Anti-aging


I know that when you read the title of this blog, you thought that I had lost my mind; however, I have not.  Let me tell you about a few of my patients and their outcomes that I think you will find very interesting.  A couple of years ago, I had an initial visit with a 50 year old woman who appeared to be the picture of health.  She was her ideal weight, didn’t take any medications, played tennis 2 hours per day and didn’t look a day over 35 years old.  Not only that, she spent several hours in the gym weekly doing cardio and weight training.  When I looked at her lab results, however, what I observed made me think that she was a heart attack waiting to happen.  Her results were as follows:

  •  Cholesterol – 384 mg/dL (optimal is < 200)
  • LDL – 260 mg/dL (optimal is < 100) – This is known as the “bad cholesterol”
  • HDL – 92 mg/dL (optimal is > 60) – This is known as the “good cholesterol”
  • VLDL – 32 mg/dL (optimal is < 30) – ↑ levels are associated with heart disease
  • Triglycerides – 160 mg/dL (optimal is < 150)

Most people know that having high cholesterol levels is a major risk factor for heart disease.  So, after considering her level of physical fitness and her healthy lifestyle, I thought that this must have been a lab error.  I actually had her go back to the lab to have her lipid panel retested.  Also, I had the lab do what is called a VAP (Vertical Auto Profile) Cholesterol Test which determines whether or not the LDL cholesterol particles are small or large.  This is significant because if the LDL particles a small, they are more likely to cause plaque in the arteries.  If the LDL particles are large, however, they are not likely to cause plaque in the arteries.  I was so convinced that the lab must have initially made a mistake, and I was expecting to see her have a total cholesterol result of under 200 mg/dL.  Unfortunately, I got the repeat results back, and this time her total cholesterol was 418 mg/dL and her LDL cholesterol was now 277 mg/dL.  Even though her LDL particles were large (good), the knee jerk reaction still would have been for me to immediately prescribe a statin (Crestor, Lipitor, Zocor, Mevacor, Pravachol, etc) and send her to a cardiologist.  I just knew in my gut, though, that there must be another reason for her high cholesterol level.

So, using the functional medicine approach that I heavily leverage in my practice, I took an in depth look at her other labs, and what I saw was that her thyroid hormone levels were extremely low meaning that she had hypothyroidism.  It is so tempting for me to go off on another tangent and explain what you really need to know about diagnosing hypothyroidism, but I know you have other things to do and I don’t want to make this too detailed and too long.  Quickly, however, so many of my patients have told me that they have had their thyroid tested and have been told that their thyroid was “normal” despite the fact that they had difficulty losing weight, hair loss, cold hands/cold feet, constipation, dry skin, depression, brain fog and brittle fingernails just to name of few of the symptoms.  Using the evidence-based view in which physicians seek to achieve optimal thyroid function, I have found that many of the untreated or inadequately treated patients benefit from proper doses of thyroid medication.  As you can probably tell, I need to cover assessing thyroid function in a future blog.  Anyway, this woman didn’t have any of the above symptoms at all, but I knew that there must be a link between her low thyroid hormone levels and her high cholesterol levels.  So, I did not prescribe a statin for her; instead I prescribed thyroid hormone for her.  Six weeks later I retested her lipid panel, and her total cholesterol had dropped down to 180 mg/dL.  This was a greater than a 200 point decrease without using a statin. 

Many of the patients that I have seen were already taking statins to lower their cholesterol levels prior to seeing me.  I have now lost count of the number of patients that I have seen who no longer have to take a statin at all, or they are taking a significantly lower dose since their thyroid function was optimized.  For example, some of the patients who were taking Lipitor 40 mg/day are now taking Crestor 5 mg twice weekly.  Most people think that the lower the cholesterol level is, the better.  This, however, isn’t true since we need cholesterol in order to make our reproductive hormones.  Estrogen, progesterone and testosterone are synthesized in the body from the cholesterol molecule.

Please don’t misunderstand me as I am not saying that I am totally against the use of statin medications.  I prescribe them when the functional approach that I use doesn’t yield a satisfactory reduction of the cholesterol levels.  Patients need to realize, however, that there are potential risks with any medication including statin drugs. Though it is somewhat controversial, there is research that shows that statins may lower CoQ10 levels.  CoQ10 is an enzyme that is produced in the body that is responsible for production of energy at the cellular level.  Statins sold in Canada are required to carry a precautionary warning expressly stating that this class of drugs may seriously deplete CoQ10 levels.  In the United States, however, the FDA does not require that drug manufacturers give this same warning.  I believe that this is the reason why many physicians don’t routinely recommend the use of CoQ10.  Interestingly enough, there are  numerous small studies that demonstrate that abnormally low levels of CoQ10 are seen in patients with cancers of the breast, colon, lung, pancreas, lymphomas as well as melanomas.  I have not read any information that reports any downside to giving CoQ10, so my position is that all of my patients who are on statins should be taking a CoQ10 supplement.   Additionally, for those patients who really want to be proactive about their health, I recommend that they take CoQ10 even if they are not taking a statin.   For that reason, my own brand of daily nutritional supplements (Proactive EssentialsPLUS) includes a clinically significant dose of CoQ10. 

Now, I’d like to share a few numbers that you might be interested in. Depending on the source, there are approximately 100 million Americans with high cholesterol and over 12 million Americans with thyroid disease, many of whom are untreated or inadequately treated.  And many of the untreated or inadequately treated have high cholesterol that is a direct result of their thyroid disease.  Another survey showed that 90% of the people surveyed were not even aware of the connection between thyroid disease and high cholesterol. The point here is that you or someone you know may be impacted by this phenomenon, and unfortunately the broader and more conventionally thinking medical community is not focused on this issue for reasons that are beyond the scope of this blog.

In conclusion, I hope you now understand that there is a thyroid-cholesterol connection.  In addition to improved cholesterol levels, the other benefits of achieving optimal thyroid function are increased energy, relief of constipation, weight loss, normal body temperature, decreased brain fog, better memory, avoidance of hair loss and less depression just to name a few.  So, if you have high cholesterol levels, remember to ask your doctor to check your thyroid hormone levels since this just might save you from years of taking statin drugs.

I can’t believe that it is already November!  As most of you know, October was Breast Cancer Awareness Month, and this year was the 25 year celebration of the National Breast Cancer Awareness Month Organization.  As I read different literature and talk with different people about what breast cancer awareness really means to them, the common thread is focused on early detection rather than prevention.  There is a lot of focus on making sure that screening mammograms are done routinely and that patients do breast self-exams, but there is little discussion in the popular literature on prevention strategies  Also, many people feel that if they purchase pink cell phones, pink curling irons, pink flatirons and pink clothing that monies will be donated to organizations that will find a cure for breast cancer. 

In my practice, I focus on proactive strategies in general to help patients “prevent” cancers and other degenerative diseases in addition to the early identification strategies.  Don’t get me wrong, I do believe that mammography has its place and has offered many benefits especially in people who have early stage breast cancer; however, I recently read multiple articles including an article that was written by a prominent radiologist by the name of Leonard Berlin, MD that I am sure you will find very interesting.  This article was quite an eye opener for me and I am sure that it will open your eyes, as well.  Dr. Berlin stated that people need to understand that screening mammograms have their limitations, and he went on to say that 30 – 70% of breast cancers are missed by screening mammogramsYes, 30 – 70%!  He then stated that because of this awareness by the medical profession that many breast cancers are missed, this often times leads to over diagnosis and over treatment.

This reminds me of a patient that I recently saw who was diagnosed with DCIS (ductal carcinoma in situ), and had undergone a radical mastectomy with a TRAM flap reconstruction.  Essentially, the surgeon used part of her abdominal muscle to create a breast after the mastectomy was done.  The good thing is that this patient wanted a tummy tuck anyway, so she was happy about not having to pay out of pocket for a cosmetic procedure.  Now, here is the tragic part of the story.  DCIS (ductal carcinoma in situ) is a non-aggressive form of cancer that has a 98% survival rate in 5 years even with no treatment.  Over 50% of cancers detected by mammograms are DCIS, and once the diagnosis is made it is typically treated as if it were an aggressive cancer.  As I mentioned, there have been many articles written on the over diagnosis of breast cancer, and this is not only limited to the radiologists, but also with the pathology interpretations.  To make a long story short, the pathology report of this patient’s breast tissue following the mastectomy did not reveal any cancer at all.  To make matters worse, I recently read an article that stated that one third of the time pathologists will disagree on a diagnosis of DCIS when looking at the same specimen.

It was certainly not my intent to frustrate or confuse you, but I simply wanted to give you the facts.  As I stated in the beginning of this blog, it is my opinion that there is not enough attention given to breast cancer prevention strategies. When I read the literature, I find that there are so many simple things that we can do to decrease the incidence of not only breast cancers but many other cancers and degenerative disease in general..  Remember, 20% of whether you will develop a disease such as cancer is due to your genetics, and 80% is due to the environment that you expose your cells to.  This means that you may genetically be predisposed to developing cancer; however, it may never manifest itself because of strategies that you can implement to keep the disease at bay.  When it comes to breast cancer in particular, you don’t have to stand around with your head in the sand hoping and praying that it won’t happen to you.

Instead, I recommend that you act proactively and consider incorporating the following into your health strategies:

  1.  Make sure that you have sufficient iodine levels.  Japanese women have a lower incidence of breast cancer than American women, and they also consume higher amounts of iodine in their diets.  90% of Americans are iodine deficient.
  2. Optimize Vitamin D levels.  I have seen many patients who have had a breast cancer diagnosis, and many of them have extremely low Vitamin D levels.  My goal is to get the levels between 60 – 80 ng/dL. 
  3. Do aerobic exercise at least 3 hours per week.  Obesity is associated with both breast and prostate cancer. Also, sweating is one of the ways that we detoxify our bodies.
  4. If you are overweight, implement healthy strategies to reach and maintain an ideal weight and body composition.  
  5. Eat organic as much as possible.  We were never meant to be able to handle all of the toxins that we are exposed to on a daily basis, and toxins can cause damage to DNA.  DNA damage can result in the formation of cancer.
  6. Make sure that you are metabolizing estrogen to a healthy metabolite.  The Estronex 2/16 Test is a measurement of two important forms of estrogen.  The 2-OHE1 is the “good” estrogen and the 16-OHE1 is the “bad” estrogen.  Diindolylmethane (DIM) has been shown to raise the 2/16 ratio.
  7. Avoid synthetic hormones and use only natural bioidentical hormones.  Natural Progesterone has been found to be breast cancer protective.   

The above are just a few examples of strategies that you can do to decrease your chances of developing breast cancer, and in one of my next blogs I will be adding other strategies.  

Here are the relevant statistics:

In 2009, approximately 192,370 women in the U.S. will be diagnosed with breast cancer, accounting for more than one in four cancers diagnosed.
In 2009, an estimated 40,170 women will die from breast cancer
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 I hope that it makes perfect sense to you that you must be proactive and not solely rely upon screening mammograms to protect you.  Remember the old adage that an ounce of prevention is worth a pound of cure.  The best strategy is prevention, and I pray that I have shed a new light on what a breast cancer awareness initiative should include.

It was thrilling to have had the opportunity to speak to such an influential group of well-accomplished women. These types of engagements allow me to execute on one of the pillars of my practice, which is to educate men and women about strategies to avoid disease and achieve optimal health. I truly hope that my message was heard by many that struggle with health issues and those that have good health and want to keep it that way. In one-half hour, I couldn’t possibly do justice to the complex topics that I touched on, but I do believe that my “real” message got through. YOU have to get educated and make informed decisions about your health. Comments and feedback are welcome!

Click here to download the presentation!

Suzanne Somers, Oprah Winfrey and Robin McGraw (Dr. Phil’s wife) have done a great job of stimulating the thoughts of many women who are experiencing peri-menopause/menopause that getting their hormones in balance is one of the keys to achieving the energy and vitality of their younger years. When most people think of hormones, the four that immediately come to mind are estrogen, progesterone, testosterone and DHEA. In her latest book (Breakthrough: Eight Steps to Wellness), Suzanne Somers has clearly done a phenomenal job of conveying that there are eight pillars for achieving optimal health, but many people only resonate with the hormone message. I speak with many people who feel that once their estrogen, testosterone, DHEA and progesterone levels are balanced that they will magically feel and look younger; however, the reality is that our bodies produce hundreds of hormones, and putting the major focus on only four of them cannot produce the kind of impact that most people are searching for when is comes to their health.

I agree wholeheartedly that hormone balance is an extremely important key for achieving optimal health. However, I subscribe to a more complete, functional medicine-based approach, where I focus on optimizing all of the systems of the body, not just hormone levels. For that reason, many of my patients initially come to me for hormones, but we end up focusing on metabolism, body composition, thyroid optimization, nutritional supplementation, healthy eating, detoxification, lifestyle changes and gastrointestinal issues in addition to balancing their hormones. This approach is helping my patients achieve the optimal health they deserve.

I am going to stop for now with Part 1, but this is just an introduction. I am very passionate about these topics and I will be publishing “More Than Hormones: Part 2, Part 3…..” and so on. At this point, I don’t know how many parts there will be, so I invite to you subscribe to my blog so that you won’t miss the next article. I won’t publish on this topic every week, but you can check back every couple weeks for more of my thoughts.

In April of this year, I published the first edition of my newsletter, Focus on Wellness,  that I had planned to be a quarterly publication.  Quite a few patients read it, and I generally got positive comments, but it just didn’t seem to fit in a “right now” world.  Publishing quarterly meant that I would have to hold onto all of my thoughts for 3 months until it was time for the next edition. 

In July, we had begun assimilating content for the July edition of Focus on Wellness, but we never got it published.  Then, just a few days ago, Andre, my Chief Strategy Executive, suggested that I start blogging in lieu of continuing with the newsletter, so less than a week later we have launched my blog.  I am confident that this tool will better serve my current and future patients much better and I am committed to adding meaningful content weekly.

So, stay tuned.