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In the United States, the average age of Female Menopause is about 51.  During the lead up and times after this physiologic transition, many women will complain bitterly of changes in their hair.  Many times, these complaints are of thinning and hair loss but other complaints such as brittle, dull, or lackluster hair are common. In my office, women will tell me that they see more and more hair in the drain of the shower or on the floor of their bathroom.  Several times I have had women bring in baggies full of fallen hair.  It is devastating to many of these women who feel their self-image changing rapidly and dramatically.

Female menopausal hair loss is common, and it increases with age and notably, it increases with the change in hormonal balance that occurs with the menopausal transition.  There are a few hormones that are particularly responsible, and it is true that declines in actual blood levels or receptor sensitivity to Estradiol and Thyroid hormone are the primary causes.  Other factors that are often associated with hair loss include genetics, food sensitivities (gluten is a major culprit), systemic inflammation, and nutrient imbalances such as iron and ferritin, though there are certainly a number of other nutrients that can lead to hair loss.

In my next blog, I will go into a more detailed discussion of what can be done from a medical standpoint to deal with female menopausal hair loss, but for now, I would recommend that women who start to lose their hair in the 40’s and beyond do several things that can lay the physiologic ground work for a healthy head of hair. I would first make sure that you pay very careful attention to hair hygiene.  It is important to keep the scalp clean and vibrant.  Frequent hair washing (at least 4 times a week, if not daily) is crucial to keep the hair follicles free of dirt and debris and to stimulate the blood flow through the mechanical action of massaging the scalp.  And it is important to use an extremely high-quality hair product.  Few hair products in grocery stores or corner pharmacies have the quality necessary to adequately care for the hair.  In addition, far too many of these products contain chemicals and additives that are actually toxic to the skin or hair.  I would recommend a high-quality product that is organic and made from natural ingredients.  One product that I have seen outstanding results with is called Monat®.  This product has ingredients are naturally-based, safe, pure and sustainable and they work in harmony with each other to create an exceptional product that yields a healthier head of hair.

When it comes to nutrition, avoiding inflammatory foods is essential.  One of the most inflammatory foods known is gluten.  Gluten is one of the primary proteins in wheat.  Over the years, genetic modification of the wheat used in the U.S. has led to gluten proteins that are essentially foreign to the human body.  These proteins can lead to systemic inflammation that may manifest in hair loss.  I would recommend at least a 4-month trial of a gluten free diet to see if hair growth improves with this dietary modification.  I cannot count the number of times I have heard dramatic positive stories of what gluten free has done to my patient’s health and well-being.  The skin, gut and hair improvements can be impressive.  Beyond gluten, I would recommend a nutritional program that consists primarily of vegetables and proteins.  Some fruit and an avoidance of gluten, carbohydrates and processed grains.  More specifically, an anti-inflammatory diet is an excellent way to start.  Finally, I would make sure that everyone includes a pharmaceutical grade multivitamin in their program.  Only with high quality multivitamins can you be sure to get the optimum daily quotient of micronutrients necessary for good health and optimal hair support.

Female menopausal hair loss is a major concern among aging women in the U.S. today.  With some very simple changes in daily routine, hair health can be dramatically improved.  In my next blog I will discuss some medical issues that are associated with Female Menopausal Hair Loss and what can be dome to improve hair health from a medical perspective.

The post Three Ways to Prevent Menopausal Hair Loss appeared first on Florida Center for Hormones and Wellness.

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Menopausal Hair Loss is a vexing problem for many women.  Thinning hair is the cause of so much emotional distress and body image alteration that women spend substantial sums of money in attempts to remedy the situation.  Unfortunately, if the underlying cause is medical or physiological, simple topical treatments may be insufficient to get satisfactory improvements. 

My office is full of women who complain bitterly of thinning hair with aging, particularly as they pass through their 40’s and 50’s.  They become frustrated with the lack of improvement with everyday over the counter remedies and the answers that they get from their family doctors.  I clearly remember my mother, from way back when I was young, crying in absolute agony on the bathroom floor about her hair falling out and not knowing what to do.

The good news is that there are solutions!  As I mentioned in a previous blog on this subject, eating a healthy, non-inflammatory diet is important.  Eating gluten free and taking a well-balanced pharmaceutical grade multi-vitamin can help tremendously.  And proper hair hygiene, using a top-quality hair product such as Monat® can produce exceptional improvement in many people.  However, there are some women who just do not get results with the remedies just mentioned.  For them, there is the likelihood of a metabolic or physiologic deficiency.  These issues require the help of a trained and experienced physician.

One of the most common metabolic deficiencies is a lack of thyroid optimization.  I am not necessarily saying “hypothyroidism” because many people may have normal thyroid levels and still experience symptoms that are suggestive of thyroid deficiency (for a full discussion of thyroid deficiency go to: https://youtu.be/ZeTeU7-rY8o) .  So, in my office one of the first things I do to correct hair loss is to optimize thyroid levels to those levels that alleviate thyroid symptoms (including hair loss).  Many times, this is dramatically successful.

At times, despite thyroid optimization, the hair loss continues.  In these instances, I may find the person to be deficient in iron or, more specifically ferritin.  Ferritin is essential in hair growth and stability.  Women, who we know are already at risk for iron deficiency, seem to be affected quite often by ferritin deficiency.  A simple blood test will show this issue and it can be corrected by proper supplementation.  My favorite iron support is a prescription medication called Integra Plus®.

As another step in the treatment protocol of Menopausal Hair Loss, I will often prescribe a hair specific nutritional supplement.  My favorite supplement for hair support in menopausal women is Nutrafol Core for Women Plus® (https://nutrafol.com/science).  It is specially designed for women before, during and after menopause and it is formulated with natural ingredients that target key underlying causes of compromised hair growth.  In my office, I have seen spectacular results with this product.  And one sure way I can tell it works is by the number of refills I get.  With Nutrafol Core for Women Plus®, my patients refill month after month after month.  It is a good product.

Menopausal Hair Loss in women is a common and often very frustrating problem.  However, there is hope for restoring a heathy head of hair in most women. Proper treatment begins with a good nutritional program and proper hair hygiene.  If these simple measures are insufficient, there are several medical interventions that a properly trained physician can implement to increase the likelihood of hair recovery.  So, don’t end up on the bathroom floor in tears like my mother once did.  Jump into action today and do the things necessary to restore your hair health.

The post Treatment of Menopausal Hair Loss appeared first on Florida Center for Hormones and Wellness.

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Doctor: “My hair is falling out”; “I’m cold all the time”; “I’m so tired and fatigued, I want to take a nap at 3:00 in the afternoon”; “My skin is dry”; “My fingernails are cracking”; “I can’t think straight”.  How many of you experience some of these symptoms or know someone who does??  These are symptoms of thyroid insufficiency. And all too often this condition goes undiagnosed and untreated.  So many people suffer from symptoms like these and these symptoms can be alleviated.  But, all to commonly, they are just overlooked and neglected by far too many everyday doctors.  Why?  Because too many doctors rely on blood tests rather than listening to and understanding the patient.

I remember early in Medical School.  I was in a class on physical diagnosis and my professors made it perfectly clear: “listen to the patient and he will tell you want is wrong.  Labs tests are for confirmation and monitoring of the diagnosis and should not be solely relied upon to make the diagnosis”.  Where did the medical profession go wrong?  All too often these days, the opposite happens: look at the lab test and then tell the patient the diagnosis.

The condition in which this conundrum happens most frequently is “hypothyroidism”.  It is true, the “classic” definition of hypothyroidism is a collection of typical thyroid symptoms AND an abnormal blood test.  The blood test in question is called TSH (Thyroid Stimulating Hormone).  TSH is produced by the pituitary gland (a small pea sized gland located in the brain, often called the ‘master gland’).  When thyroid hormones (triiodothyronine – T3 and Thyroxine – T4) decrease in amount, the pituitary senses this and will produce more TSH to signal the thyroid gland to produce more thyroid hormones.  So, in “classic” hypothyroidism (low thyroid) the TSH level rises as the pituitary gland signals the thyroid to produce more.  The opposite is true in hyperthyroidism.  When the thyroid is overactive, the excess amounts of thyroid hormone influence the pituitary to produce less TSH and thereby lower the influence on the thyroid gland to produce T4 and T3.  However, the actual appearance of true hypothyroid is far lower than the number of patients presenting today with hypothyroid symptoms and NORMAL thyroid levels.  These poor patients are suffering, and many traditional doctors are simply overlooking them and not treating them adequately.

Why does this happen?

There are several reasons for this.  Time and insurance pressures are causing doctors to improperly rely more and more on blood tests to diagnose and treat patients.  As a result, despite the high degree of symptoms, patients with “normal” blood levels are not treated for symptoms of low thyroid.  In fact, even the American Academy of Clinical Endocrinology practice guidelines state that otherwise normal patients with “normal” levels of TSH should not be treated for hypothyroidism.  The clinical application of such a “strict’ guideline, many times, leaves patients with uncomfortable and sometimes debilitating symptoms.  Endocrinologists will insist that the symptoms are due to something else.  Just what that “something else” is often remains elusive or is something that “your primary doctor should investigate”

In actual practice and from my experience with hundreds of patients with low thyroid symptoms, treating symptoms will result in more healthy and vital patients.  And there is substantial medical evidence for this.  I refer to a paper published in 2012 by the National Academy of Hypothyroidism.  That paper stated “it becomes clear that standard blood tests, including the TSH and T4 levels, cannot be used to accurately determine … thyroid level in the presence of a wide range of common conditions, including … dieting, anxiety, stress, insulin resistance, obesity, diabetes, depression and bipolar disorder, hyperlipidemia (high cholesterol and triglycerides), chronic fatigue syndrome, fibromyalgia, neurodegenerative diseases (Alzheimer’s, Parkinson’s and multiple sclerosis), migraines, cardiomyopathy, and aging” further “the pituitary has different [response to thyroid hormone] than every other tissue in the body; the thyroid [response by other tissues in the body is] affected by numerous conditions while the pituitary is minimally affected.

What this means is that the symptoms a person feels regarding thyroid depend on so many different factors; that simply measuring a blood level that reflects the pituitary response may not tell the entire story in the patient as a whole.  Going back to my medical school directive: Patient’s must be asked how they feel and what symptoms they are having and then a preliminary diagnosis can be made. Once the diagnosis is presumed, the blood work should be properly used to monitor the results of treatment as long as the blood levels are carefully coordinated with the patient’s clinical response and not used in lieu of the patient’s symptoms.

While patient’s with thyroid symptoms and normal levels of thyroid hormones do not technically have “hypothyroidism”, the medical literature clearly makes the point that using thyroid as an “off label” supplement can reduce their symptoms, improve their physiology, aid their well-being and substantially improve their quality of life.

The post Why is Thyroid so under treated? appeared first on Florida Center for Hormones and Wellness.

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Even though far too many patients with symptoms of low thyroid are not adequately treated, Levothyroxine (Brand name: Synthroid®) has been one of the top 5 most prescribed medication in the Unites States for many years running.  Beyond that, Synthroid is often NOT the best treatment for patients needing thyroid supplementation.  So, the questions are: How does the thyroid work? what is Synthroid®? What is “natural thyroid”? Why is Synthroid so commonly prescribed? Why is it that natural thyroid is, so often, mocked by the traditional medical community?  What should I do if I need thyroid supplementation?

The thyroid is a butterfly shaped gland located in the lower neck, in front of the voice box.  It is the producer of a life critical series of hormones, the most important of which are called Thyroxine (T4) and Tri-iodothyronine (T3).  Without these two hormones (the most important of which is T3) life would be impossible.  Thyroid hormones regulate almost every tissue and organ in the body.  When the thyroid is low, a patient might experience symptoms of sluggishness and fatigue.  Others include cold intolerance, brain fog, trouble concentrating, brittle or thinning hair, weight gain, menstrual irregularity, infertility, depression, and improper metabolism of blood sugar or cholesterol.  In fact, almost every organ system and tissue in the body needs thyroid hormones for proper function.

Many people have true hypothyroidism, a condition where a constellation of low-thyroid symptoms is accompanied by a measurably low level of thyroid.  Interestingly, perhaps even a greater number of people have symptoms of low thyroid yet have “normal” levels of thyroid hormone.  It is these patients that often present a treatment quandary for traditional medicine.

The thyroid gland produces hormones in response to signaling from the pituitary (a small pea sized gland in the brain).  In a perfect world, when the pituitary senses a lowering of thyroid hormone, it sends a signal in the form of another hormone called Thyroid Stimulating Hormone (TSH).  The TSH gives the thyroid gland a “wake up call” and causes it to start producing thyroid hormone – about 90% of which is T4 and most of the remaining 10% is T3.  While T3 is the “active hormone”, that is it is the one that causes the tissues or the organs to be healthy and carry out their functions properly, it has a short half-life, meaning that it does not last long in the body.  So, to make sure that there are adequate supplies of T3, the body produces T4 that is in a higher concentration in the blood, yet it has a longer half-life, meaning that it hangs around longer.  When the body needs more T3, the body uses a special protein called an enzyme along with some co-factors like zinc, iodine and selenium to remove one iodine molecule and thus convert T4 into T3 (a process called deiodination).  There is then a supply of T3 to act on the organs and tissue to produce the life enhancing effects.

If one assumes that the process of conversion of T4 into T3 is efficient and constant, then when a patient was to develop a reduced production of T4 that led to symptoms (classic hypothyroidism) and when that patient needed “thyroid replacement” a simple replacement of T4 should be adequate.  It would increase the stores of a hormone that lasts a long time in the body and is easily converted in the active hormone T3.  Those are the assumptions necessary to understand the use of Synthroid® (a synthetic hormone made to mimic T4).  With millions of people suffering from true hypothyroid, it is easy to see why the production and sales of Synthroid® has reached the fantastic levels it has.

However, there is a potential HUGE problem.  Many people, particularly older people and those that suffer from illnesses like diabetes and other chronic conditions, do not metabolize T4 into T3 effectively.  So, when T4 is given, its level can be measured to rise.  The pituitary senses the rise in the T4 and feels “satisfied” that there is enough thyroid hormone in the body, the pituitary then reduces the amount of TSH that is produced.  The thyroid may eventually stop all production of any thyroid hormone, even the essential T3.  In some instances, particularly in people who do not convert T4 into T3 effectively, when these people are given T4 (Synthroid®) their symptoms might even get WORSE when T4 is administered because what little T3 that was made by the thyroid gland itself has ceased due to the feedback system reduced production of TSH by the pituitary.  This is what is known as a “paradoxical effect”, that is when given “Thyroid Hormone – T4”, the patient actually gets worse rather than better.

Enter – “Natural Thyroid”.  Natural thyroid is a purified product derived from porcine thyroid (though it can be compounded from purified hormone in a compounding lab to avoid potential issues with food limitations of some ethnic and religious groups).  It is harvested, purified and used very effectively to replace thyroid hormone in deficient patients.  Natural Thyroid has a near normal balance of T4 and T3 in approximately the same percentages as is produced naturally by the patient’s own thyroid.  So, when it is eaten and gets absorbed into the body, the body senses an effect more like the natural production of Thyroid hormone.  Since T3 is the active hormone, by taking it as a supplement, it is more easily assured that there are adequate amounts of T3 in the body.

Years ago, natural thyroid was not regulated by the FDA.  Consequently, the natural products on the market varied widely in the reproducibility of their dosing and effectiveness.  As a result, the early use of natural thyroid led to variable and many times ineffective results in patients.  Rightly, natural thyroid back then was considered ineffective and inefficient.  However, in recent years, the manufacture of natural thyroid has become much more highly regulated by the FDA and the USP (United States Pharmacopeia) resulting in a product that is reproducible and able to give solid medical support.  However, to this day, there are many in the medical community that still believe that natural thyroid products are substandard despite the solid standardization of the dosing that exists today.  Thus, their historically fact based but currently incorrect belief that natural thyroid products are not good.  However, there are several studies that do confirm that natural thyroid may in fact be superior to Synthroid®.

In a 2013 article in the “Bible” of endocrinology (The Journal of Clinical Endocrinology and Metabolism) natural thyroid was compared to Synthroid®.  This was an excellent study done according to very rigorous investigative guidelines.  The researchers concluded that “thyroid hormone therapy with [natural thyroid] in place of [Synthroid® led to] weight loss and possible improvements in [thyroid] symptoms and mental health without appreciable adverse effects.”  The conclusion is clear, natural thyroid products that have T3 produced better results than synthetic thyroid products containing T4 only.  And that a combination product with T3 and T4 gave better outcomes.  Indeed, this conclusion is supported by several other articles in leading journals (one of which is the New England Journal of Medicine – the Bible of all medical journal Bibles).  In an article in the 1999 volume of the NEJM the authors concluded that a natural product containing both T3 and T4 “may be an improvement over standard [T4] treatment for patients with hypothyroidism”.  And there are others.  The literature is clear: combination T3/T4 products (like that in natural thyroid) consistently give better clinical results that single compound (T4 only) products like Synthroid®.

The treatment of patients with significant thyroid symptoms is widely prevalent in medicine today.  Despite Synthroid® being one of the most commonly prescribed medications today, I would argue that there are many more patients with symptoms bothersome enough to require treatment.  Using thyroid “off label” as a supplement in these patients can produce life altering effects in terms of mental focus, energy and improvement of fatigue.  And the medical literature does demonstrate that symptom improvement using a natural thyroid product can be far superior to the synthetic thyroid products on the market.  Finally, treating symptoms rather than numbers will produce a healthier, happier and more vital patient population.

The post Thyroid Synthetic or Natural? Which one’s for me? appeared first on Florida Center for Hormones and Wellness.

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Estrogen and progesterone are female sex hormones produced by the ovaries. Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) regulate these sex hormones to aid in the reproductive process, but when a woman goes through menopause, her ovaries become less responsive to LH and FSH. This means that the circulation and production of estrogen significantly decline, resulting in a host of uncomfortable symptoms (such as hot flashes, lack of desire, irritability, etc). One of the main areas of the body that suffers is the body’s largest organ: skin.

When Your Body Turns On You

Since all of your organs contain estrogen receptors, it’s clear that the hormone plays a vital role in their health and maintenance. In particular, the reduction of estrogen can interrupt your skin’s ability to hold water, which can cause itching and dryness. Menopause also changes your skin’s elasticity, culminating in an increase of wrinkling and sagging — some women barely recognize themselves after menopause has fully set in. Luckily, you have options. You don’t need to live with the sometimes unbearable side effects of menopause, and you certainly don’t deserve to wake up every morning and not recognize the face you see in the mirror.

How To Feel Comfortable In Your Own Skin Again

In this wonderful age of technological advancements, the medical and cosmetic industries can offer a wealth of beneficial menopause treatments. If you’re simply looking to correct your hormone imbalance, you can consider trying bioidentical hormone replacement therapy (BHRT). These hormones are scientifically designed to match the naturally occurring hormones that are already present in your body, so your body should have an easier time accepting them.

BHRT can take a while — usually a few months — to see full and consistent results. If you’re looking for a more immediate form of menopause treatment, there are a variety of non-invasive cosmetic procedures that can ease the burden of your sagging skin. Botox is an excellent option: over 82% of users report seeing an improvement within a week of treatment. New to the cosmetic scene is the aptly named “vampire” treatments. Blood is drawn from your arm, spun through a centrifuge to isolate the platelet-rich plasma (PRP), and then this plasma is re-injected into whatever body parts need plumping (even your breasts). The process stimulates collagen, leaving your skin wrinkle-free and glowing.

Menopause can be a debilitating experience for women of all shapes, sizes, and walks of life. Find the right menopause treatment for you, and learn to love yourself ( and your skin) again!

The post Understanding Menopause: The Effects Of Aging appeared first on Florida Center for Hormones and Wellness.

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Over the years, many women struggling with hormonal issues including menopause have turned to hormone replacement therapy (HRT). While there are many medical ways to help reduce any menopause hormones-related issues, there are some natural menopause treatments that can help supplement HRT. Here are a few of them.

Eat Broccoli

Vegetable like broccoli, brussels sprouts, cabbage, cauliflower, and kohlrabi contain something called indole-3-carbinol. Indone-3-carbinol is metabolized in the body to help produce diindolylmethane. These substances can help modulate estrogen and have been proven to have some anticancer effects. Specifically for breast cancer. So next time you’re thinking of what to eat for dinner, consider stocking up on your broccoli and brussels sprouts as a natural menopause treatment.

Get Your Weight in Order

If you notice any problems with your hormones, your weight may be to blame. And it has nothing to do with the number you see on the scale. The problem lies within the fat your body is harboring. Excessive fat tissue can produce more estrogen in the body than you should normally have. Talk to your doctor and see if that’s the issue. If it is, do your best to eat healthier, get to the gym more, and cut out all of those delectable French fries from your diet. It may seem hard to do, but it’ll be worth it to reduce your menopause side effects. You can also look into cosmetic procedures that can help reduce your weight. Almost $13.3 billion was spent on cosmetic procedures in the United States in 2015.

Introduce Phytoestrogens Into Your Diet

Just like eating broccoli, brussels sprouts, and cabbage can act as a natural hormone treatment, there’s another group of food that you should give a try. Phytoestrogens are found in flax seeds, soy foods, sunflower seeds, bean sprouts, and legumes like peas and beans. They’re plant-based substances that can help your hormones balance out naturally. You can eat them throughout the day or mix them together with the indole-3-carbinol foods to kill two birds with one stone.

There has been some controversy in the media regarding soy consumption. But there hasn’t been any study to show that soy is extremely harmful. Don’t overdo it, though.

Before you head into the doctor’s office, try out a few of the natural hormone treatments listed above. They might actually help.

The post Tips for Naturally Balancing Your Hormones appeared first on Florida Center for Hormones and Wellness.

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While decreasing levels of estrogen are a normal part of aging for women, it can lead to adverse effects: weight gain, muscle weakness, decreased collagen, and increased risk of cardiovascular disease can all be caused by low estrogen levels in menopause. Fortunately, there are options for balancing hormones during menopause. One popular treatment choice is bioidentical hormone replacement therapy.

Bioidentical Hormone Replacement Therapy: What Is it?

Bioidentical hormone replacement therapy, or BHRT, is a treatment that uses chemically identical hormones to alleviate symptoms of hormonal imbalance. Because these hormones are identical to the ones the human body creates, it generally has fewer adverse effects compared to other hormone replacement methods. BHRT is used to increase hormones like estrogen, progesterone, and sometimes testosterone or adrenal hormones. During the transition into menopause, women experience lower levels of estrogen that can cause unpleasant side effects. Some of the common side effects women may experience include:

  • Decreased energy
  • Weight gain
  • Dry skin
  • Hair loss
  • Difficulty concentrating
  • Changes in body temperature
  • Thinning hair
  • Lowered sex drive

But BHRT can help make the transition easier and can help maintain normal levels of hormones. Whether it’s one symptom or multiple, BHRT can help alleviate the effects of menopause. This may be especially helpful for the 21 million women in the U.S. experiencing hair loss. Menopause is a difficult time for most women, but with BHRT it doesn’t have to be.

Could BHRT Be Right for You?

While a drop in hormones is natural and unavoidable, you can take steps to minimize the side effects of this process. Women who experience pre-menopause symptoms may have to look into hormone replacement options before other women. But it overall depends on the woman — some women go through menopause with minimal issues. Other women may experience adverse effects before they even start menopause. And while BHRT is not the only option for hormone balancing, it is a safe and effective method that’s worth considering.

Growing old is unavoidable. And while there are some unpleasant side effects of lowered estrogen, women can take action and get their hormones back in balance. So if you’ve been wondering about hormone replacement, ask your doctor is BHRT could be right for you.

The post Could You Benefit from Bioidentical Hormone Replacement? appeared first on Florida Center for Hormones and Wellness.

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Doctor: “My hair is falling out”; “I’m cold all the time”; “I’m so tired and fatigued, I want to take a nap at 3:00 in the afternoon”; “My skin is dry”; “My fingernails are cracking”; “I can’t think straight”.  How many of you experience some of these symptoms or know someone who does??  These are symptoms of thyroid insufficiency. And all too often this condition goes undiagnosed and untreated.  So many people suffer from symptoms like these and these symptoms can be alleviated.  But, all to commonly, they are just overlooked and neglected by far too many everyday doctors.  Why?  Because too many doctors rely on blood tests rather than listening to and understanding the patient.

I remember early in Medical School.  I was in a class on physical diagnosis and my professors made it perfectly clear: “listen to the patient and he will tell you want is wrong.  Labs tests are for confirmation and monitoring of the diagnosis and should not be solely relied upon to make the diagnosis”.  Where did the medical profession go wrong?  All too often these days, the opposite happens: look at the lab test and then tell the patient the diagnosis.

The condition in which this conundrum happens most frequently is “hypothyroidism”.  It is true, the “classic” definition of hypothyroidism is a collection of typical thyroid symptoms AND an abnormal blood test.  The blood test in question is called TSH (Thyroid Stimulating Hormone).  TSH is produced by the pituitary gland (a small pea sized gland located in the brain, often called the ‘master gland’).  When thyroid hormones (triiodothyronine – T3 and Thyroxine – T4) decrease in amount, the pituitary senses this and will produce more TSH to signal the thyroid gland to produce more thyroid hormones.  So, in “classic” hypothyroidism (low thyroid) the TSH level rises as the pituitary gland signals the thyroid to produce more.  The opposite is true in hyperthyroidism.  When the thyroid is overactive, the excess amounts of thyroid hormone influence the pituitary to produce less TSH and thereby lower the influence on the thyroid gland to produce T4 and T3.  However, the actual appearance of true hypothyroid is far lower than the number of patients presenting today with hypothyroid symptoms and NORMAL thyroid levels.  These poor patients are suffering, and many traditional doctors are simply overlooking them and not treating them adequately.

Why does this happen?

There are several reasons for this.  Time and insurance pressures are causing doctors to improperly rely more and more on blood tests to diagnose and treat patients.  As a result, despite the high degree of symptoms, patients with “normal” blood levels are not treated for symptoms of low thyroid.  In fact, even the American Academy of Clinical Endocrinology practice guidelines state that otherwise normal patients with “normal” levels of TSH should not be treated for hypothyroidism.  The clinical application of such a “strict’ guideline, many times, leaves patients with uncomfortable and sometimes debilitating symptoms.  Endocrinologists will insist that the symptoms are due to something else.  Just what that “something else” is often remains elusive or is something that “your primary doctor should investigate”

In actual practice and from my experience with hundreds of patients with low thyroid symptoms, treating symptoms will result in more healthy and vital patients.  And there is substantial medical evidence for this.  I refer to a paper published in 2012 by the National Academy of Hypothyroidism.  That paper stated “it becomes clear that standard blood tests, including the TSH and T4 levels, cannot be used to accurately determine … thyroid level in the presence of a wide range of common conditions, including … dieting, anxiety, stress, insulin resistance, obesity, diabetes, depression and bipolar disorder, hyperlipidemia (high cholesterol and triglycerides), chronic fatigue syndrome, fibromyalgia, neurodegenerative diseases (Alzheimer’s, Parkinson’s and multiple sclerosis), migraines, cardiomyopathy, and aging” further “the pituitary has different [response to thyroid hormone] than every other tissue in the body; the thyroid [response by other tissues in the body is] affected by numerous conditions while the pituitary is minimally affected.

What this means is that the symptoms a person feels regarding thyroid depend on so many different factors; that simply measuring a blood level that reflects the pituitary response may not tell the entire story in the patient as a whole.  Going back to my medical school directive: Patient’s must be asked how they feel and what symptoms they are having and then a preliminary diagnosis can be made. Once the diagnosis is presumed, the blood work should be properly used to monitor the results of treatment as long as the blood levels are carefully coordinated with the patient’s clinical response and not used in lieu of the patient’s symptoms.

While patient’s with thyroid symptoms and normal levels of thyroid hormones do not technically have “hypothyroidism”, the medical literature clearly makes the point that using thyroid as an “off label” supplement can reduce their symptoms, improve their physiology, aid their well-being and substantially improve their quality of life.

The post Why is Thyroid so under treated? appeared first on Florida Center for Hormones and Wellness.

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Even though far too many patients with symptoms of low thyroid are not adequately treated, Levothyroxine (Brand name: Synthroid®) has been one of the top 5 most prescribed medication in the Unites States for many years running.  Beyond that, Synthroid is often NOT the best treatment for patients needing thyroid supplementation.  So, the questions are: How does the thyroid work? what is Synthroid®? What is “natural thyroid”? Why is Synthroid so commonly prescribed? Why is it that natural thyroid is, so often, mocked by the traditional medical community?  What should I do if I need thyroid supplementation?

The thyroid is a butterfly shaped gland located in the lower neck, in front of the voice box.  It is the producer of a life critical series of hormones, the most important of which are called Thyroxine (T4) and Tri-iodothyronine (T3).  Without these two hormones (the most important of which is T3) life would be impossible.  Thyroid hormones regulate almost every tissue and organ in the body.  When the thyroid is low, a patient might experience symptoms of sluggishness and fatigue.  Others include cold intolerance, brain fog, trouble concentrating, brittle or thinning hair, weight gain, menstrual irregularity, infertility, depression, and improper metabolism of blood sugar or cholesterol.  In fact, almost every organ system and tissue in the body needs thyroid hormones for proper function.

Many people have true hypothyroidism, a condition where a constellation of low-thyroid symptoms is accompanied by a measurably low level of thyroid.  Interestingly, perhaps even a greater number of people have symptoms of low thyroid yet have “normal” levels of thyroid hormone.  It is these patients that often present a treatment quandary for traditional medicine.

The thyroid gland produces hormones in response to signaling from the pituitary (a small pea sized gland in the brain).  In a perfect world, when the pituitary senses a lowering of thyroid hormone, it sends a signal in the form of another hormone called Thyroid Stimulating Hormone (TSH).  The TSH gives the thyroid gland a “wake up call” and causes it to start producing thyroid hormone – about 90% of which is T4 and most of the remaining 10% is T3.  While T3 is the “active hormone”, that is it is the one that causes the tissues or the organs to be healthy and carry out their functions properly, it has a short half-life, meaning that it does not last long in the body.  So, to make sure that there are adequate supplies of T3, the body produces T4 that is in a higher concentration in the blood, yet it has a longer half-life, meaning that it hangs around longer.  When the body needs more T3, the body uses a special protein called an enzyme along with some co-factors like zinc, iodine and selenium to remove one iodine molecule and thus convert T4 into T3 (a process called deiodination).  There is then a supply of T3 to act on the organs and tissue to produce the life enhancing effects.

If one assumes that the process of conversion of T4 into T3 is efficient and constant, then when a patient was to develop a reduced production of T4 that led to symptoms (classic hypothyroidism) and when that patient needed “thyroid replacement” a simple replacement of T4 should be adequate.  It would increase the stores of a hormone that lasts a long time in the body and is easily converted in the active hormone T3.  Those are the assumptions necessary to understand the use of Synthroid® (a synthetic hormone made to mimic T4).  With millions of people suffering from true hypothyroid, it is easy to see why the production and sales of Synthroid® has reached the fantastic levels it has.

However, there is a potential HUGE problem.  Many people, particularly older people and those that suffer from illnesses like diabetes and other chronic conditions, do not metabolize T4 into T3 effectively.  So, when T4 is given, its level can be measured to rise.  The pituitary senses the rise in the T4 and feels “satisfied” that there is enough thyroid hormone in the body, the pituitary then reduces the amount of TSH that is produced.  The thyroid may eventually stop all production of any thyroid hormone, even the essential T3.  In some instances, particularly in people who do not convert T4 into T3 effectively, when these people are given T4 (Synthroid®) their symptoms might even get WORSE when T4 is administered because what little T3 that was made by the thyroid gland itself has ceased due to the feedback system reduced production of TSH by the pituitary.  This is what is known as a “paradoxical effect”, that is when given “Thyroid Hormone – T4”, the patient actually gets worse rather than better.

Enter – “Natural Thyroid”.  Natural thyroid is a purified product derived from porcine thyroid (though it can be compounded from purified hormone in a compounding lab to avoid potential issues with food limitations of some ethnic and religious groups).  It is harvested, purified and used very effectively to replace thyroid hormone in deficient patients.  Natural Thyroid has a near normal balance of T4 and T3 in approximately the same percentages as is produced naturally by the patient’s own thyroid.  So, when it is eaten and gets absorbed into the body, the body senses an effect more like the natural production of Thyroid hormone.  Since T3 is the active hormone, by taking it as a supplement, it is more easily assured that there are adequate amounts of T3 in the body.

Years ago, natural thyroid was not regulated by the FDA.  Consequently, the natural products on the market varied widely in the reproducibility of their dosing and effectiveness.  As a result, the early use of natural thyroid led to variable and many times ineffective results in patients.  Rightly, natural thyroid back then was considered ineffective and inefficient.  However, in recent years, the manufacture of natural thyroid has become much more highly regulated by the FDA and the USP (United States Pharmacopeia) resulting in a product that is reproducible and able to give solid medical support.  However, to this day, there are many in the medical community that still believe that natural thyroid products are substandard despite the solid standardization of the dosing that exists today.  Thus, their historically fact based but currently incorrect belief that natural thyroid products are not good.  However, there are several studies that do confirm that natural thyroid may in fact be superior to Synthroid®.

In a 2013 article in the “Bible” of endocrinology (The Journal of Clinical Endocrinology and Metabolism) natural thyroid was compared to Synthroid®.  This was an excellent study done according to very rigorous investigative guidelines.  The researchers concluded that “thyroid hormone therapy with [natural thyroid] in place of [Synthroid® led to] weight loss and possible improvements in [thyroid] symptoms and mental health without appreciable adverse effects.”  The conclusion is clear, natural thyroid products that have T3 produced better results than synthetic thyroid products containing T4 only.  And that a combination product with T3 and T4 gave better outcomes.  Indeed, this conclusion is supported by several other articles in leading journals (one of which is the New England Journal of Medicine – the Bible of all medical journal Bibles).  In an article in the 1999 volume of the NEJM the authors concluded that a natural product containing both T3 and T4 “may be an improvement over standard [T4] treatment for patients with hypothyroidism”.  And there are others.  The literature is clear: combination T3/T4 products (like that in natural thyroid) consistently give better clinical results that single compound (T4 only) products like Synthroid®.

The treatment of patients with significant thyroid symptoms is widely prevalent in medicine today.  Despite Synthroid® being one of the most commonly prescribed medications today, I would argue that there are many more patients with symptoms bothersome enough to require treatment.  Using thyroid “off label” as a supplement in these patients can produce life altering effects in terms of mental focus, energy and improvement of fatigue.  And the medical literature does demonstrate that symptom improvement using a natural thyroid product can be far superior to the synthetic thyroid products on the market.  Finally, treating symptoms rather than numbers will produce a healthier, happier and more vital patient population.

The post Thyroid Synthetic or Natural? Which one’s for me? appeared first on Florida Center for Hormones and Wellness.

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The plain and simple fact is that you are not alone. A number of medical studies reveal that Erectile Dysfunction (ED) may occur in up to 80% of men at some point in their life. The real truth is that it is almost certain that virtually every man will experience at least one event of erectile problems at some point or another (come on admit it guys!!) The “real men” understand that this frustrating occurrence is just a part of life and they do their best to do live their lives in a clean and healthy manner and do some of the basic nutritional support recommendations to maintain healthy sexual function.

Erectile function is an extremely complex process. Normal erectile function is dependent on a healthy brain, normal spinal connections, intact nerves, healthy erectile tissue, adequate levels of nitric oxide, low levels of systemic inflammation, healthy blood sugar management and a host of other anatomic and physiologic considerations. The more of these things that are off, the more likely there is going to be, how should I say… trouble “getting things off the ground.” The more my practice grows, the more I see men with ED issues, the more I can absolutely state that the statistics I quoted above are accurate.
Unfortunately, way too many doctors think that the only solution to the problem is “the little blue pill”. While Viagra®, Cialis®, Levitra® and Stendra® are wonderful medications, they only “attack” one component in the erectile cascade (they are called Phosphodiesterase-5 or PDE-5 Inhibitors) they have a significant rate of failure (some studies quote 50% or more of men) or less than satisfactory results. After all, if the race horse is “really sick,” kicking him is not going to make him run any faster.

I recently created a short video that discusses a variety of approaches to deal with ED (21 Ways to Treat Erectile Dysfunction that Actually Work). Using a systematic and physiologic approach, it is remarkable how well many men can recover a great deal of their lost sexual function with lifestyle changes, the proper supplements, nitric oxide enhancement, proper testosterone replacement and several other treatments. However, one of the most exciting treatments for ED is the Priapus Shot.

Priapus is an ancient god of fertility, protector of horticulture (cultivation and management) and viticulture (cultivation of grape vines). His symbol portrays a visual image of erectile prowess and has come to be associated with this remarkable treatment. The Priapus Shot treatment uses a person’s own blood to stimulate healing and rejuvenation of the erectile tissue in the penis. It is a simple 5 minute virtually painless office procedure in which a small amount of the person’s blood is taken and processed so as to yield several ounces of highly concentrated healing and growth factors. Those healing and growth factors are then introduced into the erectile tissue. The concentrated growth factors then stimulate the endothelium lining of the blood vessel to heal and regenerate so that it can more normally perform the physiologic steps necessary to induce a solid, strong durable erection. Once healthy, the endothelium produces more nitric oxide and the nitric oxide creates the physiologic environment for better erectile function.

Hocus Pocus you say?? I don’t think so. First of all, my own experience in my office has seen dozens of men get significant restoration of erectile function. And independently, there are a number of great reviews of the procedure that can be seen at realself.com .

Men, you do not have to settle for declining sexual function. With cutting edge technology, doctors (such as myself) can do amazing things to improve life and sexual function. The Priapus Shot is one of those technological advances in medicine that can be absolutely life changing.

The post Shhhhh!!!! (there is help for ED!) appeared first on Florida Center for Hormones and Wellness.

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