cereals, candy, cake, cookies, chips, crackers etc.  This is the average American diet, and it is killing us!

Years of eating this diet has made us fat and insulin resistant, as well as malnourished. Humans need food for fuel, and we have made it into entertainment! We need a varied diet of proteins, fats, and carbs. Our genetics dictates how much of each group we need; however, the one size fits all mentality of the FDA and the US government has led citizens to believe that cereal and bread is the basis for diet because America grows grain and sells it to our citizens…it is a diet based on GNP not our metabolism. Simply said this has left most children and adults obese and fatigued because they are not getting the right nutrition from their food intake.  Now we have to work backward, and the insurers of this country will not pay for the drugs we need to reverse the process.

The drugs above are all variations of the generic name Semaglutide.  The only drug that is different is Mounjaro or Tirzepide. It is more effective for treatment of diabetes and obesity, however Ozempic and the only oral version, Rybelsus, are also effective for both Diabetes and weight loss.  We generally prescribe Wegovy for weight loss without diabetes, and we can try to get it approved by insurance for weight loss. However, this is generally not approved.

The requirements for insurance to pay for these drugs for weight loss includes:

BMI over 30 Two other illnesses that are associated with being overweight, eg hypertension, heart disease, prediabetes.

Even with these requirements fulfilled they usually don’t pay for it!  The price is $ 1,500 for one month!  Three months is around $4,500.  This is prohibitive for everyone.

To solve this access problem, Dr Sullivan has contacted several compounding pharmacies who will make the drug for weekly self-injection at a much lower price!  The price is $540 for 3 months compared to $4,500. We have been recommending this avenue when we cannot get the drug paid for.  The only difference is that patients must draw up the small amount of semaglutide in an insulin syringe and inject themselves with a needle instead of a “pen”.

This is the way we have been accessing this medication for our patients and we have seen unbelievable results!  People who could never lose weight are losing and very obese patients who did not have the staying power to continue dieting to get appreciable weight loss are now approaching ideal weight.

The only people who cannot take this medication are those with a history of a specific type of thyroid cancer or a disease of the endocrine system called MEN II.  You know it if you have one of these rare problems. Others love to eat so much that limiting their intake is a problem for them.

Special Cases: Those people who genetically are “never full”, or “always hungry”, this is the drug for them to make them feel full for the first time in their life…..  Obesity from never feeling full or always hungry is genetic.

Dr. Maupin:

“I never understood those kids and adults who had to eat 24-seven or who could eat 2-3 plates of dinner. .I just had never walked in their shoes until I was pregnant…At that time in my life being 118 lbs and 5-3  when I got pregnant I never could catch up by eating enough calories to feed both of us. I felt full at the beginning of a meal but was always hungry, so I had to eat every 30 or 40 minutes.  I was hungry all the time!  It literally ruled my life, and it made me think about food all the time.  I felt like I was in a prison of low blood sugar restricting my activities. NOW I understand how terrible a genetic albatross having the “never full” or “always hungry” is! Except for pregnancy, I know that inherited genetics make some people always hungry, and others never feel full, and my heart goes out to them.  These GLP-1 drugs work well for people with these genes. PS.  I was thrilled to deliver my daughter, and it was both the happiest day of my life to see our beautiful baby, but I was also so relieved not to be hungry anymore!”

If you have this genetic issue, then this classification of drug is for you! You will be able to get to ideal weight and you will have to stay on a maintenance dose to keep your weight at ta healthy level. How do you go off these meds when you have reached your ideal weight? We have our patients decrease their dose per week until they start to be able to eat reasonably. Sometimes we can’t get our patients off the medication completely, but the cost is much lower because a 3-month dose will now last 3-6 months.

We like to team up Testosterone pellets with semaglutide treatment for older women to make sure they don’t lose muscle instead of fat. The T-pellets help patients become lean, and preferentially lose fat, not fat and muscle.

What you can do with the medications to make them work faster, more effectively:

For those of you who have had trouble with your weight or have had trouble losing it and keeping it off, then BioBalance Health Weight Loss program is for you!

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Most women believe that the only reason to start taking estradiol when menopause begins is to decrease hot flashes and night sweats.  But Estradiol replacement is so much more effective and versatile than just stopping hot flashes!  When it comes to the replacement of testosterone for women, most still believe that T is just for men!  If a woman has been reading for the last ten years, she may have picked up the fact that T brings back a sex drive and energy to women over 40, but most of the important benefits of Estradiol and Testosterone replacement are hidden from the majority of women.  Journalists just aren’t interested in us after we are no longer young and fertile, unless of course we are involved with a scandal!  The importance of replacing the hormones that are deficient after age 40, and the unpublished benefits that you can receive with E2, and T are the subject of this Blog.

After the age of 40, after our childbearing years, we experience a multitude of symptoms and changes that when asked, OBGYN doctors shrug their shoulders and tell their patients that these terrible, quality of life “downers” are “just aging” and therefore the don’t address them and won’t treat them!  It seems medicine discriminates against women in mid-life by ignoring their pleas for help dealing with many symptoms of aging.  These common problems are listed below, and I will address each of them in regard to hormonal solutions for these problems. By the way, the replacement of the hormones estradiol and testosterone will treat all of these problems!

As you can see many of the complaints that perimenopausal bring to their doctors can be treated with a single hormone complication! Instead, they are told that these terrible symptoms are just a normal part of aging and that they should just “suck it up”!  I believe that if the American College of OBGYN and the FDA would listen to women over 40 more, and “bless” the use of hormone replacement therapy in all forms, but especially Testosterone and Estradiol Pellets we would create a generation of women who were still productive, happy and without multiple doctors’ visits!  How can the powers that are making the rules be so discriminatory against women! We are more than half of the public….we need help in this area of medicine.

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A month or so ago I had a woman come to me for hormone replacement and one of the symptoms that bothered her the most was Lichen sclerosis on her vulva, the area around her vagina.  The symptoms are itching, burning, intolerance to putting creams and gels on the area, pain on intercourse, and the skin is fragile and breaks open and bleeds with intercourse.

My patient did not come to me to treat this problem, because she had been told by many other doctors that it was not going to get better.  Lichen sclerosis (LS) is an autoimmune disease that affects the vulva and vagina.  I know from reading the research and my 20 years of experience that our treatment with T pellets has decreased the symptoms and sometimes reversed many different autoimmune diseases, however I had not had a patient with lichen sclerosis before so I told her that I was hopeful that her lichen sclerosis would resolve with Testosterone and estradiol pellets.

After 3.5 months when she returned to the office she was grinning and said that she no longer had the LS…her gynecologist said it was a coincidence, because she had not been trained with the use of testosterone for treatment of post-menopausal symptoms, and autoimmune disease.

I had another surprise when I treated a patient who had become agoraphobic when her doctor had told her she couldn’t have any more post-menopausal hormones, even though she had had her ovaries removed 10 years before and before her hormones she had multiple severe symptoms of estradiol and testosterone deficiency. The ERT had resolved her problems but now they all came back more severely…she became depressed and anxious and afraid of leaving her house.  Her son is an Internal Medicine doctor and he called to ask for my help with his mother.  He had tried everything he knew of medically and nothing worked.

Agoraphobia is thought to be a psychiatric condition, but in this patient’s case it was merely a chemical reaction caused by a lack of estradiol and testosterone.  After 4 months of E+T pellets she was planning a trip to New Zealand and her agoraphobia was just a memory!  I had no idea that that condition could be due to menopause and lack of E2 and T. In the end it was clear that hormonal deprivation can cause agoraphobia and replacement can treat it!

I have prescribed T and E2 pellets to treat a different group of diseases, autoimmune diseases, like Lupus, Rheumatoid arthritis, Sarcoidosis, and Grave’s disease of the thyroid. The testosterone pellets are very effective at modulating the immune system and normalizing it, which decreases the severity and symptoms of these diseases.  Even though I know that every person with an autoimmune disease that I have treated with T pellets, has gotten much better the specialists who take care of them won’t admit that it was testosterone pellets that improved their patient’s quality of life.  There is plenty of research on the use of testosterone for autoimmune diseases, but it is not in the journals that Rheumatologists read.  The research is in the Journal of Metabolism and Endocrinology.  

Worse yet, These doctors have learned that “hormones” worsen autoimmune diseases, however the information they are quoting really only refers to  oral estrogen replacement and not non-oral testosterone. This scares their patients from even seeking help for their hormone symptoms, and prevents them from improving their autoimmune diseases with a safer treatment, T and E pellets.

Here are some examples of my patients who have had autoimmune (AI) diseases and have come to me for E and T pellet replacement. Women with autoimmune diseases improve drastically with testosterone pellets! Not only do their symptoms of low testosterone and menopause resolve, but their symptoms of their autoimmune diseases improve!  The old belief that hormones make AI diseases worse springs from the fact that oral estrogen (Premarin) that turns into estrone can decrease a woman’s free T and make her autoimmune symptoms worsen. However. Educated hormone specialists like Dr. Sullivan and me, know how to prevent this and in fact make the symptoms of AI improve.  Here is the key to AI success: We give our patients with AI diseases a lower dose of estradiol in their E2 pellet, and a higher than average dose of T in their testosterone pellets, and we watch our patients get better!

The Rheumatologists can’t stop patting themselves on the back for the improvement in their

patients after I treat them and tell their patients that the hormones should be stopped!  Patients are smart and they know why their symptoms disappeared!  They chuckle at the  arrogance of their rheumatologist.  The Rheumatologists just look ridiculous when they claim a patient’s progress as from their own treatment, when it was really the addition of Estradiol and Testosterone pellets that improved their symptoms. 

Some autoimmune diseases are progressive and very hard to treat in any way. I was quite surprised when T and E2 pellets  halted the progression of lupus blindness and the progression of MS (Multiple Sclerosis)!  It is remarkable and a “surprise result” that I was not told about in my training. One Rheumatologist, who is an acquaintance, told me that he stopped sending patients to me for hormones because they never went back to him!  I count that as success.

There are many other diseases and symptoms that no one associates with Testosterone Deficiency or low Estradiol, that resolve or improve with the re-establishment of hormone balance. These include:

·      Stress urinary incontinence

·      Irritable Bladder

·      Recurrent Bladder infections

·      Interstitial Cystitis

·      Anemia

·      Painful intercourse

·      Arthritis

·      Irritability associated with Menopause

·      Hormonal Migraines

We will discuss these other Unintended Benefits of T and E2 Pellets in Women in our next Healthcast and Blog.  Stay tuned!

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There was  once a Saturday night live skit that featured one of their actors, Eddie Murphy,  teaching how to spell and say Py-ro-man-ia..and every time I see the word sarcopenia, I think of that skit…mostly because it is a word only researchers and doctors use to describe a condition where a person has lost a lot of  skeletal muscle, leaving her or him without enough muscle  to move around normally.

Sarcopenia is considered a side effect of aging….but it is really a condition of low testosterone level in the blood, that occurs with aging and results in disability.  For people over 70, this is what happens, you lose your muscles if you don’t take testosterone replacement, and don’t exercise and eat enough protein.  At any age your muscle is stimulated to grow by your resistance training, daily exercise, and it must be supplied with the building blocks of muscle which is protein from animal products in your diet. However, you can exercise daily and eat the right amount of animal protein and you will still become sarcopenic if you don’t replace your testosterone to a level that is clinically needed as you age. Muscle is only made in people who have enough testosterone.

I am hoping that the next generation of women and men who are 70-year-old now will not be bent over, using walkers, and wheelchairs, and unable to get out of a chair as they age.  With long-acting testosterone pellets, in combination with daily exercise, active daily life and sufficient animal protein to make muscle I am working toward a world where humans aren’t put on the shelf because they can’t physically take care of themselves.

But muscle mass does more for you as you age than just get you from here to there without assistance.  Your muscle mass also is the primary organ in your body that burns 80% of your calories and turns them into energy.  The muscle cell itself is like a generator.  It takes in blood sugar and burns it to make energy for your cell. The trick here is to maintain enough muscle mass to make enough energy and burn your calories!  This takes the three elements above: 1) Young healthy free testosterone blood levels, 2) a diet including a large amount of the proteins needed by your body to make muscle which are found in animal proteins, and 3) exercise!  Every day, many times a day you must be active to keep your body healthy and muscled.

What happens when free testosterone does not stimulate your muscles to make more muscle?

Here is how it works when you are young and have sufficient testosterone and when you replace your deficient testosterone. Every time you move or exercise you use your muscles.  Your muscles make heat and energy for you and for your cells. Testosterone sends blood flow to your muscles to stimulate your muscle cells to take in blood sugar and make energy and heat.  Testosterone does something more; it directs the muscles to regenerate after they are broken down the 24 hours after exercise and are discarded.  The day after exercise, your use your dietary protein to rebuild your muscles.  Without the stimulation of Testosterone to rebuild your muscle mass, your muscles break down as usual, but are not built up again! This leads to a never-ending loss of muscle, leading you to lose muscle mass, bone mass, and your best burner of calories!   The endpoint is a person who is 75, looks frail, can’t walk fast, who has poor balance and falls and breaks bones. Older people who don’t take testosterone also replace their muscle mass with fat, so their weight may go down (loss of muscle with fat replacement causes the waistline measurement to go up and clothing size to go up, but weight may in fact go down from the lack of testosterone stimulating muscle growth. All of this is well known to doctors yet it is hard to explain in a 15-minute office visit. 

Now let’s talk about what is new to our knowledge of muscle tissue and the diseases of aging.

In a research article from 2023, revealed the relationship between muscle mass and diabetes.  Those people who had a high % of muscle for their weight had a lower chance of having insulin resistance and diabetes.  Diabetes increases our risk for heart disease and death and requires many drugs and doctor’s visits and increases the risk of an individual’s early mortality. Think of it like this:

Replacing T to a premenopausal level in women and to a young healthy youthful level in men increases muscle mass, which uses up blood sugar, which in turn decreases the risk of adult-onset diabetes, which decreases your risk of heart disease and early death!

Another study revealed the relationship between muscle mass and early death and found that the more muscle you have the lower your risk of mortality.  You and I know that you can’t have great muscle mass as you age, without testosterone but that was not mentioned.  They just measured muscle mass and correlated it with the chance of death, and they found that the more muscle mass you have the lower your chance of death.

A study done on men only showed that the level of testosterone was associated with thicker cortical bones and estrogen in men decreased the cortical bone strength. Bone must have the tension of muscles to stay thick and healthy, so this indirectly gives us more information about how important weight training and resistance training is to your very life.

What Dr Sullivan and I do every day is assist men and women in curing their negative symptoms of testosterone deficiency as well as protecting them from becoming frail also called Sarcopenic as they age.  It is not enough to get older if you are not functioning well and are able to take care of yourself!

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At BioBalance Health we use the information from a vaginal probe ultrasound, combined with information from your medical history questionnaire, and an extensive fasting blood panel to determine whether an individual woman is a candidate for estradiol and testosterone bioidentical pellets.

We also review the collated information to determine if we need more tests before we see a new patient.

 The ultrasound of the pelvis gives us a visual picture of the ovaries and uterus of a woman. It is necessary to know if a patient is menopausal yet to interpret a new patient’s ultrasound.  We obtain that information from your blood lab and medical history from the patient questionnaire.  All three pieces of information are essential to our treatment plan.

 What can we discover from the vaginal ultrasound?

We are ruling out (making sure a woman doesn’t have these pelvic problems):

Several of these conditions preclude the use of estradiol in any form, some require a visit to your gynecologist for treatment before we add estradiol to your hormones and some of these conditions increase the risk of side effects.

1.    Endometrial Cancer

2.    Endometrial hyperplasia

3.    Endometrial polyps

4.    Fibroids

5.    Ovarian cancer

6.    Ovarian cysts

7.    PCO

 **We use the vaginal ultrasound to determine the risk of bleeding on HRT.

 ***For the first 3 uterine pathologies listed above we look at the measurement of  the Endometrial Thickness (ET), or finding an endometrial polyp necessitates  a visit to her GYN for evaluation, and most probably an endometrial biopsy or D&C. This pathologic test will rule in or out Endometrial cancer, endometrial hyperplasia.

The other diagnoses are determined by looking at the uterine size, contour, whether there are uterine fibroids, and looking at the ovaries for cysts or masses and the presence or absence of fluid in the cul-de-sac (area behind the uterus).

 Why would we order a Vaginal Probe US for our hormone pellet patients after the first visit, while they are taking estradiol?

 1.    Uterine bleeding is nonresponsive to treatment

2.    Uterine size is getting larger (patient complains of pain or pressure)

3.    High risk patients with recurrent uterine bleeding

4.    To follow the growth of fibroids

5.    To check the ovaries in patients who have a Family History of ovarian cancer (generally we have the patient’s GYN follow this).

6.    To follow a benign looking cyst seen on the first US for growth.

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At Biobalance® Health we often find cysts or masses on the ovaries of women who are menopausal quite by accident.  We order an ultrasound before we treat a menopausal woman with estradiol to see if there is a thickened lining that might cause bleeding under the influence of estrogen replacement, or to make sure there is no uterine cancer before we treat a new patient. 

We also incidentally find ovarian masses or cysts when we are investigating pelvic pain or postmenopausal bleeding on our patients who are already on estrogen replacement.  In general, since BioBalance’s female patients have their own GYN we don’t do pelvic exams in the office, therefore we don’t find a mass by palpating (feeling) the pelvic structures, however ovarian cysts and masses can be found by ultrasound as well as by physical exam.  We generally find ours by vaginal ultrasound.

Why do we get ovarian cysts?

Before menopause we make an egg every month (if we are not on birth control) that grows within a fluid filled sack. This egg will grow to about 18 mm, or 1.8 cm before it ruptures and releases the egg.  That is the miracle of ovulation.  It is normal to see one or two of these small cysts on the ovaries of ovulating, fertile women. These small sacks are not cysts because of their size. 

Ovarian cysts are fluid filled sacks attached to the ovary that are over 2.5 cm. They often occur secondary to a trapped egg that won’t ovulate for some reason, and the cyst will remain until the next period.  If the cyst doesn’t dissolve before the next cycle, it can grow larger with the surges of hormones and it can prevent future ovulation, or it can cause pain from the stretching of the outer covering of the ovary. If a cyst is less than 2.5 mg. we don’t re-ultrasound in cycling women.   If it is larger or continues to cause pain, we follow up an ultrasound in 6 weeks to see if it is growing.  If it is growing but is still clear, depending on the size and the pain involved, we might do a laparoscopy to remove the cyst from the ovary.  If it is growing and looks unusual in shape or density, we order 2 blood tumor markers for ovarian cancer.  If those are negative, we follow up with another ultrasound in 3 more months.

In some patients, multiple ovarian cysts are the norm.  Those patients with polycystic ovaries create multiple cysts each month and rarely ovulate.  It helps to use the drug Metformin ER to improve ovulation in PCO patients (and the rupture of cysts).  Some patients require laparoscopy to punch holes in all the cysts especially if she is trying to get pregnant.

What does a postmenopausal ovarian mass or cyst mean indicate?

Now for postmenopausal patient’s ovarian cysts and masses are much more worrisome but much rarer. Because the ovary is not metabolically active, and therefore not ovulating the menopausal ovary should look small without cystic structures, however there are some exceptions!  The menopausal ovary that has a fluid filled cyst 2.5 cm or less can have been there since the patient stopped ovulating and it never deflated, or ovulated.  This type of cyst doesn’t grow and is not malignant.

Ovarian cysts in postmenopausal women that are fluid filled and larger than 2.5 cm, or solid, or partially fluid filled and partially solid are suspicious for malignancy. In this case your doctor may order an MRI, a CT scan of the pelvis, and order cancer tumor markers.  In most cases these masses are benign, or early in a malignancy and can be treated with surgery.  Sometimes we find a suspicious mass that needs confirmatory ultrasound or MRI by a GYN Oncologist, tumor markers, and surgery would be scheduled to take the uterus tubes and ovaries and sometimes the omentum and lymph nodes.

When will a patient know that her mass if not malignant and if she needs surgery?

The surgeon may do a frozen section in the operating room to see if more than the ovary itself must be removed or your GYN may wait for the final pathology report to determine if it is malignant. That takes several days to a week.

How common is ovarian cancer?

Ovarian cancer is very rare and tends to run in families.  If you have not had a relative with ovarian cancer, then you are not likely to have ovarian cancer if you have a suspicious mass. That does not mean you won’t’ need surgery, it just means the outcome has a high chance of being benign.

What can be mistaken for an ovarian mass on ultrasound?

There are several pelvic structures that might be confused with an ovarian cyst/mass. The most common is a pedunculated fibroid that hangs down from the uterus and looks like it is coming from the ovary. These muscle masses from the ovary are generally benign, but they can grow under the influence of estrogens.  There are cysts called para-ovarian cysts that can originate from the fallopian tube.  They are fluid filled and can actually grow, looking like an ovarian mass, but they are benign, and most are sedentary and don’t grow or become a problem. In my 25 years of operating on women I only had one of the next types of cysts that was thought to be a malignancy at first. It was a very large cyst, 12x 12 inches in diameter and I asked a general surgeon to come in and work with me to help with the surgery if it was a malignancy.  In the end, it was a cyst in the retroperitoneal space, called a peritoneal cyst, that was totally benign, and the patient did not require any further treatment after the surgery.

Postmenopausal women who have had an ovarian cyst or ovarian mass you know that it can be an anxiety producing situation, however the great majority of the simple ovarian cysts in postmenopausal women are benign and surgery is not necessary.  Most ovarian cysts are likely to remain unchanged or disappear during the follow-up period. The malignancy rate of these cysts is about 1 in 10,000, so worry is usually unnecessary.  In my 25 years of private practice, I only operated on 5 patients with an ovarian cyst or mass that turned out to be malignant.

As gynecologic surgeons we are trained to investigate any ovarian cysts that are suspicious through ultrasound, or surgically even if there is a very slight chance that they might be malignant. We are expected to remove any ovary that is suspected to be cancer, even if the chance is minimal that the cyst is malignant. In our practice we send all our patients with suspicious ovarian masses to their gynecologist for evaluation and treatment.

American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology. Practice Bulletin No. 174: evaluation and management of adnexal masses. Obstet Gynecol 2016;128:e210–e226. doi: 10.1097/AOG.0000000000001768

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I learned about electrolytes in medical school as the substances Sodium, Chloride, Potassium, Calcium, Magnesium, and Phosphate we check on a metabolic panel. However, electrolytes are much more than values on a blood test. These minerals are some of the most vital substances needed to keep us alive.  Electrolytes can get out of balance in normal daily life and put us at risk of illness and death if we do not replenish them orally along with rehydration with water.   Our kidneys and hormones manage electrolyte concentrations as our intake of these substances in our food and drinks replenish electrolytes that are lost in urine, sweat, and bowel movements.  We are not conscious of the bodily mechanisms that manage our water balance, urination, keep our blood pressure normal and supply our brain with these vital nutrients to maintain consciousness, and we become symptomatic only when we are severely deprived of them.

In my medical training, I also learned about how illnesses, and medications affect the amount of each electrolyte in our body however what I didn’t learn was how important it is for healthy people who exercise in the heat to replace their electrolytes.  You don’t have to be an NFL football player or play in the NBA to require electrolytes when you exercise. With inadequate electrolytes you can become weak, and confused, lose muscle strength, faint or completely lose consciousness when you are working or playing games in the heat, even if you are drinking water! 

To make my point I’ll relay a personal experience that you may have experienced as well, while playing a game outside in the heat.  I don’t play much golf, but I do play in charity golf tournaments.  They are generally timed at the height of the summer heat, and they take almost twice as long as a usual round of golf.  This scenario sets all the players up for dehydration and a deficiency of electrolytes.  For several years in a row, I noticed that I was well hydrated for about 3 hours by drinking 3 or more bottles of water while I played the first 9 holes. By the 10th hole I was becoming physically weak and mentally slow. I felt I should be ok because I was drinking water and staying hydrated.  However, I felt like I was playing golf in Jell-O.  I continued to drink water because I thought I was dry, and that is what I thought was wrong with me.  Not so…instead of feeling refreshed by drinking endless water, I got worse.  Two years in a row I didn’t finish the 18 holes. 

What had I done wrong? I started using my diagnostic brain to figure out what I was missing.  Was I sick or was there something wrong with my metabolism?  While I was watching a pre-season football, I noticed the Gatorade that the players were guzzling. I had never tried Gatorade because of the amount of sugar in that drink.  I pulled up the contents of Gatorade and found that not only did it rehydrate the hot and sweaty players with water and sugar, but it contained all the electrolytes that players lose when they sweat and exercise in the heat!  Bingo!  I bet that was what I needed to finish the golf tournament….electrolytes! 

It turns out that I had been half right by continuing to drink water, however the more water you drink while you are exercising the more your electrolytes are diluted!  It is not a reason to hold off drinking water, because dehydration can damage your kidneys and you can get heat stroke, however adding electrolytes is vital to surviving exercise in the heat.  The following year I armed myself with many bottles of water and plenty of electrolytes in the form of NUUN.  To every third bottle of water, I added NUUN electrolytes tablet…voila!  I could play 18 holes in hot weather and sweat for 5 hours without fainting, or losing muscle strength, and quitting!

So how do you know when you are getting dehydrated and low on electrolytes?  You pay attention to your symptoms! Like everything else, the symptoms of electrolyte deficiency is somewhat individual.  The possible symptoms of electrolyte imbalance, either high or low electrolytes are listed below:

·      Dry mouth and thirsty

·      Restlessness

·      Mental Confusion

·      Weakness-overall

·      Inability to stand up

·      Muscle weakness

·      muscle spasms

·      Fatigue

·      Heart palpitations

·      Constipation

·      Nausea or vomiting

·      Diarrhea

·      Slow or irregular heart rate

·      Low blood pressure

·      Headache

·      Difficulty breathing

·      Low or high blood pressure

·      Fainting (Syncope)

Remember I’m talking about electrolyte imbalance that is associated with sweating, exercise, diarrhea, drinking a lot of water without electrolytes while exercising, but the same symptoms can come from food poisoning and the severe fluid losses that accompany diarrhea and vomiting. 

I am not talking about electrolyte imbalance that can be a specifically related to chronic medical illnesses, medical treatments and medications. These imbalances are specific to a particular 

electrolyte loss and are not treated with global oral electrolyte replacement, and requires an ER or Urgent Care for rehydration.

You may not think you need electrolytes but if you take diuretics, or if you go outside in the summer and perspire for long periods of time, you are at risk of losing your electrolytes no matter what your age, however, you become more likely to have this problem as you get older.

By the way, one of the most dangerous factors in electrolyte deficiency is alcohol consumption!  Drinking alcohol uses up your magnesium and sodium, so if you drink while playing golf on a hot day, you are at high risk of having dangerous electrolyte deficiencies that can end in seizures and death!

Treatment for severe dehydration, and or lack of electrolytes is IV fluids with electrolytes in the ER.  IVs with normal saline plus electrolytes will effectively treat dehydration from vomiting and diarrhea as well as from heat related dehydration, low electrolytes. 

I don’t own any stock in NUUN or Gatorade, and my go-to prevention would be to add electrolytes NUUN SPORT to every 3rd large bottle of water while actively exercising in the heat, or drink Gatorade instead of plain water every 3-4 bottles of water. Gatorade comes in G0 which is without sugar, or G2 has a much lower sugar content. People without diabetes who are actively exercising can drink some sugar while they are exercising, and it does help muscles to function when they are stressed. Those with Insulin resistance or diabetes should use Nuun, Gatorade zero or G2.

As I say all the time—prevention is the best treatment! Be prepared …. with an electrolyte containing treatment to take BEFORE you feel dizzy or weak!

·      Drink plenty of water while exercising, especially exercising in the heat, or spending hours in the sun

·      Every so often drink something with electrolytes in it (NUUN-Sport or Gatorade products)

·      When you start to feel weak, dizzy, muscle fatigue, Stop exercising, rehydrate, and consume salty products if you don’t have electrolytes with you, and lie down in a cool place.

·      If you have symptoms of severe dehydration, muscle cramps, you stop sweating, and have changes in your ability to think, you should call an ambulance or go to the Urgent care or the ER for IV rehydration and balance electrolytes right away. Do Not drive yourself!

·      This condition can be life threatening!

Just a little personal story: My husband (age 71 and I was 67) and our best friends (71 and 60) went to Cinqua Terra in northern Italy to take a famous hike between two of the towns perched high on the cliffs above the Mediterranean between Monterosa and Vernazza.  It is beautiful walk and we had been looking forward to it.  We were told it was 3.5 miles so we packed 2 large bottles of water each, I took NUUN electrolytes with me just in case, however we thought we would be hiking early in the morning. Then multiple roadblocks occurred to our plan—the ferry we were supposed to take was not running that day, and it took us 2.5 hours to get to the starting point of the hike. We started hiking at 10:30 am and the day was in the high 70s, and we were hiking in the hottest time of day.  We were already behind the 8 ball, but we didn’t recognize it, and we had had a very early breakfast, so low blood sugar played a part as well.

Our plan was to be finished well before lunch time.  You can imagine the rest…we are all great at sweating, especially my husband.  John is 6-4 and 240 so his body required more water and electrolytes than the rest of us with normal body indexes.  It took us more than 3.5 hours and it was hot and we were going up and down thousands of stairs made for donkeys..they were very high!

You can imagine the rest…we’d finished almost all our water by the halfway mark, and there is no place to get off the trail, or to get help. My husband began to feel weak and developed a headache, and dizziness.  He was sweating profusely and couldn’t continue after 2/3 of the trail.

I had 1/3 of a bottle of water left and put a whole NUUN tablet in it (which he said tasted nasty)..but he drank it and laid down in the shade for 30 minutes.  He rallied enough to get him to Vernazza, but there is no ER there, so he got cool by soaking in the ocean and recovered with water and more NUUN.  I was monitoring him, checking his pulse that was thready, and his breathing. 

I am not sure what would happen if We hadn’t had water and NUUN.

Protect yourself and your family with being prepared for summer exercise.

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BioBalance Health® pellets are very safe and not painful to have inserted. They are also the easiest form of hormone replacement a woman can have because the dose is adapted every 4 months and our patients only have to think about their hormones three times a year.

BioBalance Pellet therapy is associated with fewer side effects than any other hormone replacement, and we have a 95% success rate for resolving the symptoms of menopause and testosterone loss. Women’s lives are drastically impaired at menopause.  BioBalance, and T pellets improve their quality of life to the level of quality they had before they were 40.

Dosage and pellet side effects are specific to the individual and it may take us a few pellet insertions and blood tests to get the ideal result. Finding your perfect fit is like having a custom suit made: hormone balance requires patience and several fittings, before we determine your maintenance dose, which will direct your dose of E/T for follow up pellet insertions.

We give a handout to each patient when she checks out after her first pellet insertion. We ask patients to follow the instructions given to them verbally and in writing in our office.

Risks of pellet insertion procedure, risk of taking estradiol and risk of taking testosterone are rare, but patients are given this handout, so they know what to expect.  These same risks are on their consent that they read and sign before they even come to the office the first time.

Here are the most important instructions for immediate care of the insertion site:

·      Take the pressure dressing off in 3 HOURS

·      Take the steri-strip off in 3 DAYS

·      Don’t traumatize your incisional area

·      If you are allergic to tape please tell us

·      For three days don’t submerge in water—hot tubs, bathtubs, the lake, a stream, or the ocean.

·      For three days don’t exercise

·      Don’t take oral or IV steroids if it is not life-threatening

Please tell us if you are on steroids or take blood thinners so we can alter our treatment plan.

The risks of the pellet insertion procedure include:

·      Infection

·      Bleeding,

·      Bruising

·      Allergic reactions

·      Swelling

·      Pain

·      Reaction to the lidocaine with epinephrine :shakiness and anxiety, lasts a short period of time, and is not permanent.  Tell us if you have this side effect, and we will use lidocaine without epinephrine the next insertion.

·      Keloid scarring

As is usual for medicine , individual patients have a higher risk based on their medical history. Patients who are at higher risk for complications secondary to the pellet insertion procedure in patients who are:

·      Diabetic

·      Have an autoimmune disease

·      Take steroids

·      Have a clotting/bleeding disorder

·      Keloid former

·      If you have many allergies

·      If you have orthopedic implants that require antibiotics at the dentist, then you should tell us so we can give you antibiotics.

Risks of taking testosterone pellets with BioBalance Health® in the first few weeks or months and are transient. These side effects usually resolve on their own without treatment.

 The transient risks of testosterone treatment include:

·      Over the top sex drive=Hypersexuality

·      Vaginal itching from increased blood flow—it is not an infection

·      Facial hair and acne (Prevented with Spironolactone preventive treatment)

·      Weight gain from muscle mass and sometimes from conversion of testosterone into estrone which is a genetic risk.

·      Increased muscle mass that is confused with weight gain.

·      Lowered voice is only a problem when you are a singer.  Generally, those who think they have a lowered voice really have reflux and it has nothing to do with testosterone pellets.

·      Clitoral enlargement—this is a reaction to a new testosterone exposure, and generally will go away in the following few months.

·      Thinning of hair at the temples and crown (Prevented with Spironolactone preventive treatment)

Women can take testosterone without estrogen before menopause, and after menopause if requested, however the symptoms of menopause will not be completely resolved with testosterone only pellets.

The risks of estradiol pellets are higher for patients with a uterus, than those women who have had a hysterectomy.

Those women with a uterus have the following risks:

• Uterine bleeding, growth of fibroids: Estradiol of any kind - pellets, pills, patches etc. - can stimulate the uterus to bleed. This can come from a thick lining, adenomyosis (spongy uterus), or fibroids. Prescribing progesterone, optimally sub-lingual progesterone or BLA progesterone from Belmar pharmacy, taken 1-2 times a day, counteracts this. Other treatments are surgical and offered by your Gyn. Your doctor will evaluate you for treatments: uterine wall ablation (80% effective), or a Mirena IUD. Sometimes bleeding will necessitate the choice between a hysterectomy and contin

Risks of estradiol pellets for women with and without a uterus:

·      Vaginal discharge: Estradiol increases the moisture in your vagina. This is a gift to some and a curse to others. This wetness is not an infection, but a normal response of the vagina to estradiol. It needs no treatment, but if it bothers you, then the choice might be that you might have to stop getting estradiol of any kind, or just put up with the wetness, or decrease the estradiol dose with the next insertion.

·       Bloating: This is sometimes caused by too high a dose of estradiol for a particular person, or the conversion of estradiol into estrone, which causes water weight gain. Some women need progesterone to balance the estradiol, to treat bloating. Others require a diuretic, or a low carb diet, thyroid medication, DIM supplementation or more exercise. Most of the time this symptom will resolve itself in a few weeks after it starts, as the body balances itself out. Bloating has many non-hormonal causes as well.

·      Anxiety/Depression: Most women’s anxiety decreases as estradiol levels rise, but others feel irritable, and for this occurs only in a small subset of the population. For those patients we add progesterone SL (Sublingual tablets) to their regimen, and they improve. Think about whether you stopped your antidepressant when you started pellets. This is a premature move and can cause women to emotionally crash. Please continue your anti-anxiety medications, or your anti-depressants until 4-6 months has passed, and have the prescribing doctor help you wean off.

·       Breast tenderness: This symptom is usually from a hormone called estrone, and not estradiol, but breasts that have not been exposed to estradiol for years sometimes hurt as they “wake-up”. This is generally limited to a month during the first pellet cycle. The product DIM can alleviate this symptom. Remember that stimulation of the breast can also cause them to swell and hurt! In rare patients, progesterone can cause breast tenderness.

·      Weight Gain: Weight gain occurs for many reasons especially over the Holidays. Other times water weight gain can come from Estradiol. This water weight is self-limited and sometimes requires progesterone balancing, a diuretic, or thyroid replacement, increase of protein and decrease of carbohydrates and alcohol. • Migraine headaches: Estradiol in high levels that increase and decrease drastically destabilize the neurotransmitters and can instigate a migraine headache. Pellets increase very slowly, and decrease very slowly, so either your headache is a tension headache and not a migraine, or has a trigger other than estradiol, such as stress, weather change, or food allergies. Migraines generally improve on Estradiol and Testosterone pellets.

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The most common cause of hysterectomy in women are benign masses that grow within the uterine wall. They occur in 4 out of 5 women, and they can be small and asymptomatic, or they can grow large and cause pain, uterine bleeding, pelvic pressure, urinary incontinence and pregnancy complications.

Uterine Fibroids are “the most common tumor in women world-wide”.

Although benign, uterine fibroids are associated with significant morbidity; they are the primary indication for hysterectomy, and a major source of gynecologic and reproductive dysfunction, ranging from menorrhagia and pelvic pain to infertility, recurrent miscarriage, and preterm labor.

Fibroids are also referred to as “leiomyomas”, “myomas”, “fibroid tumors”, and sometimes slangily referred to as “fireballs”.  They are in fact “ball-like” in shape and when we inspect them at hysterectomy, they are made up of swirling muscle cells that are laid down in concentric circles. 

Gynecologists find fibroids when we examine a patient at their yearly visit by feeling an enlarged irregular uterus.  The fibroids are within the wall of the uterus and often cause heavy uterine bleeding.  Where the fibroids are, within the wall of the uterus, determines whether they are more likely to cause bleeding or not.  Placement up against the uterine cavity (“submucosal”) increases risk of bleeding, and placement in the middle and surface of the uterine wall (“subserosal”) decreases risk of severe bleeding.

At BioBalance Health LLC we require every patient who comes to us who still has a uterus to have a formal abdominal and vaginal ultrasound to diagnose fibroids and other uterine abnormalities,  before we will give them estradiol pellets.  Testosterone doesn’t have a negative effect on fibroids so we can still put a woman on testosterone with fibroids. Otherwise, we have the risk of fibroid growth in our consents, and we discuss this issue when a patient’s ultrasound shows significant fibroids.

What causes a woman to be more likely to have fibroids during her reproductive years?

Triggers for Fibroid Development

·      Race

·      Genetics/ family history

·      Diet

·      Early Age at First Period

·      Toxins in the environment especially in early life

·      Obesity

·      Advancing age

·      Vitamin D deficiency

·      Hypertension

·      Pregnancy suppresses the growth of fibroids

 Race: Both Black and Hispanic women are the most likely to develop fibroids and experience enough symptoms to cause the need for a hysterectomy. Black women are 3X as likely as white women to have fibroids, and they are more likely to have very large fibroids. In some circumstances fibroids can prevent pregnancy and cause recurrent miscarriages and preterm labor. 60% of African American women aged 35-49 years reported uterine fibroids, whereas 80% of those aged ≥ 50 have uterine fi-broids.

Genetics/Family History: If a woman has a mother or sister with fibroids, then that woman has twice the risk compared to a woman without a family history of fibroids. “Uterine fibroid-linked mutations in MED12” are the most common mutation we have found, however a mutation in the COMP pathway is also found to be associated with fibroids.

Diet: A diet with high intake of meat, fat and alcohol increases a woman’s risk of developing fibroids.  A diet deficient in fresh fruit and vegetables also increases the risk of fibroid appearance and growth. Smoking is highly associated with fibroid growth.

Early age of Menarche is a risk for developing fibroids, which increases the years a woman is exposed to estrogens.

Toxins from the environment, and from alcohol increases the development of fibroids.  Cleanses might help rid your body of toxins that might methylate your genes and stimulate fibroid growth.

Obesity and Being overweight: Body fat increases the estrone estrogens in the circulation, which stimulates fibroids to grow. 

Advancing age until Menopause: When women enter their late 40s their ovaries decrease ovulation and the uterus is exposed to estrogen without progesterone, which causes fibroids to grow.  After menopause, some fibroids shrink while others stay the same. When women take HRT their fibroids may be stimulated again, however because it is not cyclic, it is less likely to stimulate fibroid growth.

Hormone Replacement Therapy can increase the size of fibroids:

HRT is only one of the factors that causes growth of fibroids in menopausal women.  If estrogen is balanced with progesterone (not progestins) growth is less likely.  Testosterone has no effect on fibroids so replacing testosterone is not a factor for Fibroid growth. At BioBalance we have medicated pellets that combine Testosterone with Anastrazole which suppress the growth of fibroids.  We use these on our patient who have known fibroids, if they are willing to undergo treatment with this

Vitamin D deficiency

The role of Vitamin D in development of fibroids is being researched at this time, however an adequate Vitamin D blood level is needed to help prevent Fibroid growth.

“Approximately 80% of African American women have vitamin D deficiency, compared with only 20% of Caucasian women”. This is one of the factors in Race being a factor in the development of fibroids.

Hypertension

Increased diastolic blood pressure is associated with a higher risk of uterine fibroids, regardless of use of antihypertensive drugs. Women suffering from hypertension are 5 times more likely to develop uterine fibroids.

 Not Having Babies (Low parity)

Having had one or more babies (parity) is protective, and the more babies a woman has the less likely she is to have fibroids

What are the Symptoms of Uterine Fibroids?

Fibroids are benign uterine tumors, so patients are not at risk of dying of cancer, but women with fibroids often have quality of life issues, found in the symptoms listed above, that lead them to the final treatment for fibroids, a hysterectomy (removal of the uterus). So can we prevent these masses from occurring, growing and producing symptoms?

How Do You Know You Have Fibroids?

The growth of fibroids is generally slow and is accompanied by slowly worsening symptoms.

When there are many fibroids, large fibroids or submucosal fibroids patients seek help for their symptoms which include:

·      Heavy uterine bleeding which can be severe leading to anemia

·      Pelvic pain and pressure

·      Large mass effect that puts pressure on the bladder and colon causing dysfunction of those organs like stress incontinence, and constipation.

·      Painful intercourse

·      Multiple Miscarriages

·      Preterm labor

·      Weight gain

What is the Diagnostic Process that Confirms Fibroids

When I was practicing OBGYN, and a women came into my office for a GYN exam and I felt.

The uterus was enlarged and irregular, it triggered me to do three tests to see if it was a fibroid, ovarian mass, pregnancy or other abdominal tumor.  I would first order a rapid pregnancy test. Then I’d order blood work to see if my patient was anemic from heavy bleeding, and If the pregnancy test was negative, then I would order an abdominal and transvaginal ultrasound to get a picture of what I was feeling on exam. If I found a fibroid uterus, then I would have a discussion with my patient to see how severe her symptoms were.  I would also tell her how big the uterus.  The size of a fibroid uterus does matter.  If it is greater than 16 pregnancy week size, it is likely putting undue pressure on the other organs in the abdomen.  The speed of growth is also a factor because if the uterus grew quickly, then it has a tiny chance of being a malignant sarcoma.  The risk of this is < 1%, however fast growth of a fibroid uterus is an indication to do a hysterectomy.

If the uterus is greater than 12 weeks size an ultrasound cannot adequately measure the uterus or reveal the inside of all of it so an MRI of the pelvis and abdomen is in order before surgery.

What Type of Treatment Can Shrink or Remove Symptoms of Fibroids?

The options for control of Fibroid Symptoms with Medications/Supplements include:

·      Progestins or Progesterone without cycling

·      Birth Control Pills

·      Lupron and other drugs in that class (this puts the patient into a temporary menopause).

·      Anastrazole (Arimidex®) which stops the conversion of testosterone into estrone and estradiol.

·      Stop Estrogen replacement, or. Lower the dose of estrogen if you are menopausal.

·      Treatment of inflammation (High CRP)

·      Vitamin D supplementation

·      Probiotics

·      Supplemental vitamins and minerals

These are the first treatments doctors use to lessen the symptoms of fibroids unless bleeding is so severe that it becomes an emergency and then invasive treatments are used.

·      Uterine Artery Embolization is done by a radiologist and puts a “plug” in the fibroid’s blood supply and then slowly the fibroid shrinks and dies. The only problem is that once you have had one fibroid, you can always make more.  This may be a delaying process to allow a patient to make more red blood cells before a definitive surgery.

·      Myomectomy is a procedure done under anesthesia, and it preserves the uterus while removing one or more fibroids.  This procedure makes the uterus more fragile and puts it at risk of uterine rupture if a woman gets pregnant and goes through labor.  Therefore, myomectomies are usually followed by a C-section for delivery to avoid the risks.

This procedure cannot be done on all fibroid uteruses.  The doctor must determine if it is possible to preserve the uterus, since many fibroids invade the whole uterus.

·      Hysterectomy is the one procedure that guarantees that uterine fibroids will not return.

After childbearing is complete a woman doesn’t need her uterus for anything. It is simply there to bear children and does not secrete hormones or provide any other function. A Hysterectomy is done under anesthesia and removes the uterus that contains the fibroids.  If the cervix is not involved with fibroids and there is no history of cervical cancer, a supracervical hysterectomy can be done, preserving the cervix and the nerves that stimulate deep orgasms.

The Newest Research on Fibroids:

Knowing this information should make it easier for you to understand your doctors’ findings and what is ahead of you.  I hope you can understand the risk factors and the possible treatments available to you.

References:

“Comprehensive Review of Uterine Fibroids….”Endocrine Reviews,2021, Vol. 43, No. 4, 678-719

https://doi.org/10.1210/endrev/bnab039

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If you are over 50 you have probably wished that you could have a face lift to bring you back to how you looked in your 20s or 30s. As an owner of a Medical Esthetic Spa named BioBalance Skin®, and because I am 68 myself, I have spent years looking for a facial treatment that would get the results of a surgical face lift, but without the pain, surgery and downtime. Because of the EmFace,  I have finally found what I was looking for so  I bought it!  It is called EM-Face, kin is the first medical spa to offer this treatment that makes facelifts a thing of the past.

The EM Face is not only unique because the results of the EmFace are amazing, but it is also  unique because it isn’t painful, it doesn’t require many treatments (EMFace series is 4-6 treatments, one per week), and does not require anesthesia, there is no down time, no loss of time from work, and you are not at the mercy of a surgeon’s skill to make you look like yourself at a younger age,  instead of a young stranger (think Sharon Stone).

The EmFace treatment is done in our Medical Spa, and each treatment takes 30 minutes.  There is no operating room or anesthesia needed and it takes 4-6 sessions 30-minutes long , painless treatments that you don’t even have to get undressed for!  After your treatment you can go right out in the world without bruising or any sign that you had a face lifting procedure.

How does the EmFace work?  It uses electrical stimulation of the facial muscles to pull your facial skin up toward your temples, and it also tightens the facial skin so it literally makes your skin smooth and removes wrinkles!   Skin tone and muscle tone are improved and wrinkles disappear. …A face lift doesn’t improve your skin tone and it only smooths deep wrinkles.

Leaves no evidence of having a lifting procedure except that over the following 3 months you look progressively younger.   This is an advantage if you don’t want your friends to know that you had anything done to make you look younger.  A face lift is obvious and it is hard to hide the fact that you had a major procedure to regain a youthful looking face.

How long does it last? A Face Lift lasts about 10 years depending on the thickness and tone of your skin, as well as your age when you have the surgery.  EmFace generally requires one maintenance treatment a year to maintain the “lift” indefinitely.

Cost comparison?

EM-face 4 treatments costs around $2,800  and 6 treatments cost $3600 at BioBalance Skin®and that’s it!.

A facelift surgeon can charge t up to $100,000 for his or her services. Then  you have to add the additional costs of the operating room +  the cost of the surgical assistant + supplies and usually  you have to pay for one night in the surgery center.

For a facelift, plan on paying over $150,000 total (assuming you have no complications) vs a total charge of $2,800-$3,600 for an EMSCULPT facelift.  Oh, I forgot to add the value of your time off from your job which can be 3 months after a facelift, before you want be seen  in public.

Why does a face lift prevent you from showing your face right away?

Facelift Surgery on the face involves dissecting the skin away from the muscle and bones of the face, pulling the skin up toward your temples, trimming off extra skin and then closing the incisions with suture. This massive dissection causes a large amount of swelling and bruising, requiring drains placed in your face, for weeks.  This damage lasts a long time and is PAINFUL!

It generally causes patients to remain  housebound until they completely recover, which can be months.

EMFace causes none of these side effects and complications,  so you can go out in public, or back to work right afterwards with a “glow”, and no sign that you had anything more than a facial.

What are the comparable risks?

The risks of a facial surgery of any kind are dramatic…damage to the facial nerve may not be recoverable, making you unable to smile or show expression on one side of your face.  Surgery risks are always numerous and most surgeries include the complications of anesthesia, even death, infection, bruising, non-healing, nerve damage scar formation and facial drooping.

What should I do to prepare for either of these treatments for good results?

To help you make a decision, I have to tell you a little secret about what a facelift doesn’t do.: a facelift doesn’t take the place of getting  filler every 6-12 months; A facelift doesn’t take the place of botox of other neurotoxin. After a face lift you will still need regular skin peels and hydrafacials, exfoliation, and rejuvenation of the face and neck with laser or micro-needling!

A facelift JUST LIFTS!

EmFace lifts sagging facial skin, smooths the skin on the face and forehead, and improves texture and tone of the facial skin while removing wrinkles and stimulating underlying facial muscles to become the same size and shape as when they were younger! You may notice that you don’t need a neurotoxin as often as you did before the EmFace.  You may not need as much superficial filler to erase superficial wrinkles or dimpling.  EmFace also lifts the corners of your mouth so the downturn of the corners of your mouth are not as obvious, in fact the corners of your mouth actually turn up  like they did when you were younger.

This is what you’ve been waiting for! I know it was what I was waiting for…the EmFace machine wasn’t inexpensive, so the treatments using EmFace are not cheap….but they are drastically more affordable and less dangerous than a facelift!  I have finished my series and am happy that I no longer  dread the time and risk of having a facelift in the future.

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I spent the first half of my medical life as a gynecologist trying to figure out why my patients would come to my office asking what was wrong with them when they turned 40?

They felt they could not talk to their friends about it, and they were even embarrassed to tell me that even though they used to enjoy sex with their husband/partner, they now were repelled by the thought of it!

Remember this was in the 1980s through 2002, and the only way doctors knew anything about how to treat medical problems was because they learned it in medical school, residency or in their monthly specialty journal.  At that time and throughout that time period the primary doctor for women, gynecologists, we never taught anything about sex and the problems that women had after 40 due to deficient hormones.   I wasn’t taught how to counsel women about sexual problems. This was and is a great oversight by the Specialty society that I belonged to, ACOG, American College of OBGYN.

Then in 2002, when the internet grew to include medical articles and research, I could find journal articles about sexuality and dysfunctional sex after age 40…and with the help of Beverly Whipple NP who wrote the Science of Orgasm.  I began to be able to put the pieces together so I could counsel my patients with real medical information about women’s sexual problems.  The loss of orgasms and libido (sex drive) actually comes down to one hormone that is deficient!  Unfortunately, it is the one sex hormone that ACOG doesn’t recognize for women, despite all the research that is currently available—Testosterone.

Replacing testosterone has made all the difference for greater than 50,000 female patient visits.  I have treated with it in pellet delivery systems. Replacing deficient testosterone is not complicated and it is amazing to me that the medical community shuns the simple replacement of testosterone for women and advocates many drugs to treat anorgasmia (lack of orgasms) that are risky, expensive and often have no effect on a patient’s orgasms.  I have a 95% success rate of bringing orgasms back to aging women and in fact have also been successful in helping my patients who have NEVER had one!

Recently I read an article about orgasms and how to get them back, that never once mentioned testosterone, the most effective treatment that would bring sleeping orgasms back!

A recent article in the journal called “Menopause”, titled Oh no! Where did my “big O” go? Or could severe menopausal symptoms have stolen my orgasm?  Written by Simon, James A. MD, CCD, NCMP, IF, FACOG.

Here is what the author wrote to “educate” other gynecologists and family physicians. The author blames the lack of orgasms in aging women on the dry vagina caused by a lack of estrogen after menopause, however my 40+ years of experience has taught me that giving women estrogen either systemically or as a cream to the vagina, has not improved any woman’s orgasms in the absence of testosterone.  It is amazing to me that they still get it wrong!

There are many scientific articles and studies that prove what I now have proven over the course of 20 years of giving women testosterone pellets and seeing them smile broadly when I ask them how their sexual life is going. They say that they have their orgasms back and sometimes are multi orgasmic!  Their relationship with their partner is now excellent and they have a sex drive too!   The treatment with testosterone pellets to women after age 40, is the only treatment my patients need to help their relationship and their sexuality.

There is another misconception by the OBGYN world.  They believe that women’s sexuality gets better after age 60!  After talking to so many women about their sex lives, I have evidence that this is a false statement, and one that will prevent women from getting treatment for their sexual dysfunction with testosterone pellets, while they wait for it to get better as they age.  It is a lie that that occurs…the older a woman gets without estradiol and testosterone, the more dysfunction they have. After 150,000 patient visits since 2002, who come to me for hormone replacement and help with their sexual dysfunction, aging has only ruined sexuality for women, and never improved it. The dysfunction can start as early as 36 years of age and continues until they die.  This recent article still gets it wrong! I can only imagine what the motivation of the authors are, or are they just repeating unsubstantiated beliefs from what they learned in medical school?

Remember, 35% of studies are blatantly wrong for several reasons:

1.The statistics are manipulated to prove a point

The wrong questions are asked of the patients The study age group is not the real group of women that is affected The title is a lie which scares doctors and patients alike. Medical methods and dose are wrong to produce the patient’s resolution of symptoms.

I’m sure there are more reasons a study could falsely lead one to believe a lie, but they are not important here because I am giving you examples but not an exhaustive list.

The only thing in this article that rang true was the last sentence, “Significantly more research focused specifically on orgasmic function and dysfunction is desperately needed.“  I have to say that if the OBGYN profession would review the research from other fields like anti-aging medicine, endocrinology, and sexual health, or they actually observed what makes their female patients resolve their anorgasmia then it would be as obvious to them as it is to me what makes women have orgasms…testosterone!  Testosterone not only brings orgasms back, but it does so much more for women’s sex lives as well…testosterone in the form of pellets causes women to have a normal sex drive, to have a wetter and stretchier vagina and vulva, increases the size of the clitoris that shrinks with age and makes orgasms easy! It is no wonder that I have a very busy BioBalance Health® Anti-aging practice!

Please Don’t give up searching for your orgasms….it will be found in one hormone, testosterone replacement!

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In the history of medicine over the last 2 centuries there have been many changes in the recommendations given to patients by their doctors.  In general, to change the way medicine is practiced improving the care of patients, a new treatment had to be opposed by one or two courageous doctors who were willing to put his/her livelihood and status in the society of medical doctors on the line.   Any medical practice that was contrary to the dogma that had been taught to doctors in training was looked down upon by medical peers and often the doctors who were trying to improve the life of their patients were ousted from their practices and lost their livelihood.  I have been one of those doctors trying to improve the practice of medicine in the face of criticism and “name calling” by other doctors who didn’t want to change any of their practices.  In all cases it took a decade or more to regain my status and acceptance by other doctors and in some cases the changes I have made for the sake of my patients are still not accepted, and most likely won’t be for another decade.  How and why medicine improves is a painful and complicated process that is always opposed at first.

 How Progress of Medical Practice Has Been Thwarted by Doctors’ Dogma

Example #1 Handwashing between examining patients, When Did That Become a Medical Requirement?

Doctors now embrace the practice of washing our hands between examining patients, and the practice of wearing one-use disposable gloves to do a vaginal exam on pregnant patients. However, before 1847 doctors didn’t believe in hand washing between examining patients. There were no sterile procedures or wash basins available in doctors’ suites, and vaginal exams were done on many patients in a maternity ward, one after the other without handwashing. Bacteria had not been discovered in that century and therefore washing away bacteria was unknown, then bacteria were discovered and the presence of dangerous “bugs” that one couldn’t see was questioned by the older doctors and the, but Ignaz Semmelweis proved that ha dogma of the day. With the discovery of bacteria by young doctors and scientists presented a change to the practice of medicine that the older physicians in charge didn’t accept. Then Dr. Semmelweis showed up on the scene, touting the new knowledge, and insisting that he must wash his hands between Obstetric patients in the ward.  This set off an explosion and pitted the old guard versus one young, new doctor.  His insistence in washing his hands caused the doctors to throw Dr Semmelweis off staff of his hospital and peer pressure caused him to be shunned by all of the physicians on staff. He had a hard time finding a medical practice and ended his life destitute and without anyone recognizing that he was right the whole time.

 Medical handwashing became mandatory long after Hungarian physician Ignaz Semmelweis discovered its effectiveness (in 1846) in preventing disease in a hospital environment.  He was before his time, and if he had been listened to, thousands of laboring women would have survived childbirth, instead of dying from childbed fever!

 In retrospect we can sympathize with him because we now know he was right, and his refusal to accept a dangerous practice and to help women live through childbirth, was a personally costly stand to make, but was the first step toward an advance in the practice of medicine.

 Example #2 Is Estrogen Replacement for Menopause: Dangerous or Healthy?

Reference--Menopause: The Journal of The North American Menopause Society Vol. 26, No. 12, pp. 1366-1374 DOI: 10.1097/GME.0000000000001405 ß 2019 by The North American Menopause Society

Estrogen for menopausal women has always been a hot potato for medicine. Many studies done in the 1950s and 1960s documented the benefit of giving women estrogen after menopause.  Medicine embraced this belief, and the majority of women were put on Premarin, the most popular estrogen replacement.  All went well until late in the 1960s and early in the 1970s doctors noticed that women with uteruses were getting uterine cancer at a very high number and the majority of women were taking Premarin.  Research confirmed that estrogen replacement without progesterone/progestin could cause uterine cancer!  This caused two things to happen:  Research began within the drug companies to see if giving Provera®, a synthetic progesterone, would protect women from uterine cancer; The second thing that happened was that women immediately stopped their Premarin therapy and were suffering all over the US.

 “Premarin” and “Estrogen” became bad words in the doctor’s offices, on the front page of papers.  This emotional response to a drug name was hard to erase when several years later, when I learned about Premarin replacement through medical school.  About that time Premarin + Provera, Prempro® was introduced to the public as the answer to getting uterine cancer in menopausal women.  That took over a decade to scientifically establish safety, and menopausal women were without their estrogen to relieve their symptoms. It took that much time to produce enough research to prove that estrogen replacement was not going to cause uterine cancer, but they were right. Estrogen of any type when combined with a progestin protects against uterine cancer, not every case of uterine cancer because there are other factors, but the majority of the time.  All was well in regard to E2 during the 1980s-2002 when the next shoe dropped.

 In 2002 a flawed study was released from the NIH called the WHI or Women’s Healthcare Initiative, which was published with a headline that startled doctors and women patients alike “Post-Menopausal Hormones Cause Breast Cancer and Heart Disease”.  This Press Release Title was a misinterpretation of the data in the NIH Research article that claimed that Estrogen plus Progestin caused heart attacks and strokes!  The truth has been excavated from the huge report describing the study, in the 20 years since the WHI article was published, but the original misinformation won’t go away!  The study scared millions of women off hormone replacement and caused doctors to stop prescribing them.  The outcome of the WHI study is that one brand of estrogen, Premarin(estrogens) PLUS Provera a synthetic Progestin, together do cause heart attacks and strokes. However, estrogen (Premarin or estradiol) alone, does not cause either of these diseases and were proven to protect women from getting heart disease and breast cancer!   The original press release of the WHI study should have been titled, Provera, a Progestin, Increases the Risk of Heart Disease and Breast Cancer, and the FDA should have pulled Provera from the market.  If it had been properly titled and interpreted by the publisher, doctors would have just changed the Provera® prescription to a natural progesterone (bio-identical progesterone or Prometrium®, progesterone in oil) to take with estrogen, and women would not have had their quality of life changed for 2 decades without estrogen for their menopausal symptoms.  I am shocked that Provera® is still on the market with this kind of study showing the damage it can do! I believe the FDA is protecting the pharmaceutical company that makes this substance.

 I, personally, have not prescribed Provera® since before the WHI when I tested blood levels of my patients and found very high levels of estrone.  As is typical, a fearful headline always stays in people’s minds even when it is proven to be a lie, so for 20 years, most women have not been able to treat their menopausal symptoms.  Since 2002 a multitude of studies have been published (usually by women) stating the real benefits of estradiol replacement to prevent: Heart Disease, diabetes, obesity, dementia, arthritis, hot flashes, insomnia, longer life, and many more symptoms of aging.

 You might guess, I never stopped giving estrogen to my post hysterectomy patients, and bioidentical progesterone plus estradiol to my patients with a uterus, to protect their uterus from cancer, yet to allow them to have the benefits of estradiol after menopause.

 Because I read the whole WHI study, I realized that it was not estrogen, but progestin that caused the problem in the WHI study. However One very old doctor told one of my patients that I was going to “kill” her….he was just ignorant of the study. This seems to be how doctors react when they hear part of the information published about one of the medical treatments in question. Interestingly it is an emotional response that causes them to react negatively to new information instead of investigating it like scientists, which is what we are supposed to be! They have now been proven wrong and I look pretty good to the patients who remember.

 You can see why it is both difficult to trust the information given us as doctors, and why even if we know the truth, it is difficult to treat patients in the negative environment that is caused by careless journalists. 

 This makes it difficult to make changes in medicine for fear someday, a researcher will find fault with it.

 Example #3: Medical Advice about Drinking Water with Your Meals

100 years ago the JAMA Journal printed an editorial that said no one should drink water with their meal because it isn’t healthy.  There was no scientific research to back up that medical advice and they didn’t say what would happen to you if you did drink water with your meals, but they were adamant that it was dangerous. 

 In the following century doctors have discovered and presented scientific proof that drinking water with your food helps your food digest, makes you feel full now doctors recommend that everyone drinks water with their food!  This is proven with scientific research and finally replaced the previous dogma that restricted patients from the simple habit of drinking water with their meals.  It took a long time to reverse the beliefs of people, and I remember that in the 1970s my parents believed that no one should drink water with food.  The outcome of that habit was that they both had kidney damage as they grew older!  They maintained an environment of dehydration in their bodies which is physiologically dangerous to kidney function.

Conclusion:

 So why should we listen to these medical “experts” when they are not advising us in a healthful lifestyle??  Well, about half the time they are right, and half the time they are wrong---it’s a toss-up! 

How does one tell the difference between bad and good advice from their doctor? You have to ask your doctor and trust her advice. As a doctor I read research that tests a given medical practice then I compare the outcomes of the research with the outcomes of my patients, and if their findings agree with my patients’ experiences, then I embrace the research and include it in my medical advice. If not, I don’t use that information and wait for a better study to parallel what I see every day. 

 You can do the same thing. If you think that the advice a doctor gives you is not consistent with your own experience, then you have to decide whether you take the medical advice and use it or not.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

There is an interesting conflict between the truth and the mainstream medical protocols surrounding statins, that we have noticed in our practice for a decade.  Patients who are placed on statins soon develop weight gain and Type II diabetes, and those patients who already have AODM, become worse, gain weight and need more diabetic medications. I have questioned the brilliance of the FDA letting this side effect through their testing process for years. More importantly, why are statins always prescribed for people who have diabetes, even if their lipids are normal?

Finally, here is a recent study that documents this side effect, decades after we noticed this phenomenon.

The study is found in The Journal of Clinical Endocrinology & Metabolism, Volume 108, Issue 2, February 2023, Pages 385–396. 

The reason for the study:

“Statins and possibly other lipid modifiers increase type 2 diabetes risk and body mass index (BMI). However, to what extent BMI mediates the diabetogenic effects of lipid modifiers remain unclear. “

The findings:

‘Genetically mimicked effects of statins and ezetimibe, but not PCSK9 inhibitors were associated with higher risk of type 2 diabetes (odds ratio [OR] 1.74 [95% CI, 1.49 to 2.03]; 1.92 [1.22 to 3.02]; 1.06 [0.87 to 1.29] per SD reduction in low-density lipoprotein (LDL)-cholesterol). Of these lipid modifiers, only genetic mimics of statins were associated with higher BMI (0.33 SD [0.29 to 0.38] per SD reduction in LDL- cholesterol), which explained 54% of the total effect of statins on type 2 diabetes risk.

 Statins were considered a miracle drug for people who had had heart disease in the past, which is what statins were made for. To prevent another heart attack or stroke in this particular group.   For some reason, as they were distributed as samples to doctors by pharmaceutical representatives they were pitched as preventive drugs to prevent heart attacks and strokes in normal people with high cholesterol.  Statins became the drug to choose to prevent heart disease in normal people and that is where they hit a snag.   There are many side effects that statins cause as seen in the recent study, and they also have not been tested by the FDA in women, who are the group of people who have the worst side effects and the lowest rate of MI from atherosclerosis.  In addition it was sold as a drug without risk, and I even heard internal medicine doctors telling patients it should be put in the drinking water….a joke but that is what they almost did…they gave it to many people who had no plaque in their vessels and who were not going to have a heart attack in the future. The risks then outweighed the benefits and doctors should stop giving it to women and low risk patients, especially diabetics and patients who are obese, which is 50% of the US adult population.

Statins often have lasting side effects, such as statin dementia and severe sarcopenia (loss of muscle) as well as severe muscle-aches and pains that stop people from exercising.  What should happen in medicine is that a doctor should weigh the risks verses the benefits.  If they don’t know if a patient has atherosclerosis that patient should have an x-ray called Cardiac Calcium Scan every 5-7 years and if they don’t have plaque, then they should not get a statin.  In addition, there is a genetic test to see if the severe effect of sarcopenia (muscle loss) will happen and if a person has that genetic snip, they should take something which is not a statin.  If everyone was tested for these two things most people would not take a statin!

The blood sugar increases and the increase in obesity are side effects of statins that were evident in our patients who we test for testosterone deficiency, and who were later put on a statin by their primary care. We found that their lab parameters for diabetes immediately worsened.  For those who had visible side effects, we stopped the statins and found that the lab tests went to normal after stopping the statins, and the side effects went away in most of them.  We have been waiting for this research study ever since, and now it is official.  The research matches our clinical experience!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

The Mediterranean diet was originally discovered from comparing different diet regimens around the world in the 1950s, and the researchers found that those people living around the Mediterranean had a lower risk of heart disease and related illness.  The researchers then described the Mediterranean diet and advised Americans to follow this way of eating. It has been studied over and over again and it is still true that a Mediterranean diet is healthy for Americans.  Doctors glibly tell patients you should eat a Mediterranean diet, but what really is the Mediterranean Diet? 

I know what we are taught to eat the Mediterranean diet, however what Mayo Clinic describes as the Mediterranean diet, is not what I experience when I go to Italy and Greece.  Let me start with what the Mayo Clinic lists as components of the Mediterranean diet. 

They say that we should eat:

·       primarily vegetables, beans and whole grains

·       Eat fish twice a week

·       Use olive Oil instead of butter

·       Serve fresh fruit for dessert.

However here is what I observe of the Mediterranean diet that is really what Mediterranean people eat:

·      Main courses generally include Fish, meat like lamb, beef, veal, and pork-they are NOT vegan!

·      Fresh vegetables are included but “beans” are not a primary source of protein, however milk products, fish and meat are!

·      Italians and Greeks do eat fish at least twice a week if they are on the coast, but not so in the countryside, or northern part of these countries.

·      Pasta is a healthy carb and is made of semolina flour is generally served at every meal—but in much smaller portions than we eat.

·      Homemade bread is served at every meal.

·      Olive oil and Balsamic vinegar is generally used on bread instead of butter or margarine, however they use a lot of both olive oil and butter in their sauces and cooking.

·      Desserts are usually sweet and made with creams or milk products and flour. They use honey and sugar to sweeten the desserts, and they do not just serve desserts consisting of fruit.

The main difference between how we eat and how they eat would not be possible for most Americans because it takes so much time, and most of us do not live in an area of the country that is warm enough to grow vegetables and fruit during the majority of the year!  The following differences in their diet that actually make a healthy difference are as follows:

·      Their portions are less than half the size of ours!

·      They shop every day, so they don’t eat preservatives which are added to American food to increase shelf life.

·      They make their own bread and pasta fresh, also without additives.

·      They have a garden next to their house and because of the climate they are able to eat fresh vegetables and fruit throughout the year….most of Americans don’t live in a warm climate all year round.

·      They walk everywhere!  They get exercise just visiting their neighbors..everyone takes a walk after dinner. There are fewer cars used for getting places. They also live in smaller communities that are walking distance from everything they need.

·      Nuts (Almonds, pine nuts) are integral to their diets, as a good form of protein

·      One person in the family has the job of feeding everyone in the extended family.  It is her job to shop and cook and grow vegetables for the whole family.

·      Families come home for lunch and eat their heaviest meal at lunch so they can walk it or exercise it off!

·      Exercise is key to the Mediterranean diet!

·      Every day they eat extra virgin olive oil…tablespoons of it, and it is known to lower the risk of heart disease.

·      Fast food, junk food, is available only in the cities and is not stocked except for Americans.

·      Candy is an extravagance and usually has nuts or honey or other sweeteners but not white sugar or artificial sweeteners.

So….. like most great ideas, eating like a Mediterranean when you live in America is not practical for everyone and is not plant based…it is lean meat, fish, milk products, olive oil and cheese based. Not sure why they added beans…have never seen beans on the menu for either country I have traveled to, Italy and Greece several times each, so the Mayo Clinic’s version of Mediterranean Diet is not what Mediterranean’s really eat!

 I believe for a person to actually be able to follow this diet in the US you can change some of your habits, but it is nearly impossible to recreate their society and eating habits.  Try this: Cook with olive oil instead of other vegetable oils, put olive oil on your salads or drink a tablespoon of extra virgin olive oil daily to get a portion of the M. Diet.  We can eat the same types of food but unless we go back to baking our own bread and hand making our pasta, cultivating a garden next to each house and apartment, move in with our grandparents so they can cook for us, and give up our cars in favor of walking we cannot recreate that diet here in the US, but we can embrace some of the achievable goals of that diet. 

The goals of a Mediterranean diet can be achieved in a different way in the US.

We can go back to exercises in our schools and work out (exercise) daily as adults.

We can also attempt to clear out all processed foods from our homes and begin to eat fresh vegetables and fruit daily and serve fish 2-3 times a week.  Shopping at a kosher deli would help you get healthy fresh bread without additives and grass-fed beef that does not have antibiotics and grain added to their feed. As for drinks you’ll have to clear out all canned soda, and replace it with filtered water, coffee, or tea. Sugar is dangerous in all forms and candy and baked goodies should be kept to a minimum.   Buying local eggs are much healthier than those in the grocery store.  Changing our desserts to fruit and or yogurt or plain ice cream without additives, especially soy.  These changes can save your life and the lives of your family, but it takes everyone accepting the new parameters of eating.  Remember that food is enjoyable, but it is primarily fuel for our mind and body’s energy so we can repair of our bodies and live a long, full life.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Recently I had a shoulder replacement that went according to plan, and I healed amazingly fast. Of course, my surgeon was excellent, and he gave me preoperative instructions that were integral to the speed of my recovery.  I began to think about the reasons people heal and why they may not heal from either surgery or an injury. 

I started with the instructions given to me by my surgeon, and the reason he gave asked me to prepare my body for healing prior to the surgery.  His instructions included diet, activity, and supplements to my diet.  The first recommendation was to load my diet with protein to provide my body with the necessary building blocks to heal my muscles and connective tissue during the surgery and afterwards.  His instructions told me to eat a diet including meat, milk products with yogurt and cheese, eggs, and protein shakes. The amount of protein a day required was grams of protein equal to my weight in lbs.  For example: I weigh 125 lbs. and therefore I was instructed to eat 125 grams of protein/day.  I ate the foods that he recommended, and I took daily whey protein shakes with 25 grams of protein each, plus 20 grams of collagen (another animal protein) every day in my coffee. That satisfied the need to eat the building blocks of what I would use to heal.

The next recommendation was to eat a diet with fresh fruit and vegetables at every meal, avoid sugar, and junk food, and avoid all alcohol and sugared soda and diet drinks.  This part of the instructions provided the enzymes and vitamins necessary for healing, as well as advised me to avoid toxins and junk food which can prevent healing.  Elevated blood sugar that accompanies intake of carbohydrate food and drink, promote insulin resistance and poor healing.  Alcohol is a toxin that blocks the liver from normal activity and blocks processing of nutrients.  It is absolutely contraindicated while you are pre-op and healing.

Next, there were supplement recommendations given to me to provide the necessary vitamins and minerals involved in healing, that are difficult to get in a normal diet. These included the Vitamins methyl B12, multi-methyl-B vitamins, Vitamin D, Vitamin A, Vitamin C, and the minerals Magnesium, Zinc, Selenium and copper. The additional supplements were herbs and other substances that help healing including Quercetin, NAC (or Glutamine), Bromelain and Probiotics. 

I was told to start all of these recommendations 6 weeks before surgery, and for 6 weeks after surgery. I believe that following these recommendations is key to a great recovery after surgery or an injury. 

The other factors that are key to success after surgery is to have a healthy level of testosterone, and I have taken T for 20 years and I realize that my health has been greatly improved after age 40 because of testosterone replacement.  Testosterone is an anabolic steroid and is necessary for healthy healing. Most men and women have good levels of testosterone until they get older, and ovaries and testes stop producing enough T.  When women become deficient at an average age of 45, and men at 55, our immune system decreases their production of healing white cells, our growth hormone decreases and stem cell activity decreases, all of which are deficient secondary to testosterone deficiency. This makes healing as we get older much more difficult unless we replace the key hormone of T.

The success of surgery is dependent on our overall health so we can heal, the skill of our surgeon, our own health status at the time of surgery, our diseases, and our age/testosterone blood levels, our nutrient status and our diet providing the necessary building blocks to heal our tissues.  Surgery is not something you can just show up for, it is something you should plan to prepare yourself for and to follow up with excellent self-care until you are discharged from surgery, or until you are healed.

Other issues that can cause a surgery to fail or to be redone:

·      Surgery did not completely fix the problem (lack of surgical skill or complications secondary to your anatomy or physiology).

·      Your medical condition or medications can decrease your ability to heal (steroid treatment or treatment for autoimmune diseases).

·      Diabetes, heart disease, autoimmune diseases, cancer or other chronic illnesses

·      Old age, female over 45, male over 55.

·      Testicular or ovarian removal

·      Poor nutrition

·      Lack of exercise

·      Smoking and drinking alcohol

·      Lung disease that decreases your O2 levels

·      Obesity, Body fat % > 20 % in men and > 26% in women, or BMI > 25

·      Medications that decrease your ability to heal: corticosteroids, cancer meds, autoimmune disease medications

·      Lab results that indicate your poor risk of healing:  High CRP (inflammation),

Anemia, Cortisol is high, Free T is low, Estrone is high in men > 30, High CO2 , high HBA1C, High fasting BS and fasting insulin > 10, Elevated liver enzymes, poor kidney functions, low white blood cells, low GH (IGF-1) < 150.

Follow the instructions that my surgeon gave me and get your hormones replaced, clean up your diet and lifestyle, and get as healthy as possible before and after your surgery so you will have the shortest recovery and the most successful possible.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

There is an increase in medical news and research articles that talk about what aging Americans can do to delay the symptoms and diseases of aging. Some of the articles note lifestyle changes and exercise and or supplements that can combat aging…..but these changes alone are NOT the answer!  There is another group of news articles that state the problem that aging, and they leave the reader with the feeling that nothing can be done to prevent these symptoms and diseases.  The call “aging” an untreatable part of life, therefore when these symptoms hit doctors tell their patients, “That’s just aging! Learn to live with it!”  They rarely note the hormonal changes that are KEY to preventing the changes and diseases of aging: replacing testosterone for both men and women in a bio-identical non-oral form and replacing estradiol for women!  In reality all the lifestyle changes alone will not work to reverse aging….it is a multi-pronged approach that brings aging men and women back to health: Hormone replacement first, diet and exercise optimization and supplementation of necessary nutrients. 

After treating several thousands of aging men and women over the last 40 years I can state confidently that the one key factor in staying healthy, mobile, and able to think, is the replacement of testosterone with T pellets.

The medical community shies away from stating that testosterone is key to both men and women at any age.  Why is that?  I think it is because young men who treat themselves with illegal adrenal androgens that are bought on the internet have mistakenly equated these androgen products with the pure testosterone men make in their testes and women make in their ovaries.  They are not the same and should be discussed specifically so they are not confused!  Medicine also has not accepted testosterone as a female sex hormone!  That is just an extension of the male-managed medical care in the US. Lastly the US government see older Americans as dead-weight to the society and they don’t want to make us live longer past when we are useful!  Many decisions have been made by our representatives and senators in Washington who have no idea about medicine and aren’t educated that Men and women would cost Medicare less money, not more because they would be healthier for a longer period of time. For example, Medicare warns patients not to take their thyroid medicine after they are 65!  What happens when they stop taking thyroid medicine? Patients die!

Many titles of current research articles talk the dangers of aging and then tell us we can’t do anything about it!  When a written or spoken article coming from the medical community states that the symptoms that women’s experience after age 40 is called “perimenopause” they Miss-label the period of a woman’s life between 40 and 50 with a word that means “around menopause”, when in reality all of those symptoms occur because of testosterone deficiency, not estrogen deficiency!  The word perimenopause makes doctors and patients alike think the problems of this era of life is estrogen when most of us have too much estrogen and testosterone deficiency.    Just the word “perimenopause”,implies that estrogen replacement will fix them, when more estrogen will make a woman’s bleeding problems worse, not better. secret ingredient is!  The secret label of our problem, “testosterone replacement”, is hidden from us which steers research and treatments away from the real problem….It is no wonder that experimental drugs to fix the symptoms of a woman’s decade after age 40 don’t work!

A word, or a label carries power with it, and when given the wrong name the disastrous outcomes are inevitable!

Because women begin to experience aging after 40, the sequence of events is important to get right so that we can replace what our ovaries stop producing in order of the natural hormone changes. The ovary stops making testosterone first, followed by progesterone deficiency plus estrogen dominance, with the last stage being the final one of loss of estradiol.  If this was considered by the research community, then there would be fewer worthless studies based on replacing E2 in women between age 40-50 that of course fail, and more successful studies of testosterone deficiency, that are treated with pure testosterone, and the medical health of middle-aged women would be so much less stressful, and diseases of aging would be suppressed.

I hope that when you read news articles or medical research about middle aged women with the following symptoms you will think “testosterone deficiency” not perimenopause.

Testosterone loss after age 40 causes fatigue, gain of belly fat, loss of muscle, loss of sex drive, increase in autoimmune diseases and loss of motivation and ability to think logically.  The more women who know what is really wrong with them the better!

In reality, “Testosterone” can be substituted for the word “aging”. In most medical articles that discuss the problems of advancing age, the conditions that are really caused by testosterone deficiency, are given the nebulous label, symptoms of aging or the misnomer, perimenopause. By doctors and scientists calling testosterone deficiency, “aging”, or perimenopause. It implies that these symptoms can’t be treated, and women must live with them!  Sexual dysfunction, fatigue, loss of quality of life and obesity among other symptoms and diseases that happen to women between 40-55 can bet treated with T replacement.  Their choice of words put women in a position of acceptance for their symptoms instead of a powerful position to resolve these issues with replacement of one hormone--testosterone!  Ask your gynecologist for it!  You are the patient/customer, and you should be able to get what you need!

However, after spending 20 years in my BioBalance Health ®Practice replacing women’s lagging testosterone, the rent research is very encouraging to me and to my testosterone replacement practice.  BioBalance Health® LLC….More studies are done about women and their decreased sexual desire, and women who become depressed after age 40, as well as many other articles investigating the symptoms of perimenopause (low T) in women.  Most current studies state at the end of the article, that there is no treatment for these symptoms, or that estrogen is the answer, or that new expensive drugs will relieve some of the symptoms, bringing along with them many side effects.

Why am I so sure that I am right?   It is so obvious in my medical practice that testosterone is the treatment necessary to completely resolve over 20 symptoms and multiple chronic illnesses. I see the success through the results my patients experience.  Not only do women return to my office 4 months after their first dose of testosterone pellets visibly younger, healthier and thinner, their lab results improve, and their symptoms are gone!  This doesn’t happen in just a few patients, but in 95% of the thousands of patients I have treated.

But not only is the government against the healthy aging of women, the medical societies are against us too!  They determine how doctors of their specialty think, and they brainwash their members by printing misleading studies and actual lies against the treatment with testosterone.    In 2020 the Journal of Endocrinology and Metabolism castigated doctors who gave women testosterone for their symptoms in their May 2020 issue, then only 5 months later in the same journal they advised the treatment of women who have sexual dysfunction can be treated successfully with Testosterone.  In the second article they stated that more than 30% of women over 40 have sexual dysfunction, and that these 30 % must be treated!  What a quick turnaround!  There are many articles in their research journal that support treating women and men with testosterone, however the doctors who are Endocrinologists must not read their journals because they have not embraced it as a medical society, so millions of women are left untreated by their endocrinologists.

The Journal of OBGYN has different problems.  They are decades behind other specialties studying hormone replacement with testosterone. One of the reasons is that they only print the research done by OBGYNs.  Other specialties do research on the sex hormones and their effect on cardiovascular disease, autoimmune disease, endocrine disease and cancer, however they are not printed in the only journal that OBGYNs endorse, and the only one OBGYNs read,the “green” journal! The very doctors who are supposed to be experts in the field of female sex hormones are informed meagerly while the other specialties do all the research, but they don’t acknowledge anything by other specialty organizations!

I understand why you may question this..in reality I am a skeptic, and generally must experience a situation myself, or witness it to embrace it. My skepticism is peaked when statistics are quoted, because there are many ways to make statistics lie.  Therefore, medical research articles are not a gold standard. Lately they have been questioning their own belief that testosterone is not needed by women.  I know what I see, and because numbers can be gerry-rigged to “prove” something that is not seen in medical practice, I don’t believe numbers that aren’t evident in my practice.   When one patient…then ten…then thousands of my patients respond to testosterone by being cured of more than 10 symptoms, then I believe…I have treated thousands of patients from all over the world and I have seen miraculous results by replacing testosterone!  But if this truth is not accepted by the whole of GYNs, then millions of women will have the quality of their post productive years stolen from them.  What about patients who don’t know what is wrong with them and believe their doctors who say that they just have to “live with the symptoms” because it is “normal aging”?

Let me give you some examples from the literature:

An article from Endocrine Today, September 2022, whose headline reads, (Low) Skeletal Muscle Mass is Linked to Cognitive Decline In Older Adults With Type 2 Diabetes.”

This article supports the fact that when people get “old” they lose their muscle mass, and when that happens then they are more likely to lose their ability to think and take care of themselves.

OK, I agree with that, and most of us who are observant of aging people say “duh, of course that’s true, but why does it happen? Is it treatable?” The research article does not offer treatment suggestions; however, I know that the answer is testosterone replacement with bio-identical pellets! Both issues plague women who are menopausal and without both estrogen and testosterone.  In my practice taking testosterone with pellets with or without estradiol can prevent these diseases that occur from years of estrogen and testosterone deprivation. Like many other research papers, this one never states how to treat the women who present to the doctors’ office with loss of muscle and cognitive decline, with or without diabetes…why can’t the PhD/MDs that write the papers put the pieces of the puzzle together? 

We as doctors know that there are many symptoms and diseases of aging, but my colleagues tell patients that they have to live with it!  We should know the answer to this simple deficiency.  Aging begins with loss of testosterone and the symptoms can be treated successfully with non-oral testosterone for both men and women!

Why is this so?  A minority of doctors are like me, we link the treatment we give our patients with the outcomes that we witness.  Other doctors are no better than a computer, what they are taught in med school is what they tell their patients, and no more, whether they see improvement or not!  These two groups of doctors are different based on their phycological make up, but the memorizers (the second group) do well in medical school because they can spit back exactly the lists given to them to read and remember, however they are terrible at problem-solving because they don’t know how to use what they see every day in their office to modify the treatments they learned in med school.

So many things have changed in the last 40 years since I left medical school!  I am a problem solver and I keep learning…this leaves me open to the newest epigenetic research, the use of US and MRI for many diagnoses, and helps me discover the treatment for conditions that are only ignored by the researchers currently.

20 years that proves beyond a shadow of a doubt that testosterone is a replacement is key to healthy aging without symptoms and disease.  But many Doctors repeat what they were taught in the dark ages, “You are getting old, you will have to live with it”, and turn and leave the exam room!  Many doctors did this to me as a patient after my hysterectomy, and I’m a doctor who 20 years ago was looking for a treatment for my rapid aging after my ovaries were removed.

I was told that my symptoms of low Testosterone was just aging and it is not treatable. However now, 20 years later, I read over 40 journals a week and I have thousands of medical research papers to prove that the trigger for aging is the fall of testosterone blood levels that occurs in women in their 40’s and men in their mid 50s.

Yet Testosterone deficiency is still a condition that no one seems to believe there is treatment for, and patients are told all over the country, every day to suck it up and live with it or to take multiple drugs to make them not care about their symptoms anymore, but nothing actually brings them back to health except testosterone in a non-oral form—testosterone pellets.  Subdermal pellets are the best global treatment for both sexes that bring us back to the way we felt when we were young!  In this form T is not dangerous or risky…it is a simple two synapse logical solution: Testosterone replaces the testosterone your ovaries or testicles made before aging started, by just giving Testosterone back to you we are replacing what you are now missing! What a concept!

It is obvious that there is one answer to treat a multitude of symptoms and illnesses we don’t have a “medically acknowledged treatment” for.  Why are we are unwilling to find a solution?  Is it because women aren’t equal to men, even in 2022 in the US? Is it because the FDA is an arm of big pharma and wants to sell multiple expensive new patentable meds to earn the most money, instead of treating many symptoms and diseases with one medication/hormone? Is it because most doctors are men and think women are just hysterical and imagine their symptoms?

I am forever reading articles about the symptoms of aging, in which the authors act like the treatment for these symptoms is a Rubic’s cube that is difficult to treat, but in reality, it is so simple, maybe too simple for the hubris of medical people to consider that it is the answer to such a complex group of symptoms. 

So, you should try what I am suggesting.  You will see for yourself that with one hormone a multitude of symptoms can be treated! The list goes on and on.

Loss of sex drive and sexuality

ED in men and lack of orgasms in women

Pain with intercourse

Fatigue

Obesity

Insomnia

Depression and anxiety that begins at 40

Migraines that start after 36

PMS

Irritability

Loss of motivation

Arthritis

Dry eyes

Dry skin

Thin sagging skin

Loss of hair

Loss of muscle

Loss of balance

Joint damage

Memory loss

Change in body composition

Increase in belly fat

Increase in cholesterol and inflammation

Loss of immune function that triggers infections and cancer

Loss of Quality of life

Hot flashes

All of these symptoms can be treated with bioidentical testosterone pellets safely for men and with testosterone and estradiol in women. Why can’t the studies just say, the treatment for the symptom of aging is due to testosterone deficiency?

I would like to know why no one in the FDA, the researcher community, doctors who are in charge of the medical specialties in the US, and teaching physicians have told us this?  Why are we always told there is nothing to be done about aging/low testosterone….it is our future to age, get sick, watch our bodies fall apart and our brains shrink and then we die?  Not me!  I am going to shout it from the house tops that we, mostly women, who are told there is no treatment, won’t take it anymore!  We want testosterone pellets approved by the FDA for women and paid for by insurance!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

I often see patients at the office who come back to get BBH Pellets after a hiatus of months to years, that they tell me waiting was the biggest mistake they ever made.  They were feeling so good after their hormones were replaced that they forgot how bad they felt before their treatment. Stopping their hormones brought back their symptoms, and they realize how much their pellets are doing for them!

This is human nature, and often happens because when we feel better, we forget quickly how we felt before treatment.  The problem with starting and stopping pellet hormone replacement is that slowly all the symptoms come roaring back and then my patient wonders why they don’t feel well.  Until they remember that the pellets made such a difference and come back.

Stopping Hormone Pellets for No Apparent Reason

Hormone Treatment with Pellets Is different than other medications because when a person stops therapy, pellets continue to dissolve slowly, so they continue to make our patients feel good before the pellet hormones wear out which can be 6 months for women and 12 months for men.  Because blood levels of testosterone and estradiol from pellets are slow to increase and slow to run out, patients don’t notice an abrupt change.  Generally, months after an insertion was supposed to be repeated, the symptoms of hormone deficiency are evident but patients may not put it together with not getting their pellets on time. Other medications make it easier to recognize the cause and effect, because if you don’t take a medication such as a diuretic or an ADD medication, you get the symptoms you are taking the drug for back in 24 hours.  Even oral, transdermal and suppository hormones have a half-life that is less than hours long, so if a patient is taking oral estrogen for hot flashes, then discontinuing treatment would bring an obvious return of hot flashes and dry vagina right away. That makes it easier to the return of symptoms with the stoppage of the oral hormones. Short acting hormones or drugs make it more obvious to a patient that they need to take their medication or get they will get their symptoms back. I have to ask my patients to consider their pellet treatment as a lifelong therapy like taking thyroid or blood pressure medicine.

The result of stopping pellets is that a patient feels well for a while and then slowly goes back to their symptoms before pellets, and they don’t put it together and look for other causes and other diseases without results, until they remember they didn’t get their pellets inserted. This causes patients to delay feeling well and they don’t get the benefits of symptom relief or prevention of the diseases of aging during the time without pellets. For those patients who put realize what is going on and comeback “late”, it takes months to years to get their hormones replaced and balanced again.

Stopping Supplements Has a Delayed Response Too

Let’s look at another treatment that patients often stop and then don’t know why they don’t feel well. That is treatment with supplements.  Supplements slowly improve specific symptoms by either treating genetic deficiencies or deficiencies in your diet that take a month to 6 weeks to have an effect and that same amount of time to wear off. Let me tell you a story that is an example of this very thing.

            I was at dinner with one of my friends who is also my patient. He had a knee replacement a month before.  His doctor asked him to hold the supplements that would cause bleeding at surgery 2 weeks before his surgery.  My friend is a type A guy who believes that a little is good and a lot is better, so he stopped all of his supplements. Then 4 weeks after surgery and 6 weeks after stopping all of his supplements, he sat at dinner with us and looked “deflated”…he complained that he just didn’t feel good, and this was occurring more and more since his surgery.  He left dinner early because he just didn’t feel well and that his symptoms had been getting worse over the last 2-3 weeks.

 I did my usual casual questioning with a purpose—asked about his knee, pain meds, how long since his pellets, etc.  All his answers didn’t give me a clue.  I went home and looked at his last labs and meds and supplements. I then talked to him and asked if her had gone back on the supplements his surgeon told him not to take?  He said, “I stopped taking everything two weeks before surgery!  I never restarted them.”  This “aha” moment hit at the same time for both of us…he needed his supplements both to heal and to replace the nutrients he didn’t get in his diet.

Supplements for patients who have no genetic deficiencies, who eat a perfect diet, who exercise daily and who have no bad habits or take drugs that would use up their nutrients, don’t need supplements. I haven’t seen a person who qualifies as too healthy for supplements including me and my husband. If there were a perfectly healthy patient who eats a perfectly balanced diet with enough fruit and vegetables, healthy protein, from home cooked meals without chemicals or preservatives, who eats no junk food or sugar containing food, and who doesn’t drink alcohol or any medication.

BioBalance Health uses supplements to make up for deficiencies in diet, or instead of medications for health issues. We make a plan based on a patient’s risk factors obtained from their history and blood tests, and we explain why patients should take these supplements.  Lastly sometimes medications use up your enzymes and vitamins. For example, when a patient who was on a statin had fatigue and muscle aches, I prescribed CoQ10 because that important nutrient would be used up by the statin would be taken off the CoQ10 when they stop the statin.

Patients who can’t or won’t add foods to balance their diet then we recommend the supplements that are needed to take instead of eating foods they don’t like, but need.

All patients on a weight loss diet require a multivitamin, protein supplements to increase the amount of protein eaten daily to more than ½ of the patient’s weight in grams of protein.

Some medications use up a normal supply of a certain vitamin.  An example is that the medication Metformin uses up B12 stores in the body so the patients taking metformin should be on B12 in a multivitamin, monthly shot, or a separate supplement to make up for the B12 the metformin uses up. The lack of B12 shows up as generalized pain, muscle pain, neurologic numbness or lower extremity neurological abnormalities.  Alcohol consumption is also another habit that uses up B12. All patients who drink alcohol more than occasionally should be on plenty of B12.  B12 cannot be overdosed because after you use what you need, you urinate the rest out through the kidneys.

Another example of what happens when you stop taking supplements that are indicated by a patient’s symptoms it takes weeks and months to feel the difference, or to get the original symptoms back.  A long-time pellet patient who would not go without her pellets, asked me if she could stop her supplements…she was just tired of taking them. In fact, she had stopped them months before and she had a “new list” of symptoms.  I did some lab to see what her blood levels were, and she had a low Vitamin D level, B12 level, her estrone was elevated (stopped taking DIM) and she was gaining belly fat and blaming pellets.  After a consultation, she decided to start taking her supplements again, and a month later she felt great and lost some belly fat!

 Recommending supplements is part of our treatment that we provide with our preventive medical therapy for our Pellet patients. Supplements are not required but recommended to make up for the modern lifestyle, diet, alcohol, lack of sun exposure and exercise. The fact that the effects of supplements might be silent, causes patients to doubt their activity, and usefulness.  When all supplements are stopped we can often see a  subtle decrease  in a patient’s symptom relief and overall well-being.

Sometimes understanding why we as humans are apt to do things that make us less healthy or sicker sometimes makes it easier to follow recommendations of our doctors.  I see the benefits of vitamins, minerals and supplements that my patients take every day in their blood work and their symptoms.  Sadly the medical community, funded by the drug companies don’t want us to take supplements….the medical studies they do on supplements always say they don’t work…however they create a study that will result in no improvement by lowering the dose too low, shortening the period of taking a supplement or they choose their subjects so that NO drug or supplement will work.  You can make a study say almost anything you want it to…

Don’t stop your thyroid medicine!

I live in the “Goiter Belt” in the middle of the US, so many of my patients need thyroid replacement, which resolves their low thyroid symptoms, and makes their lab look normal.  It is unfortunate that some doctors are so poorly trained in thyroid treatment that they look at a person’s lab while they are on thyroid medicine and say, “See, your lab is normal so now you can stop taking your thyroid!”.  The thyroid gland does not regenerate, start working again or heal unless you have the rare  kind that occurs after childbirth and then resolves after 12 months. Otherwise, taking thyroid is for life, and unlike pellets and supplements, you will feel the symptoms come back right away.    Taking a hypothyroid patient off their thyroid replacement medicine leaves them severely hypothyroid and unable to stay awake, with chronic swelling, low heart rate, low BP, weight gain, severe fatigue and hair loss, and feeling cold all the time. The doctors who do what I describe above and take patients off their medicine should go back to medical school physiology.

“Figures often lie, but liars always figure!” –my husband is a lawyer, and he uses this phrase all the time in his arguments.

It is true that a medical study can be manipulated to conclude anything you want it to.  A researcher trying to prove something can manipulate the structure of the study, or choice of participants in the study, or just title the article so that it implies something that is the opposite of the true findings, like the NIH did with the Womens Healthcare Initiative in 2002.

When I see different results in my office than what the studies tell me, I trust what works for my patients, and double the veracity of the study. Later I am usually happily surprised that the study was deemed inaccurate because it was done wrong, the population was one not in my patient population (like all patients are Asian, and I have very few Asians in my population) or the assumptions of the results were inaccurate.  Using the information that patients give them and determining the best treatment for that individual is the job of a doctor…to read studies critically and compare them to the results seen in their own patient populations, then use what they see with her own eyes to treat their patients.

I hope I have encouraged patients who wonder what their pellets or supplements are doing for them after years of successful treatment who might think they will stop because they are “cured”, to think again.    Menopause, Testosterone deficiency and hypothyroidism don’t just go away! They are something that must be treated to bring you back to a quality of life, you will have to treat these deficiencies until you die, or have a medical reason you have to stop treatment. Sadly, pellet therapy and nutritional supplementation are not curative if you don’t take them, you go back to how you felt before treatment!

You might lose years of joy and health by stopping the treatments that make your health and quality of life better. Think it through and talk to your doctor or NP before you make any changes.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

The best way to decrease you risk of developing illness and cancer, as well as a cancer recurrence, is to get your immune system as healthy as possible. Everyone’s body makes cancer cells daily, but your amazing immune system protects you by killing them before they multiply.

The key to preventing chronic illness, cancer, and a cancer recurrence, infections such as viruses or bacteria, and chronic fatigue is to turn the clock backwards to when you were young and your immune system’s “power center”, the thymus gland, was large and active.  The thymus gland makes T Killer and T helper white blood cells that kill cancer and bacteria.  The thymus gland is key to your immune system, and it shrinks with age.  It is large and active when we are children and gets smaller and less active as we age. After age 60 you may notice that people get sicker and that is when they have the most frequent cancer diagnoses. The thymus gland can be stimulated again by “feeding” it and stimulating it into action again.

The best way to improve your immune system’s health and reverse the thymus’s aging process is to make your thymus more active, like it was when you were younger. The best way to achieve this is to replace testosterone, stimulate growth hormone (if necessary), eat healthy food and avoid unhealthy food, add daily exercise to your lifestyle, achieve ideal weight, take supplements, and use immune-boosting peptides like Thymosin alpha-1 or Thymulin and or take medications like Metformin ER.

The following lists are meant to be helpful for you to improve the status of your immune system.

Medications/Hormone Prescriptions that improve Immunity:

Supplements that Support your Immune System & Recommended Daily Dosing:

Diet:

Exercise: Doing 45min of cardio per day or more is optimal! Add weight training for the whole body.

Red Light Therapy: 20 minutes a day stimulates the mitochondria to make more immune cells, and to activate them.

Sunshine: 45-60min/day is optimal! No sunglasses or sunscreen.

Medications to AVOID:

Medical Treatments to avoid if possible that Suppress the Immune System

Habits and substances to avoid that suppress the immune response (the thymus gland and the cells that it produces.  Avoid the habits and environmental substances that follow:

No one can avoid all bad habits and substances that block your production of White Blood cells and protect you from cancer, autoimmune diseases and infections, however you can take steps to improve your immune system to decrease your chance of these diseases. The most important change you can make that protects you with just one change is to replace testosterone with bioidentical pellets, if you are over 40 years old. Testosterone in pellet form is the one hormonal replacement that will improve your immune status more than any other single treatment or supplement. So what is stopping you from preventing future illness and suffering?

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

You probably have never heard of the need for Iodine in your nutrition, but it is a trace element that is vital to human life, because iodine plays a role in all of your hormones, your immune system, your metabolic rate and yes, your breasts!

Iodine is produced by seaweed, and is a natural mineral in the soil, sand and ocean of any area of the globe that has been under the ocean or near an ocean currently. Iodine is present in most of the US except the Midwest.  Unfortunately, the glaciers of the last ice age, scraped off the topsoil, and the iodine, from the Midwest of the US and carried it to Canada.

The Midwest, where I live and practice medicine, is ground zero for the diseases secondary to iodine deficiency.  If you live by the ocean, you probably get enough iodine, however the farther away you are from the coast, or if you live in the US Midwest, the higher your chance of having iodine deficiency.

Where do we find Iodine concentrated in our body?  The thyroid gland takes 75% of the iodine, and the rest is distributed to the breasts, ovaries, muscles and blood.

The breasts need iodine to be healthy and normal, and insufficient iodine causes women to develop fibro-glandular conditions that obscure masses on mammogram, and make the breasts feel “lumpy”.  There is a direct relationship between iodine deficiency and breast disease.

Taking Iodine can reverse the fibrocystic condition of the breast and it can give your thyroid gland the iodine it needs to make T3 and T4, and keep your metabolism burning calories.

Hypothyroidism and fibrocystic breast disease are primarily diseases affecting women, and both conditions occur most frequently at the times in a woman’s life-cycle when breast growth is most active.  Breasts are most actively growing during the following times: puberty, pregnancy, and pre-menopause.  I noticed the occurrence of these diseases at these times in my GYN patients when I practiced OBGYN. I did a breast exam on every one of my patients and I noticed that breasts because more cystic in my patient’s early teens, during pregnancy and between 35 and 50.  However my practice is in the middle of the “goiter belt” of the Midwest and almost every woman had somewhat cystic breasts due to a lack of iodine. All the mammograms I saw were fibrocystic, which doesn’t increase their chance of getting breast cancer, but does make reading a mammogram more difficult.  Fibrocystic breasts make mammograms have a “static” like quality which decreases their accuracy.

Here is how this works…when you are a child and have enough Iodine for your thyroid function, you were thin and active, then you are less likely to have hypothyroidism as a child. About 2 years before puberty, a girl’s breasts start to form and they soak up the iodine from the blood, stealing it from the thyroid.  This makes these young girls gain fat, they become fatigues and often have all the symptoms of hypothyroidism, like hair loss, thin eyebrows and lack of motivation.   During those two years as their breasts grow, women who have plenty of iodine in their diet, don’t’ become hypothyroid and don’t develop cystic breasts.

The young women who effectively increase their iodine intake, or who have small breasts don’t require very much Iodine, escape the puberty process with a normal thyroid.  Other girls soak up more of their Iodine in their breasts and starve their thyroid.  The thyroid shuts down, they gain fat, are fatigued, get all the symptoms of low thyroid, and get lumpy breasts. This leads to a group of women who get Hypothyroidism and FCBDX (fibrocystic breast disease) at puberty.

The second time of life women get hypothyroidism is during or after pregnancy when their breasts are much larger than ever before, and are lactating, using up their iodine.  Hypothyroidism can occur at this time is unlike other times of a woman’s life that puts a woman at high risk of developing hypothyroidism, they can actually get over hypothyroidism within a year of developing it. Generally, once you have hypothyroidism, you never get over it and you must take thyroid replacement medication the rest of your life.

How can you prevent the breast changes from low Iodine intake?  You would think that the government would supplement foods with Iodine to prevent this, but in their usual manner of bad dietary advice, they took Iodine supplementation out of bread and other baked goods in the 1960s under the false assumption that iodine caused hypothyroidism, when it doesn’t!  They replaced it with Bromine, which cripples the thyroid gland and can cause hypothyroidism. In addition, they added fluoride to water and that effectively blocks the effectiveness of iodine.  It basically kicks Iodine off the thyroid hormone molecule and replaces it with Fluoride which stops thyroid function.  Why does the government not reverse its previous stand on Iodine?  Because they would have to admit they made a mistake!  That seems to be more important than the health of the American public.

 How to prevent and treat the diseases of low Iodine?  You can move out of the Midwest and buy a house on the beach where iodine is literally in the air, and every time a wave crashes on the beach, iodine is dispersed in the air and you absorb it through your skin and lungs. If that isn’t practical, you can eat a lot of sushi that has seaweed wraps or you can increase your intake of seafood to supplement your iodine.  If that is not practical, then you can take a supplement call Iodoral, ½ to 1 tablet (12.5 mg) a day. Taking iodine can literally reverse both fibrocystic breasts, and hypothyroidism….you should take iodine if you have low thyroid and are taking thyroid medicine because you still need it for your breasts and the receptors on your cells also need iodine to let thyroid hormone into the cells!

In addition to ingesting iodine as a supplement, avoid the substances that block iodine from working: Fluoride and Bromide. Don’t swallow your fluoride toothpaste, in fact, buy non-fluoride toothpaste, filter the Fluoride out of your water and only buy bread without Bromine added.   A trip to the beach every few months can load up your iodine cache because you can absorb it through your skin during a walk on the beach

My plea is that governmental agencies that produce guidelines for food production reintroduce iodine into the list of fortification that is required in food!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

One of the new tests available to doctors and patients without a prescription is a test that tells you if you currently have arterial plaque and gives you reassurance for 12 years that you will avoid a heart attack from blockage of the coronary arteries.  The CACS looks for calcium buildup that shows white on the CT scan.  Where there is calcium in the arteries there is plaque. To me this is a wonderful preventive medicine adjunct to the care I give my patients. I no longer have to look at high cholesterol numbers and worry that my patient is going to have a heart attack, because I have found that high cholesterol is not always associated with development of arterial plaque!

Let me back up and explain to you what heart disease really is. Your heart is a muscle that never stops beating until you die. It is fed by arteries that cross over and around the heart and the arteries feed the heart with oxygen, nutrients, and proteins to feed and repair the heart.  Heart Disease is really disease of the heart’s arteries.  It occurs when cholesterol sticks to the arteries of the heart, which narrow the pipeline that feeds the heart.  As the plaque grows the arteries narrow more and more until the vessels clog and a part of the heart is deprived of oxygen and nutrition. That part of the heart muscle dies…that is a heart attack.

Cholesterol in the blood does not mean the development of heart disease.  Yes, there is cholesterol in the plaque, but it takes inflammation which is the glue that sticks cholesterol to the arteries.  Some people have high cholesterol their whole lives and never have arterial plaque or a heart attack.  Cholesterol is not a bad lipid, it is necessary to our whole body, and our brain is mostly cholesterol, every cell wall in our body has cholesterol as the main component, so lowering cholesterol too low can harm you!  Statin dose that makes your cholesterol too low is damaging to your brain and all your cells. There is a new kind of dementia called Statin Dementia!  This is why I think you should not take a statin unless you have arterial plaque, or your habits increase the inflammation and the formation of arterial plaque.

My own experience is key to my belief in this test.  In 2002 one of my friends who was a surgeon died at the age of 47 of a heart attack.  He had no sign of this ahead of time and it came as a surprise to everyone who knew him. I always have had high cholesterol and my husband has had it too, he was even placed on a statin at age 40, so I set us up for the NEW TEST the CACS. At that time the test was brand new, and the research wasn’t back however seeing is believing and we have used ultrasound for diagnostic purposes for years in OBGYN, so we both had the tests.  Now the test is $99 at most radiology departments and at that time it was $1000/test!  I didn’t care because it was worth knowing whether we would have a heart attack in the near future.  It turns out that we both had a score of zero (0) and there was no plaque!  Yea, I felt better and stopped worrying about my cholesterol. I was 47 and my husband was 51.

I never recommended this test to my patients because the stats weren’t totally back yet, and it was very expensive, until years  after I began my BioBalance hormone replacement and preventive medicine practice.  I began to read about the test and that it was reliable and a good way to tell if someone needed a statin or not. I began to recommend the test to anyone including anyone at risk or on statins.

Over the next 20 years I ordered tests on my at-risk patients (those who had family histories of heart disease but normal cholesterol and those who had high lipids that didn’t come down with bioidentical hormones. I was surprised when over the 20 years, at least half of the patients who had high cholesterol had no arterial plaque (no risk for heart disease and MI) and about half the patients who had positive family history, but normal cholesterol had no plaque!  So lipids and family history didn’t mean anything!  These are the 2 reasons that patients take statins!  Patients are given statins blindly for positive family history and high cholesterol not knowing whether they are at risk or not, and one test for $99 can tell if you need statins or not!

By the way, when I was 63 and John was 67 we had another CACS and I was still 0 and John who had been on statins for 27 years did have plaque!  His score was 141! The statin didn’t work to prevent narrowing of his cardiac arteries. His new cardiologist was on board and put him on a different kind of cholesterol lowering agent and I put him on Celebrex to prevent inflammation that stimulates plaque formation.  Without this test he would have been on a drug that was not working— a statin!

What is the test like?

The test is a 2 picture CT scan.  It takes 5 minutes and can tell your doctor a lot!  It is recommended after 40 in men with a family history or who are on statins, and women after 45 who have the same risks or who are just anxious over having a vascular disease like an MI.  It also tells us about your other arteries, and those leading to your brain and pelvis without taking a picture of them.  If you have plaque in the arteries of your heart you surely have plaque in your other arteries all over your body!

The pictures are taken when your heart is contracting and also when it is in diastole or relaxing.

Your doctor will tell you what the test says and means for you, however if you are a 0 amount of plaque you can breathe a sigh of relief that your heart arteries are not blocked with plaque.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

My patients who are listing their symptoms of menopause and low testosterone invariably check the box next to INSOMNIA. In addition to insomnia, they tell me that it is the one problem that they have that affects all their other symptoms of menopause such as difficulty thinking and memory, depression, restless legs, muscle aches, irritability, and generally sabotages their quality of life.  This subject has finally been studied in depth by the J or Endocrinology, and I want to share the information with you.

Insomnia is one of the symptoms that plagued me after my hysterectomy and removal of my ovaries.  When my sex hormones, estradiol, and testosterone were depleted, my sleep was significantly disrupted.  We spend 1/3 of our life sleeping, recharging and healing our brain and body. Prior to my hysterectomy I had always been able to sleep. For an OBGYN who is always sleep deprived, I was able to lie down between deliveries or surgeries and sleep for 20 minutes and wake up refreshed.  After my hysterectomy I couldn’t even sleep when I had a chance to at night!  I was literally the walking wounded, and medicine told me this was completely unrelated to hormones…..I had proof that it wasn‘t and no one would listen to me. I added estradiol to replace the only hormone that medicine accepted as a product of the ovary, but estrogen made me fatter (I gained 20 lbs after my hysterectomy) and didn’t help my sleep, it just decreased my hot flashes, but didn’t stop them.  My life path led me to Dr Gino Tutera who knew that I needed testosterone as well and the loss of T was the source of all my symptoms.  Voila! The first night after my pellets were inserted, I slept all night!  I woke rested and all my symptoms went away from that day on!  Medicine had failed me…and I began to question everything I learned.  The medical articles blamed insomnia on everything else that is downstream from T and E2 loss…..hot flashes, anxiety, depression, worry, getting olde, or normal aging.

The latest research from the Endocrine Society confirms the findings that I discovered 20 years ago…that the loss of ovarian and testicular hormones cause insomnia.

There is emerging evidence that menopause-associated hormone loss contributes to this elevated risk, but age is also an important factor. The extent to which menopause-associated sleep disturbance persists into postmenopause above and beyond the effects of age remains unknown. Untreated sleep disturbances have important implications for cognitive health, as they are emerging as risk factors for dementia. Given that sleep loss impairs memory, an important knowledge gap concerns the role played by menopause-associated hormone loss in exacerbating sleep disturbance and, ultimately, cognitive function in aging women. In this review, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining the sleep–wake cycle in younger and middle-aged females, with evidence implicating 17β-estradiol in supporting the memory- promoting effects of sleep.

 They now admit that insomnia is independent of aging, it occurs when ever sex hormones fall below the genetic normal for a patient.  We see this most acutely in patients who have their ovaries removed before menopause.

 So if sleep is vital to avoiding dementia and Alzheimer’s disease, and necessary to your ability to think and problem solve, and to prevent depression and anxiety how does this work?

The basic timing and duration of sleep is regulated by homeostasis (balance of the brain). A person has a necessary amount of sleep needed and everyone is unique.  As you are sleep deprived something called “sleep pressure” increase until you go to sleep and relieve this pressure. The second factor in timing and duration of sleep is circadian rhythm, aligning your sleep and wake cycles to the light and dark cycles of your environment. Estradiol and Testosterone affect both of these natural regulators of sleep.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Medications are getting more expensive, and the % of the price of each medication goes up every year as insurance companies hold on to their profits.  This one fact should make you listen read this blog, but there are more recent changes in medicine that has caused the average patient to take more total medications, and government with the FDA are making the personal cost of medications higher while they create legislation to prevent the use of cheaper and more medications for each medical condition that you have. So it comes down to the following agencies of “health” make more money at your expense: 1. Insurance companies, 2. Medical practices and doctors who are paid by insurance companies make your appointment times shorter and the number of issues they can take care of at one visit, one, 3. The governmental agency that your tax dollars pay for, the FDA block the basic medications from approval because they are not patentable and the FDA is  REALLY just another arm of the pharmaceutical companies.  None of these groups want you to be healthy, because they all make more money when you are sick and need more and more medications, that you pay more and more for every year.

How do we deal with this and make ourselves healthier and at a lower cost?  Efficiency!  That means that you will have to do several things to protect yourself.  The first and most important thing is to take fewer medications by treating the disease that causes the symptoms you take several drugs for, one for each symptom.  I will give you an example that I deal with every day, the symptoms of menopause.  Women who go through menopause not only have obvious symptoms of menopause, but they also have many other symptoms that medicine doesn’t connect to the loss of estrogen and testosterone in women.  For example, we all know that hot flashes, insomnia from night sweats and painful intercourse from vaginal dryness are all caused by loss of estrogen, however medicine teaches doctors to treat these symptoms separately, instead of replacing estradiol + progesterone if you have a uterus.  Treating the cause, replacing estradiol as a patch, pill, vaginal tablet or pellet can treat these obvious symptoms of menopause, but current medical practice tells doctors to give that patient one drug to treat a dry vagina—vaginal estrogen, or vaginal DHEA, or a vaginal SERM, all of which are less effective and much more expensive than giving a woman one prescription of estrogen replacement to treat the whole  body and all the symptoms plus many other symptoms that are secondary to low estradiol/testosterone, but are considered unrelated to menopause, so they need many more prescriptions (and more doctors)!

Symptoms that are considered unrelated to menopause and hormone deficiency, are treated by other specialties with multiple other drugs. For instance, many types of arthritis begin with loss of testosterone and estradiol before and at menopause, however they are treated by a rheumatologist with multiple very expensive medications that have severe side effects.  If menopause is treated with non-oral estradiol and testosterone, then there would be fewer patients with autoimmune arthritis and autoimmune diseases. Most of my patients who have developed these diseases after menopause before they see me are better after I treat them by replacing the hormones they are missing!  One Rheumatologist told me he wasn’t going to send me any more patients because after his rheumatology patients saw me they were better and didn’t need his care anymore! They never went back to him.  That says it all.  My patients who have these diseases not only don’t need the other expensive medications, but they also don’t have pain or destruction of their joints anymore!

Another symptom of menopause is insomnia.  There are many over the counter drugs that are out of pocket and many drugs for sleep that help your inability to sleep that occurs after age 40.

However, when my patients get their testosterone and estradiol replaced, they don’t need sleep medicine anymore!  They save much more money on their copays and over the counter drugs than they spend on their hormone pellets and feel more rested after they get their “sex hormones” back, without other drugs!  Insomnia is not currently considered secondary to menopause by medicine and the FDA, but it is! My patients are proof! My patients don’t have hot flashes, irritability, or painful intercourse either, so replacing hormones treats 3 symptoms of menopause and more than 2 other medical diseases, that are thought to be independent of hormone replacement.

Lastly many women develop migraine headaches at the end of their 30s or the beginning of their40s and they need at least 3 drugs to treat their migraine headaches, and they still are left leaving work to go home and sleep in a dark room the rest of the day.  I know how bad this and the other symptoms of testosterone loss and menopause remove quality of life and limit your productivity at your job….I had all of these symptoms after my ovaries were removed and they all went away the week after I had my first estradiol and testosterone pellets inserted.

Please consider the efficiency of replacing two hormones, estradiol and testosterone every 4 months for an estimated cost of  $170/ month for pellets that are placed under the skin and don’t even need to require daily dosing, AND you can treat ALL of your menopausal symptoms and symptoms of aging, make yourself more productive and a better employee, not to mention getting a great sex life again, and you save money by taking the place of 3-9 other drugs you take over the counter and as over-priced high copay prescriptions!

What this takes on your part may be to find a practice that is like mine that not only replaces hormones but helps you prevent all the diseases of aging! Mainstream internal medicine and primary care is no longer designed to make your healthier, just to put you on more and more expensive drugs that not only stresses your wallet but causes side effects and only leads to more expensive medicines but wastes your time by making you come to the doctor’s office multiple times to write you refills and make you pay copays!  You don’t get healthier that way.

As long as medicine as a business and pharmaceutical companies can make money this way, they won’t change so you will have to figure out how you are going to negotiate the system to get what you need!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

Do you want more energy, improved your immunity, develop better skin and to look younger? These are just a few of the benefits of Red Light (LED therapy), and BioBalance Skin has a Red Light Sauna.

Our Red Light sauna is a 20 minute treatment that you can have once a day every day if you want to.  You just have to be willing to sweat….but you can sit and work on your phone or computer for 20 minutes while you just sit there.  Red Light Saunas make you younger and healthier with an improved immune system just by sitting there—it is a cellular cleanse.

Recommended treatments are 1- 3 x a week, for 20 minutes.  It will dehydrate you and you should drink water before and after the therapy.

Facts: Did you know that red light therapy also called LED Therapy and can activate your metabolism by exciting the mitochondria within your cells that are contained in your cells of your major organs and metabolic systems in your body.

We recommend weekly Red Light therapy in our redlight spa at BioBalance Skin. A Red Light sauna treatment is 20 minutes long.

Instructions: You should bring clothing you can sweat in, that expose at least your arms and legs, but more skin exposure the better.  Your skin absorbs the red light, and it stimulates every part of your body. You will get hot and sweat but your phone and laptop will not, you can work in the sauna, but it is more effective if you are relaxing for 20 minutes.

BioBalance Skin® : Please schedule your 20 minute appointment by calling BioBalance Skin®  at (314) 648-5710.

We provide towels to sit on and dry off with, and the redlight sauna with each treatment.

The cost is $35 for each 20-minute treatment Monthly packages of 8 treatments are $245/use within a month – a year, 8 treatments per month or spread them out within a year from the first treatment.

You will sweat so be hydrated when you come to BioBalance Skin®. You can drink water while you are in the sauna too.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

For decades OBGYNs and oncologists have been denying estrogen replacement to women who have had ER positive Breast Cancer because they believed that estrogen would increase the risk of breast cancer recurrence…As of July of 2022, The National Cancer Institute has reversed the previous position that estrogen in local form for bladder and vaginal atrophic symptoms, and for the systemic form of estrogen would increase the risk of recurrence and death.  Now the findings of the most recent study are that the replacement of estradiol in any form to postmenopausal women who are symptomatic (vaginal dryness, bladder infections and bladder irritability and urinary incontinence), as well as ERT for hot flashes, and depression in postmenopausal ER + breast cancer patients reveal that the risk of death and breast cancer recurrence is no higher among women who take ERT compared to women who take nothing!

In my OBGYNB residency and for my ACOG boards, I was taught that Estrogen replacement was dangerous for women who have had a positive family history of breast cancer, for women who have + ER, + Breast cancer in the past, and for women who are at high risk for breast cancer. The latest study repeals that belief!

This study finally does an “about face” to the previous belief that Estrogen Replacement Causes recurrence or a shortened life span.  The newest study proves what I have seen in my gyn practice: patients taking ERT after non-metastatic breast cancer were safe and had the same rate of recurrence as women who took no estrogen.

In the latest study by the National Cancer Center found that estradiol benefitted women in general and was safe.  The biggest difference between those women who did take estrogen after breast cancer and those who didn’t take estradiol was that women on estrogen had a normal sex life and lived a healthy quality of life, and those without estradiol did not. This finding is the same conclusion I came to by watching my patients with and without Breast Cancer, who took estrogen because of severe menopausal symptoms after non-metastatic ER+ breast cancer.  Recurrence of breast cancer in my 29 years of GYN practice and in the 20 years of BioBalance Health® medical practice was no more common in those who took E2 replacement than women who took no estrogens after cancer!

Finally, research reveals, and I hope medical practice guidelines will soon include the OK to give estradiol of women at risk for Breast Cancer and those who have been successfully treated.   The refusal of doctors to give women what they need after menopause and successful treatment for breast cancer has damaged many women’s lives…Doctors need to realize that quality of life is important and fear of non-documented beliefs just hampers the health and quality of life of their patients.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

When the human body is exposed to radiation (even the sun), toxins, stress, unhealthy food, infection and extremes of temperature and physically stressful environments, it creates unstable free radicals, charged cells that travel through the body causing cellular damage.  For example, oxidative stress causes oxygen, which is usually a beneficial element in the body, to divide into two oxygen molecules, each with a charge. The oxidative stress makes O2 into two oxygen free radicals.  The two free oxygen free radicals are harmful to the body, and the damage is in the mitochondria, and the cell can’t efficiently make energy out of Oxygen and sugar.  Oxidative stress is somewhat like putting a pillow over the mitochondria so the cell can’t breathe! 

How do we get exposed to free radicals?

Sun, processed foods and toxins in the environment. Inadequate supply of antioxidants, fat, and protein, lack of fiber in the diet, inactivity, drugs, smoking, lack of sleep.

Many common items in our diet increase free radicals: Processed flour, wheat, gluten, sugar, sweeteners, and trans-fats.

Source Of Free Radicals and Oxidative Stress

Prolonged oxidative stress (exposure to free radicals) leads to increased risk of negative health outcomes, such as cardiovascular disease and certain types of cancer. It is also thought to contribute to degenerative diseases such as Alzheimer’s Disease, Parkinson’s Disease and Dementia as well as the aging process.

The Treatment for Oxidative Stress, and Mitochondrial Damage

Oxidative stress is treated with antioxidants, microniutrients, supplements, and refraining from bad habits such as smoking, drug use and alcohol.   The antidote t o oxidative stress is found in Antioxidants which are found in fresh fruit and vegetables as well as meat, healthy fats and eggs. They are also made in the body of humans and animals, and can be given as supplements. Antioxidants work by combining with free radicals, which literally defuses them, so the free radicals cannot damage the cellular mitochondria.

“Antioxidants are molecules that fight damage by free radicals, unstable molecules that can harm cellular structures. Antioxidants do this by giving electrons to the free radicals and neutralizing or defusing them.”

Fresh Foods That Contain Antioxidants

Vitamins & Nutrients That Are Antioxidants, Found In Many Foods But Can Also Be Taken As A Supplement:

How do Antioxidants remove free radicals?

Anti-oxidants actually sacrifice themselves to remove free radicals.  The antioxidants bind with the body’s free radicals, making the free radicals safe by taking the charge from them, and then they (the antioxidants) are recruited to protect the cells from oxidative damage.

The outcome of unfettered Oxidative Stress is damage to cells, proteins and DNA. This causes aging, disease, degeneration of tissues, and finally cellular and whole-body death.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Mitochondria are discussed in antiaging advertising like they are understood by the common man.  Even TV discussions and podcasts discuss mitochondria like we are all biology majors, but to most people mitochondria is a word but most people don’t know really what they are.  Most people think Mitochondria are “good”, but what are they? Some examples of ads that use the word Mitochondria, reads

“Take these Anti-oxidants every day and you will heal your mitochondria, and live longer…”

“Your mitochondria are sick and need to be treated with BLANK to bring you back to health, just buy….”

In reality, most students of biology and medical doctors are the only people who understand what they are and how they work, what can make them “sick”, and how to make them operate normally within each cell of our body. Simply mitochondria are organelles that take BS and Oxygen and make energy.  You can think of it as “breathing for the cell” , by taking blood sugar and O2 and creating energy, CO2 (carbon dioxide) and water H2O.  Mitochondria are the tiny determiners of our ability to metabolize food and make the energy the cell needs to do its job effectively.

I bet you never thought anything about the fact that when you breath oxygen it goes into your blood stream on your red blood cells, and delivered to your tissues by diffusion through capillaries and enters the cells within your tissues…but what does it do then to sustain us?  That is where Mitochondria come in…as they work as I described in the previous paragraph.

Another important piece of information about the mitochondria is that they are passed from mother to child, which means your metabolism is secondary to the genes only your mother gave you!  We call this genetic communicator that tells cells how to function metabolically, mitochondrial DNA!

To locate our mitochondria, we must take a microscope to the human body, and successively dissect her into smaller and smaller parts:  A whole human body, divided into organ systems eg. Skin, Gastrointestinal system, then divided into smaller parts called tissues such as muscles and neuro-tissue.  Smaller still are the specialized cells that make up the tissues, call cells.  Smaller still are the mitochondria that are located within each cell in the body, providing energy to the cell, to make the whole-body work!

Mitochondria are small, oval, sub-cellular “ energy packs” located inside every cell in our bodies.  These small oranelles within our cells turn sugar (glucose) from our food, into ATP (energy) and Carbon Dioxide (CO2).  They act like miniature lungs, taking in sugar which is made of oxygen and carbon, and returning CO2 as a by-product.   Scientists say that mitochondria’s activity is “respiration”!  The CO2 passes out of the cell and is excreted by the lungs.

So why do we use Mitochondria as a catchword for a way to sway lay people to buy a product to keep them healthy?  It is a way to explain complicated physiology to people who aren’t trained in a particular science like medicine or biology, and a way to sell products.  The word mitochondria is associated with sickness and how to get better and it becomes a catch word everyone knows and wants to “fix”.

However, if it is a fad or an advertising method to sell something, knowledge of what mitochondria need to make energy, is a valid pursuit. 

In short, your cells need plenty of oxygen, healthy foods, exercise and a clean environment to make energy effectively in your mitochondria.

Because our food sources do not have adequate nutrition for us and our mitochondria, we must eat foods that are particularly packed with nutrients and or add supplements such as resveratrol, Alpha-Lipoic Acid, L-carnitine and omega 3 oils to heal our “sick mitochondria”.

All the while we are trying to “help our mitochondria” with nutritious food and supplements, many of us are inactivating our mitochondria just when we need them most!  How you ask? Those of the many people who take statins are inactivating their mitochondria 24-7.  That is how a statin works!  Statins inactivate mitochondria to decrease the production of cholesterol in the cells.  So why are we killing our ability to make energy and to be healthy, just to decrease our chance of getting heart disease later?

Statins are only worth the risk if you have already had a heart attack or are about to have one and have narrowed atherosclerotic arteries.  Statins don’t treat anything, but your cholesterol lab values, and only prevent additional buildup of more plaque. Some of my patients think statins are cleaning up the arteries, but they do not do that!  The risk for a heart attack includes blocked arteries, inflammation, smoking and a high Homocysteine level and Family history.  To clean up blood vessels, Zetia is the atherosclerotic cleaner-upper without the risks of a statin!  Zetia leaves your mitochondria alone!

To know if you actually have atherosclerotic plaque, you should have a cardiac calcium scan to see if you do or not!  I have high cholesterol, and no plaque (I had one test in 2002, and one in 2019. High cholesterol doesn’t necessarily lead to heart disease, but it does definitely stop your mitochondria from working!

Since the mitochondria are so important to health, we will talk about How mitochondria can get sick and cause us to be sick in many ways throughout our body.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

One of my patients asked me why I was putting her on Metformin if she wasn’t really diabetic yet, another woman I was consulting on asked why I’d put her on a dangerous drug, and another patient with Fatty Liver refused to take Metformin because it is for Diabetes and not for Fatty Liver!  These patients made it clear that I had to create a Healthcast and blog about the miracle drug, Metformin.

Metformin has been around since 1994 while early in my private practice. Metformin quickly became the first line therapy for type 2 diabetics.  was the first line of treatment for type 2 diabetics.  In that 40 years using Metformin for diabetes has opened a whole range of other diseases and conditions that Metformin can be used for, such as:

How does Metformin work?

Metformin exerts its hypoglycemic effects by:

When I find a patient with signs of Diabetes, a high HBA1C, and or an elevated fasting Insulin level (above 10), or consistently elevated FBS I prescribe Metformin for patients who don’t have AODM yet, but who will progress to it if they are not treated and learn to eat low glycemic foods, and to exercise.  Generally, the patients that I label with Metabolic Syndrome, revert to normal and don’t proceed to AODM.

I also use this drug for weight loss because most weight gain in women after 40 is because they have become menopausal and have a loss of testosterone which causes them to gain weight and become insulin resistant.   Metformin, Diet and Exercise all work together to reverse the process and decrease a woman’s chance of getting AODM. 

What medical Diseases and Problems Do I use Metformin for?

Other patients who may or may not have IR, but who have elevated liver enzymes from Non-Alcoholic Fatty Liver Disease (NAFL) are placed on Metformin to reverse this problem as well.  I have seen many patients who thought they were doomed to having fatty liver and possibly developing Liver Cancer, become healthy, lose weight and normalize their previous Fatty Liver.

High Triglycerides (TGs) are generally from too many simple carbs over time and increase as insulin resistance gets worse with aging and length of time eating the wrong diet.  Diet and exercise are necessary to drive the TG down to normal, but patients rarely stick to these lifestyle measures unless they see a visible change in their body composition.  Metformin can make that possible and be the factor that leads patients to a healthier lifestyle.

“Cancer Loves Sugar” so I try to explain that the 2 largest factors in recurrence of a cancer or even getting any cancer are obesity and dysregulation of blood sugar with insulin resistance. Both can be transformed by diet exercise and metformin!  You can literally decrease your cancer risk by losing weight and not eating simple carbohydrates.

Elevated Prolactin levels that are not in the tumor range are lowered in both men and women with Metformin.

The article in the latest Psychiatry Today shows a use for Metformin for mood disorders.

Psychiatrists use metformin ER to decrease the weight gain often caused by anti-psychotics.  They also find that metformin increases repair in the brain and activates the brain to increase Motivation, cognition, and dopamine. This is a benefit for patients who may be on antipsychotics for life and need help with the side effects.

Countering Inflammation that causes osteoporosis, degenerative brain diseases, frailty and arthritis.

Antiaging is stimulated by Metformin..how does it work?

Improving nutrient sensing

Enhancing autophagy

Enhancing intracellular communications

Protecting against macromolecular damage

Delaying stem cell aging

Modulating mitochondrial function

Regulating gene transcription

Lowering telomere attrition

How Do I prescribe Metformin?

There are two types of Metformin, the short acting form of metformin which is made to be taken with each meal to manage BS after eating for diabetics only, and the long-acting type of Metformin, which is called Metformin ER or XR, and this is the type I use for every other problem including IR, and Prediabetes.  The long-acting form must be taken with a meal, or it simply will not work!  Generally, the dose is started with on 500 XR tablet with the largest meal of the day, then increasing each week to the max of 4 x 500XR tablets per day if needed.  I write smaller doses for less severe dysregulations, and larger for severe IR, Obesity, and higher weight individuals. 

Don’t take Metformin plain for the conditions above unless you have Diabetes and need help lowering your blood sugar. For patients who are on either form of Metformin for long periods of time, Methyl B12 should be prescribed as

Why are we all not on this drug?

The FDA works slowly and even though many of these attributes of Metformin are known in the medical community, doctors tend not to use a drug that is not approved by the FDA…even though medical studies have proved its benefit!  For those of us who know that the FDA may never look at this drug for any other uses, and that our patients need it now for reasons other than metabolic syndrome, we forge ahead and use it off label for the reasons above!

Ask your doctor about this inexpensive medication that can do you so much good!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

At BioBalance Health our primary goal for our aging patients is to reverse the process of aging and treat their symptoms and body composition changes that come with loss of Testosterone in women and men.  We also have a secondary goal   to make our patients healthy for a lifetime and prevent the many diseases of aging!    

 The diseases of aging are also started when Testosterone is deficient, years before we actually are diagnosed with one of the diseases we associate with aging.   I am listing the diseases of aging below  so you can decide if you already have one of them or if your family history put you at risk for them.  We treat preemptively for these diseases if we see any sign of them and often can prevent them, stop their progress or decrease the symptoms of these diseases.

If you have one or more of the Diseases of Aging or they run in your family:

then BioBalance Health®  can bring you back to health and prevent the diseases and symptoms of aging for you!  Please go to our website to fill out our forms and we will call you to make an appointment!  BioBalancehealth.com.

 If you have noticed that you look old in the mirror and have:

Then make an appointment at BBH BBSkin® to have a consultation, develop a treatment plan just for you and take care of the visible signs of aging skin .

Our weight Loss program can be combined with the BBH treatment and BBS beautifying skin treatments.

We provide diet and exercise treatment plans, and then make them, more effective by adding Testosterone pellet therapy i(f indicated), and or medications like Ozempic, Rybelus, Appetite suppressants, Metformin and oteher cutting edge weight loss meds and  individualize your treatment plan, while we follow your progress with our INBody Body composition scale.  We also offer Lipo-plus and HydroxyB12 shots in our office for our pellet, weight loss and esthetic patients.  Sometimes we incorporate peptide treatment and supplements to assist the rest of our diet program.

Some people are more difficult than others to start weight loss…but as you heard from our patient who sent a letter to Dave and Trish.

If this sounds like what you need and you are in the area of Kansas City or Saint louis where our offices are located, then go to our website and hit the button New Patients and change the course of the second half of your life!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

BioBalance Health LLC turns 20 this year!   We have been changing the lives of our patients for two decades. Every day I get amazing positive feedback, that makes me KNOW that I have found a unique answer to aging and a health program to treat all the symptoms of aging and prevent the diseases of aging with replacement of one hormone, TESTOSTERONE! We offer Replacement of bio-identical pellet Testosterone for men and women, and estradiol pellets for women combined with treatment of all other hormone deficiencies, and preventive treatment and lifestyle changes. We also have a very effective Medical Weight loss program that is very effective using multiple methods of weight loss and the newest weight loss medications tailored to your individual challenges.  We even follow your weight loss with an advanced body composition scale. Our third avenue to fight aging is our medical spa, BioBalance Skin®, that fights aging and makes our patients look as good as they feel.

I created BioBalance Health LLC to be the ultimate medical practice to treat patients over 40, to treat the symptoms and diseases of aging. BBH practices medicine the way it was meant to be –individualized for your specific issues—with the goals of bringing women and men back to robust health, physically, sexually, mentally and esthetically. BBH is my dream medical practice both for our patients and our medical and esthetic staff.

My patients are amazed at their progress and ecstatic about how they feel, in contrast to the debilitated feeling they had before coming to us. Bio-identical Testosterone pellet treatment is the foundation of our Anti-aging treatment plans.  Our goal is to bring you back to quality of life, with a great sex drive and a younger body and mind. I get a lot of positive feedback in the office from our patients who tell me the following things:

“You saved my life!”

“You saved my marriage!  We love each other again and have recovered the sex lives we had in our 30s”

“I have Rheumatoid Arthritis and have been limited by pain to sitting in a chair all day long.  After my first Testosterone and Estradiol pellets, I painted the whole inside of my house”

“My insomnia was severe and affected every area of my life but with testosterone pellets I sleep through the night and wake up refreshed. My medical problems have all improved.”

“I had ED and was treated elsewhere with Viagra and Cialis which improved my physical problem, but it didn’t help my lack of desire.  With BioBalance I got testosterone pellets and treated my prediabetes, atherosclerosis and I am healthier, and I have a sex drive and no ED!”

“I am 68 and I feel like I am 35 again!  Everyone asks me what I have done to look so good, and I just say BioBalance!”

BioBalance Health is known for offering their new and follow up patient’s hour-long consultations with a doctor to review all of a patient’s health history, lifestyle and lab results finishing with an individualized treatment plan. 

Recently I was forwarded a letter from Dave Glover and Trish Gazall our key advertising voices in the Midwest on AM 1120, FM 97.1 They both have been treated for the symptoms and diseases of aging and weight loss with much success and this letter was sent to them, about BioBalance Health®.  The letter- author wants to remain anonymous.

Shortened. Letter to Dave Glover

Dear Dave and Trish,

I want to give a shout-out to BioBalance Health. BioBalance has made such a difference in my health!

I remember about 10-14 years ago when you (Dave) had Crane Durham on your show, and he essentially said people are fat because they are lazy. At the time, I had been exercising regularly, with little to show for it. I had polycystic ovarian syndrome and had both of my thyroids removed, due to thyroid cancer. It was really demoralizing to know that people would make assumptions about my character and work ethic based on how I looked, without knowing anything about my medical struggles.

At any rate, I eventually resigned myself to the fact that my body was destined to be fat and there was nothing I could do about it. Exercise wasn’t helping and diets worked only if they were extreme and only for so long, so I finally gave up trying to fight it.

Over the years, I listened to your advertisements for BioBalance Health and didn’t give it much thought. But for some reason, I decided to give BioBalance a try in the summer of 2020.

I was amazed at how thorough their medical intake and blood testing was! They asked me about everything — even a foul ball hitting my head at a Cardinals game was of interest to Dr. Sullivan and I had never given the incident a second thought. Dr. Sullivan determined that medications I was being prescribed for my thyroid replacement by my Primary Care Doc was not adequate. She also diagnosed me with a metabolic syndrome. After struggling all those years, it was a relief to know that there really was a biological element behind my weight gain.

For a while, I didn’t really notice much of a change …… But Dr. Sullivan kept testing and kept tweaking my treatments. Jodie Tankersley convinced me to stick with it, and Lo and behold, we finally found the right medications for me and I began losing weight! I have lost 9.1% of my body fat and am down 35.5 pounds! (All of this was WITHOUT any significant change in diet or exercise. Don’t get me wrong – they have advised dietary changes and I SHOULD be following them. But I wanted to test if it really was about body chemistry and medication.) I still have some way to go before I get back to my pre-child-bearing weight. But I am so encouraged and motivated now that diet and exercise will just help me go further.

I don’t think it is hyperbole to say BioBalance has been life-changing for me. Dave, I am often skeptical of your pitches because you tend to over-sell. But, in this case, I don’t think you can say enough. I honestly thought this was going to be another dead end in my struggles and I am so grateful to be wrong. Please continue to encourage your listeners to try BioBalance – even if nothing else has ever worked.

BioBalance is the real thing.  If you have the symptoms of aging, we can reverse the process and bring you back to health!

If you have experienced three or more of these symptoms, you may have Testosterone Deficiency Syndrome. But take heart – there is hope! You don’t have to live like this any longer.

I ask my patients whether they have these symptoms anymore at the second consultation and I generally get a “no’ to each one.  If they are not all cured, then I develop a treatment plan that will adjust the dose of pellets or one of the other treatments I started at the first visit and inevitably all the symptoms are gone on the second or third pellet visit.

Review of lab and patient’s initial symptoms is done in the first 2 visits and yearly to make sure our treatment plan is making an individual patient all better!

Next week we will review the diseases of aging that BBH treats or prevents by using the foundation of testosterone and estradiol hormone replacement.  We will talk about prevention of diseases that occur with aging and treatment of the disease of aging with hormones and lifestyle changes. Our goal is to make our patients healthier no matter how old they are and to improve their quality of life.  It is a lofty goal but one that we have been successful to achieve in thousands of patients over the last 20 years.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Women always ask about my goal for their blood level of free Testosterone after insertion of testosterone pellets.  That is a good question, and it is not easily answered. When I was trained by Dr Gino Tutera in 2002, and he taught me that the optimal range for Free T in women who take T pellets to be over 15 pg/ml.  He taught me that each woman is an individual and the blood level that they need is specific to their metabolism and genetics.   To determine the perfect level of T free for an individual we should follow the resolution of her symptoms after her T pellets are inserted. Today we will talk about the research done by Dr Rebecca Glaser, published in Maturitis 74(2013) that confirms my practice of adjusting the dose of pellets based primarily on the resolution of Low T symptoms.  Prescribing pellet Testosterone for woman is not easy and her doctor must find her own ideal blood level.

Testosterone replacement for women has been ignored as an essential hormone replacement for women, and until recently was not considered a major sex hormone in women. Premenopausal women have 15-20 times more testosterone than estradiol circulating in their blood streams. This makes testosterone the most prevalent sex hormone in premenopausal women, yet it is still mislabeled as a strictly male hormone! 

After late 30s to mid 40s women develop a deficiency in testosterone and develop a host of symptoms that doctors have sadly called the symptoms of “aging”, when the symptoms are directly related to the lack of free T in a woman’s circulation.

Both pre- and post-menopausal women over 36 may experience the following symptoms of testosterone deficiency:

One of the reasons that the majority of doctors don’t use T pellets is because it takes intense individual training after residency and time and attention to each patient, her symptoms, and time for multiple adjustments of dose before the maintenance dose is determined.  This is something a doctor or nurse must do all the time to be good at it and the doctor must have a complete grasp of endocrinology, nutrition, and gynecology to become good at this type of T hormone treatment.

Once the pellet dose is determined it is the most convenient dosing schedule (once q 4 months, only 3 doctor visits a year) with 100% compliance because the T Pellet dose is given in the office, very rare complications, and an amazingly complete resolution of symptoms, which has not been seen in any other T preparations, bio-identical or not, given with a different delivery system.

With the right doctor or Nurse Practitioner, a knowledge of pharmacology, endocrinology, gynecology and nutrition, this form of T delivery to women brings them back to a more youthful body and mind as well as prevents diseases of old age such as Osteoporosis, Heart disease, Sexual Dysfunction, mood disorders and autoimmune diseases to name a few.

In the research paper by Dr Rebecca Glaser: Testosterone implants in women: Maturitis 2013 Dr Glaser explains that there are many problems secondary to following blood levels to determine dosage, and explains why following symptom resolution is the preferred way to provide this type of Testosterone replacement:

Specifically,

Blood tests of free T are rarely repeatable and often wrong—it is not a good, repeatable blood test. The only thing less reliable is saliva testing which I don’t recommend. No single blood test represents the true daily blood level of free T in pellet patients. How fast your body uses the available T up, varies by number of hours or sleep, stress level, estradiol and estrone levels and amount of exercise engaged in per day. Fat metabolic activity: T pellets are inserted into fat in the hip and as we are now discovering, the ability of fat to dissolve a steroid hormone placed in fat is individual and determines how quickly the pellet is dissolved and needs to be re-dosed. There is no test for this, so trial and error is needed using different dosage to determine ongoing maintenance dose. ARs (Androgen receptors) are distributed throughout the body and the number of Ars plus the “stickiness” of the receptors for free-Testosterone in the blood, is determined both by genetic makeup and age. ARs of people with dominant genetics from the northern latitudes, are relatively resistant to binding, and these receptors must have a higher blood level to respond at an optimal level.  Women who have their dominant genetics closer to the equator, require less free T to achieve optimal symptom relief.  The genes are not specifically discovered as of yet, it is impossible to test a patient to see if they have strong or weak receptors. This discovery is found through trial and error.  Age also causes a loss of the # of receptor sites, therefore more T mgs are needed in the pellets. Estrogen interferes with the free T level from a particular dose: Binding to SHBG decreases the active form of T (T free) per dose of T pellet. The amount of estradiol and estrone a woman has been given or makes, decreases the amount of active T free.  The lower the Estrogen levels, the lower the SHBG and the more T free is available. Cortisol Binding Globulin goes up when Cortisol increases secondary to life stress, surgeries and illness. This binding globulin inactivates the testosterone and decreases the percentage of active T. Speed of a woman’s Liver metabolism is increased by multiple drugs that go through the P450 system, alcohol intake, fatty food intake, and amount of environmental chemicals that act like estrogens. One patient’s liver metabolism of T through the P450 system is individual and is not the same for another woman of the same age, weight, etc.  The speed of breakdown of T determines how fast the T pellet is used up.

There are several other dosing issues that are addressed after the first pellet insertion in preparation for the second insertion. Most important is whether their symptoms are completely gone.  If they are, we leave the dose the same, if not they usually need more T dose, or they are converting T into E1 and E2 which binds the T free and lowers the effect.  For this we exchange one of the T100 mg pellets with one TA 90/10 pellets, which blocks the conversion, and releases the T free and stops increasing the E1 and E2.

There is a small percentage of women of women who do not tolerate TA pellets.  They feel like they have no sex drive and don’t feel their T free as they should….it is an opposite reaction, because in everyone else the T free is higher, they feel more sex drive and lose belly fat.  If the “opposite” patients still need to lose belly fat and lower their T-free, DIM, zinc, and Calcium D glucarate can be used to lower the Estrogen in the circulation.

I agree with Dr Rebecca Glaser MD, who states that dosage should be guided by safety, tolerability and clinical response, rather than a random T or T free levels, yet I always draw blood levels to find out if a woman’s ideal blood level specific to her has been reached, and if it is repeatable.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

At a get together of friends, I was pulled aside by a good friend who asked me how she could prevent dementia, because the mother she loves is in a memory care facility and she never wants that to be her future!  My answer was brief, but I can now think of so many other things I could have recommended for her, and I thought I would share them with you, and I will give her a copy of the blog that goes along with these suggestions.

I read research every day that tells doctors what causes dementia and increases risk of getting dementia at the middle or latter part of life.  When I get to the basis of all the findings in the medical articles, it is detailed as I will discuss, But the basic qualities and problems to treat include INFLAMMATION, ATHEROSCLEROTIC VASCULAR DISEASE, OBESITY, HIGH SUGAR DIET, HIGH BP SMOKING AND ALCOHOL AND POOR DIET.

Risk of Dementia Includes the following categories of Modifiable Risk factors:

 Low Testosterone and estradiol

Chronic inflammation Obesity Diabetes High BP Depression Cigarette/cigar smoking Hearing loss Binge Drinking and excessive alcohol intake Sedentary lifestyle Lack of sunlight High carb diet—sodas, sugar Aging= low sex hormones, poor production of nitric oxide and poor absorption of oral vitamin Bs Chronic injuries and pain that cause chronic inflammation—get that knee or shoulder fixed! Chronic heart disease---arrythmia, atherosclerotic heart disease

Foods to Eat Prevent Dementia

Eggs in moderation Cumin Anything with protein Yogurt and other foods (Kambucho) with probiotics and lactobacciluus Clean fresh foods Meats and fish that are fresh or frozen, not preserved, or processed Steamed or fresh vegetables (not canned or processed) Seeds and nuts (raw and roasted without salt preferable)

Foods to avoid to prevent dementia: Inflammatory foods and soy products

Milk, especially cow’s milk. (High carb content) especially skin milk! Soy All phytoestrogens Wheat Food with preservatives (all processed foods have preservatives)

Modifiable risk factors

       Replace hormones that are missing with bio-identical hormones, non-oral delivery system

Estradiol pellets, patches, gels, for women Progesterone for women who miss it or who have a uterus Testosterone pellets, creams, gels Thyroid replacement. Armour Thyroid for women and levothyroxine for men Neurotransmitters by taking probiotics

      Suppress LH and FSH –high levels increase risk of dementia and osteoporosis (new study)

Take estradiol and testosterone for women—enough to suppress FSH and LH to pre-menopausal levels Replace Testosterone for men

Keep Blood Sugar Normal

Eat a low sugar and low carb diet— Treat prediabetes with meds Treat diabetes with meds Decease alcohol; intake to 1 4 oz glass of wine a day and < 1.5 oz of alcohol/day Get to ideal weight

Achieve Ideal Weight –Obesity and Overweight Increases Inflammation That Increases Dementia, so Decrease Inflammation

Eat properly--Eat your base caloric intake or less daily Low carb diet Eat ½ X -1 X your body weight in protein daily Drink clear water equivalent to your weight in ounces (you weight 130—drink 130 oz of water a day) No Soda No alcohol until you achieve ideal weight No desserts or baked goods, rice, wheat products until achieve id3al weight Supplements—see below

Exercise Daily

Aerobic exercise--for > 40 minutes a day Weight training 3-4 times a week

Red Light Therapy especially in the evenings—activate your mitochondria!

Directed toward skin for 20 minutes a day Specific red-light therapy –to face or area of pain

Natural light in AM

Step outside at sunrise or early morning for 15-30 minutes—no sunglasses

 Sleep

     Supplements -Take a multi vitamin every day like Thorne daily Nutrients 2/day +

Aspirin 81 mg/day

Milk thistle

Curcumin

Omega 3 and 6 oils

DHA

NAC

DIM

Arteriorisol

Non-modifiable risk factors:

Race (Am Indians and Blacks have a higher risk) Early age of menopause (without hormone replacement) Genetics: HLA-DR15 tissue type, APO-E ¾. And 4/4 Less than high school education

Just a word about genetics. We now know that even if you carry genes for dementia, you can modify your genetics…there is hope!  This new concept is called epigenetics, and it shows that the factors we employ above can put certain dementia genes “to sleep” and activate other genes that are going to make you healthier!  We are no longer a puppet of our genes!

Genetic Risk for late-onset Alzheimer’s disease (LOAD), the most prevalent dementia, is partially driven by genetics. To identify LOAD risk loci, we performed a large genome-wide association meta-analysis of clinically diagnosed LOAD (94,437 individuals). We confirm 20 previous LOAD risk loci and identify five new genome-wide loci (IQCK, ACE, ADAM10, ADAMTS1, and WWOX), two of which (ADAM10, ACE) were identified in a recent genome-wide association (GWAS)-by-familial-proxy of Alzheimer’s or dementia. Fine-mapping of the human leukocyte antigen (HLA) region confirms the neurological and immune-mediated disease haplotype HLA-DR15 as a risk factor for LOAD. Pathway analysis implicates immunity, lipid metabolism, tau binding proteins, and amyloid precursor protein (APP) metabolism, showing that genetic variants affecting APP and Aβ processing are associated not only with early-onset autosomal dominant Alzheimer’s disease but also with LOAD. Analyses of risk genes and pathways show enrichment for rare variants (P = 1.32 × 10−7), indicating that additional rare variants remain to be identified. We also identify important genetic correlations between LOAD and traits such as family history of dementia and education.

If you’re a doc you probably understood this abstract from a recent article ..if not.. disregard.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

BioBalance Health® has always been on the cutting edge of the newest medical methodology available. In the fight against cancer, we are now using he newest genetic methodology to find cancers early, when they are treatable. Throughout my almost 40 years of practicing medicine, I have believed that medicine should embrace preventive care and be based on the belief that we should only react to a disease that is already established.  Now we finally have one test that screens for 72% of the cancers that we can’t screen for.  It is hard to believe that  out of the 55 types of cancer we can only screen for  5 Cancers!   Medicine has only developed 5 screening tests that are currently in use to find cancers early.  

Galleri is one simple blood test that screens for 50 types of cancer, to find them at early treatable stages, before they create symptoms, metastasize, or produce any symptoms. Galleri was created for those patients who have a positive family history of cancer, or those patients who are fearful of getting cancer of any type, and for those patients who have been successfully treated for cancer who want to find out early, if they have a recurrence! 

Galleri It is the dream child of a company who has been testing and retesting it with the finest geneticists in the US. We are offering this test through our office as an option for those who need it to truly practice preventive medicine!  With Galleri, you have a good chance of being cured of cancer through very early detection!

Before Galleri® was invented patients only had 5 cancers that could be detected early by screening tests.  The following list enumerates the 5 cancers we have screening tests for.

Breast cancer: Mammography can find cancer after it has been growing for 11 years. Cervical Cancer: Pap and HPV Test only finds the virus and possibly the cells that might be cancer. Colorectal Cancer, Colon Cancer: Colonoscopy and stool tests Lung Cancer: Low Dose C-T Scan Prostate Cancer: PSA Test

Routine screening tests are recommended because they have been proven to save lives by detecting some cancers earlier.3 The Galleri test does not preclude the use of the 5 screening tests that are currently in use, however there are more than 50 cancers that Galleri® can test for, and you receive your results in 10 working days.

It is time to look at cancer more broadly, in addition to the 5 cancers that are routinely screened for today.

The most important cancer is the one that you or your loved one may have — and curing cancer starts with knowing you have it!

If cancer runs in your family, and you lose sleep worrying about it you should take the Galleri® Test.  If your genetic relatives (father mother, aunt or uncle, sisters or brothers or children have had cancer then testing yourself for cancer with Galleri® will answer the question as to whether you have it or not.

Our patients at BioBalance Health® are offered this test yearly for high-risk patients and as needed, often less often than yearly.  The test is not covered by insurance as it is a new test…but can you wait until it is covered?   Worrying about cancer can make you literally sick by stimulating your adrenal gland’s production of cortisol.  This worry impairs your immune system that protects you from cancer, putting you at higher risk!

The only risk of Galleri® is the cost…$ 1,250 paid directly to the Galleri® company at the time of your blood draw.

50 Types of cancer detected by Galleri®

The Galleri test is a multicancer early detection test that detects a common cancer signal across more than 50 types of cancer through a simple blood draw.

A

Adrenal Cortical Carcinoma

Ampulla of Vater

Anus

Appendix, Carcinoma

B

Bile Ducts, Distal

Bile Ducts, Intrahepatic

Bile Ducts, Perihilar

Bladder, Urinary

Bone

Breast

C

Cervix

Colon and Rectum

E

Esophagus and Esophagogastric Junction

G

Gallbladder

Gastrointestinal Stromal Tumor

Gestational Trophoblastic Neoplasms

K

Kidney

L

Larynx

Leukemia

Liver

Lung

Lymphoma (Hodgkin and Non-Hodgkin)

M

Melanoma of the Skin

Merkel Cell Carcinoma

Mesothelioma, Malignant Pleural

N

Nasal Cavity and Paranasal Sinuses

Nasopharynx

Neuroendocrine Tumors of the Appendix

Neuroendocrine Tumors of the Colon and Rectum

Neuroendocrine Tumors of the Pancreas

O

Oral Cavity

Oropharynx (HPV-Mediated, p16+)

Oropharynx (p16-) and Hypopharynx

Ovary, Fallopian Tube and Primary Peritoneum

P

Pancreas, exocrine

Penis

Plasma Cell Myeloma and Plasma Cell Disorders

Prostate

S

Small Intestine

Soft Tissue Sarcoma of the Abdomen and Thoracic Visceral Organs

Soft Tissue Sarcoma of the Head and Neck

Soft Tissue Sarcoma of the Retroperitoneum

Soft Tissue Sarcoma of the Trunk and Extremities

Soft Tissue Sarcoma Unusual Histologies and Sites

Stomach

T

Testis

U

Ureter, Renal Pelvis

Uterus, Carcinoma and Carcinosarcoma

Uterus, Sarcoma

V

Vagina

Vulva

The Galleri test is intended to detect a cancer signal and predict cancer signal’s origin to inform diagnostic evaluation.

Cancer cases enrolled in CCGA Study1 were assigned a ​“cancer type” as defined in the American Joint Committee on Cancer (AJCC) manual (8th edition)2 (For this list of Cancer types detected, some of the names were modified/​edited to organize for easy reference). Cancer signals were detected across more than 50 AJCC-cancer types, which supports the potential for the Galleri test to detect a cancer signal over a diverse range of cancers across a wide biologic spectrum.

 If you are a Biobalance Health® patient you can ask your Nurse Practitioner to make an appointment to have your blood drawn at our office. 

The Galleri Test was created by GRAIL. 

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Don’t stop at the headline of a written article or blog about hormones or you who take hormones will unnecessarily feel anxiety all the time.  Journalists and bloggers often get you to read an article by first scaring you with a scary title….then reassuring you in the article. This is the first and primary problem with making assumptions about hormone therapy from, including estradiol, testosterone and progesterone.

Research Translated into Lay Language Generalize All Hormones into One Big Group

When reading anything about “Hormone Therapy being dangerous or safe, the author is lumping hundreds of types of hormones into one category and by doing that, dooming hormones to look like a failure, when they are not.

Not all hormones are alike, and the difference between how you take a hormone (oral, pellet, vaginal, etc.) changes the safety and effectiveness.  The other factors that change the effectiveness of hormones like estradiol and testosterone include:

All of these factors change the effectiveness of a hormone treatment in humans. Most of the time, the investigator of a medical study uses one type of hormone for his scientific tests, but generalizes the side effects or the effectiveness of that one specific type of hormone, to ALL hormones in that category, eg. Testing Oral Premarin and generalizing it to every type and kind of estrogen on the market.

For instance, Premarin® a synthetic estrogen from Pregnant Horses, was the estrogen used in a study that determined that “estrogen” causes a woman to be at risk for blood clots. This is true of the oral hormone Premarin and many doctors took their patients off all estrogens based on that one study.  Much later, years, other types of estrogen were tested for increasing the rate of blood clots and were found NOT to increase the rate of blood clots.  After many studies of different delivery systems of estrogen, the final agreement is that all non-oral forms of Estrogen Do NOT cause blood clot formation in women taking them.

That sounds like justice was served, but for the 10-20 years in between the Premarin study and the other studies and the time it takes to get a final agreement of doctors, women were denied all forms of estrogen from their doctors based on this inaccurate interpretation and generalization of one medical study!

For example, if a scientific study stated that all ice cream flavors tasted the same, could I convince you that all ice cream, of all flavors, taste the same?  Of course not, because you have experience eating different flavors of ice cream and you know that every flavor of ice cream and even different companies making the same flavor tastes different!  That is the biggest clue to doctors reading a study.  If the results don’t match their experience, they question it and should follow their experience until more study is done.  Some doctors follow blindly the results of studies or follow the ones they WANT to follow because it relieves them of work.  That is one factor in causing doctors to stop prescribing estrogen based on the study that said all estrogens caused blood clots, was that of laziness!  Hormone therapy requires hours of explanation, which means time in the office and doctors who are overworked found a way out for themselves to shorten their days!  Not talking about hormones and stating, “I don’t believe in hormone replacement therapy”, was their mantra and the cause of so many women being untreated with postmenopausal estrogens!  If your doctor says that, then flee!  Find someone who can take care of you properly.

The doctors aren’t the only ones who create the atmosphere of false information. The medical research community is trying to do with the medications (hormones) called HRT (Hormone replacement therapy) and Testosterone. Researchers  are trying to tell us that all hormone treatments are the same with the same side effects and the same qualities, no matter what they are made of (plants vs chemicals) or what hormone is contained in them (horse estrogen with 18 types of horse estrogen, none of which are similar to human estrogen) that the way they are given (oral, transdermal, injection or pellet) matters to the effect that they have on a patient.

The effect the hormone makes, and the metabolic effects are all lumped together by the research community. It’s like saying all Labradors are great hunters.  They aren’t, but to do a study you need to make a blanket statement to prove a point.  This doesn’t make sense in many areas of study, but it is really misleading in hormone research.

To get to the truth one must use a specific hormone in their tests and to get anyone to read about it they must inaccurately generalize to all hormones! They spend their time writing papers about how “estrogen” (all of them) and “testosterone “(every type, brand, and delivery system) cause side effects and diseases.  These grossly overgeneralized conclusions about hormone replacement, leads to false beliefs and fears that cause doctors and patients alike to be afraid of prescribing or taking any of these medications, hormones, that are desperately needed by women to feel and be healthy.

Remember a title about hormones can be misleading!  Even studies are often overgeneralized, so their results are alarming for no reason!  You have to ask someone who sees many hormone replacement patients what they actually see!  Experience is everything when deciding what research is really true!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Many people don’t get what they need from their doctor’s office appointment in this modern age of 10-minute doctor visits. They complain about it but don’t know how fix the problem.

I would like to challenge you to prepare yourself for your doctor’s visit before your doctor appointment, because it is the only way you can get the treatment you need.

 Doctors are smart and the most intensively trained professionals in our society, but they are often not the best communicators.  Your success when trying to get the right treatment is half your responsibility and half your doctor’s. Here are a few things you can do to start the office visit for a problem you are having,  in a way that helps your doctor come to the right treatment for you.

PATIENT’S ROLE:

DO write down your Chief Complaint (the primary problem you are seeking a solution to) and bring it with you.  Think about it before your go to the office, or while you’re in the waiting room. 

Then write down your symptoms in a list.  These symptoms that you have, when they started and how severe they are, become the clues for your doctor to solve the mystery of your medical problem. If your doctor gets distracted, you can hand him the list of symptoms you have written down.

DON’T launch into a long story!  Stories are often convoluted and unrelated to what the problem you are seeing him or her for and will confuse the issue for your doctor.  The office visit is not long, and you will waste your time talking about what you had for lunch instead of what is bothering you.

Years ago I would accompany my MIL to the doctor and she would tell him everything that occurred since her last visit..what she ate, when she went to bed, trouble with her heating and cooling system…and I could see the doctors eyes glaze over.  She never got to the reason she was there, and he doesn’t have ESP, so it took multiple office visits to get to the bottom of a simple problem, so that she could receive treatment. Remember, are there either for a health checkup or for a problem. Tell your doctor what you are there for, in a few sentences.

DO give your doctor any lab or radiology reports from your referring doctor at the beginning of a problem visit with a list of your symptoms so she can read them while you talk and get the clinical facts from them as you tell her what is wrong.

Add any related problems that started at the same time as your primary problem.

Remember, some symptoms that occur at the same time as your primary problem may be related to your medical problem and some may not.  It is the doctor’s job to help you decide what is related.

An example is that sometimes a patient in our office will notice hair loss when they are taking testosterone and immediately think it is the T pellets, however there are many other medical conditions that cause hair loss.  The many medical problems that are likely to be the cause include low thyroid, lack of protein in the diet, adrenal oversupply of cortisol, stress, autoimmune diseases, and medications. Your Primary problem may not be for the reason you think it is, but these other medical issues need to be evaluated to find the cause. 

On the other hand some medical problems happen secondary to a treatment, or a procedure, and infection or a trauma.  You should tell your doctor those things that have happened around the time of your problem starting.

My husband had symptoms of a Pulmonary Embolism on January 6th.  He got a J&J vaccine on January 3rd.  Was that the cause or was the fact that he had a positive covid test the cause? We will probably never know but now doctors have found that the J&J vaccine can cause PEs (pulmonary embolisms) on the second shot, and that is what might have caused his.  His cause is figured out in retrospect with new problems that doctors encounter in their practices. Luckily, they treated the problem, and not the cause and he got better over night!

IT is always better to know the cause of illness, but it is not always essential to treatment.

Sometimes doctors cannot give you a definite diagnosis until they put you through the necessary tests to gather more information (clues). It is necessary to go through the testing to prove or disprove a diagnosis, so please be compliant and get the necessary testing for your doctor to put all the pieces together!

BTW if you have had a test to diagnose a problem, then get the test and wait for the follow up appointment to get the results, unless it is an emergency. However, if the doctor said she would follow up by phone or email and you haven’t heard in 7-10 days then call the office to make sure the test reached her and that she will contact you. You can’t believe how many medical records; radiology reports and lab tests don’t reach the doctor in this age of fax and email reports.  However, it is better than waiting for the mail to come in like we used to do!

Sometimes, doctors don’t know the answer, or need you to see a specialist to get a particular diagnosis. We can’t know everything, and we don’t guess about a diagnosis.  Sometimes a type of doctor is not able to order a certain test because your insurance won’t pay it if she orders it but will pay for it if a specialist orders the same test.

Sometimes in newly diagnosed diseases and rare diseases your doctor won’t know the answer until more research is in!

For instance, Covid is now known to cause hair loss in both men and women, but that was not medically proven for the first year of Covid until we formulated the data from patients all over the world.

If you don’t have your symptoms relieved by a certain treatment, or medication, but the doctor says you are “cured”, tell them that your symptoms aren’t gone, and that you would like to try either a higher dose or another medication or treatment.  This should be accepted by the doctor, and they should try to treat your symptoms, not just the lab.

Sometimes symptoms are not from what they treated you for, or is a known side effect of the medicine, or they just haven’t gotten the treatment right for you. They should tell you that. If your doctor is not willing to adjust or change your treatment, try another doctor who will listen to your symptoms.

Doctors can’t know everything and sometimes doctors are not trained on certain areas of medicine, like hormone replacement for men and women, especially testosterone for women. In this case they should send you to someone who does know what they don’t…that’s called a referral.

Summary:

If you do your thinking and writing your symptoms and have a clear idea of how you would like the office visit with your doctor to turn out, then your doctor should listen, diagnose and treat, test you further, or refer you to another doctor to treat your special condition.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

The list of the factors that bind T so you can’t use it and those that produce estrogens block free testosterone in both men and women of all ages. The list of lifestyle choices and is much longer than the list of factors you can use to stimulate testosterone.

Soy in many foods: It is a fact that foods that are processed have many “fillers” that are invisible to the person eating them. These fillers are often the culprit decreasing naturally produced testosterone levels and available or active T called free T.   The biggest problem at the present is the addition of soy to nearly every processed food, even ice cream.  Soy is a phytoestrogen.  Phyto Estrogens in food (not medical estrogen) act as a female hormone, limiting the effectiveness of testosterone and the production of T. 

To avoid soy in everything you eat, you must do two things: 1. Eat basic meals cooked by you or a family member from fresh foods that do not include canned or processed foods, and 2. you have to look at the label and only buy products without soy.  Currently there are only 2 brands of ice cream that don’t add soy.

Soy gives men a “Beer Belly” and all other foods with soy will also increase the fat collection in the abdominal area of both sexes.

Soy is the primary proteins of vegans and therefore it is consumed in large volume therefore has more of an effect on lowering free T and T levels.

Eating out of and microwaving in plastic containers (even drinking water out of plastic) causes our bodies to absorb the plastic chemical’s estrogen. This does us no good and is a contaminant and toxin that we store in our body fat. It is the biggest enemy of T.  It is everywhere and is considered the leading cause of lowering the average T level of men aged 15-40.  It is everywhere so stop cooking in it and drinking from it when you can!  Don’t eat out of plastic bags, or microwave plastic containers, or plastic bags with food in it.

Diabetes should be treated, and blood levels of sugar should be kept in control as low as possible for type 2 diabetes.

Omega 6 fatty acids shrink the testes while the Omega 3 FA increase the activity of the testes

Dairy has inherent estrogen in it and animal feed often contains soy, and that makes the milk and meat higher in estrogen.

Trans Fats—Are in most processed foods.
Chips, any snack food that is not dried fruit or nuts Commercial baked goods, such as cakes, cookies, and pies.   Microwave popcorn. Frozen pizza. Refrigerated dough, such as biscuits and rolls. Fried foods, including french fries, doughnuts, and fried chicken. Nondairy coffee creamer. Stick margarine.

Alcohol is a toxin and slows fat loss, damages the liver, and increases estrogen production in the liver, which inactivates testosterone.

Obesity is dangerous to us in so many ways. The mere fact of being obese increases our risk for multiple diseases, but fat also converts testosterone in to estrone and estradiol in both men and women.  The fatter a person is the less free testosterone he or she has.

Being a Couch Potatoe. being inactive, is deadly for testosterone production and free Testosterone. Inactivity increases fat production and estrogen production.  Moderate exercise every day is the answer!

Over activity causes an increase in SHBG which binds testosterone. Marathoners and professional athletes run the risk of binding their good total testosterone so that it is not free to bind to Testosterone receptors.

Fasting can cause increase in free testosterone by increasing SHBG. Humans were built to eat small amounts often, and eating one meal a day increases SHBG, that inactivates free T.

Licorice root (in black licorice), Ashwaghanda and all mint family herbs even basil decrease active Testosterone blood levels.

Phytoestrogens are in many women’s natural supplements that are touted to decrease hot flashes. They only provide minimal relief, but also increase fat gain and estrone levels that cause inactivity of testosterone.

Medications can lower the testosterone levels in both men and women

Oral contraceptives increase estrone so much that they inactivate testosterone and suppress FSH and LH that stimulated the production of T from the ovary.

Oral menopausal ERT and HRT binds up T and causes decrease of all of the benefits of T from replacement and natural T production however minimal after menopause.

Finasteride and Dutasteride given to prevent hair loss or prostate enlargement

causes a decrease of DHT to a point where sex drive, erectile function and muscle mass are impaired.

Arimidex can cause an increase in testicular production of T, but in a small production of men and women it can inactivate the receptors for DHT and T.

As the research about testosterone progress, we will find more and more lifestyle issues that decrease T total and T free levels that can interfere with normal production of T and free T in both men and women.  As these are studied researched, we will update you on the issues you can base your lifestyle and medical treatments on.  

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

What are the factors that stimulate or inhibit your own Testosterone (T) production?

There are foods, supplements and activities that stimulate testosterone production,

Just as there are foods, supplements and activities that lower your internal T production. Today I would like to address the factors that increase the production of testosterone in both men and women.

However, there are limitations on these nonmedical pathways to a higher testosterone level:

1. One is your age. If you are a woman and menopausal then there are no foods or lifestyle changes that will stimulate your ovary to come back to life and make testosterone.  Women have a finite lifespan for their production of estradiol and testosterone, and it ends at menopause.  Estrogens can be made in the fat and the adrenal but pure testosterone is only made in the ovary, and when the ovaries “die” that’s the end of testosterone production.

2. Men make testosterone throughout their lives, but their testes become resistant to stimulation around age 55, but they can become resistant as early as age 40, and then nothing other than T replacement will increase testosterone levels.

3. A person’s body has a genetically driven sensitivity to the hormone Testosterone. Your heritage or the origin of your ancestors determine how you will “feel” with a particular blood level of testosterone. This has been studied by looking at the genetics of the T receptor on all the cells of your body. Receptors are more sensitive the closer you get to the equator in the western hemisphere, and the receptors are less sensitive if your ancestors’ origin was closer to the north and south poles than if they were from around the equator.  A certain level of testosterone doesn’t have the same effect testosterone on both groups.  In other words, those genes from around the equator need less testosterone to get the same effect as those people from extreme high and low latitudes. We are all different and our genes have an effect on our treatment.

If you are a menopausal woman or over 40 then the manipulations of diet and exercise will be less likely to increase your testosterone production.

There are foods and activities that inherently stimulate your internal testosterone production if you are a woman under 40 or a man under 50.  After that you generally must replace your T to improve your symptoms of low Testosterone.

Eating fewer fast foods and more of a well-balanced Mediterranean diet with fresh foods can optimize your testosterone production.

High protein diets with grass fed animal foods and plenty of fish will optimize your testosterone production. Cholesterol containing foods provide the necessary building blocks for Testosterone in the body.

Getting to your ideal weight will increase the free Testosterone in your blood stream making you feel your testosterone more.

Getting 7-8 hours of sleep a night will increase the production of T, because T production is stimulated at night when you sleep.

Sleeping in a dark room stimulates the production of Testosterone, Growth hormone (muscle development) and Melatonin (deep sleep).

Daily moderate Exercise (not necessarily running a marathon) will stimulate your production of Testosterone.

Supplements can stimulate production of Testosterone. There are several supplements targeted to stimulate testosterone that contain carnitine, inositol, choline.

Protein in the diet provides the building blocks of muscle and testosterone and allow the activities and foods that stimulate the production of T have something to build with. People with a low protein diet (no eggs, fish, beans, milk products or meat) have a more difficult time making T.

Most combination supplements that are touted on TV to increase your T are herbs and supplements that decrease estrogens like DIM, or supplements that increase your T by providing the hormones that are precursors to T like Pregnenalone and DHEA.

Herb Fenugreek 500 mg increases free T production

Decrease in DHT with the herb Saw Palmetto can decrease the production of DHT and increase free Testosterone, however it is important not to decrease the DHT too much because it is important in sex drive and building muscle.

Ashwagandha decreases cortisol, and cortisol binding protein that inactivates T, therefore it can increase free T. If you are taking T supplementation, then don’t take this supplement because it can cause you to not feel your free T.

Zinc piccolate and Arginine improves prostate function and health, therefore your volume of ejaculate increases, and free testosterone is improved as well

Lastly supplements that increase your erectile function by increasing Nitric Oxide e.g.  Neo 40.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Sexism and bigotry are still alive and well in medicine. I have experienced this often during my 40 years in medicine. Women are considered hysterical to the medical man (and some women) which has been what men think about us since time began. This has passed it’s “sell-by” date, as has the bigotry against people of color, but it is present, and we must somehow get what we need and get around the attitudes of medical personnel.

My best advice is to not act hysterical because the male brain then flips to the thought that we are imagining this medical symptom! But if you cannot help it then have someone with you who can talk like a man---“just the facts”, don’t embellish and don’t give them a long story…they lose interest, and forget why you are there.

Tell the ER Doctors and EMTs”

That you think you or your loved one is having a heart attack The estimated time you started having these symptoms If you took an aspirin, then tell them Have your medical history written on your iPhone app: look up this icon on any iPhone Have a list on the iPhone app or on a list in your wallet. Give all this information to your healthcare provider right away. Answer questions succinctly and quickly…no stories!

We are successful at treating heart attacks and preventing disability and death in older men, but women of all ages and people of color, both sexes, are not being treated optimally, certainly not as well as their older white male counterparts.

“Despite a decline in the number of overall heart attacks, this number is rising among young adults,” Dr. Banco adds. “And young women and young Black adults have poorer outcomes after a heart attack compared to men and white adults.”

Journal of the American Heart Association: symptoms of heart attack

As doctors, we have been taught that women have different symptoms than men when having a heart attack, AND we have been taught that men have many more heart attacks than women. Only half of that is true. Women have fewer heart attacks when they are compared to young men of the same age, BUT women reach the same rate of heart attacks as men after menopause and if they are not replaced with estrogen.  Our female patients at Biobalance Health actually have fewer heart attacks than is normal for their age after menopause because they are replaced with estradiol pellets.

Young adults 18 to 55 years old who come to the emergency room with chest pain may wait longer and get less thorough workups when they’re female or Black, a new study suggests. But they have fewer heart attacks than men and women as they age.

The studies show that the care women receive is biased and are not considered at risk for heart attacks. An expert Gulati say in Everyday health,

“There is implicit bias in how we care for women,” Gulati says. “Women are still not seen to be at risk for heart disease (https://www.everydayhealth.com/heart-disease/). It is still seen as a man's disease, despite the fact that cardiovascular disease remains the leading cause of death in both men and women.”

Delay in treatment should not be discounted. It can mean the difference between life and death and health and disability.

“Time is heart muscle,” Dr. Gulati says. “So, these noted delays and less aggressive care of women have the potential to translate into delays in care, less diagnostic testing, deaths at home for some discharged, and continued worse outcomes after a heart attack in young women — particularly young Black women.”

If you have the symptoms of a heart attack, you should take a baby aspirin (81 mg) and call 911. Time is obviously very important to the heart and lack of oxygen from a heart attack damages the heart muscle and therefore can leave you with a damaged heart that will limit your activity and lifestyle.

No matter who you are, you should tell the EMT that you think you are having a heart attack, and they will go as fast as possible to the hospital and treat you on the way. If you cannot talk then make sure you partner with your partner and make sure you help each other communicate with the EMT and doctors.

Remember you only need to tell them that you think it is a heart attack and that your symptoms are, (choose yours), chest pain or chest pressure, shortness of breath, left arm pain, jaw pain, and or upper back pain.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Most of you know that when I replace Testosterone hormones for my female patients who lose testosterone as they age. I only used Bioidentical Estradiol and Testosterone in the form of long-lasting subcutaneous pellets.  I have limited my practice to only use this type of delivery system because pellets deliver a steady supply of Testosterone, without daily variation in blood levels, and have the fewest side effects of any type of testosterone replacement. However, nothing is perfect, and it is important to know what the side effects of any treatment are.   There is no medical care that I know of that does not have associated side effects in a small percentage of patients.

There are several problems that can occasionally occur after pellet insertions.  We follow a strict sterile procedure protocol and provide a complete instruction sheet to our patients and verbal instructions on how to take care of the insertion site.  Despite all precautions, a few patients have complications associated with their pellet insertion. I will dedicate the accompanying blog to the side effects of the pellet insertion procedure.  The side effects can be caused by allergy, infection, as well as not following our instructions. The problems that are possible, but rare:

Remember that the procedure safety is only as good as the operator and choosing your doctor carefully for experience and attention to safety. The more experienced your doctor is in pellet hormones and the more she concentrates on pellet only therapy, the less risk you will have.

For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the Healthcast for #603.  This presentation will include the slides and audio explaining the procedure and side effects.   You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Most of you know that when I replace hormones for my female patients, I only use

Bioidentical estradiol and Testosterone in the form of long-lasting subcutaneous pellets.

I only use this type of delivery system because pellets deliver a steady supply of T and have the fewest side effects of any type of testosterone replacement. However, nothing is perfect, and it is important to know what the side effects of any treatment is.  There is no medical treatment without any side effects.  There is no medical care that I know of that does not create complaints by patients.

There are several problems that occur during the first 4 months after the T pellets are inserted and usually present during the first 4-12 months of treatment. I will dedicate the accompanying Healthcast to later side effects of Testosterone pellets and what we recommend to lessen these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The later side effects include:

For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #602.  This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Most of you know that when I replace hormones for my female patients, I only use bioidentical estradiol and testosterone in the form of long lasting (3-6 months) subcutaneous pellets.

I have limited my practice to this type of delivery system because pellets deliver the most stable dose with the fewest side effects, while supplying a steady supply of testosterone compared to other delivery forms of bioidentical testosterone. However, no medical treatment is perfect for everyone, and it is important to know what the side effects of any treatment is both as a doctor and a patient.  There is no medical care that I know of that does not create complaints of some form by patients. Sometimes it is because they have not listened, or not read our literature given them at their appointment. We try to prepare patients for the temporary symptoms of their first Testosterone insertion

There are several problems that occur during the first 4 months after the T pellets are inserted. These side effects are treatable and temporary. and usually present during the first 4 months after the first pellet insertion.  I will dedicate the accompanying Healthcast to the early side effects of testosterone pellets and what we recommend lessening these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The immediate side effects of this type of testosterone

Temporary issues in the first 4 months:

These four complaints compose the most common phone calls we get after treatment with Testosterone pellets, even though we give our patients handouts preparing them for the adaptation changes the female body goes through when readjusting to testosterone blood levels in their bodies. The changes caused by testosterone deficiency occur slowly, so slowly in fact that you may not realize the numbness of the vulva and vagina, the shrinkage of the clitoris and vaginal opening, and lack of libido and muscle mass that accompanies loss of T.  It takes several months for reversal of those deficiency symptoms and the adaptation that takes place as everything goes back to the normal you were accustomed to when you were younger, before testosterone became deficient.  It is the re-adaptation to testosterone that causes the symptoms during the first 4 months.

For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #601.  This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women #600-603.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Most of you know that when I am replacing hormones for my female patients, I only used Bio-identical estradiol and Testosterone in the form of long-lasting subcutaneous pellets.

I only use this type of delivery system because pellets deliver a steady supply of T and have the fewest side effects of any type of testosterone. However, nothing is perfect, and it is important to know what the side effects of any treatment is.  There is no medical treatment without any side effects.  There is no medical care that I know of that does not create complaints by patients.

There are several problems that occur during the first month or two after T pellets are inserted, and others that occur after months or years. To be completely candid, I will spend the next Healthcast #601 describing the side effects that occur during the first insertion cycle from Testosterone pellets, and the measures and treatments we use to prevent and treat them.

For a full introduction to this series of 4 lectures, please go to my website biobalancehealth.com and look for the videos which will have the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

50% of men who receive Testosterone replacement therapy (TRT) have elevated Red Blood cell counts, and high Hemoglobin and Hematocrits. The numbers that are considered normal are usually normal for men at sea level, and an elevated H/H doesn’t necessarily mean that a man will have any negative effects

If you have lung problems, or disease:

For those men who have COPD, Chronic Bronchitis, or asthma, high counts are an adaptation that help you live with a compromised ability to oxygenate your blood. You should not get your blood dumped because the high counts are keeping you alive! 

If you live at high altitude or if you spend a large amount of time at high altitudes, then you don’t necessarily need your blood phlebotomized because you need higher counts to live or vacation there. Men who live at high altitude have adapted to a lower oxygen level making more RBCs.

If you are an extreme athlete, or you train excessively you may have high red blood counts to help you collect and distribute oxygen during your exercise. You won’t have to remove blood unless this level remains a year after you stop excessive exercise.

Why are doctors telling us to get phlebotomies (blood dumped) all the time?

The problem with having a diagnosis of Erythrocytosis from TRT is that it is almost always confused with the disease called Polycythemia Vera (PCV).  PCV does carry with it a high risk of blood clots, strokes and heart attacks.  The two conditions are completely different, but ER doctors and surgeons only know that a high H/H is a sign of PCV, and PVC causes blood clotting…but they don’t know that elevated H/H from TRT or adaptation to a disease doesn’t cause the same medical problems as Polycythemia vera..

One of the ways we can separate the disease of PVC from the condition of Erythrocytosis:

The CBC will show us the difference.  PVC his elevated RBCs, H/H, Platelets and WBCs…all of them are elevated.  Erythrocytosis only has an elevated RBC, and H/H.

If your doctor gets excited about your elevated blood count, please tell him we have evaluated you for PVC and you don’t have that, so you are not in danger for clotting or CVDx.

Here are the differences between PCV and Erythrocytosis from TFT:

Polycythemia Vera

Erythrocytosis

Blood test: high RBC, High H/H and High platelets, High WBC

Blood test: only high H/H and RBC

Abnormal Platelets, increase clotting

Normal Platelets, no increase clotting

Genetics: + Jak 2 mutation

Genetics: no mutation

Cause is genetic requires blood dumping to lower all counts or hydroxyurea meds

Causes: High Altitude, TRT, COPD, Familial cause

Treatment: requires blood dumping to lower all counts or hydroxyurea meds

Treatment not necessary to keep it below HCT of 50.  Some people do better with higher counts especially COPD, High Altitude

Living, exercise at high altitude.

A lot of Research that supports the theory that these patients are at risk for blood clots and coronary artery disease.

No research paper that says high H/H from T causes CVDX, Stroke, or Blood clots.

Abnormal platelet number and function cause the vascular diseases and clotting

TFT is associated with normal platelet counts and functions.

Jak 2 increases clotting factors and platelet production, and erythropoietin from the kidneys  and increases clotting.

Way it works:  T directly stimulated the bone marrow to make more RBCs. No other blood products are elevated

Remember: It is not T that causes high H/H to require blood dumping, it is the confused medical community that goes crazy when they see high H/H and cry malpractice!  In many cases we are dumping blood to appease the primary care doctors.  We ideally would like to keep a man’s H/H below 20/55.

Other reasons for elevated H/H:

Do you have COPD, Asthma or chronic bronchitis? Don’t get your blood dumped. The high counts are helping you. Do you have, or have you had elevated platelet count with your elevated red blood cell count? If you have, please tell your primary or your BioBalance Health Nurse Practitioner you will be evaluated for PCV with a genetic test. Do you live for part of the year at high elevation? If yes, then it is not necessary to phlebotomize you to get your counts down because you need those RBCs. Do you eat high iron foods (liver, braunsweiger, pate, bone marrow, Deep green leafy veggies) ? If so of if you are taking iron, you can stop because you shouldn’t need it while taking T, because the bone marrow is stimulated to make more red cells with T. Do men in your family die of CVDX before age 50? Then you might have PCV! Get an iron panel + a Jak 2 genetic test.

Blood Phlebotomies:

Men over 70, should only have 250 cc removed at one time and told not to exercise for a few days. Blood pressure and blood volume take longer to equilibrate after the age of 70.

Make sure these patients have a lot of water and that they drink it and eat something after the phlebotomy.  Remember you just removed blood sugar, dropped their blood pressure, and dehydrated them by removing blood. They may be dizzy, but they have to sit until they are stable.

Blood tests for erythrocytosis/ PCV:

CBC

Iron panel

Ferritin

Jak-2 mutation

Hereditary hemochromatosis

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A doctor must have an ideal, healthy range for any test which they are using to diagnose a patient.  Diagnosticians cannot decide whether this ideal level or “reference range” is accurate without a great deal of scientific investigation, so he or she uses what is listed on the lab report which results in misdiagnoses.  Blood panels are expensive and should have the information listed with the result that explains what circumstances make the test fall into the healthy and asymptomatic range.   This is a problem with most large national labs, and it is leading to great numbers of misdiagnoses.  Let me give you some examples of the problem with how labs are reported:

Female Estradiol

Published Lab Reference Range

Postmenopausal: < or = 10 pg/mL

Estradiol is the female estrogen that disappears after menopause.  Before menopause the average blood level of E2 is 60-250 pg/dl depending on the pre-or post-ovulation stage of the menstrual cycle. That range of estradiol is healthy for women.  Lack of estradiol (which occurs at menopause and creates disabling symptoms) is unhealthy for women and the reference range should show that lack of E2 is “abnormal” and not within reference range. 

The lab considers that Estradiol levels are “normal” after the age of 40, if they are 7 pg/ml.

Male Testosterone Free

Published Lab Reference Range: 35.0 – 155.0 pg/mL

T and free T for men: The reference range for men is very low. The way the lab obtains these numbers for their reference range for testosterone is by using the blood levels of men who come to their lab to get their testosterone drawn. This results in the “reference range” not representing healthy young men, but representing “sick men” of all ages, usually old men, who are having their blood drawn at the lab for other reasons. Testosterone and free T decrease with illness and with age.  The way the reference range of T and T-free is skewed to a much lower level than is optimal. With a low range misrepresenting the ideal, men who have low T and free T and are symptomatic and are not treated.  The range I use is 400-1500 the average for healthy young men between 20-40 years old.  No man feels good with a total T of 234-400, the low end of the range considered normal for men by Quest and Labcorp. This misrepresentation is preventing many men from treatment.

The way they derive their blood range for total T and free T is not scientifically sound, and that affects whether a man is treated or not. Physicians who treat aging men know and should know that testosterone decreases as a man age (after age 40), and becomes symptomatic at age 55, on average. Most men are symptomatic when their free T falls below 129, not below 35. 

All testing of blood levels of hormones that decrease with age should be compared to those levels of young healthy people of the same gender. I like to compare hormone tests to the well accepted interpretation of bone density.  Bone density decreases with age just like the sex hormones.   Because bones decrease in density with age, we compare all women to 29-year-old females who have normal bones.  This same scientific method should be used for sex hormones that decrease with age. We should compare sex hormones to the blood levels of healthy young men or women of the same gender.

The faulty basis judging a man’s adequacy of testosterone is also used for evaluating IGF-1 (Growth hormone) and all the sex hormones. It looks like we have a lot of work to do!

Male and Female IGF 1

Published Lab Reference Range: 50 – 317 ng/mL 

IGF-1 is age-adjusted on the lab sheet to the age of the patient, not compared to normal healthy patients of the same gender. IGF-1 measures growth hormone which is a hormone that is “normal” before age 40 and declines thereafter. To know if you have low growth hormone a patient should be compared to healthy people who are young, under age 40. An example of why this comparison don’t work for aging patients: the IGF-1 of one 70-year-old compared to another 70-year-old does not tell you if the hormone is less than optimal, or just normal for your age. IGF-1 should be compared to 20–40-year-olds, not the average for your age!

Estrone is an adrenal estrogen.  It is normally ½ of the Estradiol level in women before they are 40 and women maintain a ratio with Estradiol (the ovarian estrogen) of E2:E1 of 2:1. The numbers are not significant, the ratio is. This is ignored on lab tests.

Insulin level is dependent on whether the patient is fasting or not.  Both labs only list the non-fasting range, even on patients who ARE FASTING.  This oversite leads to fewer patients who have insulin resistance being diagnosed and treated, which leads to more patients with AODM.

Example: The range that is on the lab report for both Quest and Labcorp is a non-fasting range (2-24), but the healthy fasting the range is 2-10. (Epocrates). However, the fasting range is not listed on the Lab report even though all of my patients are fasting! This causes me to write in the normal fasting blood level of insulin.

Thyroid Panel is misleading and is not accurate in many cases:

Male and Female T3, Free and T4, Free

T3 - Published Lab Reference Range: 2.3 – 4.2 pg/mL

T4 - Published Lab Reference Range: 0.8 – 1.8 ng/dL 

TSH (.45-4.5) is only accurate for patients who are NOT on thyroid medicine. If you are on thyroid medicine, to be accurately replaced your TSH should be less than 1.0 (read the insert of Synthroid, the most widely prescribed thyroid replacement.  There is no separate normal for patients on thyroid medication. 

For patients NOT on thyroid medicine TSH is not updated for new research. In the last 10 years TSH has a been found to be more accurate with a smaller range of normal, 0.45-2.5.  This has not been reflected in the TSH of both labs. 

Free T4 levels reported on lab reference ranges have unscientifically been adjusted over the last 15 years without true scientific research. This change is based on obtaining reference ranges from the group of sick people getting their blood drawn at a particular lab, and not a group of young healthy people who don’t have any symptoms of low thyroid.  This is a cost saving effort that has devastating effects on women especially who have symptoms of low thyroid, but who do not have a free T4 outside the reference range, so they are not treated. FreeT4 is 0.8-1.8 ng/dl is reported on lab reports as the “new normal”, when the range based on a young healthy group of people is 1-2.5 ng/dl.

We know that the group of people who go to the lab for bloodwork are generally older, sick, and may have thyroid disease. They are not a group of subjects to use to define “normal” or “healthy”.   Making this situation worse, thyroid function decreases when a patient is ill, so ranges obtained from this group of patients is not “normal or healthy”.  The medical director of Quest has confessed to using these sick patients to obtain their reference ranges for thyroid.

Free T3 levels have lowered over the last 15 years without scientific basis. The same issue occurs with free T3 as with free T4.  The range is now 2.3-4.2, pg/ml. and has lowered every few years over the last 15 years.  The range that is based on young healthy patients is 3.0-4.5. This affects many patients who are on thyroid medication whose doctors lower their dose if they are between 4.2 and 4.5, and patients are not diagnosed if they fall into the range between 2.3 and 3.0.

 This slow, unscientific lowering of the ref range by lab companies based on their sick population has negatively affected many women who need appropriate thyroid replacement and is unscientific.

Conclusion:

The reference ranges listed by the largest labs in the US are unscientifically derived and misleading.  It makes it impossible for patients to interpret their own labs appropriately.  These inaccurate “normal” referred to as “reference range” also make it impossible for young inexperienced doctors and busy doctors who are quickly going through the labs but not really looking at the changes in the numbers but whether the lab lists the results in the “in range” or, “out of range” columns. 

These numbers are expensive to order for patients and doctors and should be reported with accurate “normal” that have the most recent research applied and who use normal healthy young people to derive the “reference ranges”.

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Dr Sullivan and I spend much of our visits with our patients explaining the meaning of each lab test that we order for our patients. We explain what a lab test is meant to evaluate, which lab tests measure their general health or their hormone status or tell us whether they may have side effects from hormone therapy. After our patients go through their lab test results, they realize that self-interpretation is literally impossible.   We must also explain why we write in different reference ranges from those of the lab.  This blog is meant to help you and our patients understand the problem with the current reference ranges printed on lab tests.

Choice Of Laboratory Companies Is Vital to Getting an Accurate Result!

Lab tests are vital to our treatment of hormone deficiencies and our practice of preventive medicine; however, we always balance our results with our patients’ symptoms when we decide on a treatment plan. We preferentially order tests from Quest labs, but we also receive results from Labcorp, private hospitals and doctor’s offices.  We prefer Quest labs because they are the most accurate in terms of reporting reproducible results, which indicates accuracy.  

Another competing lab continually change the test we order to another test that is always inaccurate.  I have talked to LabCorp’s medical director about this, and he said that the fact that they change the test I order is a problem, but the fact that the results that I get from one Free Testosterone level is drastically different from the other test they offer by a power of 10 did not bother him.  His only defense was that the Endocrinologists think this is ok, so I should think its ok.  Well Truth is truth and that is an excuse like the dog ate my homework. In addition, LabCorp is currently giving us “wrong” results on the test for Estrone that we must repeat by Quest just to get an accurate, reproducible blood level that matches the symptoms of our patients!

We want our patients to have their lab paid for by their insurance company to save them additional out of pocket expense, so we choose Quest because they have drawing offices all over the country and because they have contracts with all US insurance companies.  Quest has also given us a patient discount for patients to self-pay that is many times lower than what they would pay to the lab itself.  This is usually for patients who don’t have insurance or who have high deductibles, but anyone can take advantage of it if they don’t want to use their insurance.

Importance Of Lab Results and Reference Ranges Determines Whether a Patient Is Treated!

Once we get lab results and medical history, we decide whether we can help a patient with hormone replacement.  If we have inaccurate results OR inaccurate reference ranges, we can’t determine the true health of a patient.  So, what is wrong with the reference ranges on current labs.

Eg Thyroid panel normal are different ranges for patients who are on thyroid replacement.

There are so many inaccuracies and adjustments that must be accounted for when a doctor interprets blood tests by just looking down the column of “out of range” results, we must use artificial intelligence to take into account age and compared to young healthy, sex, fasting status, medication status and develop young healthy blood levels for women as the healthy range we are looking for. indicates lack of symptoms and disease.

If total cholesterol, is representative of a dangerous score when it is over 200, then it should not be obtained by adding the good cholesterol plus the bad cholesterol.

Total cholesterol is not equal to risk for heart disease. 50% of men and women with elevated total cholesterol have zero cardiac calcium scores, and 50% of both sexes who have normal cholesterol numbers have high plaque numbers.

I disregard the total cholesterol in women, and only look at the LDL level.

CBC and Ferritin: The gender differences that are adjusted for in the CBC, Hemoglobin and HCT, is misleading for postmenopausal women, and is not corrected for the fact that non menstruating women have the same H/H ref and Ferritin range as men.  

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I have always told women who are menopausal that giving Estrogen to them after menopause lower’s their risk of Alzheimer’s, decreases their insulin resistance and helps decrease belly fat.  There are many studies that prove that testosterone decreases the risk of Alzheimer’s Disease (AD) and delays the timing of AD by 10 years.  This is what I have always told women to reassure them about taking estrogen and testosterone after their ovaries stop making both hormones.  It is a simple concept that the practice of medicine has made very complex, however this new research article in Nature 3-2022 by Dr Kamoroff, helps support the practice of replacing the hormones that women lose with menopause, estrogen and testosterone, to prevent the diseases of aging including Osteoporosis and Dementia.

Let me explain the response of the female body to our ovaries shrinking and essentially dying, which is what women’s ovaries do when we become menopausal. The ovaries are the primary source of estradiol (young women’s estrogen) and the only secretor of testosterone in women.  Other androgens are produced by the adrenal gland, but they do not provide a woman with the benefits of pure testosterone.

At menopause blood levels of estradiol (E2) decrease to nearly zero. Free T (the active form of T), and estradiol also decreases to less than 60 pg/dl from a pre-menopausal range of 60-250 pg/dl.   In response to this radical change in a woman’s chemistry, and very low levels of Estradiol and Testosterone, the pituitary raises the FSH and LH production, the hormones that, previous to menopause stimulated the ovaries to make more E2 and T. After menopause the increasing of FSH and LH continues to increase and cause hot flashes and night sweats.  These two hormones are only suppressed by a woman replacing Estrogen and or Testosterone (T). When women get E2 and T, it causes the FSH and LH to “relax” and stop sending out high levels, so hot flashes and night sweats stop.  If E and T are not replaced, LH and FSH continue to be elevated and these symptoms can continue for life!

This most recent study by Dr. Kamaroff goes one step farther toward what I already know about ERT (estrogen replacement therapy), and just described. The only way to stop the cause of elevated FSH and LH, and hot flashes and night sweats, is the replacement of estrogen and testosterone. Giving enough estrogen to achieve pre-menopausal blood levels of these two hormones is to give higher doses than the FDA approves of.  It is our goal to prevent AD, dementia and Osteoporosis my dosing adequate Estradiol and Testosterone in the form of subcuticular pellets.  Low dose estradiol is not the way to be healthy after menopause.  Women need adequate hormones to shut down the FSH and LH surges and that is the way to prevent several of the diseases of aging.

Simply, this new study links the elevation of FSH and LH to the onset of dementia, Alzheimer’s Disease and Osteoporosis (thinning of bones) after menopause.

But how does FSH and LH cause dementia and Alzheimer’s disease? This study blames the elevation of FSH and LH for causing inflammation and the accumulation of B amyloid on neurons in the brain is a response to inflammation. This accumulation of plaque causes Alzheimer’s Disease (AD). It seems that the recommendation of the American College of OBGYN gives to doctors to limit the dose and the time ERT and HT are given is counterproductive to the health of women’s brains and bones.  The result is that most women are given too little estrogen, and therefore are still at moderate risk for AD and Osteoporosis.   When we give compounded E2 and T with pellets, the FSH and LH are suppressed to pre-menopausal levels, and therefore it is the best way to prevent hot flashes but also prevent osteoporosis and AD that can develop without a sufficient amount of estrogen.  It is in this way that women without ERT or who have low dose estrogen replacement oral, or patch have a higher risk of the diseases of aging, AD and Osteoporosis than those women who are given an adequate dose that provides pre-menopausal blood levels.

A second study reported at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022, also reported that the longer a woman is without estrogen, the higher her risk of developing heart disease and dementia. This is consistent with the first study I cited, that links high LH and FSH to these diseases of aging. This study looked at women who go through menopause early, before 40, who therefore have more years of high LH and FSH, and a longer period of time associated with inadequate estradiol and testosterone. The earlier women experience menopause the higher the incidence of Dementia by 1.3 times the rate of women who went through menopause at the normal time, after age 40. The healthier aging without disease occurred in women who had more exposure to Estradiol and Testosterone, and less exposure to elevated FSH and LH.

The bottom line for both research studies is that estradiol is one of the keys to healthy aging, pivotal to preventing the devastating diseases of aging like Osteoporosis, Heart Disease, and Dementia. Estradiol is a hormone that should NOT be dosed to achieve a minimal blood level, and when it is replaced after menopause with reasonable doses meant to achieve a normal physiologic blood level , this one hormone brings a woman’s body back to homeostasis and can lead to healthy aging without the diseases of aging.

March 22, 2022

Follicle-Stimulating Hormone's Role in Alzheimer Disease, in Mice

Anthony L. Komaroff, MD, reviewing Xiong J et al. Nature 2022 Mar

Blocking FSH in ovariectomized mice protected against cognitive decline.

The incidence of Alzheimer disease (AD) is particularly high in older women, as are levels of follicle-stimulating hormone (FSH). This observation led investigators to wonder whether blocking the action of FSH might be beneficial. In mouse models of AD, ovariectomy (with its associated sharp rise in FSH level) promptly increases the degree of deposition of both β-amyloid and tau, which are cardinal pathologic features of AD.

Following ovariectomy in mice, the researchers administered a monoclonal antibody that blocked the action of FSH. The antibody reduced deposition of both β-amyloid and tau in the brain and protected against cognitive decline. The mechanism for this effect is that blocking FSH also blocks an enzyme that causes accumulation of both β-amyloid and tau. Further incriminating FSH in AD pathology, deposition of β-amyloid and tau also was reduced by using genetic engineering to knock out receptors for FSH, and deposition was increased by raising levels of FSH. FSH also is produced at low levels in males, and the FSH-blocking antibody also reduced hippocampal and cortical deposition of β-amyloid and tau in males. Experiments showed that two other features of menopause — low estrogen levels and high luteinizing hormone levels — did not explain the AD-like features seen in ovariectomized mice.

COMMENT

Many, but not all, findings in mouse models of AD have been replicated in humans. Blocking FSH also reduced bone loss and visceral fat in mice. Given all these theoretical benefits, one might surmise that trials of FSH blockade in humans will be undertaken.

Study: Early menopause may signal women's dementia risk

A preliminary study to be presented at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2022 found that women who experience menopause before they reach 40 years of age may have a 35% increased risk for dementia later in life. The researchers also found that women who entered menopause before they turned 45 years old were 1.3 times more likely to receive an early dementia diagnosis by the time they reach 65 years of age.

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I have been in the Pro-Testosterone after Prostate Cancer Team with Dr. A. Morgentaler ever since I read his book and heard him lecture at AMMG annual meeting 12 years ago. After that I read all of the studies that supported this opinion and now two new studies by  Thomas E. Ahlering etal. Department of Urology, Irvine medical Center, Department of Medicine published in BJU International 2020. This study is a game changer in the treatment of Post Prostate Cancer patients and for those worried about getting prostate cancer in the future.

The bottom line is that testosterone replacement in men who have had prostatectomy for prostate cancer is protective and helps prevent recurrence!

For those men who are afraid of getting prostate cancer in the future, keeping your testosterone level at a youthful level is protective to prevent prostate cancer.

“Prostate cancer is the most common non-cutaneous malignancy in men, accounting for ~20% of all cancer diagnoses [1]. Prostate cancer is also notable in that after a radical prostatectomy (RP) men have a predicted average survival of 22 years [2]. “2020 TRT.BCR.BJUI.

Despite the fact that even men with high grade tumors have less than a 50% chance of mortality from prostate cancer, 30-40% of men usually have recurrence of prostate cancer after being treated. When faced with this risk men who have a recurrence must decide between two risky treatments: radiation and estrogen therapy.  Both treatments limit the quality of life that these men can achieve.

The belief that testosterone causes prostate cancer was started in 1941with a flawed study of only a few men and has persisted until recently.  This “belief” has prevented men from replacing waning testosterone, for fear of occurrence or recurrence of prostate cancer.

In 1996 Dr Morgentaler showed that there is an increased risk of prostate cancer in men with a low Testosterone level. He also proved that administration of T to men who had their prostate cancer treated, would benefit from testosterone replacement therapy.

Ahlering did a study matching men based on their snip genetic status and pathologic stage of their prostate cancer. Patients were compared with those men who did not receive any T replacement.

Those men who had TRT had a much longer recurrence-free time period than those who took nothing.  Those men in both groups were similar in terms of severity of recurrence and treatment needed.  The difference is quality of life for the men who took T replacement!

The results of the study   showed that TRT is not dangerous to men, does not cause prostate cancer and doesn’t increase the risk of recurrence or dying of prostate cancer is even lowered the rate of recurrence by 53% for men with prostate cancer treated with Testosterone.  This study also proved that T doesn’t increase heart disease.

Why is T good for men who have survived treatment for PC? T stimulates the thymus to make T-killer cells and T-helper cells which is our defense against cancer, T also decreases insulin resistance, which lowers glucose levels, decreases obesity, therefore lowers blood pressure and inflammation, which lowers heart disease and the occurrence of all types of cancer.

This is the opposite of what we were taught in medical school, and it is difficult to reverse medicine once it has brainwashed a generation of doctors with the wrong information.

T is good for more than maintaining your sex drive, and sexual function.  T can also prevent prostate cancer and other cancers as well as obesity, Insulin resistance and heart disease.  It is time we let the bright light of truth shine on this new and amazingly simple reality for aging men. Testosterone can protect you from both getting prostate cancer, and from getting a recurrence of prostate cancer after the initial treatment!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

I answer many questions about Estrogen Replacement Therapy ERT every day.  Many of these questions are based on outdated information that women, and even doctors have not updated in the last 30 years.  There has been a lot of research on ERT in the last 2 decades and women need to know the truth! Today I will address all the misinformation that is out there.

First a few definitions of the lingo doctors use when talking about estrogen:

 ERT (estrogen replacement therapy) definition is replacing estrogen, in any form, to women who are menopausal and have had a hysterectomy. Women who have had a hysterectomy do not need progesterone because progesterone is given to protect the uterus from PMP bleeding and uterine cancer.

HRT (estrogen and progesterone therapy) definition is replacing estrogen, progesterone, or progestin in any form to women with a uterus.  The progesterone or progestin is given to prevent the uterus from bleeding after menopause and to protect the uterus from uterine cancer.

ET and EPT mean the same as ERT + Testosterone, and EPT is HRT+ T in any form.

At Biobalance Health® we only use bio-identical estrogen and testosterone in pellet form and bioidentical progesterone, no progestins.

What is the difference between progesterone and progestins?

Progesterone is the hormone made by women after ovulation to support the lining of the uterus and a potential embryo.  It is natural and made by the corpus luteum of the ovary.  Progestin on the other hand, is a chemical that was created to balance the estrogens in the birth control pill and oral menopausal medications. Progestins have many side effects and contribute the complications that many women get from oral hormones. Natural progesterone in all forms have very few side effects and protect the uterus from developing uterine cancer.

How long can I take Estrogen? Don’t stop! The reason women are so confused is that the College of OBGYN placed arbitrary limits on how many years a woman can take the form of estrogen they prescribe—oral synthetic estrogen and progestin…..and they keep moving the limit.  The current limit of how long a woman can take estrogen is arbitrary and not based on non-oral estradiol replacement but guesses and small studies they do on oral estrogen and progestin. They view ERT and HRT both as a one size fits all and it can’t be farther from the truth!

Does estrogen cause breast cancer? No estradiol DOESN’T cause breast cancer.  Your biggest risks of developing breast cancer are obesity, large intake of simple sugars, insulin resistance, Type II diabetes, alcohol intake and lack of exercise.  Estrogen has been circulating through your body for decades and estrogen doesn’t cause breast cells to change into cancer cells.

There are some cancers of the breast (ER receptor + breast cancers) that are stimulated to grow by estrogens, and we don’t give estradiol to women who have had these breast cancers unless they have had a double mastectomy and did not have positive nodes.

Estrogen DOES and can cause uterine lining cancer (not ovarian cancer) called endometrial cancer. We give women with a uterus progesterone to take with their estradiol pellets to counteract the stimulation of the endometrial cells into cancer.  We require our patients to take progesterone (bio-identical) to protect them from any danger from uterine cancer.

 Does Estrogen cause blood clots?

Oral estrogen can cause a woman to be more likely to get a blood clot. Oral estrogen circulates through the liver first thing before it is circulated through the body and in that way stimulates the production of fibrinogen and other subsets of blood clots to start the “ball rolling”. However, non-oral estrogen (pellets, patches, creams, gels, sublingual tablets, and vaginal tablets) does not have the same effect.  There are many studies in the last 20 years that substantiate this fact, but most doctors have not gotten the message and still advise women who have had a blood clot not to take any estrogen of any kind!  They are wrong.

 What does estrogen replacement do for me?

 Estrogen keeps women young both physiologically and physically

Why did the physician groups stop estrogen replacement therapy to women?

 They reacted to the WHI study with an emotional response before they even read the study and determined whether it was true or not!  The doctor’s leadership are so afraid of lawsuits they immediately recommended taking all women off estrogen and not restarting.  Meanwhile woman all over the country were in physical and emotional pain from their lack of estrogen.  Most of the doctors never read the WHI study, but I did!  It did show that PROGESTINs do increase the rate of breast cancer and heart disease, but not progesterone.  They didn’t even study progesterone until later when it was proven safe.

Progestins also increase the risk of heart attacks in women, but estrogen taken without progestins were safer than taking NOTHING!

Let me recap: The WHI study has been proven wrong.  It said that E2 was dangerous and caused breast cancer and heart disease.  It was misinterpreted and the cause of breast cancer and heart disease was finally found to be the progestin (not progesterone) that was used for HRT in the study.  The women who only took estradiol because they had a hysterectomy had a lower rate of breast cancer and heart disease than those women who took HRT and who took nothing!

So, what do you do If your doctor doesn’t “believe in” estrogen replacement?

Find a new doctor!  Don’t listen to old, false information repeated by your doctor.  You know what you need.  Women are very astute at self-diagnosis and after menopause to feel better we need estrogen!

At BioBalance Health we replace estradiol in the safest way to keep women healthy, safe, and without the diseases of aging.  In women with non-estrogen receptor positive breast cancer, we offer estradiol with testosterone in non-oral long acting pellet therapy. You can live well and healthy as you age!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Call BioBalance Skin at 314-648-5710 to make an appointment

There are hundreds of facial skin peels out there that provide one benefit each.  The VI Peel is not just one peel with one effect, it has 4 different peels for different needs patients have. The first three peels are graded by how much damage you have, how thin your skin is and how much treatment you need. The fourth facial peel provides treatment for acne and acne scars.

The FIRST secret to the VI Peel is that it literally is active on your face for three days! The Second secret is that the VI peel has 5 “acids” that do different things for your skin, so the treatment is often as good or better than two combined laser treatments. Three VI peels a month apart vs three laser treatments at less than half the price!

The second Secret of the VI peel is that it uses 5 acidic and active peel products combined in one peel, as well as two anti-inflammatory products to calm the skin.

The ingredients include:

Glycolic acid penetrates the skin deeply and carries the other ingredients with it. Lactic acid hydrates and lightens brown spots, hydrates and firms the skin Mandelic acid reduces oil production and suppresses pigment production to even skin tone and brighten the face. Trichloroacetic acid treats texture, pigment, acne, and wrinkles, and drives the other active ingredients deep in the skin. Phenol is an anesthetic and mimics TCA treatments

The first three types of peel provide extensive exfoliation, decrease of brown spots, and treats superficial wrinkles and tightens the skin. 

VI Peel uses all of the ingredients above and is primarily for brightening and tightening. For younger patients with minimal damage and patients with Rosacea.

VI Peel Precision is for normal Anti-aging skin with average damage.

VI PEEL Precision Plus is the strongest peel for thickened skin and Antiaging.

The fourth peel is called VI Peel Purify + Booster for Acne and Acne scarring and hyperpigmentation.

The treatment time is short in the Spa, but you must be able to use specific products for after- care for the next 2 days.  The peel is actively working for 72 hours and avoiding the sun completely, using the provided towelettes to wipe down the area several times a day is required.

How do I recover?  The first day you will look like you got a sunburn, but some patients do not have any downtime the first day.  The end of the second and third day the skin will begin to peel, and you must refrain from picking! You may trim the already peeled skin off, but don’t assist the peeling.

These peels require 2-4 peels, one a month for complete resolution.  Other treatments that. Treat the same problems often take 3-6 laser treatments so this takes less time.Each peel is about $300 and is painless.

VI has also developed body peels for those of you who have severe sun damage on the decollete, arm/hands, back or legs. The peel is effective for brown spots, acanthosis nigricans,

The body peels take longer to peel..usually 4-7 days and treatments are farther apart, every 4-8 weeks. They even have an app to track your progress on your iPhone!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Biobalance Health began in 2002 as a medical practice that provides the best, most effective delivery system for testosterone replacement for men and both T and Estradiol for women.  This is still the foundation of our practice because hormone replacement is necessary or the other methods of staying healthy after 40 to actually work.

I have seen thousands of patients who follow my individualized directions on testosterone and estradiol replacement, diet and supplementing their diet, weight loss, exercise, and lifestyle changes realize their goals of feeling and looking younger. These patients become truly healthy through these combined treatments. In contrast, I have seen the patients who want a quick fix with hormones who ignore the recommendations I give to them to become the younger healthier person they desire to be. These patients fail to achieve their goals. There is NO QUICK FIX to become healthy!  If you don’t want to participate in your goal of developing a healthier body and mind and just want to take a pill or get a pellet, then you don’t want to see me!

There is a primary rule in medical care called the Law of Intention: Achieving health requires the intention of the doctor to heal her patient, AND the intention of the patient to follow the treatment plan of the doctor to get better! Intention not only means you think about getting better, but that we both work toward that goal!

 There are thousands of medical studies that back up my treatment method of following a multi-pronged approach to health and they are right, but it isn’t easy!

I recommend my female patients receive testosterone pellets after age 40, and men when they begin to have sexual erectile function symptoms, around 50-55.

At the first office visit I present a treatment plan that includes several paths of treatment. I call it a “parallel approach” for hormone replacement, weight loss (if necessary), following a healthy diet, finding an exercise that they can stick to in any weather for at least an hour 3 x a week, as well taking temporary medications or specific supplements to prevent the diseases of aging like diabetes and heart disease, and taking other supplements to specifically attend to a patient’s deficiencies.  All these changes and treatments must be worked on at the same time, which is why I call it medical care “in parallel”…following a plan for every area of health at the same time. 

Story: One of my patients had trouble losing weight and she did weight loss consults with my Nurse Practitioner who advised her on every area needed for her to achieve her goal.  My NP came to me frustrated because after several visits and multiple medications and supplements she still wasn’t losing weight.  I joined them in the consultation and asked some direct questions, “ Do you still eat candy and drink soda?” “yes”, she said sheepishly. Do you take the supplements we have told you to take?” “Well… I start the new ones that you suggested but I stop the  ones you told me to take in the beginning..I don’t like pills”. “How about the medications we asked you to take? Metformin, and phentermine? “ I take the phenteramine!”  I asked and she told me that she thought we just wanted her to take the last one prescribed to her, but not the first medication, even though my NP had told her to stay on both meds!  So here is a formula for failure that many doctors experience with their patients.  Start one thing and when it doesn’t work  stop I  start something different…over and over again!  This method never gets anyone with a weight problem to lose weight.  You have to add meds and supplements to a treatment plan when someone is not responding to the one med alone.  Weight loss treatment is not forever and these meds are temporary!  Following all of our directions and taking the meds and supplements we prescribe  is necessary for weight loss patients to succeed.  They took years getting unhealthy and unbalancing their metabolic system by gaining fat, and it takes time and multiple concurrent treatments to lose fat!

Think of a 6 lane highway, all going the same direction with the same end point.

Each lane is a different area of your life to prevent and treat diseases and the symptoms of aging.

Lane 1 is replacing the hormones that decrease with age: Testosterone for both sexes, estradiol for women and balancing the other hormones that are deficient.

Lane 2 is your fuel to feed your body—your diet must be right for your genetics, lifestyle and the diseases you already have.

Lane 3  Supplements to your diet for vitamins and minerals you don’t get in your diet or you don’t get where you live (anywhere north of Florida needs Vitamin D), al people who don’t live near an ocean need Iodine replacement . Diseases such as Osteoporosis not only need E2 and T but need the building blocks of bones: Vitamin D3, Vitamin K, Vitamin C, Calcium and Magnesium.

Lane 4  Medications to treat diseases you already have. For example Insulin resistance and Pre-diabetes is rampant in people over 40 who are overweight. To combat this disease and prevent it from progressing. For this I use an old medication called metformin ER to treat Insulin resistance which allows the patient to lose fat and obtain normal weight. When they reach normal fat % 19% for men and 26% for women we can stop the medication.

Lane 5 Feed your gut Biome.  You have more bacteria living in your gut than you have cells in your body, and they are necessary!  The bacteria in your intestine digest your food, protect the delicate wall of the intestines so it doesn’t become leaky and lead to autoimmune diseases. Good bacteria help the gut produce the neurotransmitters in your brain that not only help you to think but also keep you from being depressed and anxious. The more types of bacteria in your gut the better and the closer you will be to your ideal weight.  Antibiotics and steroids like prednisone kill good gut bacteria and promote bad and dangerous bacteria. It is important that everyone take a Probiotic and eat a salad and or raw vegetables to feed and protect their gut bacteria.  We are symbiotic with the bacteria in our gut..neither of us can live without the other!

Lane 6 Exercise daily! We have not evolved from our ancestors days on the savannah where we ran after and caught and killed our food or gathered it from bushes and other plants. We were made to be physically active all day! We have created a sedentary world where we sit and that is very BAD for our health.  I think exercise choices should be based on any disabilities or injuries that you have and on your personality.  In her Book, The Eight Colors of Fitness, Suzanne shares the type of exercise that is best for each Meyer’s Briggs personality type.  If you don’t have a clue what exercise you would like to make a part of your life then reading her book is my advice…then just do it!

My practice BioBalance Health is meant to guide you and treat you with the most effective methods needed in your life to reach the goal of health.  When making a plan for achieving health think of these 6 areas and follow the plan…all at the same time!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Aquagold® is the newest type of microinjection process that utilizes hundreds of tiny gold needles to inject neurotoxins, filler and PRP right under the skin to stimulate the youthful turnover of facial skin cells and treat all the signs of aging.  This treatment can be used successfully on the hands, neck and décolleté too. This process is essentially pain free after application of lidocaine gel and can be done much more quickly and with less trauma than micro-needling, with better outcomes.

In addition to skin injections PRP can be injected into the scalp to increase hair growth in areas of the scalp that are thinning.

The benefits of Aquagold®

There are three levels of treatment: You can choose the level of treatment that you need

Post Care: After this treatment, post care is to leave it alone and only use a mild facial cleanser before bed the day of the treatment.  The next day only use lightweight sunscreen and very little makeup.

By the third day you can cleanse and treat your skin as you normally do, and the results are evident!

Who Can Have This Treatment:

Who Can’t Have This Treatment:

This treatment should be done at least a month after a laser , not before, and a few weeks after botox or other neurotoxin injections. You will LOVE the way you look.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

If you ever wondered if there was something other than anti-cancer chemicals, quarantine or vaccines to help protect you from cancer and viral illness, there is a safe, inexpensive and effective medical treatment.  Why haven’t you heard of this wonder drug?  The FDA has blocked the US population from access to this immune stimulator in the middle of a pandemic!  I can’t tell you why, except that it gave us a way to improve our immune status without other preventive treatments.  It is not dangerous so you can only imagine your own reasons for this action.

‘In this blog I am going to inform you of this option so your will know about it and possibly help drop the ban on compounding pharmacies from making this communicator protein.  I have included quotes from medical and scientific journals to support my information.

At the end of the blog, I will list the sources for my information in case you question my information, you can look it up!

“Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying, enhancing, and restoring immune function. Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies, as an enhancer of vaccine response, and as a means of curbing morbidity and mortality in sepsis and numerous infections “, World Journal of Virology 2020 Dec 15; 9: 67-78.

This “bit of protein” is called a peptide, and it is just one of thousands of peptide communicators produced by the human body. When we are young and healthy these communicators are all working well in healthy mature adults, but as we age, we lose the ability to produce many of the peptides that keep us healthy, like Thymosin alpha 1. This is the reason that people over 60 get sick and die from infections that don’t kill younger people.

In the Journal of Virology this information was written in December of 2020, during the Covid Pandemic:

Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells. …. thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.

What does Thymosin Alpha 1 do?

Thymosin alpha-1 (TA1) functions as a stimulator to the thymus gland.  This gland produces white blood cells including but not limited to T-Killer cells and T helper cells (CD4+/CD8+ T cells) those WBCs that kill viruses, bacteria, fungus, and cancer cells. 

The thymus gland is located behind the “breastbone” and is largest when we are born and shrinks as we age.  As it gets smaller, our immunity to everything decreases which is why older people get more severe infections and take longer to heal, and why older people need stronger vaccinations than younger people to get the same effect.

TA1 has many functions other than increasing the number of T cells, it also increases their killing ability and modulates the T cells, so they respond to both abnormally directed immune responses (autoimmune diseases) and stimulates the activity of T cells against infections. TA1 decreases inflammation and is effective in treating pancreatitis and Hepatitis C. Regarding viruses TA1 decreases viral replication, therefore limits both the infections, communicability, and the severity of all viral infections.

For cancer patients this peptide is amazing at limiting both incidence and growth of cancers. It is unparalleled in its activity against cancer recurrence.

..thymosin alpha 1 works via two main mechanisms: Either stimulating the immune system or employing its anti-proliferative activities on tumor cells. The protective action of thymosin alpha 1 against oxidative damage because of its effect on liver superoxide dismutase and glutathione peroxidase has been explored by Armutcu et al [26].

I have given TA1 to patients who have small tumors or failure of cancer treatment, when there is no more treatment left for them, to stimulate their own immune system to kill cancer cells. There are basically 3 other ways to kill cancer.  Surgically remove it, kill it with chemicals that also kill beneficial cells in your body (chemotherapy), or radiate the area of cancer.  However mainstream medicine rarely uses the fourth most effective and least dangerous method of stimulating the natural immune system and preventing and killing cancer. One of the unused methods of killing cancer cells is prescribing TA1 which stimulates your own immune system to kill cancer cells.

This fact is rarely discussed by doctors, but it is a fact that everyone produces cancer cells in their bodies daily and when they are young and healthy their own immune system kills those cancer cells. When we are young, cancer is rare because our immune cells are activated by TA1 produced in our own thymus glands.  As we age, our thymus shrinks, our TA1 decreases and some of these abnormal cells are missed and not killed, which allows these cells to grow and proliferate into what we call cancer.  The true cause of cancer is the loss of normal immunity (TA1) to kill cancer cells.

Due to the action of thymosin alpha 1 on other cell types, it is used as a therapeutic agent for diseases with evident immune dysfunction [4]. Clinical trials with thymosin alpha 1 for diseases like DiGeorge syndrome, non-small cell lung cancer, hepatocellular carcinoma, hepatitis B and C, HIV, and melanoma have been conducted and yielded promising results.  FDA approved the orphan drug thymalfasin (Zadaxin) for treatment of malignant melanoma, chronic active hepatitis B, DiGeorge anomaly with immune defects, and hepatocellular carcinoma due to its immunomodulatory and anti-tumor effect.

These diseases are the ones approved by the FDA for treatment with Thymosin alpha 1, in the form of the pharmaceutical called Thymalfasin, however they have ignored the elephant in the room: Thyomsin alpha 1 is effective against cancer, and preventing cancer recurrence, autoimmune diseases, viruses, parasites and bacterial infections.  Why isn’t it used in the US to stimulate our own thymus to act like it did when we were younger?  I can’t understand it! When we needed this compounded drug the most—in the middle of a pandemic, the FDA prevented all the compounding pharmacies from making it!  This could have been an answer for those people who could not or would not get vaccinated, but in the beginning of the pandemic, production was shut down!

Thymosin alpha 1 works and there is a lot of research to back this up, but it is unattainable in the US since Covid started.  I had several patients with recurrent cancer on this peptide for years before the pandemic, and it prevented a recurrence. These patients got their medication from compounding pharmacies, and it had to be discontinued because no compounding pharmacy was allowed to make it.  Why? Both patients, who had. exhausted their mainstream medical options for their cancer, are now experiencing a recurrence of their cancer without being able to get this drug.

With all this proof and knowledge about the power of Thymosin alpha1, to prevent and treat viral illnesses and cancer, why have you never heard of it, especially at a time of pandemic when this peptide could do so much good to prevent and treat the virus that is causing our pandemic, especially for those people with immune dysfunction, cancer, autoimmune diseases, and immune senescence of aging?

First, the government enacted an FDA letter to all doctors threatening discipline for doctors and healthcare workers who recommended “unproven” therapies for the Covid virus. Included in this new law, rule, is to silence anyone saying to their patients that Vitamin D (which has now been proven to protect against Covid), Quercetin which has supporting evidence in the medical literature to prevent the recommendation of doctors to patients from suggesting these methods of preventing supplements to our patients. If anyone can explain why our own government is working against us (both patients and doctors who are working to save lives), and using our tax dollars to do it, please tell me.

I always thought being a doctor in America meant being able to use any safe and effective means that I know works effectively, to treat my patients.  Doctors were effectively gagged by the FDA letter sent in December 2020, from telling my patients about preventive medicine practices that stimulate the immune system and protect us from infection.  Now I have lost respect for the government who treats us all like we are uneducated and sheep who will follow whatever they tell us. They use the one size fits all in a decade when the practice of medicine is becoming more aware of the individuality of patients especially in the melting pot of the US.  Drugs are ridiculously expensive and unaffordable except for the very rich.  We often use compounding pharmacies for alternatives to this price burden for patients and offer inexpensive alternatives that patients can afford. 

I am listing the medical references that support my information.  I don’t generally do this but I believe it is important to support my blog.

References:

Regulatory Focus, webpage, FDA Targets Remdesevir , Thymosin Alpha In Compounding ,concerns, posted Feb 24 2021 by Kari Oakes.

American Journal Health System Pharmacy. May 15, 2001;58(10):878-885.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

(Quotes are from the 23 and me Blog. November 2021)

Last week we talked about the research 23 and Me has done determining individual responses to the three Covid vaccine, based on the genetics of the HLA type of the individual. This week we will review their research on people who have gotten Covid infections and become Long-Haulers, those patients who develop long lasting illness and organ damage from getting the virus. We will look at the genetic characteristics of those patients who are at risk for Long Hauler condition after Covid.

“A recent study by researchers at the Translational and Clinical Research Institute within Newcastle University found that an allele (gene) protective against severe COVID-19 symptoms in the HA gene, at HLA-DRB1*04:01, was found at much higher frequency in people of Northwestern European ancestry.”

That means that if your inheritance, your ancestors come from northwestern Europe, you are less likely to develop a severe case of Covid, or “long haulers” complications. They have also found that those people with Blood type O and B are less likely to have severe effects to covid, the vaccine to covid and less likely to have severe long-term side effects of covid infection.

The way I look at this is that if you can determine your risk of severe infection or severe reaction to the Covid virus from your genetics, then you can decide whether you should take the risk of getting the vaccine, or not, and the risk of getting infected and having long-term reactions to it, so you can determine whether you should always wear a mask in public or not, get a vaccine or whether you should fly on a plane or not. 

Without knowing your risk how can you determine how to run your life in a pandemic?  We should be concentrating on three things:

Determining individual risk, based on genetics, so an individual can make an educated decision about his activity, vaccination and or use of masks. To find this risk you must know your blood type, your HLA type (which most of us don’t know), and whether you are protected from severe long haulers, by ancestors who were from northwestern Europe. Be realistic about your risk dictated by your lifestyle, and that can be somewhat controlled by how we live our lives: If you are obese, smoke, are over 60, eat processed foods, drink alcohol daily, don’t exercise, or if you have any diseases or take medications that suppress your immune system, you should take all precautions including getting vaccinated.  More importantly you should change your lifestyle and go on a mission to get healthy.

Besides cleaning up your life, there is no magic bullet that protects everyone. We now know that Covid 19 can be deadly to certain individuals, and to others it doesn’t even make them sick.  The same genetic HLA type people who have bad reactions to vaccines also have the most severe infections with Covid 19. This puts these patients in a trick box…they need to be vaccinated but they are at risk for complications, however if they get the covid virus they may die.  In this case looking at other health factors may tip the scales toward vaccination or the opposite toward quarantine for an unknown time.  A doctor should be the one to assist you in this decision.

The one non-genetic factor that puts you more at risk for reactions to the vaccines is a previous Covid 19 infection.  If you are at risk otherwise and need to have the vaccine to protect yourself from death or long-haulers then waiting 6 or more months since your Covid infection to be vaccinated is advised.

I wish the best to you all…this is a time of learning for doctors and virologists alike…we increase our knowledge every day and I will try to keep you up to date with the research and the advice based on that research.

At this time, to be preventative, everyone should improve their immune status by eating a good whole food diet low in carbs, high in fruit and veggies, and by taking Vitamin C 500-1000mg/day, Zinc 15-50 mg/day with Copper 2-6mg/day, Quercetin, Methyl B complex, have your hormones replaced including estradiol and testosterone after menopause and testosterone for men after age 55-60, and exercising daily.

Then determine your genetic status if possible and take the precautions necessary for your level of risk.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

In an article published in November of 2021 by the genetics company, “23 and Me”, new information was revealed that refutes the belief that the risks of getting and or dying from Covid 19 is equal for all humans--are a one size fits all proposition.  Today I would like to relay the information that I have learned from research done by 23 and me over the last two years during the covid pandemic.  This is not my finding, but that of this genetics company who carried out a one- and one-half year research study by asking those people who had given their genetic histories to 23 and me for research questions, if they got the infection, and if it was severe or minimal or anything in between.  They also did research on the genetics of those patients who succumbed to covid, and on those patients who did not get the infection even when exposed.  This study was to find out what genetic inheritance makes us at risk for severe covid infection and what inheritance (snips of DNA) makes us relatively immune to Covid.

This research inherently questions how the risk of infection has been portrayed by our government, as a luck of the draw type of risk with one answer…vaccination.  The findings suggest that each person is an individual with genetic and lifestyle factors that give him/her individual risks of getting the infection at all, as well as dying of the infection are partially due to an individual person’s God-given genetic makeup.

When people and governments panic, decisions are made with broad strokes and a one size fits all solution is created and following these solutions is required by citizens.  This is also a lot like how medicine is conducted currently… one dose per person no matter how old or how big or small. In contrast genetic studies like this one disprove that there is equal risk and equal treatment or prevention for each individual.  23 and me has found that one or three vaccines will not have the same risks or benefits for every person who gets the vaccine. Human Genetics is the basis of variation in diagnosis and treatment  in medicine, and now has touched all of us with a one size fits all answer to a pandemic, leaving some people to make an uneducated decision to avoid all vaccines and treatments because they know the government should not be practicing medicine, and the other extreme of people who follow all recommendations of governmental medicine who then suffer the side effects and or worse from the solutions they demand (vaccines).  

Let me assure you that we are all genetically different and there are certain genes that cause us to be more or less susceptible to a disease, virus or bacteria and all diseases. That is what this blog is about.  My mission is to help you make an educated decision based on what we know and what we don’t about the vaccines that are being required of us, and the disease that can also harm us.

Governmental medicine, that has been dictating our personal medical care for 2 years, assumes we are all the same and therefore they have the same answer for each of us.  We now know that that is not the case.  Some people have genetics that prevent them from even getting Covid, and that same genetic snip will protect a person from getting symptoms from it even if she or he gets infected with the virus. Other groups of people have pieces of their genetics called snips that cause them to be more likely to have a bad case of Covid or even die from it.  Having the government give you advice as to your individual health is a bad idea. We need to have advice that is specific to our situation.  That means telling us the truth about our genetic susceptibility to any infection that is considered an epidemic or pandemic.

In the research by 23 and Me combined with other genetic companies, the pandemic which has halted our world for two years now has been found to be an individual type of virus that affects each of us differently.  Let me describe some of the things they have found out about the Covid infection and our unique response to vaccines.

..people react differently to vaccines, noting that those who previously had COVID-19, as well as women and younger. people reacted the strongest to the vaccine.

The Genetics Behind the Different Reactions to Covid 19 Vaccines (Nov 9. 2021)

We found that some variants in a complex of genes involved in immune response are associated with being more likely to have a strong (bad) reaction to the vaccine and some make it less likely.

I am one of the 23 and me customers who volunteered my time to answer questions for 1 ½ years about my exposure to Covid 19, my lack of infection when I was exposed and my reactions to the vaccines that I took.

  “That (participation) has allowed our scientists to quickly explore how genetics plays a role in the susceptibility and. severity of COVID-19. We've also looked at other aspects of the pandemic like its impact on sleep, physical activity, and how it has hit some communities harder than others. In this latest study, we looked at the factors associated with "reactogenicity", or how noticeable a person's response was to the vaccine.”

They found a strong association between variations in the HLA genes—the human leukocyte antigen complex, which is involved in immunity, and are what is tested to find out if your tissue type is compatible for an organ transplant. 

 “These genes encode for a number of proteins that make up the major-histocompatibility complex, which is on the frontline of your immune system's infection recognition system. These results. show that variations in the HLA complex are related to the degree to which one feels ill after vaccination.”

All three vaccines work by teaching your immune response to recognize the virus and they act quickly to attack and kill the virus it is protecting you from.  So why do some people feel very sick after a vaccine, and others feel nothing?

The 23 and me findings suggest the primary function of HLA molecules is to present foreign antigens on the cell surface in order to elicit an immune response.  As such, the HLA plays a key role in presenting the proteins derived from the vaccine to the immune system.

 Because of this some HLA types (your genetic type) carry a strong (negative) reaction to the vaccines and others little or no reaction.  Therefore, when you combine a prior history of Covid 19 infection + younger age + female sex + certain HLA types you find that these individuals have severe side effects to the vaccines.

But what HLA types did we find to cause more severe side effects?

This is the table in the 23 and me article:  The first and last HLA type do not have severe side effects from the Covid Vaccines.  The three in the middle do have a high risk of severe consequences of taking the vaccine.  It doesn’t mean no one in the first and last group will have a side effect..it is just a CHANCE of not having a side effect.  That is the other problem in medicine—nothing is a sure thing…and if you are the one that gets the disease, then it is 100%.

I think knowing the risks of vaccination for each individual vs the risk of getting the disease we are trying to prevent, will give each of us an educated idea of what to do for ourselves. To do this we need to have all the information….the side effects that are possible, and the ones that we are more at risk for individually.  The study of our genetics would make us prepared next time to guide patients with specific snips to get one treatment, while someone else may not need it or would have a low risk of getting the infection at all, and then the vaccine would not be necessary.  This pandemic was our warning shot….genetic study will be the gateway to all of us surviving the next round.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

At BioBalance we have been treating women who have had ER positive breast cancer with Testosterone Pellets for 20 years Testosterone pellets improve their quality of life and actually decreases their risk of recurrence.  This fact has been proven not only by research but by our experience.  We believe that quality of life after cancer is very important and we not only believe that testosterone replacement is helpful to improve sex drive, muscle mass, skin texture, and other symptoms of aging, but also treats the symptoms of estrogen deficiency safely.

The first thing patients have to deal with when told that they have Breast cancer is how to treat it.  There are many opinions about what treatment is the best and how much treatment is needed.  In my 39 years of diagnosing and following the treatment of breast cancer patients, the history was that doctors started by throwing the kitchen sink at even the earliest smallest cancer and not only prescribed either radiation or radical surgery, and chemotherapy.  We have been working our treatment path away from these radical therapies to an individualized therapy based on the aggressive nature of the cancer and severity or spread of the cancer.  We should have done this long ago, and we would have helped more women regain their sexuality and their self-esteem, but this is how the practice of medicine works.

I always have to go through the process of putting myself in the shoes of the patient I am talking to and ask myself what I would do if this was me with this disease. I have had a love hate relationship with chemotherapy for Breast cancer unless the cancer had metastasized and chemo would improve life expectancy at least 50% over other treatments. In many cases, Chemotherapy is lifesaving, but it also caused so many side effects and impaired the immune system which can cause a second or third cancer somewhere else down the line.  I would make sure if I had the cancer that before I took the advice of a surgeon or a medical oncologist, I would weigh the effectiveness AND the side effects of each treatment mode for my stage of cancer. 

In addition to knowing the numbers of the effectiveness of a breast cancer therapy, and weighing the real risks, I would want to know the risk of long-term damage to my immune system and how much disfigurement I would have to endure afterwards. 

Many women make the decision for which treatment they receive when they are in shock over their diagnosis. They don’t hear or can’t think through the fact that removing your breasts without provision for reconstruction, or radiation damages the skin so much that no reconstruction is possible after the fact. I can’t tell you how upset my patients have been when they have chosen a treatment that is more radical than their cancer justified, based on the emotion of fear, without understanding the side effects until it was too late.  A woman’s breasts are extremely important to her self-esteem therefore preserving them and or reconstructing them after mastectomy is extremely important. It is because of this issue, that in 2001-2002 I sponsored a bill with our new Governor Holden who passed it into law by executive order.  This new law required insurance companies to pay for the reconstruction of breasts that have to be removed to treat breast cancer.  In Missouri, the passing of that bill made all the difference to women who have been disfigured with mastectomies to treat their cancer, and many states followed our state’s law.

I can tell you that my logical plan to treat estrogen positive breast cancer would be to have the following treatment If I developed breast cancer: I would have a biopsy to confirm the type and the spread of my cancer, allowing the biopsy of one axillary node, to avoid the side effect of lymphedema in that arm that comes with removing many nodes.  Then, if necessary, I would have a mastectomy with nipple sparing surgery and reconstruction at the time of mastectomy.  If I had ductal breast cancer, I would have a bilateral mastectomy because it is often bilateral, even if it is not visible at the time of the first surgery.  I don’t want to worry about breast cancer in my remaining the rest of my life!  If it was contained in the breast tissue that was removed, I’d be able to lead a normal life and take Testosterone and Anastrazole to block the testosterone from converting into estrogen.

Chemotherapy has been recommended for patients who have low grade, and stage or early breast cancers to improve a patient’s survival as little as .1%!  Because taking chemo increases your risk of other diseases and cancers it should give you an appreciable survival advantage to take that risk.  Always ask your oncologist how much your survival will be improved by taking chemo.  You will have your own number to accept chemo…I would have to have 33% improvement in my survival to take traditional chemo.  Taking aromatase inhibitors which is oral chemo-like therapy, is often recommended and has very few side effects if you take testosterone pellets with it.

Another treatment for breast cancer is radiation. It is often disfiguring and the damage to the skin can’t be fixed with plastic surgery, so I would only do that if there was spread to the lymph nodes, or for a recurrent cancer.   Chemotherapy should be reserved for those women who have metastasized and need it to save their lives. The question you should ask your oncologist is what % will chemotherapy increase my survival? If it is minimal, I would think twice before going forward.

In the NE Journal of Medicine December 16, 2021 they agree with me about the course of treatment not requiring chemotherapy if certain criteria are met: If a woman has ER positive Breast cancer and has 0-3 axillary nodes positive and a recurrence score < or = to 25 they can forgo chemotherapy without a negative impact on disease free survival.

This solves the Cancer treatment portion of the equation, but what should you do about those symptoms of estrogen deficiency that women experience after menopause? The answer for my patients is NOT nothing, because if you do nothing you are making a choice! Try testosterone pellets and minimal estrogen cream to the vagina for lubrication. The small amount used on the vagina will not be absorbed into the body enough to stimulate the estrogen receptors of cancer cells.

Testosterone pellets have been found to address the symptoms of menopause, and to improve the number and function of the immune cells called T cells (cancer killing blood cells), and stimulate T cell activity to kill cancer cells of all kinds. 

If you have been given the advice that you cannot take T after you have ER + breast cancer, then get another opinion…the cancer doctor’s goal is only to keep you cancer free but they usually have no concern about your quality of life, and the research they read is not about improving your symptoms of estrogen and testosterone deficiency.  The relief of these symptoms is not on their radar, but it is definitely worth trying T to relieve your symptoms of menopause.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Kathy: Today we are welcoming back Brett Newcomb, the co-author of our book,  

Got Testosterone?, as well as co-author of our first book The Secret Female Hormone to announce the release of our third joint project, and our first audio book, Got Testosterone?

Brett: Our audio book, Got Testosterone?  has just been made available on Amazon books, Audible, and dozens of other audiobook access points.

Our book Got Testosterone? is dedicated to men, to help them get through the aging process by choosing the one most effective treatment, testosterone pellets.  We felt the need to write this book because there is a subterfuge that keeps this information from men and keeps them sick and sexless as they age.  We want men to know that the replacement of one hormone testosterone can both treat their symptoms and prevent the second half of their life from being non-productive, sexless, and filled with illness.  This book tells the truth to men and offers a plan of action for them to prevent the diseases of aging by taking Testosterone replacement with long-acting pellets.

Kathy: We are proud of this work because it is wholly ours…we wrote it, and Brett is the voice of the book as well.  In that way, we can offer our listeners a wholly homogenous work for their listening pleasure. Brett and I tried at every turn to talk to men in this audio book like they wish to be talked to—concise information, delivered in a logical fashion with a limited number of examples to make our necessary points.

I was asked many times by my patients why we would spend 3 years writing each book, and another year producing an audio version of our book for men, Got Testosterone?. I explain that with all the confusing information out there, I think it is important to  tell the truth about testosterone replacement, so men can make informed decisions about their health as they age.

When I am in my office seeing a male patient, I hand our book, “Got testosterone?” to them to read.   Many wives have told me that their husbands probably won’t read it, but they would listen to it when they are driving.  I made a decision to record an audio version of our book so that men would listen to it and receive the truth about testosterone.

Brett: We are very proud of this book.  The year it was released, 2019, Got Testosterone?, won the first place  award for men’s health books, from International Independent Publishers.  This recognition was very big for us, and it recommitted us to increasing the number of men who would access the information in our book.  Recording the audio book was the way we arrived at to bring our findings about testosterone replacement for men.

Brett: People all learn in different ways, and our audio book is for those people who learn by listening and like to listen to books as they drive or listen as they do things around their yard or as they exercise.   A book must be read or heard to educate so we decided to cover both the access points for our patients.

Kathy: It is not typical to ask one of the authors to record the voice for the book.  I chose Brett to read our book for many reasons, but the over-arching reason is that his voice is distinct and memorable. This fact was obvious when we attended medical Anti-aging conferences, and men and women alike came up to Brett to tell him how they loved listening to his voice during our Healthcasts.  That sealed the deal for me…if both men and women admired his voice..who would be better to tell our story?

Brett:  I have had quite a lot of experience in broadcasting, TV and radio.  This audiobook was an opportunity to use my experience as the voice of our book.

Kathy: Other than working with the company that distributes audiobooks, I did not do the woman’s work on the audiobook of Got Testosterone?  Brett and our audio

Specialist performed the complicated task of recording, re-recording, and editing the audiobook. Brett, can you explain how an audio book is composed?

Brett:   The book professor, Nancy Erickson, ( thebookprofessor.com) referred us to an audio genius,  Aaron Reppert  (www.AaronReppert.com) of Travsonic Studios (www.travsonic.com/aaron-reppert/) , who is an expert producing audio books, and who did all the tech and editing and many, many other processes that take hours, days, and weeks of work over the past year and a half. 

I got together with Aaron of Travsonic at his sound studio and spent many hours reading in a soundproof room with Aaron critiquing all the time.  He had an impressive array of screens and sound editing machines around him and he coached me, and edited and retaped sections of each chapter. He edited everything to comply with distribution requirements and did his magic, and voila! We have an audio version of our book Got Testosterone?.

Kathy: Nancy Erickson also was integral in our process of distributing the book.  She put us in touch with a distributor, Lantern Audio Distributor, who brought our audio book to the public through many outlets, including the most well-known Apple Books, Audible, Audiobooks, Nook Audio, Google Play, Walmart in the US and throughout the worldwide with audio-press.

There was even more work that had to be done to publish our audiobook.  The book cover which was created by the COO and art director of BioBalance Health®, Joe Baalmann, had to be redrafted to fit the DVD discover dimensions.  He also made sure all the requirements of the distributor were carried out.  Behind the scenes work is often painful and unrecognized, but we were thankful for his work and talent.

 Brett: The audio publishing world has stretched our experience with communication methods farther than we had imagined we would go.  Previously we successfully worked with social media, You Tube, Traditional Book Publishers and Independent Book Publishers.  The audio book was a unique experience for us.  We hope you all take advantage of being able to listen to the information we have compiled and have made available to everyone. The goal is a healthy life for men after age 40, and to prevent the symptoms and diseases of aging.

Kathy: Our goal has always been to bring patients and other doctors and Nurse Practitioners the un-tainted truth about the best and healthiest treatment for men over 40 as they age.  We think prevention of disease is the way forward in a world that is saturated with an expensive pill for every symptom, and a questionably effective treatment advertised on the internet, and on TV. being healthy throughout your life is the only way to avoid illness and the expensive, painful, and often ineffective treatments used once you are sick.  If you are over 40 and a man, or the woman or man who loves a man over 40, then please stop listening to commercials and get some truthful answers, and listen to our book, Got Testosterone?.

Thank you for joining Brett and me for this healthcast about our new audio book for men, Got Testosterone?

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

EMSculpt-® is a new treatment for sculpting your body into the body you want, and we have it at BioBalance Skin®!   EmSculpt® is not for people who need to lose 100 lbs. all over, but for those of you who want to lose specific areas of fat to sculpt your body, without pain or surgery! This technology is the best there is and is very effective for building specific muscle groups and removing the fat from on top of them so you can see the actual individual muscles.

EmSculpt Includes two types of treatment that are used at the same time to provide two different benefits: the first is electromagnetic contraction of the muscles providing thousands of contractions of the muscles in the area of the body you want to build which usually increases muscle mass 25%, while the second treatment dissolves 30% of fat in the area after 4, 30-minute treatments. The treatments should be given a week apart for 4 weeks, and for 30 minutes each. You can increase the muscles in your abdomen, melt the fat and   get your

Waistline back!  If your calves are too small you can just use the EM part to increase the size of the muscle in your calf.

I’m 67 and one of the issues with getting older is the loss of muscle mass and the deposition of fat on top of the muscle so that age causes women especially, to look fluffy and soft, instead of muscled and “cut”. Worse yet, you usually gain muscle in the wrong places and lose fat where you would prefer to keep it.

Pellet therapy with testosterone makes it possible for post-menopausal women to build muscle and lose fat.  Without T, fat loss and muscle building are next to impossible after menopause.  We replace the testosterone with pellets first.  Then as a patient is beginning to lose weight, we suggest EmSculpt® treatments for losing fat and gaining muscle in the right place. Why not just exercise you say? Because you will probably lose your breasts and bum, but not your belly fat.  Moreover, 30 minutes on the Emsculpt® is like doing over 1,000 crunches…and it is hard to do 50 of them!

If you have had surgery and have been told not to exercise for a period of time, this machine will help you keep your muscle and lose fat while you recover.   other dieting or exercise is needed!

It also is ideal for those patients who want to augment certain muscle groups to make their contour better, when exercise wont’ work…or the area that you need to exercise is difficult to isolate like your inner thighs.

 In one month and 4 Emsculpt treatments on my abdomen, I gained almost 1 lb of abdominal muscle and lost 2.9 % body fat, and 4.5 lbs.

Insert my inbody results.

I have been trying to lose those inches for 3 years.

Many people are worried about the side effects of a treatment.  These facts should ease your mind.

--No pain!

--30 minutes per area

-series of 4 treatments one week apart

You can have this treatment on several areas of the body that need more muscle and less fat: Abdomen, inner thighs, outer thighs, front or back of the arms, and upper back, and calves will soon be approved by the FDA.  

-You can do one to three areas at one 1.5-hour appointment

How it works:

Who cannot be treated with this device?

The electromagnetic part of this device acts like a magnet, or an MRI, so patients with any implantable medical devices cannot have these treatments. Joint replacements with metal in them can heat up with this treatment.  We must ask you to fill out a medical questionnaire so we can make sure that there is no metal in your body or near the area we are treating. Metal IUDS like the copper T or copper 7 will prevent you from getting this treatment. 

It is necessary that the area that is treated must not have any open sores, or tattoos on them. The lymphatic system must be fully healthy to carry away fat, and you should be without a fever, cancer or infection and well hydrated.

If you aren’t happy in your swimsuit then please schedule a consultation at our BioBalance Skin® for EMSculpt®, to shape your body for swim season, now.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

Last week we reviewed the traditional weight loss medications that were used commonly before this very effective new class of weight loss drugs. Like most medications, drug companies’, researchers and doctors find amazing new drugs for a use that the drug was never intended for.  An example of this is the drug Viagra.  It was initially being presented to the FDA as a blood pressure and cardiac drug.  It increased nitric oxide and that dilates arteries, which lowers blood pressure and eases the work on the heart.  On the pathway to approval, they found that Viagra was the first drug discovered that could create an erection in men who were important.

In 2010 a drug-group called GLP-1 receptor agonists was introduced as a treatment for diabetes.  This class of drug, much like Viagra, was found to induce loss of fat, while preserving muscle mass resulting in weight loss.  The first drug name was Victoza (liguride), and after the weight loss aspect of this drug was confirmed, the weight loss drug was named Saxenda. These drugs are injectable only but are subcutaneous delivered with a “pen” and are extremely effective for weight loss.

If a patient doesn’t have a problem with injecting a subcutaneous medication every day, then this drug has it all!  GLP-1 RAs causes weight loss 3 ways: 1) They decrease hunger, 2) they cause patients to feel full when they eat half as much as usual, and they 3) speed up their overall metabolism so they burn more calories at the same level of activity.  These drugs can also be continued for life if necessary to maintain a healthy weight.

These drugs are perfect for pre-diabetics, and Adult-Onset Diabetics (AODM), because not only is weight loss successful but insulin resistance is treated with this medication.  As usual, with any excellent answer to a problem, we are limited in its use by the cost of this medication.   For those people who need to lose weight and can go on it for 6 months or less to achieve their goal, it is still unaffordable.  There is no way to write a script for this medication and expect a patient to pay $667-928/month, and unless they have diabetes insurance will not generally pay for this drug.  The side effects from Liguride may also be a reason it can’t be used by everyone.  Patients who have GI reflux, Barret’s esophogus, or GI ulcers can’t take this drug because it slows the emptying of the stomach and makes these conditions worse.

Prior to 2010, Metformin ER had been used for the treatment of pre-diabetes, AODM, and Insulin resistance for years, and has been effective for weight loss in many patients who have these conditions as the reason for their obesity.  Metformin ER is inexpensive and is paid for by insurance, unlike all the other weight loss drugs, because it is also used for diabetes. In my practice, for patients with IR, AODM, hypertension, and heart disease who need to lose weight

This is a very safe and effective way to lose weight, but it only works when a patient follows a low carb diet, and daily exercise to be truly effective.  Metformin literally makes my patients healthier and is considered one of the most effective anti-aging medicine available.

Another rather new combination of drugs used for weight loss is Naltrexone/Bupropion is not one that I have used in the office because of the high risk of side effects. I suspect in other medical hands it can be effective.

The newest drug, Semaglutide, sold under the name of Ozempic and Rybelus, is extremely effective  and is given as a subcutaneous shot that can be self-administered once a week so compliance is not a factor. Rybelus must be taken daily but is a pill and not an injection, so is good for those with needle phobia.   Semaglutide in either form stops hunger, makes my patients feel full, and increases the speed of metabolism so they burn more calories than other people at the same level of exercise.  Ozempic/Rybelus can be given to patients who are not candidates for amphetamines and who have reflux side effects from Victoza/Saxenda.

Ozempic/Rybelus is well tolerated and can be given to anyone who will give themselves a shot once a week.  The only problem with this medication is the cost, 4-6 weeks costs $900-$1200. We have found a way around this for those patients who can’t afford this price and have gotten it down to about $500/2 months.  If you think about it, you can be very compliant and not use it very long to get to your ideal weight, then you would only have to use the drug for a short period of time.  We have achieved a great weight loss for our patients when we manage their diet, exercise, and replace testosterone with pellets if they are over 40, by seeing them in the office every month until they achieve their ideal weight.

We always recommend a low carb diet, keeping a diary of food, water and daily exercise in My Fitness Pal app, which makes all of these treatment methods more successful than the experts claim. There is no weight loss that lasts without dieting and exercise, even with medication.

Taking a drug to lose weight is your chance to change your lifestyle so that you can keep the weight off after you stop the medication. You have to be completely on board to actually succeed at achieving your ideal weight….and staying there.

Talk to your doctor about these drugs …but only if you are ready to change your lifestyle for the better..you must be all in to get healthy for life!

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

During 2021 several new weight loss drugs have been approved by the FDA for weight loss.   The Lancet is a very well-respected medical journal and in December of 2021 they-compared the available medications intended to help people lose fat and become healthy. Today I will discuss the weight loss medications that we use to assist our patients in weight loss and in our next Blog I will review the new, very effective weight loss drugs that have been released, and explain how doctors choose the right weight loss medication for you.

At BioBalance Health® we provide medical weight loss treatment utilizing all the common methods of managing food intake, and exercise, and we add medications that are chosen for each patient based on their age, medical conditions and type of trigger that causes overeating.   This is referred to as an individualized medical weight loss program and we have been very effective.   Choosing a treatment program for each patient requires that we order blood lab tests, measure body composition at each visit, and find out a patient’s history of weight gain to determine the most effective weight loss drug to prescribe for each patient. We also use blood type diets, which are a type of genetic evaluation that determines the best and worst food for each person.  It has been scientifically discovered that different body types (endomorph, ectomorph or mesomorph) require different forms of exercise and this observation plus blood type, and personality type helps us suggest the most effective type of exercise.  In the future we will be employing genetic testing to determine which medications would be the best for each individual.

Today we will discuss the medications available by prescription that can make weight loss, or rather fat loss, possible. Because we are all different it is true that one particular medication, like one particular diet is not effective for all people. The first thing we consider is the medical condition of the patient including other medications that they are on which might interact with weight loss medications, and we don’t want to give a patient that would make her blood pressure or other condition worse.

After considering the safety of a particular treatment for an individual patient, I consider an individual’s problem with food:

Because there are so many reasons for people to be overweight, many solutions must be found to treat the problem that causes weight gain.

The first and most popular weight loss class of medication is appetite suppressants, or amphetamines, are ideal for patients who always feel hungry, who are young, and who don’t have hypertension, or heart disease. Amphetamines are the same medication that are used for ADD/ADHD, and both constant hunger and ADD originate from a deficiency of norepinephrine in the brain.  Patients with untreated ADD and weight gain are a perfect match for amphetamine appetite suppression.

Amphetamines were the first weight loss medication available for appetite suppression. They were commonly prescribed to women beginning in the 1960s.  These medications were widely used and were very effective, however they were often habit forming and only continued weight loss as long as they were taken. When they were discontinued patients generally gained their weight back. This particular class of medication didn’t fail to result in lasting weight loss because of the drug itself, but when given without diet and exercise training, patients could not sustain the weight loss after the drug was stopped.  Today we still use amphetamines for appetite suppression and weight loss, but we combine it with low carbohydrate diets and daily exercise to achieve long lasting weight loss in a select group of patients. The names of these drugs are Phentermine, Dexedrine, and phendimetrazine.

In the 1980s a drug called Orlistat® was introduced. This weight-loss medication worked by causing fat that was in a meal to pass through without being digested and absorbed. The fat passes through to the intestines and resulted in fatty stools.  This medication worked by decreasing calories absorbed from fat in the diet.  This was somewhat effective for patients who would not, or could not diet, but who still wanted to lose weight.  This in itself did work for a time in some patients, but was not an effective lifetime plan, because there was no accompanying training on how to eat appropriate amounts of food, and how to incorporate exercise in their diet.  This medication is now over the counter even though it prevents the absorption of fat soluble vitamin like Vitamin D, A, and E. Worse yet Orlistat causes the side effect of fatty diarrhea, fecal incontinence, and terrible gas.  This medication was not a long-lasting answer to obesity because it was not well tolerated and because it didn’t cause patients to change their overeating habits so what weight was lost, came back when they were off the medication.

The third weight loss medication is a combination of two drugs, Topamax (an anti-seizure medication) plus amphetamines, specifically phentermine. This duo is effective as a long-lasting weight loss answer for patients who are always hungry and can’t control their appetite, as well as patients with food addiction, and sleep related eating disorders.  This treatment requires that a patient takes 25-100 mg of Topamax at bedtime and a dose of phentermine in the morning.  Weight loss with this drug combination is effective when it is combined with low carbohydrate diets and daily aerobic exercise.  This weight loss medication can be used long-term, however there are side effects for some patients which makes it intolerable.  Some patients experience dizziness, diarrhea, insomnia, depression, and numbness, that can cause patients to stop taking it, as well as to change to another medication for weight loss.  Many of the patients who have had success with these drugs, can’t say enough good things about this combo!

Next week we will discuss the new weight loss medications, who they are effective for and their side effects. I hope you join us to discover the new long-term answers to weight gain and obesity.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

We made a discovery at the last AMMG anti-aging meeting in Dallas…we found a non-invasive way to treat urine loss in women!  It does much more than just treat your urine loss and also vaginal laxity to improve your sexual response!

The best part is that this treatment consists of 30 minutes of sitting on the Emsella machine 6 times over 3 weeks…no pain, no surgery, you don’t even have to take your clothes off!

EMSELLA by the company BTL, is intended to provide entirely non-invasive electromagnetic stimulation of pelvic floor muscles for the purpose of rehabilitation of weak pelvic muscles and restoration of neuromuscular control for the treatment of urinary incontinence in women. ​​ It is FDA approved!

 Because I practiced OBGYN for 29 years I know that childbirth and aging have a devastating effect on the bladder and bladder function.  It is not unusual for women who have had vaginal deliveries especially after difficult deliveries and a long pushing stage, to have to wear diapers, pads, or Depends for the rest of their lives. Until now the only treatment for premenopausal women has been bladder surgery with or without pelvic reconstruction.  These operations are not only expensive, but they require 6-12 weeks of recovery and abstaining from sex.  Even then, bladder function is usually better but not necessarily without problems like post-voiding dribbling, difficulty starting the urine flow, pain with urination and more. These operations “tie up” the bladder to attempt to bring the bladder back to the right position, however it does not treat the lax and stretched muscles in the pelvic floor that are meant to support a normal bladder.

Emsella focuses on strengthening the muscles of the pelvic floor that hold the bladder, vagina, and uterus up against gravity.  One 30-minute treatment equals 11,000 Kaegle exercises and strengthens the pelvic floor.  The result is a tighter vagina, normal bladder function, and it even treats rectal incontinence that can often accompany urinary incontinence.

Post-menopausal women often lose their bladder control because of loss of estrogen and testosterone at, and even right before, menopause. I suggest replacing estrogen and testosterone with pellets first, for 6-12 months can improve bladder function. If bladder function is better after that interval, but my patients aren’t dry, I suggest starting

Emsella® treatments for 3 weeks to strengthen the muscles….in addition to their hormone replacement.

This solution to the incontinence of bladder and rectal contents is truly a natural solution by using electromagnetic energy to contract the muscles of the pelvic floor and perineum which literally “exercises” the pelvis and bladder into a normal position, with recreated strength!

This treatment treats both Stress Urinary Incontinence (urine loss with coughing and sneezing), Irritable bladder (bladder spasms that cause urine loss), rectal incontinence, uterine and vaginal prolapse (the uterus and vagina “falls down” to the vaginal opening, vaginal laxity that contributes to lack of stimulation during intercourse, and labial lengthening that comes with age.  The FDA is also testing this same machine for male ED, which will be approved in the near future.

For women who develop bladder incontinence, and any of these other the Emsella®  is a perfect solution that is pain free, doesn’t involve intravaginal treatments or injections or surgery.  In three weeks a woman can get control of her bladder and sexual enjoyment with EMSELLA!

Key words: Emsella, electromagnetic energy, bladder control, urinary incontinence, stress urinary incontinence, rectal incontinence, menopause, sexuality, sexual function, labial, prolapse, uterine prolapse, estrogen, testosterone, rectal tone, vaginal laxity, pelvic floor, natural solution, bladder surgery, pelvic reconstruction, sexual enjoyment, diapers, pads, Depends.

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

When I started practicing medicine, I realized that there were many medical problems and patient symptoms which had no treatment approved by the FDA.  This was frustrating and I realized I had a talent for finding alternate treatments that were compounded by a compounding pharmacy for my patients.  I followed research, basic science, and the advice of a compounding pharmacist to find these treatments, and miraculously they worked!  Many of those treatments are now accepted by the mainstream medical establishment and even the FDA. That was over 35 years ago…

I have continued to research treatments to address the problems of my patients. Many times, I have read research novel uses for an old drug or research that finally documents the treatments I have been successfully employing in my practice for years. My husband is a really entertaining guy and when I tell my husband that mainstream medicine has finally accepted and now endorses a treatment I have been using for 10-20 years, he has a pat response:   He sings an old Mac Davis song,, “Oh Lord it’s hard to be humble when you’re perfect in every way……your medical discovery is finally endorsed!”.  He is making sure I don’t get full of myself because I found a treatment long before the “other guys”.

It is one of my two favorite things…finding the answer for a patient’s pain or illness! It is hard to wait for the huge leviathan of medical knowledge to finally endorse what I have been seeing and using for years! 

The practice of medicine was and is supposed to be using what a doctor knows, has learned and what she has read in the form of research, to deductively find a solution for individual patients, instead of following a well-worn algorithm that rarely works.  What most patients experience in the doctor’s office is a watered-down treatment, orchestrated by the insurance companies to save them money and to pay doctors very little for their work. They only pay for 5 minutes of a doctor’s visit and decrease what they pay every year, so that doctors are expected to treat one thing at a time, and never has time to look at the whole patient picture.  It is one of the reasons I left the practice of insurance run medicine…I wanted to be able to put the pieces together for each patient and create a treatment plan to make each patient healthier so they could enjoy a quality life.  That is what I do now...I live the dream of most doctors. I have enough time to look over every part of a patient’s life and create a workable plan that involves not only hormones but treatment of pre-diabetes and Pre-heart disease and other diseases of aging. Making people healthy has always been my goal and in the last 20 years I have been able to do so! 

This situation came up recently when I read a research article in the Journal of the AMA (JAMA) that stated that Statins, such as Rosuvastatin, atorvastatin, simvastatin, and pravastatin, frequently make patients’ diabetes worse.  The title stated, “Association of Statin Therapy Initiation with Diabetes Progression”. This is something I discovered in private practice, and from reading research a long time ago, but the majority of the doctors in my community contradicted my advice to my patients to stop statins, if they had not had a heart attack, so their diabetes would improve, and it always did.  Some of my patients were no longer diabetic when they were taken off their statin.   If they had a lot of plaque on their arteries, I put them on Zetia, a non-statin lipid lowering drug, which did not affect their AODM.  I was ecstatic when I read in JAMA that now the majority of the doctors will treat patients like I have for the last decade. 

Think this through logically. Why would you take a medication to lower your chance of heart disease if you weren’t at risk for it anyway.  A high cholesterol doesn’t mean you have arterial plaque.  Many patients have high cholesterol and have no plaque in their vessels.  If that is you, you could be taking a drug to prevent a problem you’ll never have, and develop type 2 diabetes, a disease that can cause heart disease and damage to your arteries. 

My advice is to take statins only if you have had a heart attack, had stents placed, or a stroke from arteriosclerosis.  If you have a cardia calcium scan of zero-50, and have not had any of the previously mentioned heart problems, then statins aren’t doing you any good, and they might cause you to have type II diabetes, which in itself can cause heart disease and strokes.

So, for all the times I have been criticized for treatments that work, don’t cause complications and make people well, I am now tooting my own horn like Mac Davis did in his song.  The proof is in the current medical articles that appeared years after I already treated patients with this “new discovery”.  I am just thankful that I can have the time and motivation to practice like am able to do now.  

More importantly take a statin only if you need it, in other words, only if you already have proven arteriosclerosis.

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One of the questions I ask my patients about when they first come in for Estradiol and Testosterone pellet replacement is whether they have trouble remembering names of things and places, or if they have difficulty remembering how to get somewhere or if they are just having difficulty thinking through problems that they haven’t had in the past.

The reason I ask this to my new patients is primarily to find out if they have symptoms of low testosterone and low estrogen (in women). It is widely known that replacing testosterone in both sexes and replacing T and estradiol in women can improve recall and speed of mental tasks.  If taken in the first 10 years of loss of these two hormones Taking Testosterone plus or minus Estradiol delay the onset of dementia, especially Alzheimer’s disease.

A new study in Clinical Endocrine News 6/2021 shows that a lack of enough thyroid hormone

Can also cause brain fog.  I always treat low thyroid in my patients as well to make sure they become completely hormonally replaced, to improve their symptoms and prevent future disease.

Just a little information about the thyroid gland.  The thyroid gland is located in the neck right above the collar bone at the base of the neck. It extends a few inches laterally and is shaped like a butterfly.  When the gland is having difficulty making enough thyroid hormone it enlarges and looks like a thickening of the lower neck or like the neck is getting “fat”.  This is called a “goiter”.

The hormones made by the thyroid gland are distributed to every cell in the body and are the primary determinant of how many calories you can burn.  Thyroid hormone stimulates the production of heat in the body and that indicates the burning of calories.  The thyroid hormones, T3 and T4, not only make burning calories and making heat possible, but they also make hair and nails grow, and assist in cell turnover (exchanging new cells for old).

Patients with low thyroid may or may not have a goiter, but generally they are very fatigued, and their hair breaks off and falls out, their skin is extremely dry, and they feel cold all the time.

The list of all of the symptoms that can occur from low thyroid are below.

The following are symptoms of hypothyroidism:

The treatment for hypothyroidism is relatively easy…patients are given an oral thyroid medicine.  The reason many people are walking around with hypothyroidism is partially the fault of the government and the medical community.  40 years ago, the primary necessary component to make thyroid hormone is Iodine, and we used to supplement our foods like bread with iodine.  This kept many Americans who don’t live near the coast (where there is plenty of iodine in the soil and air) supplied with iodine and prevented thyroid disease.  Ever since the government stopped requiring foods to have added iodine, the number of patients with hypothyroidism has rapidly grown and they either don’t get treated because the lab numbers are adjusted to cause fewer people get a diagnosis of hypothyroidism even when they need it, or doctors don’t follow the method of determining dose of Synthroid. Doctors are trained to give the very lowest dose of thyroid possible and not to check the real thyroid hormones (T3 and T4) but to check the TSH which doesn’t tell a doctor the real thyroid hormone level and doesn’t parallel the symptoms a patient is experiencing.

Back to how thyroid hormones affect the memory and thought process. Many people are evaluated for dementia every day because they have memory problems and difficulty thinking, however their doctors do not evaluate the thyroid hormones when evaluating these patients.  It is well known that low thyroid hormones and low Testosterone can cause problems with mentation, but these hormones are not tested.   The patients who do not have traditional dementia or Alzheimer’s disease are told that they don’t have those devastating diseases by their neurologist however the cause of the problem is not looked for in the levels of thyroid and testosterone.  Most people live in fear of having Alzheimer’s because they can’t think anymore but are never treated for the real causes which are hormonal!  Other people are given too little thyroid, which is like not treating them, but doctors act like they are giving a narcotic and must be worried about addiction, when this hormone is necessary for life, and quality of life!

One of my hormone patients was the best example of the damage that doctors who are stingy about giving thyroid medication.  Judy, 49-year-old came to me for many symptoms, only a few of which were related to low thyroid, however she was most concerned about her ability to think!  I explained that she had three reasons she couldn’t recall names of friends and restaurant or street names. She immediately started to cry, “You mean I’m not crazy and I‘m not imagining my symptoms, and I don’t have dementia?”  I have been to 5 doctors asking about my thyroid function because I had a lot of the symptoms and they all told me I was normal, and maybe imagining my symptoms!  My GYN told me he doesn’t “believe” in replacing hormones after menopause, so he refused to give me any hormone replacement after my total hysterectomy!  Do you mean I can get better?”

I treated Judy’s thyroid deficiency by the weight-based formula= weight in pound/2.2, times 1.75.  That gave me the dose in micrograms of levothyroxine.  Her number was 150 of levothyroxine, however I use Armour Thyroid for women.  The formula to convert the mcgs of levothyroxine to Armour thyroid is 100 mcg= 60 mg of AT.  I wrote her a script for 90 of Armour Thyroid and in 4 weeks her symptoms were gone! This formula is not a secret or hard to find..it is on the insert the pharmacist gives you when you pick up your prescription!  Sadly,most doctors don’t know how to prescribe thyroid properly.  The key to adequate thyroid prescribing is when your patient’s symptoms are gone, they are usually at the right dose!

I also replaced Judy’s estradiol and testosterone with pellets which took care of her other menopausal symptoms, and other causes of memory problems.  She is back to normal, thinking clearly, not living in fear of having dementia and happily living her life again.

Brain fog can be from any or all of the three hormones estradiol and testosterone in women and testosterone in men, and thyroid in both sexes.  Don’t give up.  Find a doctor who will treat your thyroid with enough thyroid and remind them that the dose isn’t right if your symptoms of low thyroid aren’t gone.

There is a multitude of effective and safe treatments that mainstream medicine has not accepted yet, and I hope they change how they view the thyroid and thyroid deficiency. However, our patients are suffering now, and can’t wait for mainstream medicine to come to the realization that patients should feel better and have their symptoms treated, it is not just the numbers on a lab sheet that need treatment!

It seems to take decades for medical guidelines to catch up with medical research and curative hormone replacement.  “MEDICINE” will not arrive at these answers for years.  Patients can’t wait for the leviathan of medical practice figures this out.  Your knowledge should help you negotiate treatment with your doctor, so you can live a full and productive life!

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Not all inflammation is damaging, however long-term inflammation can damage healthy tissue, create disease, allergies, and heart disease.  We know that a limited exposure to inflammation is needed to heal injuries, but exposure to inflammation for an extended period causes the changes that occur with autoimmune diseases, it breaks down the collagen of joints, and skin causing joint pain and sagging skin, arteriosclerosis and creates a hyper-allergic state like asthma and eczema. We test for inflammation with a blood test called Highly Sensitive CRP.

We try to control inflammation in our patients to help them avoid the consequences of inflammation listed above.  We do this by treating our patients with curcumin, and turmeric two herbal supplements that decrease inflammation.  This is generally not enough to reverse longstanding inflammation.  We use all the ways we know to limit the damage done by inflammation.

We also use the following methods of inflammation reversal:

 We have reviewed the first four methods of treating inflammation in other healthcasts, but we have become aware of a very effect oil and increasing the amount of Omega 3 oils.  Omega 3 oils in your diet.  We find Omega 3 oil in Marine fish and shellfish, so if a person increases their intake of fish like: Salmon, Halibut, Herring, Sardines, Trout, Oysters, Mackerel, and Tuna. You should eat at least 3 servings of fish a week or you can take Omega 3 oils in the form of DHA and Eicosatetraenoic Acid (EPA) every day as a supplement.

Omega 3 oils (DHA and EPA) are used by the body to limit the inflammatory process.  Inflammation can be improved by limiting Omega 6 oils and increasing Omega 3 oil.

Omega 6 fatty acids primarily increase inflammation by increasing prostaglandins which have many positive actions in the body, so the goal is to increase Omega 3 oils from marine fish and shellfish, over and above the Omega 6 oils.   By changing the ratio between Omega 3 oils and Omega 6 oils we can prevent or improve the symptoms of Crohns’ Disease, inflammatory bowel disease, endometriosis, and autoimmune disease.

The healthy amount of Omega 3 oil required to maintain a health, and prevent inflammatory diseases and side effects, is much higher than the amount that most American’s ingest every day.  The ideal ratio of Marine Omega 3 oil, to the Omega 6 oils from seeds and nuts is 4:1. Most Americans consume Omega 3: Omega 6 oils in the ratio of 1: 20.  New studies say this puts Americans in a state of inflammation throughout their lives and therefore there is a huge increase in inflammatory based foods.

In the past, we thought that oils made from seeds and nuts was healthier than fat and oil from animals and corn, so we thought we were healthier when we cook with oils made from seeds like sunflower oil or peanut oil.  We now find out that that change in our diet has caused us all to be filled with inflammation!  Now we know that Olive oil is the best oil to cook with to avoid using sunflower oil and other nut oils.    

Patients who have inflammation on blood work (highly sensitive CRP > 3) require diet changes that changes the fats that they intake, decreasing the nut oils and increasing olive and fish oil.

This lifestyle change takes up to up to 18 weeks to reverse inflammation, but the process can be hurried along by taking fish oil with DHA, and EPA. Fish oil has both DHA and EPA in it.

Omega 3 oils should be increased for patients with high CRP, to decrease inflammation, and the diseases caused by it. If you have a high CRP this indicates inflammation, then changing your diet to eat more fish oil with DHA and EPA in it for as long as it takes to decrease your symptoms and your HS CRP is required.  It is no wonder we have so many autoimmune diseases in our present patient population…our diet has changed to an unhealthy high level of Omega 6 fats and a low ratio of Omega 3: Omega 6 oils and the outcome is a deluge of autoimmune inflammatory diseases, allergies, and obesity!

Omega 3 oils are also vital to the health of your brain and arteries. For a long healthy, productive life, changing your diet is necessary. Sometimes being someone who doesn’t follow the crowd pays off, and in this case the crowd is headed off a cliff like lemmings!

You are what you eat and suffering from these diseases is the outcome of eating the wrong way!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/

#8 You drink alcohol while you are dieting. Alcohol is a toxin, not a food and slows or stops weight loss. When you drink, your liver prioritizes your alcohol and gets it out of your system first….then fat and other toxins that you need to metabolize.  Drinking every day keeps you from processing and losing fat…so it keeps you overweight.  When dieting..stop drinking!

#9 You don’t drink water…just diet soda or tea or juice. Water consumption is necessary to mobilize and get fat out of your body.  You MUST DRINK 8-10 8 oz glasses of water a day to be able to get rid of fat! Drink water…its free!

#10 Your medicines are working against you!  Anti=psychotics often used for sleep cause weight gain, as do anti-seizure meds and ORAL estrogen (birth control pills, postmenopausal hormones, especially Provera) and ORAL testosterone, and some blood pressure medications like beta-blockers. Ask your doctor for alternatives if possible.  If not, then you will have to emphasize the other ways to lose weight…it will just be a little more difficult.

#11. You eat because you are bored, not because you are hungry. This is a common reason people just can’t lose weight.  Emotional Eating!  Food should be your fuel, and you should consider what you are putting in your tank. Whole foods, clear water, fruit, meat, fish, and veggies are necessary to give you your energy to go through your day.  Eating mindlessly should be replaced by eating at meals.  Start by doing something else with your hands that keeps you from eating—do your nails, sudoku or crossword puzzles, petit-point, or hand sewing. These activities will keep you occupied and your hands busy.  If you must eat something, make it pistachios with the shells—you will burn more calories getting the sells off than eating the nuts!

 #12 Your gut bacteria have become damaged by antibiotics, fast food, and alcohol.  You need healthy gut bacteria to absorb your nutrients and to lose weight.  Feed your gut Pro-biotics and a salad every day and you will build a biome that will help you lose weight. The need for a healthy gut is cited every day in medical literature.  People with just a few types of gut bacteria are fat and those people with many forms of gut bacteria are normal weight…You just must add a probiotic to your vitamins every day and eat salads to feed your bacteria!

#13 You don’t take vitamins and supplements: Our food is not as nutritious as it used to be.

To be truly healthy we must add to the nutrition we get from our food, especially when we are dieting and removing carbs from our diet.  Everyone in the US should take Vitamin D 5,000 units/day, magnesium glycinate 400 mg/day, methylated B complex vitamins, probiotic, Vitamin E 400 MIU, Vitamin A 25,000 units, Zinc 15 mcg, and trace minerals.

If you are dieting you should add DIM ES 250-500 mg, chromium, protein powder with 25 gms of protein 1-2 times a day, Berberine, and vitamin K 100 mcg/day.

#14 You don’t plan your meals or your shopping list—you just buy food that looks good.

Being healthy and having the right foods at home is not more expensive but takes a few minutes a week. Shopping for food should be a stealth attach not a dirty bomb.  When you go to the store you should have planned what you will cook for dinners, and what should be available for lunches and breakfast.  There are expensive foods you don’t need to pay for the fresh foods you do need.  

Here are my shopping guidelines: It is about WHAT you eat!

#15: You don’t Eat right for your Blood type. 

Genetically, certain foods are either good or bad for your genetics.  Follow the blood type foods for you type…(Dr. DaDamo, Live Right For Your Type). 

Remember: Our parents didn’t necessarily feed us what was good for you…they just continued the habit of feeding you what they learned to cook from their mothers.  In addition, you can have many different blood types in a family and the same food that is good for one of you is not the same for another member of the family.

Don’t perpetuate bad eating in a family!

Please take this to heart and follow the plan and you will be able to achieve a healthy weight!

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

I have seen so many patients who come in for anti-aging Testosterone and estradiol who are 50-100% overweight and who do not follow my instructions for weight loss, that I am tired of talking to myself in my office!  It is frustrating to try to help a patient who doesn’t really want to help themselves when it comes to denying oneself food or sugary drinks, or alcohol to lose weight……many of my patients just shut me out when it comes to diet and exercise.

I think being obese allows people to feel like a victim in our society when they are not!  Working at being healthy is WORK!  The benefits are that you get to your ideal weight, your joints don’t have to be replaced, you can exercise, walk, and keep up with your kids and grandkids and you will live longer and happier.  If you take the easy way out and whine when I tell you to stop eating and drinking certain foods, then you are making the decision to be sick and overweight. 

I am a prime example of working at being normal weight: I have the genes for adult-onset Diabetes and for Obesity (yes there are genes that make it harder to lose weight), but I am not diabetic or obese.  A doctor taught me how to eat and not be hungry as well as to exercise to fit my body type, to keep me normal weight. It isn’t fun or easy….but I’m accustomed to it and I know every day I have to eat properly to be healthy!

 Let’s start with going over the reasons you have trouble losing weight…you may have some or all of these reasons….but they can be adjusted if you have the courage to go for it! 

#1.  All calories are not equal: This means that any food has calories in it but foods made of one type of food like a carbohydrate, isn’t equal to the same number of calories as a protein.  A calorie is a measure of the energy you can get out of any type of food, but your body uses the food differently based on the type of calorie it is, and how your metabolism is set up, genetically.

 Example: If you eat 2 pieces of white bread you eat around 200 calories of carbohydrate. Instead, if you eat 3 eggs you have about the same number of calories, but your body doesn’t use them the same way.  If you are already overweight, you are insulin resistant so a carbohydrate will overstimulate your insulin, and the carb calories will make fat and not energy.  If you eat 3 eggs your insulin will not be over stimulated, and you will be able to make energy from the eggs.

A low carbohydrate diet is the one all women over 40 should follow to remain healthy and normal weight. NO SUGAR, NO CANDY CAKE< BAKED GOODS OR SODA!  The carbs should be in the form of complex carbs like nuts, vegetable, and fruit carbs, but no corn syrup sweeteners.

#2 Your genes are working against you, and you may have inherited the genes for weight gain, Obesity, and or diabetes, but it isn’t necessarily going to cause you to be obese or diabetic.  We now know that a person can turn off their genes for obesity and diabetes by living a healthy lifestyle.  The study of this fact is called Epigenetics. 

You are born with the genes from your parents and grandparents; however, genes are not a blueprint for your life that can’t be changed…If you eat a low carb diet and exercise daily you can turn your genes off and look and feel different from the blue print you were born with.

#3. You just diet and don’t exercise.  Diet alone will not give you lasting weight loss.  It is true that people who diet and fast can lose lbs. quickly, but it is generally a loss of water. Lasting weight loss takes eating right and exercise at the same time!

#4. You just exercise and don’t eat a low carb whole food diet: Exercise alone is not an effective weight loss method. Sadly, we can always out eat our exercise, and diet alone without exercise is not effective because our bodies were born to move, and they shut off calorie burning if you are sedentary. The more muscle you have, the more ability you must burn calories.  It takes exercise to create and maintain muscle mass.

Exercise + a Healthy low carb Diet is the only way to lose weight!

#5. You are over 40 and gaining weight. Your successful ways of losing weight no longer work.    After age 40 testosterone from the ovaries and testes decreases and goes away which causes weight gain.  Testosterone is vital to weight loss because testosterone turns the calorie burning that occurs in our muscles, on.  You need to replace it when you don’t have any!

Weight loss requires muscles and testosterone to burn calories efficiently.  This is the reason most women gain weight after 40—testosterone decreases, the muscles don’t burn calories, and the muscles are replaced by fat.  The smaller your muscle mass, the lower your basal metabolic rate.

#6. You just eat junk food and carbs, no salad, or fresh foods.  Everyone who wants to be healthy should eat a salad every day.  We are omnivores—we are built to eat fruit, veggies, nuts, meat, and a wide variety of fresh foods.  Salad fills you up and provides nutrients that everyone needs.  Salad also feeds your gut bacteria that make your feel-good neurotransmitters and peptides communicators.  If they don’t get roughage…they aren’t fed and you don’t absorb nutrients or make the right neurotransmitters….you gain weight and get depressed!

#7  You don’t eat meat or high protein foods—Humans must eat half their weight in grams of protein every day to maintain their muscle mass and burn calories!  If you don’t eat enough protein, you will lose muscle and decrease the number of calories you burn in a day. To find the number of grams of protein you need per day, divide your weight in pounds in half. The result is the number of grams of protein you need per day.  If you exercise daily…you need even more!

Next week we will discuss the reasons you are having trouble losing weight, #8-15.

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

I always hear my patients say things like, “I don’t care if these pellets cause me to die early, I’m taking them anyway because they improve the quality of my life and relationships”….I have to stop and correct them!!!

NO! replacement of estradiol and testosterone to women after they lose their own hormones makes you live longer!!!  There are many research articles that prove that the replacement of hormones decrease the rate of dementia, osteoporosis, cancer, heart disease, Parkinson’s, autoimmune diseases and poor immunity that leads to death from infections, but it is hard to find a research article that says “Hormone Replacement Therapy is Associated with Lower Mortality”….but it does! American College of Cardiology March 8, 2017, published this study and supported it with real statistics---why didn’t we hear about this?  Probably because if you are healthy because of estrogen replacement…then you don’t need so many meds and the drug companies don’t make as much money on medications!!!  If you doubt that they have the power to suppress information, then you are dreaming!

You don’t have to give up a long life to lead a quality life!  My goal in treating my patients is to lengthen and strengthen them against all diseases!  Hormones are what makes us bulletproof when we are young, and if we replace them, we don’t age as quickly and we avoid the diseases of aging.  In my books The Secret Female Hormone, and Got Testosterone? (Available on Amazon), I describe the diseases that can be avoided or delayed by taking bioidentical testosterone pellets for both sexes.  This is just one of the thousands of research articles I have found that prove that replacement of E2 and T for women and T for men make us live longer.

The article cited here tells us that women taking estradiol for hot flashes and vaginal dryness also decreased their risk of death from atherosclerosis, decreased plaque buildup in the heart’s arteries, compared to women who did not take estrogen after menopause.

It also states that the replacement of E2 has been considered controversial because of the flawed 2002 research by the NIH (WHI STUDY) that stopped women all over the   country from receiving prescriptions from their Doctors  for estrogen.  The doctors didn’t read the study…just the headlines and stopped prescribing estrogen. It was also easier for them to never have to talk about estrogen again…but their patients suffered.  I can remember all the screaming horrible phone calls we received after my patients stopped taking their estrogen on their own after reading the NIH headline…the headline was in fact wrong…it was Provers—a synthetic progestin (NOT PROGESTERONE) that caused the results…not estradiol!

I never took my patients off estradiol because I knew the truth…and I needed the replacement of my estrogen after my oophorectomy, and I couldn’t think or sleep or anything else! 

Now 15 years later we get the right information that estrogen replacement saves us from heart disease (the biggest killer of women), and osteoporosis, stroke, and even cancer!

The 2002 WHI study cause American women to stop taking estrogen—60% of menopausal women took E2 replacement in 1998, and less than 23 % inn 2012. 6 percent of women died during the average follow up period of 8 years.

During the study period women on estrogen replacement therapy (ERT) were 30% less likely to die of heart disease than women not on estrogen at the same ages, Estrogenized women also had much lower rates of diabetes, high blood pressure, high cholesterol, and higher rates of zero plaque on their cardiac calcium scans!!

The lower rates of plaque are due to the estrogen effect of decreasing cholesterol and diabetes. Studies show that women with high levels of estrogen during

premenopause, have the cardiovascular health of men 10-20 years younger than they are!  After menopause that advantage is lost, but women have the opportunity to regain cardiovascular benefits by replacing estrogen.

What are your reasons for not replacing your lost estradiol? It saves your heart and vessels and prevents many diseases of aging.  If you replace your estrogen with pellets, you avoid the risk of blood clotting problems found in oral estrogens, and there is no increased risk of breast cancer either!  What is your reason for not replacing your estrogen?  Your doctor won’t write a script?  Change doctors to someone who is up to date and not too lazy to bother with your hormones!

Reference Am College of Cardiology MARCH 8, 2017, “HORMONE REPLACEMENT THERAPY ASSOCIATED WITH LOWER MORTALITY”.

https://www.biobalancehealth.com/healthcast-blog/

Vitamin D is not just a vitamin, as most people think, it is a HORMONE called Cholecalciferol that is required for general health, thick bones, for making muscle and your immune system, your brain function, and for protecting you from diabetes, heart disease and cancer. Vitamin D also acts to assist your body in absorbing calcium and zinc from your food and supplements.  Without Vitamin D3 these vital minerals go through your body without absorption, and you just excrete them without being able to use them.

The vitamin-hormone Vitamin D comes in several forms.  The form D2 comes in natural food sources such as salmon, swordfish, egg yolk and fortified foods such as milk, orange juice and other milk products like yogurt.  However, Vitamin D2 is not a potent form of Vitamin D. Vitamin D is also produced by your skin in the melanin when you go out on a sunny day, however you would have to be out daily for most of the sunny hours, without sunscreen, at a latitude like where Phoenix and Destin Florida is or further south to absorb enough Vitamin D from the sun.

Your skin absorption in the 21st century is usually minimal since medical science has promoted the use of sunscreen every day all day long which blocks our absorption of Vitamin D.

Your skin tone also alters how much Vitamin D you absorb from the sun.  if you have very light skin and burn easily it takes less time in the sun to absorb the same amount of vitamin D than someone who has dark skin.  It is a given that most people who do not live in the southern US and have dark skin are not getting enough Vitamin D from the sun even if they work outdoors all day long, so they must take a supplement orally or in a shot of VitaminD3. The recommended oral dose is 5,000 MIUs of Vitamin D3 every day to receive enough Vitamin D in their body.

For all people with all skin types, you should be out in the sun for an hour before you cover yourself in sunscreen.  The sun gives you vitamin D, but also has other benefits. Remember no matter what skin type you have, the tanner you get the less vitamin D3 you absorb.  It is a protective mechanism to prevent overdosing with D from the sun for those people who have dark skin and live in the sun around the equator.

What does it really do?

For one thing Vitamin D is essential to your immune system.  If you want to be immune to viruses and bacteria as well as cancer you must have a normal blood level of vitamin D.  The accepted level is 30 from the US government but it is preferable to have a blood level of 40-100 for optimal health. The other jobs of Vitamin D include Building muscle and bone, normalizing blood pressure and Type 2 Diabetes, preventing heart disease, stroke, and dementia. If you want to stay healthy throughout your life you should take oral Vitamin D3 5,000 miu per day.

The Actions of Vitamin D3:

We have already listed the important job of supporting your immune system to prevent infection and cancer.  The addition Vitamin D supports Muscle and bone.  Without Vitamin D, children get a disease of soft bones that bow their legs and prevent normal height, called Ricketts. It was common in the early industrial age when children were kept inside factories all day long to work instead of playing outside. 

Adults we must have Vitamin D to keep our muscles strong, and our bones thick.  Muscle and bone are in a state of homeostasis which means they are growing and breaking down all of the time.  If breakdown is more rapid than growth the bones become thin and are apt to break.  The other necessary elements to keep bone and muscle strong are Calcium, Magnesium Vitamin C, and Vitamin K2.

For optimal skeletal muscle (which includes the heart) you have to have adequate vitamin D levels in your blood. For example, patients in a recent study increased their muscle fiber size by taking 4,000 IUs of Vitamin D3 a day. They also made more Type II muscle fibers which are responsible for rising from a chair or lifting things over your head. Type two muscles are located in your hips, back and shoulders.  Another study showed the just 1,000 IUs of Vitamin D3 increased muscle strength by 25%, without any other changes in diet or activity.  Muscle training and exercise are also important, but you won’t get the results from just taking Vitamin D, or exercise alone, that you would if you take Vitamin D3 + Exercise + Testosterone. If you are over 50 and don’t exercise while you take Vitamin D and replace Testosterone with pellets.

Type 2 Diabetes also affects 50% of our population, primarily from eating too many carbs, without exercising, but low vitamin D contributes to the development of diabetes and obesity as well. All people who are Insulin Resistant, who have Type 2 Diabetes or Prediabetes should be taking 5,000 MIU of vitamin D3 a day.

Summary: The easiest and cheapest way to prevent heart disease, stroke, osteoporosis, cancer, type 2 diabetes, and dementia, among others because it improves your immune system too. If you are Latino, Black, Italian, Israeli, or Greek, in, fact if your genetics are from any country around the Mediterranean, or just have dark skin, you must take Vitamin D3 to stay healthy! It is over the counter and relatively cheap.  You should take Vitamin D3 in oil-capsule form for good absorption.

Remember….Taking Vitamin D3 doesn’t replace going outside for sun absorption.  It is in addition to being in the sun! Sunscreen prevents Vitamin D3 absorption.

Vitamin D may cut heart disease risk in dark-skinned adults

A study to be presented at the Experimental Biology 2021 virtual meeting found that taking vitamin D supplements may help people with dark skin, including African Americans, to reduce their risk for heart disease.”Promoting adequate vitamin D status in young, otherwise healthy adults may improve nitric oxide availability and blood vessel function, and thereby serve as a prophylactic to reduce risk of future development of hypertension or cardiovascular disease," says researcher Tony Wolf.

 Full Story: Medical Dialogues (4/27) 

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

Colon Cancer is the third most common malignancy in the US and is something you don’t want to get and there are many ways to test you to see if you have pre-cancer, cancer or polyps which are also risks for cancer.  They advertise these tests that you can do yourself by testing your own poop.  My family physician daughter advises our patients that those tests do not adequately test for pre-cancer or colon cancer.  They might find a cancer, but they will miss more than they find.

90% of Colon cancers are diagnosed after age 50. The incidence of colon cancer in the US is 4.2% and if there is a family history in a close relative before the age of 50, the incidence doubles to 8.4%.

What makes a person high risk other than family history?

Colon cancer can progress without many signs therefore it is important to get a colonoscopy under sedation when you are 50. After that, depending on your risk factors your doctor will tell you how often you will need surveillance.

Now, as for the other tests that you can do at home in between colonoscopies, my favorite is the stool guaiac test looking for microscopic blood. This blood doesn’t look red and is not visible.  I used to do vaginal and rectal exams at the same time during gyn exams and would test the stool on my glove for microscopic blood (the guaiac test) by taking the sample, smearing it on a card and dropping a drop of developer on it.  If it turns blue, there is microscopic blood and possibly cancer.   I rarely had a positive, but if I did, a referral was made for a colonoscopy, and it was about 50% positive in my testing experience. The same test at home can be done on 3 successive stool samples and this should be a good test to do at home. 

They have just come out with a FIT test (fecal immunochemical test) that tests for DNA mutations of colon cells.  It is more sensitive and accurate than Guaiac test but not as accurate as a colonoscopy.  It was determined that the best frequency was 2 x a year.

As it stands the colonoscopy is the best test, but it requires sedation and an invasive procedure, however low risk.  I still recommend a colonoscopy at 50 and every 10 years thereafter.  Soon I am sure this FIT do at home test will be recommended frequently to lower the number of Colonoscopies, as a matter of cost saving. High risk individuals should continue with colonoscopies until the recommendations change.

Prevention is my recommendation:

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

Osteoporosis is a side effect of aging and is one of the diseases that affects aging women more than aging men.  Osteoporosis can lead to fractures of fragile bones, spinal stenosis, chronic back pain, and inability to walk or take care of ones-self. In the aging population it is one of the diseases that leads to women being admitted to nursing homes.

The disease occurs in women more than men for two reasons. Bone thickness is stimulated by the hormones estradiol and testosterone, and testosterone builds bone better than estradiol. Men have ten times as much of it than women!  Therefore, men have stronger bones to begin with, before their testosterone starts to drop, and men never totally lose testosterone like women do!  The second reason is that women lose both testosterone and estradiol earlier and more completely than men lose testosterone, so their bones start to thin over a decade before men.  Osteoporosis is a women’s disease and the cause of many women’s deaths.

A bit about how bones grow: Your bones are dynamic and always growing and breaking down.  When we are young our bones grow at a much more rapid rate than they break down.  They are under the stimulation of growth hormone and low doses of sex hormones as well.  After age 40 the breakdown process occurs at a faster rate than the building of bone unless testosterone and estradiol are replaced. I bet you thought your bones stopped growing when you reached your adult height, and were static…doing nothing until they started to dissolve?

When I went to medical school, (late 1970s) we knew that hormone loss was the cause of osteoporosis, but it was not such an epidemic as it is today. In the 70’s, women were routinely given estrogens when they went through menopause and stayed on them for years, which counteracted their loss of bone. Result? No osteoporosis!

We didn’t even need to look for a solution for osteoporosis because women didn’t get it!  The reason the use of estrogens ended was that they were given without progesterone, and some women got uterine cancer from un-opposed estrogen. It is a generally a very treatable cancer, but the use of estrogen was banned because like all governmental medical decisions, the US government overreacted to a small subset of women getting uterine cancer instead of looking for a way to give estradiol safely.  The resultant ban of the use of estrogen resulted in a current epidemic of osteoporosis.  

In the 1990’s the people that control medicine in the US realized the danger of osteoporosis to women and the drug companies created drugs to treat it!  Instead of using the best treatment for osteoporosis, estrogen and now we know testosterone, they reinvented the wheel and created bisphosphonates, Fosamax an Alendronate.  These drugs have many side effects, but we have found over time that the only thing that these drugs do for bones is to make them look denser on Xray, but they are NOT stronger!  What a mess!  This disease is very slow to cause fractures therefore finding out that bisphosphonates don’t work to prevent fractures!  The drugs however did make billions of dollars for the pharmaceutical companies!

Now we are in another century, and we have discovered that treating women with Estradiol and testosterone is the best treatment to prevent fracture!  An old trick that should have been found decades ago and saved many lives. My patients can improve their bone density in 2-3 years on E2+ T pellets, from osteopenia (mild thinning of the bones) to normal.  It takes a little longer with patients who have overt osteoporosis, but it works. 

Some patients depend on Vitamin D3 and Vitamin K2 to treat their osteoporosis after menopause.  That is really just fooling yourself!   These two nutrients are necessary for bone growth and should be taken with the two hormones, but after menopause without hormones, they don’t make bone.  It is like putting plant food in the potted plant and putting the plant in the closet.  Hormones are the sun that make bones grow. I know about this problem intimately because my mother the herbalist refused to take estradiol after menopause.  She literally died in excruciating pain because her vertebrae collapsed and there was no bone left to repair her.  She had to wait for death in hospice because her bones had dissolved.

So, what if you are under the delusion that because you have dark eyes, dark skin, and dark hair you have great bones?  Nope….your coloring doesn’t necessarily determine your bone density!

My mother had osteoporosis and was blond with blue eyes, however I look like my dad but have my mom’s bones! Add Lupron for endometriosis, too many diet cokes, and no Vitamin D3 in my diet and you get Osteoporosis in my 40s!  At age 47 I was treated with T and E2 pellets and two years after that my hormones built my bones back to normal density!  I knew bisphosphonates didn’t work so I never would have taken them…I also didn’t prescribe them unless I couldn’t treat a patient with anything else!

So, if you think that you can use supplements to build bone after age 40, or that you are immune because of what you look like, or your heritage, think again.  The only guarantee to prevent osteoporosis and dying like my mom or of a broken hip is to replace the hormones that you had when you were young!

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

Testosterone treats many illnesses in addition to sexual dysfunction.  Most patients and doctors don’t associate testosterone with the anxiety and depression that occurs after age 40.  Depression is a direct side effect of low T.  T is a mood elevator and stimulates Seratonin production, improving mood in that way.  Many of our patients can decrease the dose of antidepressants or even go off their medications after they have been on T for more than 4 months.  I always ask my patients to ask their “depression doctor”, who prescribed the antidepressant, to help them wean off. A side note: I do not recommend decreasing or stopping antidepressants during the fall, because we live in the Midwest and there is very little sunlight at our latitude between September to February, so I ask that they don’t change their antidepressant during those months.  Remember testosterone if you develop depression after the age of 40.

Testosterone also treats anxiety in both men and women by lowering FSH and LH, the pituitary hormones that surge after T and Estradiol decrease with age.  Many men come in to see me for low T and ED, who have recently been prescribed Xanax or some other antianxiety drug that is not working for their anxiety.  However, when I treat them with testosterone pellets, they miraculously are cured of their anxiety!  Women generally have hot flashes from elevated FSH/LH, however some of them have anxiety as well.  Women are cured of their anxiety attacks, with T pellets plus or minus Estradiol.

Other conditions that are improved when I treat my patients of both sexes with T pellets is Insulin resistance, AODM, and weight gain.  T improves insulin resistance and increases the calorie burning in the muscles.  You burn most of your calories every day in your muscles and T facilitates the metabolic work in the muscle tissue.  With testosterone, you literally burn more calories by jut breathing (your Basal Metabolic Rate). T increases your muscle’s activity by burning more calories of fat and stabilizes your blood sugar.  Our patients lose fat, gain muscle mass, and become more insulin sensitive with T pellets.  Those with diabetes decrease their medication over time and have a lot more energy…the natural way…by activating their muscles!

Immune dysfunction occurs when you age and is why older people need a higher dosage of immunizations, and why they die of viruses that younger people don’t die of. Your immune system is controlled by your thymus gland which makes white cells called T killer cells, T helper cells that kill cancer cells and viruses.   B cells make antibodies. The thymus and its function is growth hormone and testosterone dependent.  As growth hormone and T decrease, the gland shrinks and by age 50, and by age 60 it can’t be seen and stops doing its job of protecting us.  By taking testosterone, growth hormone is stimulated, and the thymus gland grows and is active making these cells that protect us.  There is a peptide that stimulates the thymus for those people who don’t fully respond to Testosterone, called Thymosin alpha-1.  This is a communication peptide that stimulates the production of protective immune cells.  It has

been around forever as a medication, but no one used it because it doesn’t have a big drug company behind it…so it is available at compounding pharmacies. The FDA has started to stamp it out across the US, for no apparent reason. It improves immunity to all infections.  In this time of pandemic, this drug should be applauded and not taken off the market!  What are they thinking?

Autoimmune diseases occur when your immune system, your T Cells and B Cells, become confused and instead of killing viruses and bacteria, attack your own healthy tissue.  This imbalance occurs secondary to a genetic weakness as well as exposure to infections that “look like” normal tissue.  Testosterone deficiency causes an unstable immune system and leaves the door open for autoimmune diseases. I was very surprised when my patients with autoimmune diseases like RA, Lupus, and Sarcoidosis, improved drastically after they got T for completely different indications!  I then researched this association between T and Autoimmune diseases and found that there is a lot of research that proves T is an excellent treatment and prevention for autoimmune diseases. 

Migraine Headaches response to T replacement, were another surprise for me.  As I treated sexual dysfunction in women, they came in to see me and said: “The weirdest thing occurred after I got my pellets…I stopped having the incapacitating migraines I used to get!  This is an amazing two-for….I have stopped taking my migraine medicine!” .  Once again, I went to the research and found that hormonal migraines can be treated with non-oral testosterone.  The migraines that are triggered by food additive and weather changes are usually not improved, but women have hormonal imbalance migraines, and T works for that.  Why?  Testosterone is a modulating hormone for many systems, but in this circumstance, it is working in the brain to balance the neurotransmitters and the vasodilation chemicals that get “confused” when it is deficient, and the effects of E2 increased and dilated blood vessels.

PMS is another problem that is improved with testosterone.  PMS affects every part of a woman’s body…It is the outcome of estrogen dominance with a progesterone deficiency.  This era of a woman’s life can occur at any time in her life; however, it is much worse during after age 40.  Why is that?  Because after 40, testosterone becomes deficient, estrogen is dominant, and ovulation becomes spotty which is the function that produces progesterone.

Weakness and loss of strength occurs after age 40 in women and some men, and this is directly due to the loss of Testosterone and the decrease of T free.  This dominos to a less active person, and this results in osteoporosis and frailty.  Here is a news flash…Frailty is the one thing that will cause a person to become dependent on others and unable to live independently!  Losing muscle is not what you want!  Testosterone prevents frailty, by directly stimulating muscle mass and strength, including the heart, which is a muscle, and by stimulating growth hormone which also builds muscle and bone!

You get so much more than a good sex life (Which should be good enough) when you replace your T .  Health is a precious commodity, and it should be a priority for you!  Life with health is the only way to age…consider replacing your T in the safest way possible— T pellets are my choice, but please replace missing T in any way you can.

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

Last week we talked about obesity as the biggest risk to both individual health and to the overall health of Americans.  This is not fat shaming…this is a fact!    Americans are inundated with advertising which literally makes them hungry for foods that make them fat, which then makes them hungry for more high calories food….we are being fooled into eating what is killing us!

I think the epidemic of Obesity in the US is caused by the following:

Fast food, Junk Food Sugared and Diet soft drinks Excessive Alcohol intake (and high calorie mixers they are served in) Lack of physical movement Lack of exercise: TV, driving, video games, Mental vs Physical labor Sugar substitutes that cause obesity (Splenda (yellow) Saccharin (pink) Equal (blue) Stress

Fast food= High calories + High Carbohydrates= Weight gain

The only time I have fast food is when I am traveling by car.  This summer, I took note of all the calories/carbs in the fast food we were stopping for which made me horrified at the possible total daily calories one meal can generate.  By driving I am not exercising so basically, I am fatter when I get somewhere than when I started….next year I’m packing my food! 

The basal metabolic rate = the number of calories you burn in a day if you aren’t working out and exercising is generally less than 2,000 calories, and the shorter you are the fewer calories you need. Your weight doesn’t increase the number of calories you need unless your weight is from muscle.  Fat doesn’t burn any calories, only muscle does!!  This means that if you eat 2,000 calories per day and sit at your job you will stay the same weight.  If you eat more you gain if you eat less you lose.

But a calorie isn’t a calorie…in other words all calories aren’t equal.  Even though fat contains more calories per oz than protein or carbohydrates, carbohydrates impair your ability to burn calories by making you insulin resistant…carbohydrates are more damaging to your weight loss than any other food and fast food is full of them!

Here is what I found out about fast food.

Big Mac = 540 calories

Burger King Large Fries = 434 calories

Chick Filet Chicken sandwich = 430 cal

Chick Filet sandwich = 440 calories

Chipolte Burrito-Carne = 570 calories

Dairy Queen ½ lb. grilled burger with cheese = 800 calories

Dairy Queen brownie batter Blizzard, medium = 880 calories

KFC Fried Chicken one Chicken breast = 360 calories

McDonald’s French Fries large = 510 calories (all carb and fat)

Panera/STL Bread Co asiago cheese bagel = 320 calories (all carb)

Pizza Hut meat lover’s 1- slice = 410 calories (who eats just one slice?)

Taco Bell soft Taco = 180 cal each

 Coffee Calories:  Coffee at Starbucks is really just drinking dessert!

Coffee black any size = 0 calories

Starbucks Café mocha Vente = 280 calories

Starbucks Café mocha vente = 330 calories

The Point: Cooking at home with olive oil and other polyunsaturated oils with low carb contents is more conducive to weight loss than eating fast food….No surprise!

Soft Drinks

Soda is just eating a bowl of corn syrup with carbonation---It is deadly because it readjusts your insulin, by increasing your insulin to cause insulin resistance.  Insulin resistance is the problem when it comes to weight loss as adults…and some children.  These drinks should be removed from the American diet…they provide no nutrition, and they cause obesity.

Obesity can only be treated by and avoided by consciously eating a healthy diet without fast and junk food, without soda and simple sugars.  The other side of this is that Americans must sit less and exercise and walk more. Know how many calories you can eat and minimize carbohydrates.  If we eat it, big business will continue to sell junk and fast food.  We have been a bad example to the rest of the world by exporting all the fast-food franchises to other countries. We must take the lead in following healthy patterns that provide profit for companies that make healthy food and drink instead of the food and drink of obesity and the addiction to sugar!