Testosterone replacement therapy can be a necessary medical intervention in some men for conditions such as sexual dysfunction, depression, and chronic fatigue. However, there are known risks. Popularity of testosterone prescriptions are skyrocketing, but who is it safest for and who is at the greatest risk of early cardiovascular death and heart attack? How do consumers make decisions in combination with their doctor without knowing the consequences? Ultimately you have to rely on the experience and knowledge of your provider, but having the right information in front of you can only help the decision process.
In a recent publication from Endocrine Today, evidence suggests that a new subset of men should not use testosterone replacement therapy. Men with obstructive coronary artery disease have higher risk of death and heart attack when using testosterone replacement therapy.
But that leaves some questions, doesn't it? What if you've had a coronary angiograph which confirmed obstruction or perhaps had an angioplasty or stent to correct obstruction and also have confirmed or suspected low testosterone levels? Are you just out of luck with no therapy for the hormone imbalance?
Symptoms of hormone imbalance in aging men are not limited to sexual dysfunction. Rather, depression, poor sleep, poor recovery from activity, poor stamina, libido (sex drive), lack of energy, and decreased strength and performance may all be symptoms of hormone imbalance. We also note that stress and poor blood sugar control can deteriorate men's hormones at an accelerated rate as well. Does this sound familiar? If so, read on.
We often suggest lifestyle modification such as weight loss, stopping smoking, and increasing exercise, especially activities such as weight training and sprinting to improve hormone balance in aging men, but the reality is that besides stopping smoking, these are quite tall orders for those who have obstructive coronary artery disease. Thirty minutes of weight lifting or daily sprinting probably isn't going to be approved by the cardiologist or cardiac rehab therapist. Not to mention that poor hormone balance often makes losing weight difficult.
Getting back to the basics of health, the pillars of good living, may be the answer along with specific products to support hormone balance.
From a diet perspective, adequate protein is an absolute must to stop the breakdown of muscle in aging men. Supplemental protein shakes are often a good way to go if appetite isn't great or cooking isn't your strong suit. If you can tolerate whey protein, it seems to be one of the best sources. It raises glutathione levels which is important from an antioxidant perspective and also contains branch chain amino acids which support muscle health. Vegan protein powders are a bit easier on the body. These contain hemp, pea, and/ or rice but often times are much lower in protein content. Shoot for 20 grams per shake. Nuts and seeds provide excellent protein from plant sources as well. Vegetable and plant nutrients cannot be understated for general heart health and all doctors and practitioners should be encouraging this behavior.
From a dietary supplement side, Revolution Macalibrium is a tested formula of specific phenotypes of maca (Lepidium peruvianum). Maca has a rich history of supporting men's hormone health; however, research has shown that there are specific phenotypes ideal for men’s hormonal health. Revolution Macalibrium not only has these exact phenotypes but has concentrated levels of the full spectrum of active constituents ten to twenty times higher than the levels found in raw maca which is why doctors and patients are getting such strong results quickly. This is a foundational product that works through the hypothalamus-pituitary-adrenal axis to help a man make his own hormones versus relying on hormones from outside of the body. A man's own hormones made by him is much safer since nothing is more natural than your own hormones.
Omega-3 fatty acids, especially those rich in EPA and DHA are recommended. If a man has high triglycerides, the American Heart Association suggest 2.4 grams of EPA + DHA per day. This seems like a prudent suggestion for all men facing either hormone imbalance, obstructive coronary artery disease, or life in the modern world. Reducing inflammation and supporting cell membrane health are just two well known mechanisms of omega-3 fatty acids and since the human body doesn't make its own omega-3's it has to rely on us to ingest them every day. I prefer high EPA products. Some products contains as much as 1060 mg of EPA and 274 mg of DHA per 2 capsules. Two capsules twice per day is ideal to hit this goal dose of 2.4 grams. Be wary of lower doses or you'll end up taking 8 capsules per day. Many products will contain 180 mg of EPA and 120 mg of DHA. This is perhaps suitable for the percentage of the population that gets nearly adequate dietary omega-3 fatty acids and is already healthy.
Other interventions and supplements may be indicated given your history and complicating factors, and in that case we recommend working with a doctor who understands your condition and also natural approaches. Click here to find a practitioner close to you.
So, if you know a man considering testosterone replacement and also has obstructive coronary artery disease, arm them with this important information so he can make an empowered decision.
Showing posts with label heart. Show all posts
Showing posts with label heart. Show all posts
Friday, November 9, 2012
Tuesday, June 5, 2012
Updated evidence on menopause hormone therapy
A recent panel has re-evaluated the scientific literature
since the 2001 publication of the Women’s Health Initiative in order to
determine if hormone replacement therapy is safe long term and for chronic
conditions such as bone loss, cardiovascular risk, and / or mood health. The
results of this panel are from critical review of 51 published articles and
will guide the standard of care for postmenopausal women. Frankly, we’ve
learned a lot in the last 11 years and I think this panel did an excellent job
of culling the data albeit falling short of offering reasonable and safe
solutions to the challenge of increased risk of chronic disease beginning at
menopause. But that's okay. It wasn't their goal.
In full disclosure, I’m an
advocate of natural products so my first inclination is the cheer the panel’s
recommendation. It has been my read of the last decade of literature as well.
However, it is oversimplified to come to the conclusion that HRT is good or HRT
is bad. That binary way of thinking is ruinous. I strongly believe there is a
definite place for Hormone Replacement Therapy. I also believe it cannot be
used as the panacea it once was thought to be. In the case of bone health, we
must be ever mindful of the complete physiology. Sure, estrogen inhibits
osteoclastic activity and helps to maintain bone mineral density, but other
hormones have a role in osteoblastic activity such as progesterone and
testosterone. Growth hormone and cortisol have their own effects partially
independent of sex hormones and partially dependent on their levels. Furthermore,
we now have evidence that bone morphogenetic proteins, progenitor cells for
bone, have cross talk with estrogen and there may be other unknown interactions
to other hormones and signals. Some authorities now place osteopenia and
osteoporosis, especially precocious bone loss in the inflammatory disease
marker, causing us to work through the contribution of cytokines and
prostaglandins whose pathways are influenced by estrogen levels. And this is
just bone health, not to mention cardiovascular health and other quality of
life issues that are also influenced by hormone status. Why is this important
to say? Because, we haven’t heard the last of HRT. We will likely come to
understand a further undeclared subpopulation that has little to no risk of
cancer and cardiovascular incident. However, we aren’t there yet and we have
patients in front of us that need our help. This panel’s recommendation brings
us one step closer to the truth. What is missing from the conversation and
really outside the scope of this article is the reason for hormone imbalance
and potential less risky recommendations that clinicians can make today to
support not only the symptoms of menopause but also the long term consequences
of hormone loss. Personally, I’ve been involved in understanding this exact
mode of action. That is, improving the function of what has become known as the
HPA or hypothalamus-pituitary-adrenal axis. In fact, there are several axes
that we should be aware of that are influenced by an aging hypothalamus. These
axes, but particularly the HPA, when supported can stimulate the body’s own
production and balance of hormones. In essence, improving this system allows
the feedback and control of hormone production to be self-regulating without
the burden to liver biotransformation that exogenous hormones appear to have.
When a post-menopausal woman can improve her ability to produce her own
hormones with changes in menopausal symptoms, bone mineral density scores, and
cardiovascular support, then we have something to write about. This approach
can be used in conjunction with hormone therapy in order to be in line with the
recommendation of smallest dose, shortest duration of time. This is the
question that should be asked. “What can we do, today, for women to be on the
smallest dose of hormone replacement for the shortest amount of time and still
retain quality of life?” The question should not be “is HRT good?”. More
research into patient selection criteria is warranted. However, what I’m afraid
will happen, at the expense of quality patient care, is disregard for these
recommendation with some clinicians refusing to prescribe and others continuing
to over-prescribe. We want something with a broad therapeutic window with no
history of safety concerns. Something that supports endogenous hormone
production so that lowest dose, shortest duration can be honored. We want
something that has clinical trials that support efficacy in a broad spectrum of
conditions the way HRT does. What we want exists and is available on the market
as a natural product. Femmenessence (Maca-GO®) is that commercially available natural product. The following is a technical/ White Paper on the evidence of Femmenessence
Monday, September 6, 2010
How Hormones Affect Heart Health for Women
While many women know that cardiovascular disease (heart attack and stroke) is the number one cause of death in women in the United States, most do not know how significant it is. If you add the 2nd, 3rd and 4th causes of death together they do not add up to the number of deaths from cardiovascular disease. Another important detail is that this increased risk does not really become a factor until a certain stage in life called menopause. Consequently, the majority of women go from having a very low risk of cardiovascular disease throughout their life until menopause, when it jumps significantly.
So why such a big jump in risk? What happens at menopause?
You are still eating the same foods, doing the same amount of exercise, and taking the same supplements! Many women can attest that more often it is not until they reach menopause that issues related to cholesterol, blood pressure or body weight become a concern. It begs the question, what happens?
It is the body’s declining production of hormones that significantly affects a woman’s health.
Due to the Women’s Health Initiative results in 2002 indicating that Hormone Replacement Therapy (HRT) could increase the risk of breast cancer and stroke, many women have been concerned about hormones in general. HRT was introduced over 40 years ago by doctors who knew the importance of a woman’s own hormones on health and believed that re-introducing them into the body, either synthetic or equine formulation, was the best way of reversing the ill effects from loss of hormones. Since then, we have seen that foreign hormones introduced into the body may have side effects, as well as concern over the amount of hormones introduced into the body, the form of administration and/or how long they should be taken. Another issue is the body needs to metabolize foreign hormones in order to make them available; consequently this can have an impact on liver and kidney function, in essence inversely affecting our body’s ability to detoxify. Also HRT is often just two hormones: estrogen and progesterone. It is typically not a patient-specific combination of all the hormones, which a woman may need.
What is understood and accepted is that throughout our life the body’s OWN hormones have supported a healthful state. This ability to support the body’s production of hormones is what makes Femmenessence so unique and exciting. Without introducing hormones into the body, it naturally supports the body’s own production of not one or two hormones, but ALL hormones.
So what do our own hormones do:
• Estrogen increases HDL “good cholesterol,” which reduces plaque build up and possible blockage in arteries.
• Estrogen reduces LDL “bad cholesterol,” which can cause plaque build up and possible blockages in arteries.
• Estrogen also maintains the elasticity of arteries and blood vessels. Triglycerides may contribute to hardening of the arteries or thickening of the artery walls, which increases the risk of heart disease.
• Progesterone protects arteries from spasms. Women’s arteries are much smaller than a man’s and spasms of heart arteries can adversely affect blood flow to the heart.
• Adrenal hormones like cortisol, testosterone, and DHEA, affect sleep, energy, hair growth, muscle growth, and weight just to name a few. Adrenal fatigue and the biological effects of stress, mediated by hormones produced in the adrenal glands, plays a major role in obesity and its deadly consequences, including inflammation, insulin resistance, hypertension, atherosclerosis, and other conditions that together constitute “metabolic syndrome.”
• Thyroid Hormones control how quickly the body burns energy, makes proteins and how sensitive the body should be to other hormones.
Not only does Femmenessence™ create the optimal hormone balance by positively impacting estrogen, progesterone, thyroid, adrenal levels, and reducing FSH levels, but in our double blind placebo controlled clinical trials we saw it increase HDL, reduce LDL, reduce body weight, reduce triglycerides, and empirically we have seen it improve blood pressure from long term use.
It is important to note that there is no such thing as a magic bullet and Femmenessence isn’t the sole answer. Exercise, healthy diet and emotional support are also important. Dr Christiane Northrup in the Wisdom of Menopause talks about the part emotional stress plays in this equation. “Emotions such as depression, anxiety, panic, and grief have been shown to cause constriction in blood vessels, thereby impeding the free flow of blood. And anything that causes constriction in your blood vessels makes your heart and your vessels work harder to do their job. I’ve seen happy, joyful women with high cholesterol counts live healthy lives into their eighties and nineties, while much younger women whose lives were characterized by depression, anxiety, or hostility might have the first sign of heart disease symptoms in their early fifties despite normal cholesterol levels.”
Using Femmenessence™ for 3-4 months continuously should be the first step in creating the balance that promotes a healthy heart. Ideally it would be combined with emotional support, a stress reduction therapy like meditation, and a top quality fish oil, Niacin, and possibly CoQ10 .
• Fish Oil: Decreases the risk of irregular heartbeats that can lead to sudden cardiac death. Improves blood vessel function, decreases triglyceride levels, lowers blood pressure, and decreases the growth rate of plaques that clog arteries.
• CoQ10: Used mainly in heart conditions: congestive heart failure (CHF), heart attack, heart valvular disease and heart muscle disease.
• Niacin: Very effective in supporting lipid levels.
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So why such a big jump in risk? What happens at menopause?
You are still eating the same foods, doing the same amount of exercise, and taking the same supplements! Many women can attest that more often it is not until they reach menopause that issues related to cholesterol, blood pressure or body weight become a concern. It begs the question, what happens?
It is the body’s declining production of hormones that significantly affects a woman’s health.
Due to the Women’s Health Initiative results in 2002 indicating that Hormone Replacement Therapy (HRT) could increase the risk of breast cancer and stroke, many women have been concerned about hormones in general. HRT was introduced over 40 years ago by doctors who knew the importance of a woman’s own hormones on health and believed that re-introducing them into the body, either synthetic or equine formulation, was the best way of reversing the ill effects from loss of hormones. Since then, we have seen that foreign hormones introduced into the body may have side effects, as well as concern over the amount of hormones introduced into the body, the form of administration and/or how long they should be taken. Another issue is the body needs to metabolize foreign hormones in order to make them available; consequently this can have an impact on liver and kidney function, in essence inversely affecting our body’s ability to detoxify. Also HRT is often just two hormones: estrogen and progesterone. It is typically not a patient-specific combination of all the hormones, which a woman may need.
What is understood and accepted is that throughout our life the body’s OWN hormones have supported a healthful state. This ability to support the body’s production of hormones is what makes Femmenessence so unique and exciting. Without introducing hormones into the body, it naturally supports the body’s own production of not one or two hormones, but ALL hormones.
So what do our own hormones do:
• Estrogen increases HDL “good cholesterol,” which reduces plaque build up and possible blockage in arteries.
• Estrogen reduces LDL “bad cholesterol,” which can cause plaque build up and possible blockages in arteries.
• Estrogen also maintains the elasticity of arteries and blood vessels. Triglycerides may contribute to hardening of the arteries or thickening of the artery walls, which increases the risk of heart disease.
• Progesterone protects arteries from spasms. Women’s arteries are much smaller than a man’s and spasms of heart arteries can adversely affect blood flow to the heart.
• Adrenal hormones like cortisol, testosterone, and DHEA, affect sleep, energy, hair growth, muscle growth, and weight just to name a few. Adrenal fatigue and the biological effects of stress, mediated by hormones produced in the adrenal glands, plays a major role in obesity and its deadly consequences, including inflammation, insulin resistance, hypertension, atherosclerosis, and other conditions that together constitute “metabolic syndrome.”
• Thyroid Hormones control how quickly the body burns energy, makes proteins and how sensitive the body should be to other hormones.
Not only does Femmenessence™ create the optimal hormone balance by positively impacting estrogen, progesterone, thyroid, adrenal levels, and reducing FSH levels, but in our double blind placebo controlled clinical trials we saw it increase HDL, reduce LDL, reduce body weight, reduce triglycerides, and empirically we have seen it improve blood pressure from long term use.
It is important to note that there is no such thing as a magic bullet and Femmenessence isn’t the sole answer. Exercise, healthy diet and emotional support are also important. Dr Christiane Northrup in the Wisdom of Menopause talks about the part emotional stress plays in this equation. “Emotions such as depression, anxiety, panic, and grief have been shown to cause constriction in blood vessels, thereby impeding the free flow of blood. And anything that causes constriction in your blood vessels makes your heart and your vessels work harder to do their job. I’ve seen happy, joyful women with high cholesterol counts live healthy lives into their eighties and nineties, while much younger women whose lives were characterized by depression, anxiety, or hostility might have the first sign of heart disease symptoms in their early fifties despite normal cholesterol levels.”
Using Femmenessence™ for 3-4 months continuously should be the first step in creating the balance that promotes a healthy heart. Ideally it would be combined with emotional support, a stress reduction therapy like meditation, and a top quality fish oil, Niacin, and possibly CoQ10 .
• Fish Oil: Decreases the risk of irregular heartbeats that can lead to sudden cardiac death. Improves blood vessel function, decreases triglyceride levels, lowers blood pressure, and decreases the growth rate of plaques that clog arteries.
• CoQ10: Used mainly in heart conditions: congestive heart failure (CHF), heart attack, heart valvular disease and heart muscle disease.
• Niacin: Very effective in supporting lipid levels.
Follow us on Facebook at http://www.facebook.com/naturalhealthint
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