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Archive for the ‘Hormone Physician’ Category

Dr. Art Mollen: Finding a silver bullet for weight loss – AZCentral.com

Dr. Art Mollen, Special for The Republic | azcentral.com 5:04 a.m. MT March 21, 2017

Dr. Art Mollen started tje 3TV Phoenix 10K and Half Marathon 40 years ago. In 2011 he created the Arizona Runners Hall of Fame to honor individuals who have made significant contributions to running in Arizona.(Photo: Richard Buchbinder)

Many people are looking for the silver bullet to weight loss.In fact, for some people, it may be a good idea. However, most doctors only prescribe themif your body mass index is above 30 or at least 27 and you also have diabetes or high blood pressure.

The most common prescription weight loss drugs include Orlistat, Contrave, Belviq, Saxenda and Qsymia. In the past the most common prescription weight loss drugs were amphetamines, which had the potential for addiction and abuse.

The most important consideration before taking medications for weight loss is to evaluate your medical history for high blood pressure, diabetes, heart disease and a compromised immune system, all of which could be affected. Even natural or herbal weight loss products can cause significant problems.

Orlistat also called Xenical, blocks your body from absorbing the fat that you consume and may cause side effects, including abdominal cramping and excess gas.

Contrave is a combination of naltrexone and wellbutrin. Naltrexone is also approved to treat alcohol and drug dependence. Wellbutrin is also approved to treat depression. Contrave works on the brains thermostat, which controls appetite, temperature and how the body burns energy signaling the brain to reduce food intake.

Belviq works by suppressing your appetite. However, some common side effects, include headaches, dizziness, nausea and fatigue.

Saxenda is the same drug as Victoza used to treat diabetes. It helps diabetics by mimicking a hormone in the intestines and tells the brain that the stomach is full. The side effects include nausea, vomiting and diarrhea.

Phentermine is an amphetamine and combined with Topamax, an anticonvulsant drug in a medication called Qysmia. It makes you feel full, suppresses appetite and speeds metabolism, however, it can raise blood pressure, cause heart palpitations and insomnia. It is a controlled substance and potentially addictive.

All of these medications have a caveat which is, if you do not lose at least 5 percentof your body weight after 12 weeks of taking it, you should discontinue the medication.

These weight loss drugs must be monitored by a physician and are indicated to be taken in conjunction with exercise and fewer calories.If the medication galvanizes you to exercise and eat differently, that may be a good idea.

A recent study in the Journal of the American Medical Association pointed out that the best prescription weight loss drug is the one that works for you.Qsymia and Contrave were able to create about a 5 percentloss of body weight, which is 11-12 pounds and is considered to be the most effective.

There is no one size fits all when it comes to weight loss drugs as some people will simply respond to one drug better than another.At the end of the day there is no silver bullet to weight loss simply exercise, diet changes and lifestyle.

One last note as a practicing physician, I seldom prescribe these medications for my patients, not because they are ineffective, but because they are the antithesis of my personal philosophy for long-term weight control.

Dr. Art Mollen is an osteopathic family physician and a health, fitness and preventive medicine expert. Reach him at 480-656-0016 or askdrartmollen@gmail.com.

Dr. Art Mollen: All you need is love with a little bit of chocolate

Dr. Art Mollen: Peanut allergic reactions are serious

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Dr. Art Mollen: Finding a silver bullet for weight loss – AZCentral.com

Deepak Chopra speculates about Trump’s brain – USA TODAY

President Trump’s behavior has medical professionals, including Deepak Chopra, concerned about his mental health. USA TODAY

Deepak Chopra tweeted that President Donald Trump should be tested for psychiatric and neurological disorders.(Photo: Alberto E. Rodriguez, Getty Images)

Does the nation need to know more about President Trumps brain?

Alternative medicine promotor Deepak Chopra is the latest medical professional to suggest we do.In a series of tweets late Monday theday FBI director James Comey shot down the presidents unfounded but continuing claims about wiretapping at Trump Tower Chopra asked Trumpto please submit to a psychiatric and neurological evaluation to restore our confidence.

Chopra, who trained as an endocrinologist (a hormone specialist), not a psychiatrist or neurologist, also suggested that a form of dementia, a brain disease that affects behavior and thinking, should be ruled in or ruled out, for the safety of the world.

For the record, Trumps longtime personal physician Harold Bornstein recently told the health news site Statthat while Trump carries some extra pounds, theres nothing seriously wrong with him. In two letters issued during the campaign, Bornstein also said Trump, 70, was in fine physical health. Bornstein also told The New York Times he probably would not screen Trump for dementia if he became White House physician (so far, he has not).

That has not stopped speculation, especially about Trumps mental health. Suchspeculation, at least by psychiatrists, has been officially discouraged by the American Psychiatric Association (APA). Earlier this month, the group updated its longstanding ethics policy against opiningonthe mental health of politicians or other public figures. The policy is called the Goldwater Rule, after 1964 presidential candidate Barry Goldwater, and was created after manypsychiatrists participated in a magazine survey about Goldwaters mentalfitness.

The rule is based partly on the belief that psychiatrists should not diagnose unconsenting people they have not examined. But it also reflects concerns that equating mental healthwith fitness for certain jobs stigmatizes people with mental illness, said Rebecca Weintraub Brendel, an assistant professor of psychiatry at Harvard Medical School and consultant to the APAs ethics committee.

The public doesnt really need psychiatrists to reach conclusions, about whether politicians should stay in office, she added.

Despite the policy, 35 psychiatrists, psychologists and social workers signed a letter to the Timesin February saying Trumps speech and actions demonstrate an inability to tolerate views different from his own, leading to rage reactions. They said this grave emotional instability made him incapable of serving safely as president. The letter did not suggest any diagnosis for Trump.

In a separate letter to the Times, Allen Frances, apsychiatry professor emeritusat Duke University School of Medicine, took a different view. He wrote that Trump may be a world-class narcissist, but this doesnt make him mentally ill. Francis said that associating Trump’s behavior with mental illness is a stigmatizing insult to the mentally ill.

As to whether Trump should undergo the kind of testing Chopra suggests, some experts think all modern presidents should. Arthur Caplan, a bioethicist at New York University’s Langone Medical Center, told NPR: “I think we’re about 50 years overdue for having some sort of annual physical for the president and vice president, the results of which should be reported publicly. Part of this should be psychiatric and cognitive testing.”

But thats different from suggesting that public concerns generated by a presidents TV appearances and social media posts should trigger psychiatric testing, Weintraub Brendel said. That, she said, would be a political misuse of psychiatry.

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Deepak Chopra speculates about Trump’s brain – USA TODAY

Ask The Doctors – Daily Journal Online

DEAR DOCTOR: I’ve been taking thyroid medication for several years, and my doctor says my blood tests are where they should be, but my face feels like sandpaper, my nails are brittle, and I’m losing so much hair that I can see my scalp. Could there be some underlying problem my physician is missing?

DEAR READER: Hair loss can be a distressing symptom, made all the more so when its cause is a mystery.

Your thyroid hormone levels are an obvious place to start, because both low and high thyroid levels can lead to hair and nail changes. Symptoms of high thyroid levels include hair loss, skin that is unusually smooth and warm, and nails that soften and loosen from the nail bed. The remaining hair becomes thinner, softer and does not hold a wave. Symptoms of low thyroid levels also include hair loss, including in the armpits and genital area, but the hair in this scenario is dull, coarse and fragile. As for the nails, they tend to be delicate, thin and have multiple grooves. That said, if your physician has done a complete panel of thyroid tests and the results have been normal, then most likely the function of your thyroid gland is not the cause of the brittle nails nor the hair loss.

That doesn’t mean the thyroid isn’t a factor. Autoimmune thyroid disease can lead to hair loss, both patchy and more diffuse, as well as inflammatory conditions of the skin. Such disease isn’t always reflected in thyroid hormone levels. Checking anti-thyroid antibodies in the blood can identify autoimmune thyroid disease, and point you and your doctor in a clearer direction.

Hair loss also can be caused by androgenic alopecia, linked to an excess of androgens, a type of male hormone. These hormones are present in both men and women, but they’re higher than normal in some women, such as those with congenital adrenal hyperplasia or polycystic ovarian disease, which is relatively common. Simply checking levels of testosterone and dehydroepiandrosterone (DHEA) can either rule out androgenic alopecia or suggest that it be explored further.

Another potential cause is medication. Some medications can lead to hair loss, so if your symptoms seem coincidental to starting a new medication, there might be an association.

Biotin deficiency, which is rare, can also cause hair loss and inflammation of the facial skin. But if you have a normal diet and eat eggs, you have a low likelihood of this condition. Nonetheless, it’s something to rule out.

Iron deficiency also can lead to both brittle nails and hair loss. This doesn’t explain the skin manifestations that you have, but if you are looking at other possibilities, checking the iron level of the blood should be part of the workup.

Any major illness can lead to hair loss and nail changes, and psychological stress can lead to hair loss. So, if there have been major stressors in your life, either physical or psychological, consider that a potential culprit.

In summary, if your thyroid levels are normal, it would be wise to check your thyroid antibodies, androgens and iron levels — and your level of stress.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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Ask The Doctors – Daily Journal Online

PHYSICIAN SPEAKS AT UNITED NATIONS ABOUT MEDITATION – The Indian Panorama

UNITED NATIONS (TIP): When you can go to the United Nations to hear a talk about meditation, you know something has changed in the world.

On Friday, March 10, 2017, Dr. Kunwarjit Singh Duggal, guest of the United Nations Salus Well-Being Network, spoke to a packed audience in the Secretariat Conf. Room 8 on Cultivating Inner Peace for Outer Peace. He began: My main message here is to talk about peace. How do we achieve peace? . . . In order to take peace to the next level, we have to find peace within ourselves first before we can go on helping the rest of society.

By his own admission, Dr. Duggal is quite passionate about meditation as an intervention for many of lifes challenges, whether worldly or personal a universal paradigm.

His topic on Friday, particularly timely today,detailed the latest scientific research on theproven benefits of meditation. Noting the many different types of meditation, he talked about several significant studies, most focused on peace, stress and anxiety.

He quoted one randomized controlled study in which people were asked to meditate each morning for 21 days straight for a short duration of time. The researchers measured cortisol (the stress hormone) levels before and after 21 days and found a significant decrease in every participant. Notable studies also found that for patients undergoing orthopedic rehabilitation those who meditated benefitted twice as much as those who were treated only with therapeutic exercise.

One telling example was an experiment done in a troubled San Francisco school district in whichtwo 15-minute periods of quiet time wereinstitutedfor students. The results were improved test scores, attendance, psychological state and enhanced concentration. These students also reported increased calmness and decreased anger. By increasing the calmness in these students, their corresponding troubled geographical regions noted decreased crime rates and improved safety.

Dr. Duggal then presented the meditation technique practiced in Science of Spirituality, Jyoti meditation, after which everyone had a chance to meditate for a short period.

The afternoon concluded with a lively question and answer session.

Dr. Duggal was at the United Nations representing the Science of Spirituality,(NGO), a worldwide, spiritual organization dedicated to transforming lives through meditation. His father, Sant Rajinder Singh Ji Maharaj, head of Science of Spirituality, spoke at the UN last May on Meditation as Medication for the Soul.

Dr. Duggal is a Board-Certified Physical Medicine and Rehabilitation Specialist and Assistant Professor at Rush University Meditation Center in Chicago. He lectures extensively on meditation as an effective intervention for physical and emotional medical disorders.

For more information about Science of Spirituality: http://www.sos.org.

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PHYSICIAN SPEAKS AT UNITED NATIONS ABOUT MEDITATION – The Indian Panorama

Yup, Working Out During Your Period Can Help Dull Cramps and PMS – SELF


SELF
Yup, Working Out During Your Period Can Help Dull Cramps and PMS
SELF
Medical professionals like Spencer Nadolsky, D.O., a licensed practicing board certified family and bariatric medicine physician in Olney, Maryland, agree that exercise is often an effective antidote for period-related woes. Exercise can be a stress

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Yup, Working Out During Your Period Can Help Dull Cramps and PMS – SELF

Dear Dr. Roach: Dietitian is important resource in treating celiac disease – Herald & Review

Dear Dr. Roach: I am a 78-year-old woman who was just diagnosed with celiac disease. I had an endoscopy in 2007 because I was anemic, and the doctor told me I had an ulcer that healed itself. This year I had an endoscopy because I again was anemic, but this time he did a biopsy, which came back as celiac. I have no dysentery or stomach pains, which are red lights for celiac; I have had inflamed joints for years, accompanied by dry skin. Is it possible that I have had this disease for years and was never diagnosed? My doctor told me not to eat wheat but never went any further than that. I have been educating myself about the disease. Who else would I see about this? Also, what would happen if I ate wheat by mistake? I also have been short of breath for years, but heart and pulmonary tests all come back normal. Could celiac be causing this shortness of breath?

A: Celiac disease, also called “gluten-sensitive enteropathy” or “nontropical sprue,” is an uncommon but increasingly recognized condition caused by a reaction to gliadin, a protein found in gluten-containing grains, especially wheat, rye and barley. The spectrum of symptoms caused by celiac disease and its associated conditions is too broad for this column to cover comprehensively.

Not everyone with celiac disease has gastrointestinal symptoms, such as diarrhea and weight loss. Some people get mild abdominal pain and mood changes, and never put these together with their diet. At age 78, it’s very likely that you have had celiac disease for many years. The anemia 10 years ago possibly was celiac-related, through iron deficiency. People with celiac disease are more likely to develop arthritis as well, and one skin condition, dermatitis herpetiformis, is so characteristic of celiac that a biopsy is not needed.

Shortness of breath is uncommon with celiac disease, but a severe anemia can cause it, as can one rare lung disease, pulmonary hemosiderosis, which often goes away on a gluten-free diet. Disease of the heart muscle itself is rare but more common in people with celiac disease.

Unfortunately, the dietary information you got was woefully inadequate, so I would strongly recommend a visit with a registered dietician nutritionist, who can give you much more information. Don’t eat wheat: Proper care of this disease depends on meticulous avoidance of gluten, and even small amounts count.

Dear Dr. Roach: My doctor just tested me for high calcium, and my vitamin D was low. He put me on 12 weeks of 50,000 IU once a week. You said something in a recent article about high vitamin D. Why the difference?

A: Unfortunately, I am confused by your vitamin D treatment: I suspect the vitamin D has nothing to do with the calcium. A high calcium level can be caused by many things, including faulty technique in obtaining blood (if the tourniquet is on too long, the blood can become more acidic, which makes the calcium level appear higher), but I mentioned excess vitamin D (a rare cause) and elevated parathyroid hormone levels in my recent column. A repeated high calcium level should get your doctor to check a PTH hormone level. A high PTH level almost always means a benign tumor of the parathyroid gland, which is often but not always treated surgically.

Dr. Roach writes: I solicited opinions about televisions in physician waiting rooms, and have the results of what readers wrote me. Ninety-three percent of respondents did not like them. Some suggestions included artwork or an aquarium instead; music (especially classical) to provide white noise and privacy; and 1950s television shows or informational shows with closed captioning.

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Dear Dr. Roach: Dietitian is important resource in treating celiac disease – Herald & Review

Doc: Dietitian a resource in treating celiac disease – The Detroit News

Keith Roach, To Your Health 5:09 p.m. ET March 16, 2017

Dear Dr. Roach: I am a 78-year-old woman who was just diagnosed with celiac disease. I had an endoscopy in 2007 because I was anemic, and the doctor told me I had an ulcer that healed itself. This year I had an endoscopy because I again was anemic, but this time he did a biopsy, which came back as celiac. I have no dysentery or stomach pains, which are red lights for celiac; I have had inflamed joints for years, accompanied by dry skin. Is it possible that I have had this disease for years and was never diagnosed? My doctor told me not to eat wheat but never went any further than that. I have been educating myself about the disease. Who else would I see about this? Also, what would happen if I ate wheat by mistake? I also have been short of breath for years, but heart and pulmonary tests all come back normal. Could celiac be causing this shortness of breath?

Anon.

Dear Anon.: Celiac disease, also called gluten-sensitive enteropathy or nontropical sprue, is an uncommon but increasingly recognized condition caused by a reaction to gliadin, a protein found in gluten-containing grains, especially wheat, rye and barley. The spectrum of symptoms caused by celiac disease and its associated conditions is too broad for this column to cover comprehensively.

Not everyone with celiac disease has gastrointestinal symptoms, such as diarrhea and weight loss. Some people get mild abdominal pain and mood changes, and never put these together with their diet. At age 78, its very likely that you have had celiac disease for many years. The anemia 10 years ago possibly was celiac-related, through iron deficiency. People with celiac disease are more likely to develop arthritis as well, and one skin condition, dermatitis herpetiformis, is so characteristic of celiac that a biopsy is not needed.

Shortness of breath is uncommon with celiac disease, but a severe anemia can cause it, as can one rare lung disease, pulmonary hemosiderosis, which often goes away on a gluten-free diet. Disease of the heart muscle itself is rare but more common in people with celiac disease.

Unfortunately, the dietary information you got was woefully inadequate, so I would strongly recommend a visit with a registered dietician nutritionist, who can give you much more information. Dont eat wheat: Proper care of this disease depends on meticulous avoidance of gluten, and even small amounts count.

Dear Dr. Roach: My doctor just tested me for high calcium, and my vitamin D was low. He put me on 12 weeks of 50,000 IU once a week. You said something in a recent article about high vitamin D. Why the difference?

A.K.

Dear A.K.: Unfortunately, I am confused by your vitamin D treatment: I suspect the vitamin D has nothing to do with the calcium. A high calcium level can be caused by many things, including faulty technique in obtaining blood (if the tourniquet is on too long, the blood can become more acidic, which makes the calcium level appear higher), but I mentioned excess vitamin D (a rare cause) and elevated parathyroid hormone levels in my recent column. A repeated high calcium level should get your doctor to check a PTH hormone level. A high PTH level almost always means a benign tumor of the parathyroid gland, which is often but not always treated surgically.

Dr. Roach Writes: I solicited opinions about televisions in physician waiting rooms, and have the results of what readers wrote me. Ninety-three percent of respondents did not like them. Some suggestions included artwork or an aquarium instead; music (especially classical) to provide white noise and privacy; and 1950s television shows or informational shows with closed captioning.

Email questions to ToYourGoodHealth@med.cornell.edu.

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Doc: Dietitian a resource in treating celiac disease – The Detroit News

Ask the Doctors | Print Only | virginislandsdailynews.com – Virgin Islands Daily News

Dear Doctor: Ive been taking thyroid medication for several years, and my doctor says my blood tests are where they should be, but my face feels like sandpaper, my nails are brittle, and Im losing so much hair that I can see my scalp. Could there be some underlying problem my physician is missing?

Dear reader: Hair loss can be a distressing symptom, made all the more so when its cause is a mystery.

Your thyroid hormone levels are an obvious place to start, because both low and high thyroid levels can lead to hair and nail changes. Symptoms of high thyroid levels include hair loss, skin that is unusually smooth and warm, and nails that soften and loosen from the nail bed. The remaining hair becomes thinner, softer and does not hold a wave. Symptoms of low thyroid levels also include hair loss, including in the armpits and genital area, but the hair in this scenario is dull, coarse and fragile. As for the nails, they tend to be delicate, thin and have multiple grooves. That said, if your physician has done a complete panel of thyroid tests and the results have been normal, then most likely the function of your thyroid gland is not the cause of the brittle nails nor the hair loss.

That doesnt mean the thyroid isnt a factor. Autoimmune thyroid disease can lead to hair loss, both patchy and more diffuse, as well as inflammatory conditions of the skin. Such disease isnt always reflected in thyroid hormone levels. Checking anti-thyroid antibodies in the blood can identify autoimmune thyroid disease, and point you and your doctor in a clearer direction.

Hair loss also can be caused by androgenic alopecia, linked to an excess of androgens, a type of male hormone. These hormones are present in both men and women, but theyre higher than normal in some women, such as those with congenital adrenal hyperplasia or polycystic ovarian disease, which is relatively common. Simply checking levels of testosterone and dehydroepiandrosterone (DHEA) can either rule out androgenic alopecia or suggest that it be explored further.

Another potential cause is medication. Some medications can lead to hair loss, so if your symptoms seem coincidental to starting a new medication, there might be an association.

Biotin deficiency, which is rare, can also cause hair loss and inflammation of the facial skin. But if you have a normal diet and eat eggs, you have a low likelihood of this condition. Nonetheless, its something to rule out.

Iron deficiency also can lead to both brittle nails and hair loss. This doesnt explain the skin manifestations that you have, but if you are looking at other possibilities, checking the iron level of the blood should be part of the workup.

Any major illness can lead to hair loss and nail changes, and psychological stress can lead to hair loss. So, if there have been major stressors in your life, either physical or psychological, consider that a potential culprit.

In summary, if your thyroid levels are normal, it would be wise to check your thyroid antibodies, androgens and iron levels and your level of stress.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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Ask the Doctors | Print Only | virginislandsdailynews.com – Virgin Islands Daily News

Low Hormone Level Linked to Postpartum Depression – PsychCentral.com

A new study links low levels of the hormone allopregnanolone in the second trimester of pregnancy, to the risk of developing postpartum depression.

Researchers at Johns Hopkins University in Baltimore, Maryland, said the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The small-scale study consisted of women with previously diagnosed mood disorders, with findings published online inPsychoneuroendocrinology.

Investigators said the study used an observational methodology among women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression.

But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.Postpartum depression affects early bonding between the mother and child.

Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping, and developing normally.

Moreover, an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

Many earlier studies havent shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individuals vulnerability to fluctuations in these hormones, and they didnt identify any concrete way to tell whether a woman would develop postpartum depression, saidLauren M. Osborne, M.D., assistant director of the Womens Mood Disorders Center for Johns Hopkins Medicine.

For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible.

In the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at Johns Hopkins University and the University of North Carolina at Chapel Hill.

About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost one-third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood.

Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV, for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression.

However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later, saidOsborne.

She said many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication, making it difficult to detect trends in those women most at risk.

Because the study data suggested that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne saidin the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression.

She saidJohns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautioned that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne said, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Prior research by Osborne and her colleagues previously showed that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression. Investigators discovered these modifications target genes that work with estrogen receptors and are sensitive to hormones.

These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she said, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers.

The researchers say that the medication dosages werent prescribed by the study group and were monitored by the participants primary care physician, psychiatrist, or obstetrician instead.

We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we dont have any evidence that this is true, Osborne said.

If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mothers illness.

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians dont screen for it, and there is a stigma for mothers.

A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

Source: Johns Hopkins

APA Reference Nauert PhD, R. (2017). Low Hormone Level Linked to Postpartum Depression. Psych Central. Retrieved on March 16, 2017, from https://psychcentral.com/news/2017/03/16/low-hormone-level-linked-to-postpartum-depression/117738.html

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Low Hormone Level Linked to Postpartum Depression – PsychCentral.com

Low levels of ‘anti-anxiety’ hormone linked to postpartum depression … – Science Daily

In a small-scale study of women with previously diagnosed mood disorders, Johns Hopkins researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a report on the study, published online on March 7 in Psychoneuroendocrinology, the researchers say the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The researchers caution that theirs was an observational study in women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression. But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.

Postpartum depression affects early bonding between the mother and child. Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping and developing normally, and an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

“Many earlier studies haven’t shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individual’s vulnerability to fluctuations in these hormones, and they didn’t identify any concrete way to tell whether a woman would develop postpartum depression,” says Lauren M. Osborne, M.D., assistant director of the Johns Hopkins Women’s Mood Disorders Center and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible.”

For the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at The Johns Hopkins University and the University of North Carolina at Chapel Hill. About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost a third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood. Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression. However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

“Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later,” says Osborne. She says that many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication — making it difficult to detect trends in those women most at risk.

Because the study data suggest that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne says in the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression. She says Johns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautions that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne says, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Osborne and her colleagues previously showed and replicated in Neuropsychopharmacology in 2016 that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression; these modifications target genes that work with estrogen receptors and are sensitive to hormones. These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she says, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers. The researchers say that the medication dosages weren’t prescribed by the study group and were monitored by the participant’s primary care physician, psychiatrist or obstetrician instead. “We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we don’t have any evidence that this is true,” says Osborne. “If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mother’s illness.”

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians don’t screen for it, and there is a stigma for mothers. A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

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Low levels of ‘anti-anxiety’ hormone linked to postpartum depression … – Science Daily

Testosterone therapy has mixed results, studies find – Fort Worth Star Telegram

Testosterone therapy has mixed results, studies find
Fort Worth Star Telegram
They looked at the impact of testosterone therapy in hundreds of men 65 and older who had measurably low levels of the hormone. (About 20 percent of men over 60 have diagnosable low testosterone.) The findings: One less-than-positive conclusion was …

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Testosterone therapy has mixed results, studies find – Fort Worth Star Telegram

Reader has lingering E. coli post-biopsy – The Steubenville Herald-Star

National News

Mar 10, 2017

DEAR DR. ROACH: My husband acquired a drug-resistant E. coli infection from a prostate biopsy. His urologist initially treated him with gentamicin injections and cephalexin. Two days after discontinuing the cephalexin, the infection returned (chills, fever, malaise and pain in the urinary tract). He got more gentamicin injections and more cephalexin. Finally, the doctor read the lab results and discontinued the gentamicin, which was shown to not be effective. He had 10 more days of cephalexin, and after a few days off the drug, the infection was back. Finally, the urologist switched him to amoxicillin-clavulanate, and he got better. Its been three weeks since his last pill. Can we be confident that the infection wont return?

I did some reading right after he got sick and learned about the increasing number of men becoming ill after prostate biopsies with drug-resistant E. coli nearly 4 percent. I assumed the urologist had tested him and that it was not this strain. I was wrong. He waited nearly two weeks before ordering a urinalysis and another week to carefully read it. My husband spent two months getting shots and taking oral meds.

On the plus side, the prostate biopsy was negative.

I hope you can print this as a cautionary tale for anyone considering this procedure. Anon.

ANSWER: A prostate biopsy is most commonly done to confirm suspected prostate cancer after an abnormal PSA test or physical exam. Antibiotics commonly are given before the biopsy to prevent urine infections, but that has increased the likelihood of resistance.

There are several lessons to be learned from your letter. The first is that an infection that returns immediately after stopping an antibiotic should raise the possibility of resistance, and a culture should promptly be performed and susceptibilities should guide future antibiotic treatment. Seven to 10 days of an effective antibiotic should be curative in nearly all cases, and in those in which it isnt, another solution should be sought.

Getting many biopsies increases risk of infection. The increasing use of MRI scanning to guide prostate biopsy may decrease the need for so many biopsies, and hopefully decrease infection rates.

DEAR DR. ROACH: I would like to get off levothyroxine 0.05 mg daily. Would that be possible? J.

ANSWER: Levothyroxine, a synthetic form of thyroid hormone, is used in people who are unable to make enough thyroid hormone. There are many reasons why. People who have had complete surgical removal of the thyroid are absolutely dependent on taking the replacement and would be seriously ill and eventually die if they were to stop taking a replacement. People who are taking it after thyroid cancer often are given slightly high amounts, in order to suppress TSH, the regulatory hormone. This, in turn, reduces the likelihood of cancer recurrence. I would never consider stopping replacement.

In people with Hashimotos thyroiditis, an autoimmune thyroid disease, the thyroid often is unable to make hormone but eventually, after months or years, can recover. In the U.S., we usually keep people on replacement hormone for life, but I have seen instances where people have gotten off their medication. This requires your physician to agree (some wont, because not everyones thyroid will recover) and very close management of both lab tests and symptoms for an extended period of time. The low dose you are taking suggests a good chance that you could get off it. I would ask you to think twice, though, as to why you want to stop taking it.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)

D.C. Capitol Switchboard: (202) 224-3121 Ohio House U.S. Rep. Bill Johnson, 6th District, 1710 Longworth House …

Dear Annie: After a series of, lets just say, not-so-nice relationships, my best friend and old college roomie …

TEMPE, Ariz. Encouraging developments are as welcome as they are rare in colleges and universities that …

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TODAYS BIRTHDAY (March 14). Theres sunshine in your mind this year, and the cheerfulness you feel will touch …

International Womens Day is a once-a-year acknowledgment of what women do every day of the year, which is to …

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Reader has lingering E. coli post-biopsy – The Steubenville Herald-Star

Women’s Health: Women, Headaches and Migraines – myfox8.com


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Women's Health: Women, Headaches and Migraines
myfox8.com
When life style changes aren't enough, your doctor may recommend other treatment such as hormone therapy, over the counter medication, doctor prescribed medication or Botox injections. Botox injections have become a popular treatment method for …

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Women’s Health: Women, Headaches and Migraines – myfox8.com

Dr. Charles Mok Releases Innovative New Book on Women’s Health – Forbes

Dr. Charles Mok Releases Innovative New Book on Women's Health
Forbes
NEW YORK (March 7, 2017) Physician and business leader Dr. Charles Mok today announced the publication of Testosterone: Strong Enough for a Man, Made for a Woman (available now). The book is published with ForbesBooks, the exclusive … In the book

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Dr. Charles Mok Releases Innovative New Book on Women’s Health – Forbes

Doctors talk aging: What’s normal, how to manage it – Times Daily

FLORENCE — The aging process takes a toll on the body, and knowing that helps individuals adjust to the new normal, doctors said.

Dr. Saquib Anjum, a geriatric and palliative care physician, said helping aging patients know what are typical changes to the body can help ease fear when the patient notices those changes.

“I see a lot of anxiety patients go through because of aging,” Anjum said. “Aging is broadly predictable.”

As life expectancy increases, it’s important that the growing number of senior adults understand these body changes, Anjum said.

He said when patients notice changes he describes as typical of someone growing older, the first request is often a medication to reverse the change. However, Anjum said the best thing to do is to identify lifestyle changes to adjust to them.

Typical body changes related to aging include decreased heart rate from thickening of heart walls and slight enlargement of the heart muscle; an increase in blood pressure; a more noticeable decrease in blood pressure from standing or changing position; a less effective immune system; and loss of muscle mass.

Those changes, Anjum said, can manifest themselves like symptoms of a disease, but are typically just related to the normal aging process. A healthy diet and regular exercise are the best ways to stave off such changes, and to control the effects of them when they do occur.

“A lot of older patients are on multiple medications and will go through multiple rounds of medications trying to find one that works,” Anjum said. “These are just things that happen as you age.”

Anjum noted that as people reach geriatric status, kidney function can decrease. He said that’s especially important for patients who are cycling through medications trying to find one that “fixes” their symptoms.

“When kidneys don’t functions as well, drugs stay in your system longer,” he said. “That increases the risk of side effects.”

Dr. Robert Webb said there are several “syndromes” that occur in older patients that people need to be aware of as they age.

Disruption of the sleep cycle is a frequent complaint from senior patients, Webb said. He said older patients often have a harder time falling asleep; wake more often during the night; and experience restlessness during sleep more often.

He said 50 percent of seniors use some sort of prescription medication for sleep, and 30 percent have a chronic problem with sleep.

He recommends lifestyle changes, such as eating large meals earlier, taking medications that can disrupt sleep earlier in the day, and taking melatonin, a hormone that regulates sleep.

“Melatonin is very helpful for seniors,” he said. “It helps reset your sleep/wake cycle.”

Falling is another common risk for seniors that can be managed to a degree, Webb said. He said certain types of medications, such as antidepressants, benzodiazapines and anti-inflammatory drugs, can increase falls for older patients.

He recommended increased strength exercises, and physical and occupational therapy for better balance and mobility. He said correcting environmental factors can reduce the risk of falls.

“You don’t want throw rugs,” he said. “What happens when you have throw rugs? That increases the risk of catching your foot on the rug and falling.”

It is often medications, Webb said, and the side effects of those medications that cause complaints from older patients.

“All senior symptoms are drug side effects until proven otherwise,” Webb said.

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Doctors talk aging: What’s normal, how to manage it – Times Daily

She listened to her doctors and her baby died. Now she’s warning others about breast-feeding. – Washington Post

The doctors and nurses told Jarrod and Jillian Johnson that their newborns case wasnot that unusual.

Landon Johnson had been trying to breast-feed almost continuously since his birth days earlier and screaming each time his mother pulled him from her chest.Just stick with it, the first-time parents were told; it will take some time to get the hang of breast-feeding.

But hours afterthe Johnsons took their sonhome from the hospital, Jillian found him unresponsive.

His skin was blue and, she said, when she picked him up, his body felllimp in her arms.

Jarrod started CPR.

Jillian dialed 911.

Landon was rushed to an emergency room.

But it wasnotuntil days after their newborn had stopped breathing after his medical team wasunable to resuscitatehim and after he was put on life support that Jillian Johnson said she and her husband learned what might have happened to him. A doctor in a neonatal intensive care unit told them he suspected Landon was so severely dehydrated that his heart had stopped beating, she said.

It was really hard for me to comprehend at that point, because I had beenbreast-feeding him What do you mean he was dehydrated? Jillian Johnson said she told the doctor in February 2012. I couldnt wrap my head around it.I was frustrated with myself because, there were these doctors and nurses who kept telling me, Just keep feeding him. Just keep him on the breast. Youve got a great latch. Youre doing fine.

But she had no breast milk to offer him, she said.

Just 19days after Landon was born, his parents made a heart-wrenching decision to remove himfrom the machines that were keeping him alive.

Then they watched their baby die.

Five years later, Jillian Johnson is speaking out about her sons death, warning other mothers about breast-feeding in a blog post that has gone viral.

Althoughbreast-feeding is considered the ideal wayto feed ababy, she said, women should understand the risks such as not being able to produce enough milk and realize that there is nothing wrong with using formula in bottles.

I want people to stop shaming each other, Johnson told The Washington Post. Regardless of how you feed your baby, just make sure theyre fed. Its plain and simple.

I want people to educate themselves, she said. You want to do whats best for your kid? Fine. Breast is best, sure as long as the baby is getting something out of it.

Landon died ofhypoxic-ischemic encephalopathy, or brain injury caused by oxygen deprivation;cardiac arrest; andhypernatremic dehydration, according to records from the Los Angeles County coroner.

Johnson, who lives in the Los Angeles area, declined to name the hospital where he was born or release any records.

[Doctor says: When it comes to breastfeeding, your health and happiness matter as much as your babys]

Christie del Castillo-Hegyi, aphysician and co-founder of Fed is Best Foundation, said she has studied Landonsmedical records. Castillo-Hegyi, whose nonprofit foundation focuses oninfant feeding,noted that the boy was born Feb. 25, 2012, by emergency C-section because he was not getting enough oxygen during labor.

At birth, he weighed 7 poundsand 7 ounces but, by day three, he had lost9.7 percent of his weight, she said.

Johnson described the ordeal late last month in a post on theFed is Best Foundations blog:

Landon cried. And cried. All the time. He cried unless he was on the breast and I began to nurse him continuously. The nurses would come in and swaddle him in warm blankets to help get him to sleep. And when I asked them why he was always on my breast, I was told it was because he was cluster feeding. I recalled learning all about that in the classes I had taken, and being a first time mom, I trusted my doctors and nurses to help me through this even more so since I was pretty heavily medicated from my emergency c-section and this was my first baby. But I was wrong.

Johnson wrote thatalactation consultant told her Landon had a great latch and was doing fine but noted that she may have a problem producing milk because she had been diagnosed with a hormonal disorder calledpolycystic ovarian syndrome.

The consultant told her to take herbal supplements, she said.

The Johnsons took Landon home on Feb. 28, 2012. Early the next morning, on Leap Day, they found him unresponsive.

We were both crying, But to watch your husband he was squeezing me so hard it hurt, but I couldnt pull myself away from him because he was bawling and praying that God would bring his baby back to him,Jillian Johnson said in an interview, sobbing.

No one at the baby-friendly hospital where Landon was born told her this could happen, she said.

In the United States, more than 400 suchhospitals believe that human milk fed through the mothers own breast is the normal way for human infants to be nourished, according to Baby Friendly USA, an organization that implements the Baby-Friendly Hospital Initiativeby theWorld Health Organization and the United Nations Childrens Fund.

Baby Friendly USA Executive Director Trish MacEnroesaid the organizationexpects designatedhospitals tohelpmothers bond with babies and care for them, whichincludes exclusively breast-feeding. When mothers waver,she said, hospitals shouldtry to identify the obstacles and help mothers overcome them.

But, she said, its ultimately the mothers decision.

Regarding the case of Landon Johnson, MacEnroe said it was indeed tragic but added, I think its really important for mothers to know that breast-feeding is safe,and it is the optimal means for infant nutrition.

Because Johnson would not identity the hospital where Landon was born, MacEnroe said she did not know whether it was a baby-friendly hospital.

[Why I breastfed my son until he was 3]

Medical experts say starvation caused by breast-feeding is extremely rare; in fact,theAmerican Academy of Pediatrics recommends that babies exclusively breast-feed for the first six months, for a variety of reasons.

General pediatrician Andy Bernstein,a spokesman for the American Academy of Pediatrics, saidhumans are hard-wired to go several days without fullyfeeding.Typically, experts say, newborns can subsist thosefirst days on their mothers first milk, known ascolostrum, until their mothers mature milk comes in.

Bernstein said most pediatricians agree it is acceptable for newborns to lose up to 10 percent of their birth weight during this transition. But, he added, physicians must also consider any factors that could put mothers and babies at risk, such as being a first-time mother; having a long, complicated delivery or a C-section; or suffering from certain health issues, including some hormone disorders.

Im definitely going to encourage breast-feeding when possible, Bernstein said. We easily get the majority of our patients breast-feeding, but there is still a significant number of patients who, for a variety of issues, breast-feeding just doesnt work out. As gung-ho as we are about breast-feeding in 2017, I think it has to be done carefully.

Still, he said, formula is very acceptable source, both alone or to supplement breast milk.

But much more common is the societal pressure some women say they feel to breast-feed.

In an op-edfor The Post last year, three psychiatrists wrote that although the benefits of breast-feeding are backed by science, the recommendations carry the force of a threat: If I dont breastfeed, my child is more likely to get sick; if I dont breastfeed, my child wont be as smart; if I dont breastfeed, Im not a good mother.

Heres what not enough people talk about: Just as new babies are vulnerable, so are their mothers. And a mothers mental health is crucial not just to her, but also to her baby. A depressed and anxious mother isnt able to provide the nurturing that her baby needs to develop and grow. And if that depression and anxiety is caused or worsened by the breastfeeding experience, breastfeeding isnt worth it.

Then theresthe physical pain some women say they endure to breast-feed their babies.

Johnson, Landons mother, said that during the three days she was constantly nursing her son, her breasts were sore and her nipples were raw and bleeding.

She was also hurting for her newborn; she felt that she was failing him, she said.

Despite the horror she lived through, Johnson said she is not against breast-feeding. She has given birth to two girls since Landons death and has breast-fed them both supplementing with formula.

I am not against breast-feeding; I am pro-breastfeeding, she said. Thats the one thing I dont appreciate is everyone saying I need to stop being anti-breastfeeding. I am not. Honestly, if I was anti-breastfeeding, my kid would probably be alive.

I had no idea he was starving, she added. Oh my God if Id known that, I would have given him a bottle.

Read more:

We had no hope: The amazing story of the baby born with his brain outside his skull

The incredible story of how a newborns cry may have helped save her mothers life

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She listened to her doctors and her baby died. Now she’s warning others about breast-feeding. – Washington Post

Doc: Pill’s hormone regulation benefits women with PCOS – The Detroit News

Keith Roach, To Your Health 5:40 p.m. ET March 2, 2017

Dear Dr. Roach: My daughter has just been diagnosed with polycystic ovary syndrome. She is in her mid-20s, exercises regularly and watches what she eats, but still puts on weight. She does not want to go on birth control. Where do we start? I know there is no cure.

B.M.

Dear B.M.: Polycystic ovary syndrome is very prevalent, affecting 6 to 8 percent of women, but it is variable in terms of both the types of symptoms and their severity. The most common symptoms are menstrual irregularities and consequences of high male hormones (such as excess body hair and acne). Being overweight or experiencing weight gain is important, as is the metabolic risk from diabetes and abnormal cholesterol levels. Lesser-known symptoms that are seen regularly in women with PCOS include depression, anxiety and eating disorders. The polycystic appearance of the ovaries themselves is demonstrated in women with PCOS, but also can be seen in normal women and therefore is not needed for diagnosis. Diagnosis is made after a careful history and physical exam, and by laboratory testing ( also necessary to exclude some other causes.)

Treatment of PCOS is intended to reduce symptoms, to reduce the risk of heart disease and diabetes, to manage fertility (including contraception, if needed, and helping women get pregnant, if desired) and to reduce risk of abnormal growth of the lining of the uterus (the endometrium) associated with abnormal hormone levels. The primary treatment is with lifestyle changes, so I agree with getting regular exercise and a prudent diet. If these are inadequate, it is reasonable to consider medication treatment.

For women with symptoms of high androgen (male hormone) levels, birth-control pills are the most prescribed treatment, and your daughters doctors should discuss your daughters concerns about taking them. They provide many benefits in women with PCOS, especially by reducing male hormone effects (acne, excess body hair) and reducing risk of abnormal endometrial growth (and possibly cancer). Of course, they have side effects, including risk of blood clots.

For women who cannot take birth control pills, metformin, which reduces insulin levels, has some benefits. It helps with weight gain and menstrual irregularities, and it probably reduces diabetes risk. It does not help with the body hair.

PCOS is a large topic that I cant cover fully. I recommend starting with the information on the American Congress of Obstetricians and Gynecologists FAQ page at tinyurl.com/z7we7er.

Dear Dr. Roach: My primary-care physician and gynecologist are recommending I take Fosamax. What is the alternative to taking Fosamax?

K.J.

Dear K.J.: If there are no other treatable causes, such as low vitamin D or high parathyroid hormone levels, then I think Fosamax or another bisphosphonate is a good choice. There are others, but Fosamax has been well-studied.

Email questions to ToYourGoodHealth@med.cornell.edu.

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Doc: Pill’s hormone regulation benefits women with PCOS – The Detroit News

USMLE Step 1: Postpartum amenorrhea and hormone levels – American Medical Association (blog)

If youre preparing for the United States Medical Licensing Examination (USMLE) Step 1 exam, you might want to know which questions are most often missed by test takers. Check out this example from Kaplan Medical, and view an expert video explanation of the answer. Also check out all posts in this series.

A 32-year-old woman comes to the physician because of amenorrhea for the past 15 months after delivering a baby. She says that she has also had fatigue, facial swelling, cold intolerance and has gained an additional 4.5 kg (10 pounds) since her baby was born. A review of her records shows that the delivery was complicated by severe hemorrhage. Laboratory studies of serum show:

Injection of 500 g of thyrotropin-releasing hormone fails to produce an increase in either serum TSH or prolactin. Assay of other hormones is most likely to show normal levels of which of the following hormones?

A. Aldosterone

B. Cortisol

C. Follicle-stimulating hormone (FSH)

D. Gonadotropin-releasing hormone (GnRH)

E. Growth hormone

The correct answer is A.

Sheehan syndrome is hypopituitarism caused by ischemic damage to the pituitary resulting from excessive hemorrhage during parturition. The pituitary is enlarged during pregnancy; it is more metabolically active and more susceptible to hypoxemia. The blood vessels in the pituitary may be more susceptible to vasospasm because of high estrogen levels.

In about 30 percent of women who have excessive hemorrhage during parturition, some degree of hypopituitarism eventually manifests. The symptoms depend on how much of the pituitary is damaged and what cell types are destroyed. Although some pituitary hormones may be unaffected even in severe hypopituitarism, pituitary hormones and the hormones controlled by them are more likely to be reduced than hormones that are not primarily controlled by anterior pituitary function.

Our patient has amenorrhea (decreased LH) and symptoms of hypothryoidism (decreased TSH). Aldosterone secretion is relatively independent of adrenocorticotropic hormone (ACTH); it is controlled mainly by angiotensin II and plasma potassium concentration. Aldosterone is least likely to be reduced by hypopituitarism. Treatment is replacement of thyroid hormone and cortisol.

Read these explanations to understand the important rationale for why each answer is incorrect.

Choice B: Cortisol is controlled by pituitary production of ACTH; because ACTH is often impaired in Sheehan syndrome, reduced secretion of cortisol is likely.

Choice C: The pituitary necrosis that is the root cause of Sheehan syndrome is highly likely to reduce secretion of FSH. The observation of reduced estradiol in this patient strongly suggests that FSH is low because estradiol increases as follicular development occurs.

Choice D: The presence of the depressed levels of estradiol and LH in this patient releases hypothalamic secretion of GnRH from its normal feedback control. GnRH levels are likely to increase above normal.

Choice E: Growth hormone is very likely to be reduced by the pituitary necrosis.

For more prep questions on USMLE Steps 1 and 2, view other posts in this series.

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USMLE Step 1: Postpartum amenorrhea and hormone levels – American Medical Association (blog)

Obesity May Raise Girls’ Risk of Asthma, Allergies – WebMD

By Alan Mozes

HealthDay Reporter

MONDAY, March 6, 2017 (HealthDay News) — Obese girls may face a significantly higher risk for developing allergies, a new study suggests.

But the researchers found the opposite was true for obese boys: They may actually face a slightly diminished risk for asthma, food allergies and eczema when compared to normal-weight boys.

“We found a direct increase in the number of atopic [allergic] diseases associated with obesity in urban female children and teenagers, but not in males,” said study co-author Dr. Sairaman Nagarajan. He’s a resident physician in the department of pediatrics at SUNY Downstate Medical Center in New York City.

“These results were highly significant, even after adjusting for the effects of age and race,” he said.

Nagarajan and his colleagues were scheduled to present their findings Monday at the annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI), in Atlanta.

Their investigation focused on 113 children (45 percent girls, 55 percent boys), about a quarter of whom were obese.

All the children lived in Brooklyn, N.Y., and were on average between the ages of 8 and 9. Allergies aside, all were deemed to be relatively healthy.

Medical histories were taken to assess for a range of allergic conditions, including asthma, food allergies, hay fever and/or eczema. The children were then given allergy scores, with those struggling with more allergic conditions getting higher scores.

The researchers found that obese girls had allergy scores higher than normal-weight girls: 4 vs. 2.6.

In contrast, obese boys were found to have slightly lower allergy scores than normal-weight boys: 3 vs. 3.4.

The upshot, said Nagarajan, is the possibility “that lifestyle modification therapies and exercise and diet programs may be specifically beneficial to urban obese girls.”

But why?

“We hypothesize that there are hormonal differences causing girls to have higher atopy [allergies],” said Nagarajan.

For example, he pointed to the possibility that higher adrenal sex hormone levels found among girls may predispose them to a higher risk for both becoming obese and also for having a stronger overall inflammatory response.

This, Nagarajan said, may “[cause] them to react to things non-obese females wouldn’t have.”

Still, the study wasn’t designed to prove that obesity caused the allergies, and the research team acknowledged that more study is needed.

That point was echoed by Dr. James Baker Jr., CEO and chief medical officer Food Allergy Research & Education (FARE), an allergy information organization.

“These appear to be preliminary findings,” Baker said, “and really need to be validated in a larger, prospective study to understand their significance.”

Dr. Jay Lieberman, an assistant professor of pediatrics with the University of Tennessee Health Science Center, and LeBonheur Children’s Hospital in Memphis, agreed.

“Overall, I am not too surprised by these findings,” he said, adding that many studies have suggested “that the obesity effect on allergic diseases may be more pronounced in females rather than males.”

“There are many theories as to why,” Lieberman added. “The main theory is the role that hormones — estrogen, estradiol, progesterone, etcetera — may play [a role] in driving allergies, and that hormonal levels may be imbalanced in obese patients. And, thus, females with obesity are more prone to allergies than obese males, who do not produce these hormones at levels that females do.”

Still, Lieberman cautioned that “one must take into account that this was a retrospective study on a relatively small sample of children.” Thus, the results must be taken with a grain of salt, meaning the findings could very well be due to chance, he said.

Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

WebMD News from HealthDay

SOURCES: Sairaman Nagarajan, M.D., MPH, resident physician, department of pediatrics, SUNY Downstate Medical Center, New York City; Jay Lieberman, M.D., assistant professor, pediatrics, University of Tennessee Health Science Center and LeBonheur Children’s Hospital, Memphis; James Baker Jr., M.D., CEO and chief medical officer, Food Allergy Research & Education; March 6, 2017, presentation, American Academy of Allergy, Asthma & Immunology meeting, Atlanta

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Obesity May Raise Girls’ Risk of Asthma, Allergies – WebMD

Area doctor to launch book on women’s health during menopause – Southgate News Herald

For decades, doctors have assumed that symptoms of menopause, such as hot flashes, sweating and reduced sex drive, are caused by a reduction in the amount of estrogen that the body is producing. Dr. Charles Mok, a former emergency room physician who is board certified in Anti-Aging Medicine and the founder of Allure Medical Spa and Allure Vein Center of Southgate, has evidence that doctors have focused too much on estrogen for menopause and science has found low testosterone levels are also responsible for many symptoms. In his new book Testosterone: Strong Enough for a Man, Made for a Woman (Forbes Hardcover $25.99, ISBN 978-0998365503), Dr. Mok provides peer-reviewed studies which support this view, translating scientific literature into an easy to understand manual for hormone replacement therapy. The book launch is scheduled for March 2 at a Macomb County Allure Medical Spa location.

The evidence for testosterone therapy is overwhelming, and we want to get the message to doctors and, importantly, to their patients, says Dr. Mok. Clinical research shows that testosterone reduces the risk of breast cancer by 50 to 75 percent, which has enormous health implications, and natural estrogen cuts the risk of heart attacks by over 70 percent if used long term. For women suffering from debilitating symptoms such as mood swings, anxiety, hot flashes and reduced libido, the treatment can really improve overall quality of life.

Dr. Moks book takes readers on a journey that chronicles the start of hormone replacement therapy in the 1940s through to the flawed 2002 Womens Health Initiative which suggested women taking a combination of synthetic estrogen drugs and synthetic progesterone had an increased risk of heart disease and breast cancer, which ultimately dissuaded millions of women from seeking hormonal help. It is important to note that further research into the Womens Health Initiative data showed that when women took even the synthetic hormones around the time of menopause and stayed on them, there was a 40 percent reduction in their risk heart attacks and premature mortality.

Dr. Moks book provides compelling evidence about the important role of testosterone in shaping womens health. The hormone is 10-20 times more abundant than estrogen in young women, but then falls as women age. Dr. Mok provides myriad long term studies showing that modern testosterone therapy (normally delivered in the form of a tiny pellet, about the size of a grain of rice, inserted underneath the skin) keeps women healthier, with no adverse side-effects.

Benefits can include weight loss, better sex life, improved mood, fewer sleep problems, reduced hot flashes and night sweats, thicker hair, lower risk of breast cancer and lower risk of heart disease.

Dr. Mok became interested in preventive medicine while working as an emergency room doctor, recognizing that many of his patients conditions could have been avoided. His medical career has now taken him on a path to help patients live their best lives, and for many this approach has been life-changing.

Dr. Mok will launch his book with a lecture, followed by a party, at 6 p.m. March 2 at Allure Medical Spa, 8180 26 Mile Road, Shelby Township.

The event is free to the public and all attendees will receive a copy of the book. RSVP by calling 586-992-8300 or emailing info@alluremedicalspa.com.

Source: CKC Agency

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Area doctor to launch book on women’s health during menopause – Southgate News Herald

Is testosterone-replacement therapy good or bad? One man suffering from low levels searches for answers. – Men’s Fitness


Men’s Fitness
Is testosterone-replacement therapy good or bad? One man suffering from low levels searches for answers.
Men’s Fitness
But, leading experts agree, first you need to visit a urologist or an endocrinologistspecialists more adept at diagnosing and treating hormone deficiencies than the average family doctor or low-T clinicto have your blood-testosterone level checked.

and more »

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Is testosterone-replacement therapy good or bad? One man suffering from low levels searches for answers. – Men’s Fitness

Introducing Bio-Identical Hormone Replacement Therapy at Young Medical Spa in Center Valley and Lansdale … – PR Web (press release)

Montgomery County and the Lehigh Valley, PA (PRWEB) February 28, 2017

Dr. Thomas E. Young, Owner and Medical Director of Young Medical Spa, is excited to announce the addition of a new service: Bio-Identical Hormone Replacement Therapy for restoring hormonal balance and improving overall health and vitality.

Suitable for both men and women, Bio-Identical Hormone Replacement Therapy may help correct hormonal imbalances that can result from aging, relieving such symptoms as depression, fatigue, migraines, low libido, urinary incontinence, lack of mental clarity, trouble sleeping, and more.

A customizable treatment that is tailored to each patients exact needs, Bio-Identical Hormone Replacement Therapy at Young Medical Spa involves inserting tiny pellets beneath the skin that gradually release a steady stream of natural hormones over time. Patients can receive therapy for low testosterone, estrogen, or a combination of both hormones, as needed.

In concert with Bio-Identical Hormone Replacement Therapy, Young Medical Spa clients have access to a complete line of nutraceuticals that promote thyroid, heart, liver, and brain health. The combination of nutraceuticals and Bio-Identical Hormone Replacement Therapy provides a natural approach for long-lasting results without the potential negative side effects of prescription medications and traditional synthetic hormone replacement therapy methods.

Young Medical Spa offers Bio-Identical Hormone Replacement Therapy at both of its locations in Lansdale and Center Valley, convenient to patients in the greater Philadelphia and Lehigh Valley areas. Please visit youngmedicalspa.com to learn more about these treatments at Young Medical Spa. Center Valley patients can also call 610-816-0077; Lansdale residents can learn more about this new service by calling 215-660-4121.

About Young Medical Spa in Center Valley and Lansdale Pennsylvania

Dr. Thomas E. Young founded Young Medical Spa with the mission to provide the highest quality aesthetic treatments and services within the comfort of a relaxing, spa-like environment. At Young Medical Spa in the Lehigh Valley region, all patients are treated under the supervision of medical aesthetic experts to ensure that results match the teams passion for aesthetic medicine.

Dr. Young is a leader within the medical aesthetic industry, and shares his expertise by training other physicians with his advanced techniques and wealth of experience. At Young Medical Spa, Dr. Young works diligently to ensure that each patient is able to achieve their desired results within a state-of-the-art location and in the company of a friendly and welcoming staff.

Services offered include Bio-identical hormone replacement therapy (BHRT), hand rejuvenation, intimate rejuvenation with ThermiVa, P-Shot, and O-Shot. Patients can undergo facelifts, neck lifts, eyelid surgery, thread lifts, Kybella, and PrecisionTX for facial contouring. Body sculpting and shaping treatments include SmartLipo Triplex, CoolSculpting, SculpSure, Brazilian butt lift, natural breast augmentation, cellulite reduction, and the Young Diet Program. Botox, Dysport, and dermal fillers (Juvderm, Restylane, Radiesse, Belotero Balance, and Voluma are administered with clinical and aesthetic expertise. Young Medical Spa is a Brilliant Distinctions participant and a Cynosure Center of Excellence. Additional services include Laser Hair Removal and skin rejuvenation (IPL photofacials, microneedling, skin tightening, laser skin resurfacing, stretch marks & scar revision, laser leg vein therapy, chemical peels, microdermabrasion, and clinical facials. Clients can also purchase from a suite of professional medical-grade skin care products.

Young Medical Spa has two locations serving the Lehigh Valley and greater Philadelphia areas. Their Center Valley medical spa is convenient to Allentown, Bethlehem, and Easton. The Lansdale medical spa is located in Montgomery County outside of Philadelphia, serving King of Prussia and Lower Bucks County. Every patient is given the time and attention necessary to develop a unique treatment plan and foster a valuable relationship with the staff. Young Medical Spa is dedicated to patient care and comfort, maximizing results while ensuring the utmost safety.

Young Medical Spa is conveniently located at 4025 West Hopewell Road in Center Valley, PA, and at 635 North Broad Street, Lansdale, PA.

About Dr. Thomas Young Thomas E. Young, M.D. is the owner and medical director of Young Medical Spa located in the Lehigh Valley and Lansdale, PA. Double board-certified by the American Board of Internal Medicine, he is a native of the Lehigh Valley, and has been practicing medicine in the Lehigh Valley and surrounding areas since completing his residency at the Harrisburg Hospital. He is double-board certified by the American Board of Internal Medicine in Internal Medicine and Geriatrics.

Dr. Young is an experienced cosmetic injector and specializes in multiple awake tumescent procedures and techniques, and began performing SmartLipo Laser Body Sculpting soon after approval by the FDA. Dr. Young has performed well over 6,000 procedures to date, identifying him as the most experienced awake tumescent liposuction physician in the region.

Dr. Young is consistently the first physician to introduce many advanced aesthetic procedures and technologies to the region including awake tumescent laser liposuction, natural breast augmentation, Brazilian butt lift, Cellulaze cellulite reduction, CoolSculpting, SculpSure and stem cell procedures. He also trains other physicians across the country in awake tumescent liposuction & liposculpture procedures.

Dr. Young received an International Award in the category of Best Overall Body Make-Over (a combination of procedures) at the inaugural THE Aesthetic Awards at THE Aesthetic Show in Las Vegas, NV. He also has been voted Leading Aesthetic Physician Botox, Laser & Cosmetic Enhancements in the 2011, 2012, 2013, 2014, 2015, and 2017 Whos Who in Business for the Lehigh Valley, and was twice voted Best Aesthetic Physician by Lehigh Valley Magazines Best of the Valley Readers Poll. Additionally, Young Medical Spa was voted Best Medical Spa in The Morning Calls Readers Choice Awards in 2011, 2012, 2013, 2014 and 2015.

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Introducing Bio-Identical Hormone Replacement Therapy at Young Medical Spa in Center Valley and Lansdale … – PR Web (press release)

Perth doctor Amish Dwarka Singh guilty over weight loss, bodybuilding prescriptions – ABC Online

Updated February 23, 2017 15:53:59

A Perth doctor with 25 years’ experience has been found guilty of professional misconduct for prescribing large amounts of steroids and other drugs to patients for weight loss and bodybuilding.

Amish Dwarka Singh was found by the State Administrative Tribunal (SAT) to have “acted carelessly, incompetently and improperly” for prescribing the drugs for “no proper therapeutic reason” between 2008 and 2014.

Singh also ordered iron and fresh frozen plasma infusions for patients when they were not necessary for any treatment.

He also was found to have “engaged in a general practice of prescribing Human Growth Hormone”.

The SAT found that in some cases, there were adverse effects from the drugs one male patient who was prescribed steroids over two years required surgery to remove enlarged breast tissue.

In the case of another patient, Singh prescribed steroids after diagnosing them with “body dysmorphia with an overlap of binge eating disorder”, but the tribunal found that “was simply a cover” to prescribe drugs for bodybuilding.

He also was found to have acted unprofessionally towards another doctor, who treated one of his supposed bodybuilding patients in hospital after they had suffered a seizure, believed to be related to drug withdrawal.

Singh was found to have kept “inadequate” medical records, but he told the hearing he did not take notes on some of his patients because they were high-profile people and they did not want him to.

Singh denied the allegations against him, but the SAT found much of his evidence to be “deliberately untrue”.

“The ultimate findings of this tribunal reflect a tragic fall from grace of a very well educated and experienced physician,” it said.

Singh’s penalty is yet to be determined.

Topics: courts-and-trials, doctors-and-medical-professionals, perth-6000, wa

First posted February 23, 2017 15:16:57

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Perth doctor Amish Dwarka Singh guilty over weight loss, bodybuilding prescriptions – ABC Online

Major study finds testosterone therapy is no fountain of youth – Philly.com

Testosterone supplements have grown into a $2 billion market, with millions of men of a certain age taking it for low energy, low libido, low mood what marketers call “low T” even though that’s not an approved use.

Now, the first study to rigorously test whether the quintessential male hormone can fight the toll of aging shows it isn’t much of a youth elixir.

A year of testosterone treatment was no better than a placebo for memory and thinking, and it increased fatty plaque in coronary arteries, a risk factor for heart disease. The hormone helped anemia and low bone density in the minority of men with those conditions, which can be treated with other, proven therapies.

The results, published Tuesday in the Journal of the American Medical Association and JAMA Internal Medicine, add to findings from a year ago: Testosterone did not improve fatigue or walking speed, and its modest benefits on sexual function faded by the end of the study.

“The hopes for testosterone-led rejuvenation for older men are dimmed and disappointed if not yet finally dashed,” University of Sydney professor of medicine David J. Handelsman concluded in an editorial accompanying the latest results.

University of Pennsylvania endocrinologist Peter Snyder, who led the complicated, government-funded clinical trials involving 788 senior men at 12 medical centers, disagreed.

“It shows for the first time that treatment of older men with low testosterone has certain benefits, including bone density and anemia,” Snyder said. “I would say the effects on bone and anemia were striking.”

He added a caveat. Even though the $50 million “T Trials” are the most conclusive studies ever done on the hormone, researchers didn’t follow enough men long enough to tell whether testosterone increases risks such as heart attacks, stroke, or prostate cancer.

AbbVie, which donated its leading brand, Androgel, to the trials, said in a statement that the company is “committed to our patients and is proud of our continuous support of research that advances science for the benefit of hypogonadism patients.”

Actually, hypogonadism occurs when the body doesn’t produce enough of the hormone due to disease, injury, or chemotherapy.It’s the condition for which testosterone-replacement therapy is approved.

Prescribing testosterone for age-related deficiency which is only vaguely defined took off in 2000. The trend was driven not by solid scientific evidence, but by the introduction of convenient, rub-on testosterone products, the first being Androgel. Many men are put on testosterone with no tests of their levels or despite tests showing normal levels, a study of Medicare claims found.

Two years ago, the U.S. Food and Drug Administration cracked down on this overprescribing. It ordered drugmakers to revise product labeling to stress the approved use, and to warn that the drug may increase the risk of heart attacks and stroke. Another order that manufacturers conduct a clinical trial to clarify the heart risks is “under discussion,” the FDA said Friday.

Concerns about testosterone use also led the National Institute on Aging to fund the T Trials, which began enrolling men over age 64 in 2009.

T Trials researchers had to screen more than 50,000 men to find 788 with confirmed abnormally low testosterone levels along with one or more age-related symptom that the hormone might help. More than 60 percent of the men were also obese, a condition that can depress testosterone levels.

Now, with a clearer scorecard on benefits, Snyder would like to see the government fund a study to tease out the risks an effort that would take 5,000 men, five years of treatment, and $500 million.

Other experts see no point in defining the downsides of a therapy with weak upsides.

“The improvements in outcomes in the T Trials were minimal,” said Deborah Grady, a professor of medicine at the University of California, San Francisco, and an editor of JAMA Internal Medicine.

Grady was a leader of the Women’s Health Initiative, the mammoth government study that in 2002 shattered the deeply held belief that menopausal hormone therapy protected women’s hearts. The National Institutes of Health agreed to fund the initiative because estrogen, unlike testosterone, had decades of circumstantial evidence of cardiac benefits.

Testosterone’s cardiac effects are still unsettled. Some studies that mine medical records including one in Tuesday’s JAMA Internal Medicine have found men taking it have fewer heart problems.

The T Trials’ anemia findings add to the complexity.

Testosterone is known to increase production of red blood cells, which carry hemoglobin, a protein that ferries oxygen. In 126 men with mild anemia a deficiency of red blood cells or hemoglobin that can cause fatigue testosterone was better than a placebo at boosting hemoglobin. The hormone corrected anemia that had no apparent cause, as well as anemia caused by iron deficiency or inflammation.

However, in six men, the hormone triggered an oversupply of red blood cells. Testosterone labeling warns about this because the blood can become too thick, a risk for dangerous blood clots or stroke.

Like all participants in the trials, the six men were closely monitored, so the problem was detected, their testosterone dose was reduced, and their red blood cell counts returned to normal, Snyder said.

“The results illustrate that decisions about testosterone treatment need to be individualized,” said Evan Hadley , director of the National Institute on Aging’s geriatrics division.

Physician Michael Carome, director of health research at the consumer advocacy organization Public Citizen, drew a different bottom line: “This body of research indicates that testosterone is not the fountain of youth that some patients, doctors, and industry have hoped, or represented it as being.”

Published: February 21, 2017 11:03 AM EST The Philadelphia Inquirer

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Major study finds testosterone therapy is no fountain of youth – Philly.com

Family pushes bill expanding medical training in schools – WBIR.com

Currently only a school nurse can administer a shot to a student in the condition, but a bill in the state legislature would allow other school employees to be trained so they could also intervene.

Grant Robinson , WBIR 11:57 PM. EST February 19, 2017

KNOXVILLE – On Wednesday a couple from Knoxville will address the senate education committee in support of a bill that would expand access for training and administering a life-saving drug.

Adrenal insufficiency is a condition where a body doesn’t produce cortisol – a hormone essential for managing stressors.

People with the disease may go into adrenal crisis, a medical state marked by severe pain, low blood pressure and loss of consciousness that if untreated can lead to death.

Adrenal crisis can be treated, but under the current state law school nurses are the only employees at schools who can administer the shot.

Senate Bill 117 amends that law by allowing other school employees to be trained to administer the injection.

Landon Adzima is a junior at Gibbs High School and lives with adrenal insufficiency. During last year’s wresting state tournment, Landon suffered an adrenal crisis.

“There’s nothing I could really compare it to,” Adzima said. “It just felt like my body was shutting down and that I was helpless and there was nothing I could do about it.’

Adzima’s parents were in attendance and were able to administer the drug. They worry that if a student is at school and the nurse is off campus, an adrenal crisis could cause lasting damage.

“We think it’s important that school employees could be properly trained to give this injection in the absence of a school nurse,” Andy Adzima said. “They’re always the nearest person to the student in an emergency that might happen at the school and the time they might have to wait for someone who’s legally allowed to give this injection could make a huge difference.”

The bill would only require schools to train personnel if a parent or guardian notified the school that a student is diagnosed with adrenal insufficiency.

The bill is sponsored by Senator Richard Briggs (R – Knoxville), who is also a physician.

( 2017 WBIR)

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Family pushes bill expanding medical training in schools – WBIR.com

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