Archive for the ‘Hormone Physician’ Category

As physicians who collectively care for thousands of transgender children, adolescents and adults in Philadelphia, we are deeply troubled by the presidents new policy that bans transgender Americans from joining the military and immediately stops gender-affirming medical care for those in active duty.

The reasoning for such a policy outlined earlier by the president that the military cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail is not supported by scientific evidence or by our experiences with transgender patients.

This reasoning implies that care to support transgender individuals medical transition is necessarily invasive and expensive. In fact, for our patients, the most common interventions include supporting social transition and prescribing hormones, like estrogen or testosterone, which cost less than $50 per month.

Despite higher costs for procedures like gender reassignment surgery, which only a minority of transgender individuals undergo, a report by the RAND corporation and a recent study published in the New England Journal of Medicine confirm that the overall cost to the military to care for transgender soldiers would be negligible.

Actually, most gender-affirming treatment for transgender individuals will in the end save the health care system money. A report by PolicyLab at Childrens Hospital of Philadelphia (CHOP) details how treatments like puberty blockers and mental health support services for transgender children and adolescents can actually prevent the need for some expensive procedures later in life.

These treatments also lead to better health outcomes as adults by shielding patients from the high costs of mental health conditions or substance abuse that might result from untreated gender dysphoria. Further restricting such treatments as the ban proposes could have unintended consequences.

As stated in our recent qualitative studies published in Journal of Adolescent Health and Transgender Health, we found that many young transgender women described lack of access to gender-affirming hormone therapy as a barrier to receiving other essential preventive and cost-saving care, such as mental health support or HIV Pre-exposure Prophylaxis,a daily pill to prevent HIV infection.

Transgender women are at nearly 50 times the risk for HIV infection compared to the average person.

Beyond this flawed over estimation of health care costs, and underestimation of potential savings, any message of you are not welcome here can cause major harm to the mental and physical well-being of transgender individuals, which make up one percent of the U.S. population. Transgender people have high rates of depression and anxiety, and as many of 40 percent have attempted suicide. These and other physical health problems are not due to their identity, but rather a result of shame, stigma and isolation when ones identity is not affirmed.

When caring for transgender children and adolescents, we talk to them about what they want to be when they grow up. They have the same hopes and dreams as other kids.

Take, for example, one 18-year-old patient who during his first visit to the CHOP Gender and Sexuality Development Clinic disclosed that despite being born assigned female sex at birth, he knew he was a boy since age four. At that young age, he had begun walking around with his shirt off because he felt he was a boy like his dad and couldnt understand why he was being told to put it back on. He also said that he has always wanted to serve our country in the military, just like his father.

But, we cant only be concerned for those who have hopes of serving their country; if enacted, this directive could have particularly grave consequences for the thousands of transgender individuals already serving in the military.

The current U.S. Department of Defense policy states that transgender individuals can serve openly and cannot be discharged solely on the basis of being transgender.

This policy helped a patient, who we are calling Sarah, at Philadelphias Mazzoni Center transition socially and medically while continuing to serve in the military. She was able to start hormones safely under medical supervision, and she had the full support of her fellow service members and her commanding officer. Without this policy, Sarah would have been forced to decide between her duty to her country and hiding her true self.

The policy also allowed a patient, here referred to as Michelle, at the University of Pennsylvania Health System begin to affirm her female gender via hormone therapy while actively serving her country. Michelle was able to seek civilian medical care for gender affirmation in collaboration with her base physicians and supervising officers. Though she enlisted as male, Michelle said that the reception to her transgender identity on the base was overwhelmingly positive, especially among her peers. She considers her status as a member of the U.S. military as integral to her identity as her gender, and has always hoped it would be her lifelong career.

Clearly this policy does not align with the real stories that we, as physicians, confront every day when we talk to patients for whom this is a deeply personal matter. Even if you disregard stories like our patients, there is no evidence to support the idea that allowing transgender individuals to serve in our military would burden us with medical costs, and there could be major negative effects to health and well-being of those currently serving if gender-affirming medical care is restricted. Our patients, and any transgender individuals, who wish to bravely serve their country should continue to be able to do so.

Nadia Dowshen, MD, MSHP is a pediatrician and adolescent medicine specialist who is co-founder of the Childrens Hospital of Philadelphia Gender (CHOP) and Sexuality Development Clinic, a faculty member at PolicyLab at CHOP and assistant professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

Allison Myers, MD, MPH is a family medicine physician and clinical assistant professor of family medicine and community health at the University of Pennsylvania where she specializes in the care of LGBTQ patients.

Lin-Fan Wang, MD, MPH is a family medicine physician at Mazzoni Center Family & Community Medicine, which provides comprehensive health care with a primary focus on the needs of lesbian, gay, bisexual, and transgender individuals.

The views expressed by contributors are their own and are not the views of The Hill.

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Military ban will risk the health and well-being of transgender Americans - The Hill (blog)

What Makes Ehormones Different?

Each person is biologically unique, therefore, EHormones s Physicians design a comprehensive Hormone Replacement Therapy (or HRT) protocol to match each persons individual needs. At EHormones, individuals undergo comprehensive lab work as well as a physical examination. Additionally, each individual receives a thorough consultation with his or her physician to discuss and interpret the comprehensive lab results. Thereafter, every EHormones managed physician will use your medical history, symptoms, and labs to develop an individualized and comprehensive Hormone Replacement Therapy protocol.

Testosterone Replacement Therapy (or TRT) is typically administered in the form of once weekly Testosterone injections. There may be ancillary medications which allow the testes to continue its natural production of testosterone while on therapy, and an Aromatase Inhibitor, an estrogen suppressing pill typically taken once to several times weekly.

HGH Therapy prescribed by an EHormones managed physician is also administered by injection, typically in the form of Sermorelin and/or Growth Hormone Releasing Peptides.

Female Bio-identical Hormone Replacement Therapy is generally administered in the form of transdermal creams, typically applied daily to the skin.

We offer comprehensive Hormone Programs for nearly all budgets.

Our affiliates have offices in many US cities and we continue to grow. Getting started is as easy as setting you up for lab work.

With 100% confidentiality, our doctors and staff are available by phone for any questions you may have while you are under our care.

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EHormonesMD Hormone Doctors - Ehormones

When an experiment turns into a tradition in Laughlin, it means there was a show worth taking a chance on at one timethen consistently that same show proved itself time after time to be one audiences didnt want to miss. The Memorial Day Comedy Festival at the Riverside Resort was that show. Experiencing comedy served up as a variety show with veteran comedian Gabe Lopez as the shows producer, performer and emcee was like discovering a hidden gem on the entertainment landscapemore along the lines of one of those underground clubs in Vegas, known only to a lucky few. But now the word is out and the Comedy Festival is coming back to the Riverside Resort over the Labor Day weekend this time.

If you are a local, or a regular visitor to Laughlinespecially if your visits are on holiday weekendsyou are aware that the Avi Resort & Casino doesnt simply wait for the Fourth of July to set off a major fireworks display. Nope. Beginning in 1996, and continuing every year since, they have been filling the skies above the Colorado River with the amped-up creations of Zambelli Internationale Fireworks on Memorial Day weekend, the Fourth of July and Labor Day weekend.

The Colorado Belle is home to a multitude of outdoor festivals that embrace particular themes and for the Labor Day Riverwalk Festival, its a celebration of the end of summer and the cooler temperatures just starting to take hold of the Colorado River regionthink of it as one big neighborhood block party.

Theres a lot to be said for being in the right place at the right time, but could Air Supplys long-time success be the result or a chance meeting or was the cosmos working overtime on a little something called destiny? Maybe, but one thing is for surenone of it would have been possible at all without their hard work and tenacity to make it happen.The two Russells, Graham Russell and Russell Hitchcock, happened to be cast in the same Sydney, Australian production of Jesus Christ Superstar in 1975, and everything changed after that.

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Husband on clomid for low sperm count - The doctors who pioneered the ivf procedure in australia - Laughlin Entertainer

Theres a lot to be said for being in the right place at the right time, but could Air Supplys long-time success be the result or a chance meeting or was the cosmos working overtime on a little something called destiny? Maybe, but one thing is for surenone of it would have been possible at all without their hard work and tenacity to make it happen.The two Russells, Graham Russell and Russell Hitchcock, happened to be cast in the same Sydney, Australian production of Jesus Christ Superstar in 1975, and everything changed after that.

Many an audience member has probably asked himself if a fine looking group of ladies about to take the stage could possibly do justice to one of the most popular rock bands in the world. Its a legitimate question considering its not easy music to play, so a person cant help but wonder if the music will be taken as seriously as the people in the audience do. However, once the guitars are plugged in and the girls dig into those first few chords, the obvious answer to that question is, oh, hell, yes.

Many a cook tries their hand at duplicating foods they love in restaurants and specialty shops, telling themselves, it cant be that difficult. Often times, theyre right. It can be doneand its pretty simple. However, sometimes, its not as easy as it looks.Mexican food for example looks easy because ingredients are simple, sauces are often slow-cooked and meat is marinated, making this comfort food one of Americas favorite. Recipes are often handed down and each time theyre prepared, a spice might be tweaked or flavor added, depending on taste and preference.

Its been 40 years since Elvis Presley died (August 16, 1977) and millions of people still have the date circled in red on their calendars. People still remember and they still mourn. Some internet sites have gone to the extent of estimating what he would look like now, if he were still here in the physical.This time of year Memphis fills up with more people than usual as crowds in large numbers make their pilgrimages to Graceland for visits to his home while tribute shows pop up all around the country to remember the huge icon that he was.

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Brand cialis - Difference generic brand cialis - Laughlin Entertainer

Ten years ago, a young woman came to Dr. Cynthia Li, seeking treatment for fungal overgrowth causing chronic fatigue and digestive disorders. Drawing on years of internal medicine training, Li dismissed the patients self-diagnosis. I thought it was probably some quackery she found on the internet, she recalled. Little did Li realize that she, too, would soon turn to alternative solutions for her own mysterious medical condition, in a development that would change her approach to life and to medicine.

(Photo courtesy of Cynthia Li)

Up until her thirties, Li was living every well-intentioned doctors dream. She worked at the San Francisco General Hospital and taught UCSF medical residents, volunteered with Doctors Without Borders at an HIV/AIDS clinic in rural China, lived in a classic Victorian-style house in San Francisco, exercised regularly and ate a mostly vegetarian, organic low-fat diet.

Not until the spring of 2007 as she was being rushed to the hospital, heart rate over 200, delirious and slipping out of consciousness, did she realize she was spiraling into an inexplicable chronic health crisis.

Li had experienced severe fatigue and dizziness after her first pregnancy, but brushed it off because she felt well enough. This time in 2007, while visiting her family in Beijing, she experienced the perfect storm pollution exposure, stomach flu, unusual foods and a second pregnancy left her bedbound for six months after the emergency room visit and another two years housebound. Having endured 36-hour shifts, Li was no stranger to fatigue, but what she felt now was a completely different animal. I couldnt move my muscles and didnt feel like I had the energy to draw my next breath, she said.

Her primary care doctor, endocrinologist and psychiatrist shuffled her around in a referral merry-go-round. Screening tests including the thyroid-stimulating hormone, TSH, were normal. No sign of depression or mental health disorders. She had become one of the invalids those with a medical case that went unrecognized and deemed incurable.

Growing up, Li was not one to deviate much from the norm. Her parents emigrated from Taiwan and held a high regard for authority. She lived her life by the book went to church on Sundays and always turned in her schoolwork on time. In her third year of medical school, she shoved a nasogastric tube down the nose of an unwilling patient because a resident told her to. She attributed repeated instances like this to unknowingly stifling her curiosity and will to question what happens in medicine and why.

It came as a shock, then, when she violated medical norm and became the difficult patient. Desperate but still skeptical of alternative treatments, she began with acupuncture, and then slowly integrated other paradigms like environmental health (how pollutants and chemicals disrupt hormone function) and ancestral health (how an evolutionary perspective helps define diet and lifestyle) into her personal healing routine.

She understood diets had to be personalized there is no one-size-fits-all perfect diet and ditched vegetarianism for more nutrient-dense foods like bone broth soup, learned to rewire her brain and dampen inflammatory stress responses through a technique called neural retraining, took up Qigong practice, and supplemented with things ranging from amino acids like L-glutamine for repairing the gut lining to vitamin B-complex with active folate and B12 for healthy detoxification support.

Li, 46, eventually diagnosed and slowly healed herself from autoimmune thyroiditis, multiple food sensitivities and chronic fatigue syndrome. Her personal health journey profoundly changed the way she now practices medicine. In 2012, she opened her own practice in Berkeley, based on an approach known as functional medicine, which seeks to find root causes and mechanisms for chronic disease instead of ruling out and reducing problems.

Cynthia Li (Photo courtesy of Cynthia Li)

Matthew Sades son was one patient who walked through Lis door last year. When the 8-year-old boys eyebrows and eyelashes began to fall out, their pediatric dermatologist diagnosed him with alopecia areata, an autoimmune disease that causes excessive hair loss. Treatment included monthly injections of steroids in his scalp and daily topical creams. It was labor intensive and after three to four months of very minimal progress, Sade decided to take his son to see Li.

Li ordered a battery of stool, urine and blood tests and found that his sons gut flora the microorganisms that resided in his gut was out of balance. She prescribed a cocktail of probiotics and prebiotics to restore the dysbiosis, and vitamins and minerals to support his immune function. In addition, his celiac panel testing for gluten sensitivity turned up positive, and Li provided articles citing an increased incidence of alopecia in celiac patients. Sades son remains gluten-free today.

Sade, CEO of natural food company Kite Hill, admits that conclusions can never be definitive, but says that for his son, the results were significant. Four weeks into the new regimen and boom, it was just like night and day. His hair grew back like it had never happened, Sade said.

Hes a big believer in Lis work and has referred a half a dozen people to her this past year whom he felt, much like his son, were not getting the answers and relief they needed from their conventional Western medicine practitioners.

Not everyone is enamored by Lis less-than-standard method of care. When Sade shared the good news of his son with a physician at UCSF Benioff Childrens Hospital Oakland, she replied that this was a new body of medicine with insufficient research to speak to it.

It was a little bit disappointing because it felt there was this undertone of adversity to the possibility that there are other practices that could be yielding different and potentially better outcomes, Sade said.

Cynthia Li traveling with her husband in South Africa, while still in her prime. Her life would soon change as her health took a turn for the worst. (Photo courtesy of Cynthia Li)

Christopher Gardner, professor of medicine and director of nutrition studies at the Stanford Prevention Research Center, said what functional medicine practitioners do is plausible and makes sense and may work well for some. (EDITORS NOTE: Peninsula Press is a project of the Stanford Journalism Program and not affiliated with Stanford Medicine.) However, his impression is that they believe in a lot of non-standard diagnostic tests, many of which are related to the gastrointestinal tract and system, which have limited scientific evidence to either support or refute their claims.

More outspoken critics include Wallace Sampson, the late oncologist and emeritus professor of clinical medicine at Stanford University, who wrote that functional medicine is nothing more than a treatment of phantom diseases and a non-scientific, ineffective, jingoistic, cultic approach to dysfunctional somatoform, non-disease conditions.

Li is undeterred by the naysayers. She said that functional medicine does not replace her medical training but instead enhances it. In addition, in randomized controlled trials, people become statistics. The idea that this gold standard of research always produces the best evidence-based medicine is limiting, she claims. Standard practice has been proven ineffective time and time again and off-label uses of drugs are often prescribed. Conversely, functional medicine is not without the more out there practitioners. Integrative medicine people can be equally dogmatic, Li said, chuckling.

While sitting at a bustling Berkeley brunch spot picking at her fruit salad, Li articulated a keen awareness and respect for the complexity of the human body, while remaining pragmatic and skeptical throughout the conversation. Of course, she would research each of her patients cases thoroughly, scouring PubMed articles and natural supplement databases, but her humility stood out the most. The most valuable thing that I learned in my health journey was to come to the place of not knowing, she said.

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Breaking the mold: A doctor's illness journey changes her practice - Peninsula Press

Dr. Omar P. Haqqanifor the Daily News

Dr. Omar P. Haqqani

Dr. Omar P. Haqqani

Haqqani:Cardiovascular health in women Part two

In part 1 of our series addressing cardiovascular health in women, we discussed the three most significant risk factors in developing cardiovascular disease. This week, we focus on the two deadliest cardiovascular events that can result from CVD, which are heart attacks and strokes.

Heart Attacks

Heart attacks are often viewed as something that primarily strike men; however, nearly a quarter million women a year die from them. That is 5 times higher than the number of deaths resulting from breast cancer.

In order to reduce occurrences of this cardiac event, women should be aware that a heart attack does not always feel the same in females as it does in men. The typical heart attack signs -- severe chest pain radiating down one arm or extreme shortness of breath -- can certainly occur in women, but many times, their symptoms are much more subtle.

They include:

Chest pain or discomfort that feels more like a fullness or squeezing throughout the chest rather than sharp, severe pain on the left side.

Pain in your back, neck or jaw that can build gradually and that can come and go.

Stomach pain and abdominal pressure that may be mistaken for heartburn.

Shortness of breath, nausea or lightheadedness for no apparent reason.

Sweating suddenly even though you have not exerted yourself.

Fatigue after engaging in activities as simple as walking up the stairs.

If you have any of these symptoms, do not ignore them. Get medical attention immediately and, rather than driving yourself to the hospital or asking a friend or family member to do so, call 911 so first responders can manage the event. Acting quickly can save your life and decrease the damage done to your heart.

To reduce your overall risk of a heart attack, make heart-smart lifestyle choices including getting regular exercise, not smoking, maintaining a healthy weight and eating a healthy diet. It is also very important to keep your blood pressure under control and manage your blood sugar if you are diabetic.

Strokes

Stroke is another cardiovascular event that is a leading cause of death in women. In addition, because women live longer than men, the long-term effects of a stroke can have a much more negative impact on their lives. Once again, there are risk factors, warning signs and symptoms that are unique to women.

The typical risk factors for stroke -- being overweight, high blood pressure, an inactive lifestyle, smoking and diabetes -- apply equally to both sexes. But there are others that occur only in women such as pregnancy, using birth control pills or taking hormone replacement medications. Women who are in their child-bearing years or who are post-menopausal must be alert to the increased chances of having a stroke and be vigilant about monitoring symptoms.

Women will experience different symptoms than men when having a stroke. These include fainting, dizziness, hallucinations, nausea or vomiting, and frequent hiccups. Women may also feel numbness over their entire body rather than in a localized area. If you experience any of these symptoms, call 911 immediately, particularly if you have difficulty speaking or see drooping in your face. Just like with heart attacks, it is imperative you act quickly to minimize stroke damage.

To reduce your risk of a stroke, stop smoking immediately and work toward reaching and maintaining a healthy body weight. If you are pregnant, monitor your blood pressure carefully throughout your pregnancy. Monitor it closely as well if you are on birth control pills or hormone replacement therapy drugs and see your physician immediately if it rises.

While heart attacks and strokes are real dangers for women because the signs and symptoms are very different than those experienced by men, you can reduce your chances of having either by making important lifestyle changes, being alert to the signs and reacting quickly if symptoms appear.

Next week, part three of our series on cardiovascular health in women will specifically address how ethnicity plays a role in cardiovascular disease and cardiovascular events.

Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.

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Haqqani: Cardiovascular health in women Part two - Midland Daily News

(Reuters Health) - Black men with riskier prostate cancers may be less likely than their white counterparts to get aggressive treatment that can give them the best survival odds, a recent U.S. study suggests.

Researchers focused on men with medium- and high-risk localized prostate tumors likely to benefit from aggressive treatment like surgery or radiation, rather than the conservative approaches of watchful waiting or hormone therapy often used for men with low-risk tumors.

While 83% of white men received aggressive treatment, just 74% of black men did, the study found.

Given the evidence suggesting a benefit for treatment in men diagnosed with intermediate- and high-risk prostate cancer, our findings may explain, to some degree, the differences in survival odds between black and white men diagnosed with prostate cancer," said lead study author Dr. Quoc-Dien Trinh, co-director of the Dana-Farber/Brigham and Women's Prostate Cancer Center in Boston.

Black men are more likely to develop prostate cancer and to die from it than white men, the researchers note in European Urology, online August 2. Black patients are also more likely to be diagnosed when tumors are more advanced and more difficult to treat.

For the current study, researchers examined national cancer registry data on 223,873 white men and 59,262 black men aged 40 or older diagnosed with prostate tumors in the U.S. between 2004 and 2013.

Half of the white men in the study were at least 65 years old, while half of the black men were at least 63.

Black men were more likely to be low-income and uninsured or covered by Medicaid, the U.S. health program for the poor.

During the study period, the proportion of white men receiving aggressive treatment rose from 81% to 83%, while for black men it increased from 73% to 75%.

Overall, 39% of the 356 facilities in the study were significantly more likely to give aggressive therapy to white men than to black men with similar tumors. Only 1% of facilities were more likely to give aggressive treatment to black men.

Geography also played a role. For example, in the southeastern U.S., white men were 69% more likely to receive aggressive treatment than black men, the study found.

From a system-level perspective, we need to do a better job to (standardize) prostate cancer counseling and recommendations, Trinh said by email. There is no reason why there would be such a variation in how black men are treated from one institution to another.

One limitation of the study is that researchers lacked data on patient preferences that may have driven treatment decisions. Researchers also lacked data on patients treated at smaller facilities and places that treated fewer than 50 men a year for prostate cancer.

Its also hard to say how many patients may have opted against aggressive treatment because they didnt trust their physician or worried about side effects like urinary incontinence or erectile dysfunction, said Dr. Simpa Salami, a urologist at the University of Michigan in Ann Arbor who wasnt involved in the study.

We do not know if black men were offered definitive therapy at the same rate as white men but chose other options instead, or if black men were simply not offered the same treatment options as white men, Salami said by email.

Differences in income and insurance may also help explain the disparities in how men were treated, said Dr. Brian Chapin of the University of Texas MD Anderson Cancer Center in Houston.

I would expect that if a comparison was made between whites and blacks within the same income bracket and equivalent insurances, the findings may not have been as significantly different, Chapin, who wasnt involved in the study, said by email.

Even so, the findings suggest that men should speak to more than one doctor before deciding how to proceed, Chapin said.

I would encourage any newly diagnosed prostate cancer patient to obtain a second opinion regarding their cancer care, and meet with both a radiation oncologist and a urologist to be presented with all available options and make sure they are fully informed before making a treatment decision, Chapin advised.

SOURCE: bit.ly/2voWkvq

Eur Urol 2017.

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Blacks with prostate cancer less likely to get ideal treatment - Reuters

Menopause is often associated with troublesome symptoms like hot flashes and mood swings, yet even more serious health issues may be part of this life stage, such as heart disease.

The North American Menopause Society estimates that 2 million 6,U.S. women reach menopause every year.

Women experience a number of changes during menopause due to shifting hormones and lower levels of estrogen, said nationally renowned natural health physician and author, Dr. Fred Pescatore. Hot flashes, night sweats and fatigue can interfere with everyday activities. These symptoms can be severe and can occur for several years as the body adjusts to the reduced level of estrogen. We know that fluctuating hormones can also contribute to increased risk of heart disease and its important to take steps to manage that risk during menopause.

There are several ways for women to manage menopause symptoms and heart health risks, Pescatore said.

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A healthy life starts with a nutritious diet, and this becomes even more important during menopause. For women experiencing menopause symptoms, I recommend adopting a diet filled with more vegetables, lean protein, nuts and seeds to support a healthier lifestyle and a healthier heart, he said.

One of the best things you can do to help your body and mind adjust to shifting hormone levels during menopause is to maintain an active lifestyle. Just 30 minutes of cardio each day can really make a difference. Get moving. Try taking a brisk walk or a bike ride. You can even do things in your own home, like jumping jacks, Pescatore said.

A new peer-reviewed clinical study shows that daily supplements of the anti-oxident found in pine bark oligomeric proanthocyanidin compounds, also found in grapeseeds, peanut skin and witch hazel bark (trademarked as Pycnogenol) can help reduce the symptoms of menopause and related heart disease risk factors. This study shows the effectiveness of Pycnogenol in alleviating perimenopause symptoms like hot flashes and night sweats and reducing key cardiovascular risk factors like high blood pressure, Pescatore said.

This new study further expands on previous research conducted on hundreds of patients that shows the benefits of Pycnogenol for minimizing common, disruptive symptoms of menopause including night sweats, hot flashes, depression, anxiety and memory problems by supporting vascular relaxation, which allows the body to rid itself of excess heat. For more information, visit pycnogenol.com.

Herbal extracts that contain natural phytoestrogen compounds that mimic estrogen are also readily available and work for many women. Isoflavones such as those found in soy products and red clover may help, DHEA supplements are another hormone replacement option,and other popular supplements include flax seed oil, black cohosh, dong quai.

Check with your doctor before trying a supplement to be sure its safe for you.

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How to manage the symptoms of menopause - The Oakland Press

To state the obvious, poop problems are the worst. Whilecramping, constipation, and diarrhea are a drag for everyone, those who suffer from irritable bowel syndrome (IBS) have to live with those symptoms on a daily basis. IBS is a gastrointestinal syndrome characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause, says Niket Sonpal, M.D. It is the most commonly diagnosed gastrointestinal condition. The prevalence of IBS in the United States is estimated from population-based studies to be approximately 10 to 15 percent but, in my experience, I feel the prevalence is much higher.

Unfortunately, women are twice as likely as men to have IBS, according to theU.S. Department of Health and Human Services. Women can attribute their likelihood of getting IBS to the fact thathormonescontribute to flare-ups and estrogen and progesterone both rise and fall during the monthly menstrual cycle, says Sonpal. Because these hormone receptors are found in the G.I. tract, their fluctuations manifest symptoms. Furthermore, womens symptoms can differentiate from one another because, in addition to hormonal fluctuations, IBS flare-ups can be influenced by emotional health and the guts microbiome as well.

IBS is what Sonpal calls a diagnosis of exclusion, meaning a physician should rule out all other possible causes of symptoms first. Because of that and the way women uniquely experience IBS, it can be difficult to diagnose. After all, how do you tell if its IBS or intense period cramps or anxiety?

Here are some classic symptoms that can help you tell whats what:

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7 IBS Symptoms Every Woman Should Know About - Women's Health

Not surprisingly, physicians working in a big city hospital emergency room are under plenty of stress.

A Michigan State University physician has now shown how this stress affects the care of their patients.

The more stress an emergency room physician experienced, the more likely he or she was to make a minor mistake, also known as a near miss among hospital staff, according to a new study led by Arnetz and published today in BMJ Open, an online British medical journal.

Researchers took blood and saliva samples from 28 emergency room resident physicians before and after their shifts to check for biological stress markers, Arnetz said, who is chair of the MSU College of Human Medicines Department of Family Medicine. After their shifts, the doctors were questioned about the number of critically ill patients and trauma victims they treated and how many near misses they made.

The result: the physicians who reported the most near misses had the highest biomarkers for stress.

Stress among physicians is not just perception, Arnetz said. It has a biological affect and that biological affect might impact the wellbeing of patients.

The study was conducted in the emergency department of the Detroit Medical Center, which defines near misses as any process variation that did not reach the patient, employee or visitor, but for which a recurrence carries a significant chance of a serious adverse event in other words, a mistake that, if repeated, could harm a patient.

Arnetz has been investigating psychophysiology the relationship between the brain and the body since 1983 when a hospital in his native Sweden hired him to look into the health of its medical providers. He has done previous studies on how workplace stress affects workers productivity.

The more stress in general in an organization, the less efficiently it is run, Arnetz said.

His latest study is the first that associates near misses with biomarkers of stress, including cortisol, a stress hormone found in saliva. The researchers also took blood samples, looking for markers of inflammation in the brain, which increases in stressful situations.

In addition to contributing to errors in patient care, stress can negatively affect the cardiovascular health of physicians, Arnetz said.

Very few emergency physicians work past 50, he said. They burn out.

Those in the current study were young physicians in their second and third years of residency, a continuation of their education after graduating from medical school. Some stress might be self-induced by the residents unsure of their own medical skills and afraid to ask a supervising physician for help, Arnetz said.

Thats a dangerous combination, he said. Were trying to move the whole thing from being punitive.

Arnetz hopes to conduct a follow-up study of whether the near misses caused by stress are associated with poor outcomes for patients. Further research also could look for ways to help emergency physicians reduce stress, he said.

The study was funded by the Blue Cross Blue Shield of Michigan Foundation and conducted by researchers from Michigan State University and Wayne State University.

SOURCE: MSU Today

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Physicians with increased stress make more mistakes in patient care - WSYM-TV

The first office visit includes an hour and a half with Dr. Pierce, and an hour and a half with a nutrition consultant. In that time we develop a unique treatment and nutrition plan based on each patient's individual needs, their symptoms and lab results, as well as personal preferences.. We emphasize a more holistic approach and use dietary modification, nutritional supplementation and hormone balancing when indicated, as opposed to going straight to patented pharmaceutical drugs.

We do not take medical health care insurance. We are a fee-for-service medical wellness clinic. You may however use your health care insurance for your lab work. Remember, you have a contract between yourself and your insurance provider. We are not a part of that contract. Your insurance provider also has a contract between itself and their preferred laboratory. Our staff will help you figure out what is your insurance's preferred laboratory and submit your requisition and/or blood work to that laboratory. We will also provide you with the proper CPT codes and submit them to your insurance carrier to give you the best chance of having your tests covered.

There are some tests, such as a cortisol saliva test, that are not covered by any insurance to our knowledge. This is because the performing laboratory is not contracted by any insurance provider to perform the test and they are a fee-for-service company as well.

You may take your lab requisition directly to the lab and have your blood drawn there, or we can provide the blood draw service for you at our clinic at a scheduled convenient time for you. This avoids waiting in line at the laboratory for an unknown amount of time, while fasting, to get your blood drawn.

Is important to know that when you submit a request for your insurance company to cover your lab work, they will have access to you labresults. They can use this information to increase your insurance premiums in the future.

However, if you pay out-of-pocket directly to Ageless Forever for your lab work the information stays between Ageless Forever and you, the patient. Your insurance company does not have the right to obtain your lab and health information at that juncture.

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Ageless Forever - Bio-identical Hormone Replacement

Haywood Regional Medical Center (HRMC) is announcing that obstetrician Dr. Jenny Van Winkle joined the medical staff on August 1, 2017.

We are very pleased with the addition of an experienced physician and surgeon like Dr. Van Winkle, said Rod Harkleroad, CEO of Haywood Regional Medical Center. With Dr. Van Winkle on board, we plan to expand upon the services for womens care to meet the needs of Western North Carolina so more patients can get quality and personalized care closer to home.

Van Winkle is board certified in Obstetrics & Gynecology. She received her medical degree from Texas A&M Health Science Center College of Medicine and completed her residency at The Methodist Hospital Houston Obstetrics & Gynecology in Houston, TX. Her special interests and training include prenatal care, contraception, infertility, laparoscopic and vaginal surgery, colposcopy and LEEP (Loop Electrosurgical Excision Procedure) procedures, PCOS, heavy menstrual bleeding, fibroids, incontinence, pelvic organ prolapse and menopause. Van Winkle is also fluent in Spanish.

Dr. Van Winkle, with her husband and children, decided to move to the mountains of Western North Carolina from Houston for a better quality of life. I love that obstetrics and gynecology provides me the opportunity to form long-term relationships with women, managing all stages of their life. My philosophy is to provide high quality patient centered care. I believe in listening and spending as much time with patients to offer individualized care, and Im looking forward to becoming part of the community. Shes also excited about working with the team as the practice service line pursues designation as a center for excellence for minimally invasive gynecological surgery.

Womens care providers at Haywood Regional Medical Center also include Robin Matthews, MD, and David Kirk, MD both board certified physicians. Also the hospital recently welcomed the addition of a certified nurse-midwife, Jody Schmit.

Dr. Van Winkle is accepting new patients. Appointments may be made by calling 828.452.5042. Services include obstetrics, well-women gynecological exams, adolescent gynecological care, ultrasounds, minimally invasive hysterectomy, abnormal pap smear treatments, endometrial ablation, infertility evaluation, breast and cervical cancer screenings, contraceptive management including IUDs, hormone replacement, incontinence, pelvic pain, pelvic prolapse, perimenopausal symptoms, laparoscopic surgery, and treatment of menstrual disorders.

As a part ofDuke LifePoint Healthcare, Haywood Regional Medical Center is supported by Duke University Health Systems world-renowned leadership in clinical excellence and quality care andLifePoint Healths extensive resources, knowledge and experience in operating community hospitals.Visit us at HaywoodWomensCare.

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Jenny Van Winkle, MD, OB/GYN joins Haywood Regional and Haywood Women's Medical Center - Mountain Xpress (blog)

(Newser) When Kimberly Mascott Zieselman was 15, she had surgery she now says caused "irreversible harm" due to others' "discomfort with difference." In her op-ed for USA Today, Zieselman explains how, as a young teen, she didn't get her period like other girls, and when her parents took her to get examined, doctors made a surprising discovery: She was intersex, meaning a person born with both male and female characteristics. In Zieselman's case, that meant that even though on the outside she appeared female, she had male XY chromosomes and testes (instead of ovaries and a uterus) inside her body. She had androgen insensitivity syndrome, so that her body resisted male sex hormones called androgens and led to an external appearance of being female.

She says her parents agreed, per physician advice, to have her "healthy gonads" taken out, "without my knowledge or consent." She was also placed on a lifelong hormone replacement therapy, as her natural hormones had halted. She says these types of "non-consensual and medically unnecessary procedures" on intersex kids have been common since the '60s, with "often catastrophic" results and "largely unproven" benefits. "We are erased before we can even tell our doctors who we are," she writes. Zieselman believes most doctors and parents think they're doing the right thingbut she notes the "devastating impact" on patients and says "every human rights organization that has considered this practice has condemned it." "The right thing is to wait until an intersex person can participate in these life-altering decisions," she writes. Read the full piece.

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Parents and Doctors, Hold Off on This 'Devastating' Surgery - Newser

Marielle Mohs

St. Louis, MO -- St. Louis is now home to a first-of-its-kind clinic for transgender teens and kids. It's being administered by Washington University physicians based out of St. Louis Children's hospital.

The clinic aims to provide transgender children and teens with comprehensive health care including mental health resources, hormonal therapy, voice therapy, and reconstructive surgery. Washington University physicians have been taking care of transgender children and teens since 2009 and noticed the growing demand which sparked the push to establish a fully operating clinic.

In 2016, Washington University physicians had 74 transgender patients. From just January to May 2017, they've already seen 71 patients.

This clinic is a huge milestone for the Seay family this month, especially for 15-year-old Leslie.

"Sometimes I identify as a girl, sometimes a boy, sometimes neither," said Leslie Seay.

She started exploring gender identity at 13-years-old, ultimately assigning to being gender fluid, which means she will always feel a mix of identifying between a boy and a girl.

"I would really like to go on hormone blockers so that my voice doesn't get any more feminine and [no] more feminine features show up," said Seay.

Leslie's identity is simple to her, so she needs a pediatrician who understands transgender health simply too.

"Having support and acceptance is extremely important for this patient population," said Dr. Christopher Lewis, founder and physician of the Transgender clinic. "Transgender patients already deal with harassment and discrimination within the medical community and that is a barrier to them accessing care."

Leslie's dad, Peter Seay, is thrilled to know his child is in safe, supportive care with an expertise in transgender health.

"To find out that the gender center was opening this month was something we've been celebrating for a little while. We've been very excited about this," said Peter Seay. "There could not be a greater value, the gratitude will not stop."

The Transgender Center of Excellence opened the first week of August. They are already booked through mid-September with new patient appointments. It's the only clinic of its kind within a 250-mile radius.

KMOV

TM & 2017 Cable News Network, Inc., a Time Warner Company. All rights reserved.

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Transgender clinic for kids and teens opens in St. Louis - WENY-TV

Any health change can bring questions and concerns. One of the most common issues patients ask OB/GYN Dr. Lesley Furman about is menopause. A lot of women come into the office with either questions about menopause or symptoms of menopause and want to know whats going on? Is what Im going through normal?

Dr. Furman says while the symptoms are normal, they can be uncomfortable. Hot flashes are the biggest one. Hot flashes, night sweats, sleeplessness, decrease in libido, vaginal dryness, those are the main ones, said Dr. Furman.

The average age of menopause is 51, but doctors say symptoms can start when women are in their 40s and can last a few years. Its important for them to know that it is a natural process. Its not going to last forever but there are treatment options, said Dr. Furman.

Treatment options, like medications, lifestyle changes, even hormone therapy can help. Each treatment option should be tailored for each patient, not just one size fits all. They should be aware that there are certain factors in their lifestyle that they can alter to help. There can be medications that we can offer that will help, said Dr. Furman.

Doctors may recommend different treatments to help with different symptoms. Patients often have a lot of symptoms; in fact most of the symptoms start way before that last menstrual period occurs, said Dr. Furman.

Women may even experience anxiety or depression during menopause. Whatever the symptoms are, doctors say they are normal and its important to explain them to your physician so treatment can be started.

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Health Matters: Answering Questions about Menopause - NBC2 News

Blogs | Aug. 6, 2017

Why dont doctors tell women about NFP? Often the doctors have no idea themselves.

At a localpregnancy center, the young women I talk to are constantly stunned to learn that there's a scientifically proven way to planor postpone children. When I mention that natural family planning is far better for their bodies, can even help detect various medicalconditions early on (such as endometriosis), and is effective and completely risk- and expense-free, I get a blank look. They've simply never heard of it.

Most of them are casuallyusing birth control pills or similar hormonal based contraceptives that have all sorts of health and psychological risks they know nothing about. Why didn't their doctors tell them? Often the doctors have no idea themselves.

Sadly plenty of doctors themselves prescribe birth control pills or other hormonal-based contraceptives without having read the research themselves.For the most part, that research isn't new; it's been known since the 1970s and only replicated around the world since then, with only worse reports since then. For example, a recent extensive study of Danish women found a correlation with hormonal contraceptives and depression.

One supporter of NFP is theFertilityAppreciationCollaborative toTeach theScience (www.FactsAboutFertility.org), a group of physicians and other health care professionals and educators workingto educate the medical community as well as the public onnatural or fertility awareness based methods (FABMs) of family planning.

A big reason a lot of child bearing aged women are completely unfamiliar with NFP is simply that no one is profiting from it. The birth control industry is a $6 billion a year business with a hugemarketing campaign. Television, magazine, social media ads, brightly colored posters and brochures on college campuses, health centers, even high schools and middle school's bulletin boards and health offices, and doctors offices promotethe birth control pill, patch, IUD, etc., with no mention of the risks. With no money to be made promoting NFP, it's remained low-profile.

The young women I speak to are exasperatedwhen I tell them that the World Health Organization, not exactly a bastion of conservative or Catholic thought, classifies the birth control pill as a Class A carcinogen. They feel betrayed by a medical community and pharmaceutical companies that are suppressing the full truth about the ramifications of hormonal birth control.

Dr. Marguerite Duane, a family physician and director of FACTS, said in a Relevant Radio interviewthat part of the lack of awareness is that only about 6% of medical doctors are aware of the scientific researchconfirming the effectiveness and benefits of NFP, particularly the latest research. She highlights theCenters for Disease Control website which continues to have extremely outdated information on NFP that doesn't mention the newest most compelling and most accurate reports. For example, the CDC says that NFP has a 24% failure rate which iscompletely false; based on the most up-to-date and highest quality published medical research,the effectiveness rates of Fertility Awareness Based Methods (FABMs) with correct use are between 95% and 99.5%. In fact, her organization is promoting a petition to the CDC which can be read here:http://petition.naturalwomanhood.org/cdc/script/.

The Pill is the most widely used drug given to healthy people to suppress a normal physiologic function. [Yet]it exposes women to a myriad of side effects including blood clots, bleeding irregularities, breast tenderness, mood changes, and many others, said Dr. Duane in an interview with Verily magazine. She pointed out that hormonal contraception introduces synthetic hormones, which modulates hormone production already occurring in the body. As noted in a recentJournal of the American Medical Associationarticle,External progestins, probably more than natural progesterone, increase levels of monoamine oxidase, which degrades serotonin concentrations and thus potentially produces depression and irritability.Serotonin is a major neurotransmitterinvolved in the control of pain perception, the sleep cycle, and mood. It should come as no surprise, then, that hormonal contraceptives impact aspects of the body beyondthe reproductive cycle.

Dr. Duane asksthe commonsense question, Why would we want to expose healthy women to serious or a substantial number of side effects under the guise of preventing pregnancy when there are other effective options available that pose no health risk?

Fertility Awareness-Based Methods, or FABMs, for instance, area very effective method of family planning and are comparable to most artificial methods of birth control when it comes to avoiding pregnancy,Dr. Duane says. AndFABMs arenatural, hormone-free, and free of side effects.

FABMs are notgrandmas rhythm method. Rather, they arebased on decades of solid scientific research of a womans reproductive physiology. Dr. Duane shares that FABMsallow a woman to work with her body rather than suppress her normal physiology.In fact, Dr. Duane calls FABMsthe only true methods of family planning because couples can use them to both avoid and achieve pregnancy.

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NFP is a Low-Profile But Best-For-You Method - National Catholic Register (blog)

As if the heat werent enough, late sunsets, dehydration and pollen allergies can all make sleeping difficult in the summer months.

Keeping ones bedroom cool and dark, showering to cool down and wash off pollen, and drinking plenty of water can help.

But people can be their own worst enemy when it comes to a good nights rest, according to Cameron Johnson, MD, a psychiatrist at Loma Linda University Health. The single biggest return on effort for better sleep, Johnson said, is to avoid all electronic screens starting an hour before bedtime.

Johnson delivered a presentation on sleep to a standing-room-only crowd at Loma Linda University Healths recent 2017 Womens Conference. Here are seven of his other top tips:

Power down. TVs, computers, smartphones, tablets and e-readers should be turned off and banished from the bedroom. The blue light waves emitted by these devices interfere with the bodys production of melatonin, a natural hormone that helps regulate circadian rhythm. To avoid this, put down your devices an hour prior to your desired sleep time.

Know when to exercise. Staying fit is one of the best things people can do for their well-being, but for the sake of a healthy sleep cycle, the timing is important. Exercising 20 minutes in the early-morning sun helps set your body clock to the right schedule. In the evening, dont exercise within at least one hour of bedtime; this is the time when you should be winding down.

Prepare your body and your bedroom for rest. They dont call it body clock for nothing; schedule is everything when it comes to getting adequate rest. To signal your body that it will soon be time to fall asleep, create a relaxing bedtime ritual. To complement this, the bedroom should be like a tomb: cold and dark, Johnson said. Cooling caps or blankets can help aid sleep, along with white noise.

BedTIME matters. Bedtime shouldnt change daily. Hit the pillow within the same half-hour timeframe each night. What time should that be? Johnson recommends getting to sleep by about 10 p.m. Doing so takes advantage of an important window for the delta portion of sleep, which helps the brain lock in the days memories, clear toxins, increase energy stores and release growth hormone to repair the body, he said. A 10 p.m. bedtime also protects REM sleep. REM promotes a healthy immune system, improves memory, prevents mood problems and protects nerve cells.

Avoid napping and night shifts. If at all possible, Johnson recommends avoiding overnight shiftwork. To a lesser degree, napping can also wreak havoc on a healthy sleep cycle. Try not to nap, but if you must, do so before 2 p.m. and only sleep 15-20 minutes, he said.

Weigh the benefits and risks of chemical help. Johnson recommends trying to avoid sleep medications that interfere with REM and/or delta sleep which is most of them, he said. Additionally, taking melatonin can help people fall asleep, but this risks lowering the bodys own natural production of this hormone. Discuss options with a qualified physician. When daytime comes, dont be fooled by caffeine it gives a false sense of well-being, Johnsons said. Sufficient sleep is vital for the health of ones mind and body.

Get tested for a sleep disorder. Sleep apnea, Johnson said, is a huge cause of mental health problems. A sleep study is in order, he noted, for people who have symptoms such as morning headache, fuzzy mind and irritability, as well as family members who snore.

Dont be too hard on yourself if you cant do all of these, Johnson cautioned.

The best approach to improving sleep habits, he said, is to choose one of these tips and practice it for three months, by which point it will become an unconscious habit. Then repeat with a second change for three months, and so on.

Don't push yourself too hard, Johnson said. Get early wins.

A pleasant way to start? Get a weekly massage for six weeks, which can improve sleep and cause a cascade of other health benefits, Johnson said.

Approximately 40 million Americans suffer from sleep disorders. The Sleep Disorders Center at Loma Linda University Medical Center can help. Opened in 1982, the center is accredited by the American Academy of Sleep Medicine and treats both adults and children. Call 909-558-6344 to learn more.

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Summertime, and the sleeping is not easy: 7 tips for putting insomnia to rest - Loma Linda University Health

Newswise CHAPEL HILL A higher proportion of aggressive breast cancer subtypes are seen in black women, University of North Carolina Lineberger Comprehensive Cancer Center researchers have found. The study findings help to explain a gap in mortality that exists between black and white women with breast cancer, and could lead to improved treatment approaches to help close it.

In the Journal of the National Cancer Institute, researchers published results of an analysis of approximately 1,000 invasive breast tumors. The study confirmed that young black women are more likely to have triple negative, or basal-like, breast cancers, a subtype that does not express any of the receptors for targeted biologic therapies. The study also identified variation by race within a clinical breast cancer type that has the greatest mortality disparity. Researchers found that younger black women with hormone-receptor positive, HER2-negative breast cancer were more likely to have a high risk of recurrence score.

When we look at a more clinically homogeneous group, such as women who have hormone-responsive, HER2-negative disease, we see pretty significant and biologically important differences between black and white women, said the studys lead author Melissa Troester, PhD, UNC Lineberger member and professor of epidemiology in the UNC Gillings School of Global Public Health. With genomic information, were better able to say which patients are likely to have indolent or slow-growing disease. And right now, we might mistake some people as having indolent disease, when actually they have a more aggressive tumor.

The study was part of the third phase of the seminal Carolina Breast Cancer Study, a population-based study launched at UNC-Chapel Hill in 1993. A driving motivation for the study has been to understand why African-American women disproportionately die from breast cancer. Since 1993, the study has gathered data on more than 8,000 women from 44 counties in North Carolina.

In the new study, researchers compared the findings of commonly used immunohistochemical tests, which classify breast cancer according to tumor markers, with the findings of the PAM50 gene expression assay, which classifies tumors into different risk groups as well as different molecular subtypes based upon each tumors genomic characteristics.

Confirming previous findings, researchers found that black women were less frequently diagnosed with luminal A breast cancer, a subtype of breast cancer that has a better prognosis overall. Black women had significantly higher odds of all three non-luminal A breast cancer subtypes: Their odds of basal-like breast cancer, a particularly aggressive subtype, were three times higher for black women compared to white women; odds were 45 percent higher for luminal B breast cancer or black women, and odds were twice that of white women for HER2-enriched breast cancer.

If you look at the group of basal-like breast cancers, the burden of this disease is much higher if youre young and black, said UNC Linebergers Lisa A. Carey, MD, physician-in-chief of the N.C. Cancer Hospital. We believe this is playing a role in racial disparities in outcomes between young and old, and black and white women with breast cancer.

They also found variation within a clinically defined subtype the hormone-receptor positive, HER2-negative subtype in particular. Hormone receptor-positive, HER2-negative breast cancer has the best prognosis overall, but the researchers report mortality disparities are also greatest within this group. In both black and white women, hormone receptor positive, HER2-negative breast cancer tumors were sometimes classified into the more aggressive genomic subtypes, including as basal-like breast cancer. In addition, on average, black womens tumors were more often classified into aggressive subtypes and had higher risk of recurrence scores within this group.

The findings underscore the role for genomic testing to drive precision medicine approaches to treatment, and may help explain a disparity in survival for black women with this type of breast cancer. In addition, the findings could have important clinical implications: Black patients with higher risk of recurrence scores could be candidates for chemotherapy or new treatment approaches since high-risk scores are an indication for chemotherapy.

If you really have a luminal A, low-risk tumor, and you were hormone receptor-positive and HER2-negative, you could be treated less aggressively, and have different surgical options, Troester said. But if you had these other tumor genomic subtypes, your doctor might consider a more aggressive treatment plan. We can do better to distinguish aggressive and indolent cancers if we use the genomic data that is becoming available.

In addition to Troester and Carey, other authors include Charles Perou, Xuezheng Sun, Emma H. Allott, Joseph Geradts, Stephanie M. Cohen, Chiu-Kit Tse, Erin L. Kirk, Leigh Thorne, Michelle Matthews, Yan Li, Zhiyuan Hu, Whitney R. Robinson, Katherine A. Hoadley, Olufunmilayo I. Olopade, Katherine E. Reeder-Hayes, H. Shelton Earp, and Andrew F. Olshan.

The study was supported by the National Institutes of Health and the National Cancer Institute.

Perou is listed as an inventor on a patent application on the PAM50 assay, which is licensed to BioClassifier LLC, Perou is an equity stock holder and board of director member of BioClassifier.

SEE ORIGINAL STUDY

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Aggressive Breast Cancers May Contribute to Racial Survival Disparities - Newswise (press release)

Scientists say there are no known safe levels of phthalates for pregnant women and young children

Published Jul 30, 2017 at 11:13 am (Updated Jul 28, 2017)

For the study, the coalition contracted with an independent laboratory experienced in the testing of phthalates in food to test 30 cheese products purchased at retail grocery stores in the United States and shipped to the lab, unopened, in their original packaging. Findings revealed:Phthalates in nearly every cheese product tested (29 of 30 samples), with 10 different phthalates identified and up to six found in a single product.Phthalates in eight of the nine Kraft cheese product samples tested.Toxic chemical phthalates at levels on average more than four times higher in macaroni and cheese powder than in hard cheese blocks and other natural cheese.DEHP, the most widely banned phthalate around the world, in all 10 macaroni and cheese powders. DEHP accounted for nearly 60 percent of all phthalates found in the cheese product samples that were tested.

The cheese powers in ten varieties of macaroni and cheese products tested all contain toxic industrial chemicals (known as phthalates), according to the Coalition for Safer Food Processing and Packaging, a national alliance of leading public health and food safety groups.

Phthalates (THAL-eights) are hormone-disrupting chemicals that can lower testosterone, the male sex hormone, and alter thyroid function. Scientists have linked exposure to some phthalates, during pregnancy and early childhood, to changes in the developing brain that may result in kids who grow up struggling to succeed in school, at work, and in life.

Serving up one of Americas favorite comfort foods shouldnt mean exposing your children and family to harmful chemicals, said Mike Belliveau, executive director of the Environmental Health Strategy Center, a coalition member.

Two million boxes of macaroni and cheese are sold every day in the United States.

An 'indirect' food additiveScientists say there are no known safe levels of phthalates for vulnerable populations, such as pregnant women and young children," said Charlotte Brody, RN, national director of Healthy Babies Bright Futures, a coalition member.

Federal scientists reported this year that up to 725,000 American women of childbearing age may be exposed daily to phthalates at levels that threaten the healthy development of their babies, should they become pregnant.

Scientists agree that for most people, the greatest exposure to phthalates comes from the food we eat.

Phthalates are not intentionally added to food, but are classified as indirect food additives by government agencies. Industrial chemicals commonly added to plastics, rubber, adhesives, inks, and coatings, phthalates have been shown to migrate into food products during food processing, packaging, and preparation.

Source: Center for Food Safety: centerforfoodsafety.org

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Mac and cheese products contain harmful chemicals, study finds - The Pike County Courier

Despite best efforts to do no harm, clinicians should be prepared to respond to patients who experience adverse outcomes even if everything is done right. Often thought to refer only to medical error, the term iatrogenesischaracterizes a wider range of possible health care outcomes that are, as the Greek etymology suggests,physician-generated. Iatrogenic outcomes are particularly fraught in pediatrics, due to childrens inherent vulnerability as patients who typically lack decision-making authority.

This months issue of theAMA Journal of Ethicsgrapples with neglected clinical and ethical questions about pediatric iatrogenesis, including how clinicians communicate iatrogenic risks to patients parents or guardians, how clinicians manage therapies with inevitable iatrogenic harms, as well as how clinicians might consider, respond to, and mitigate iatrogenic consequences of their practices.

Take a moment to consider this question: A 12-year-old girl identifies as a boy, has been diagnosed with gender dysphoria (GD), and wants to begin gender transitioning with prepuberty hormone therapy. Her physician worries about the long-term iatrogenic risks of therapy. How should the physician respond?

Give your answer and find responses to this question in theAugust issueof theAMA Journal of Ethics,which features numerous perspectives on ethical questions related to pediatric iatrogenesis.

Articles include:

Should Clinicians Medicate Against Structural Violence? Potential Iatrogenic Risks and the Need for Social Interventions.Physicians should weigh not only the iatrogenic risks of off-label antipsychotic medications but also the possible consequences of failing to treat related, complicating social factors. Advocates must address structural violence and failures of imagination in their efforts to improve mental-health equity among vulnerable youth.

How Should Physicians Help Gender-Transitioning Adolescents Consider Potential Iatrogenic Harms of Hormone Therapy?Counseling and treatment of transgender youth can be challenging for mental-health practitioners, as increased availability of gender-affirming treatments in recent years raises ethical and clinical questions. In cases involving adolescents, it is critical that clinicians communicate appropriate expectations about the effectiveness and limitations of hormone therapy, as well as the risks of psychological and physical iatrogenic effects.

Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries?Physicians should, in certain cases, be held accountable by patients and their families for harm caused by successful genital surgeries performed for social and aesthetic reasons.It is important for physicians not just to know when and why to perform genital surgery, but also to understand how their patients might react to wrongful performance of these procedures, and to respond to their own blameworthiness in socially productive and morally restorative ways.

Clowning as a Complementary Approach for Reducing Iatrogenic Effects in Pediatrics.Hospitalized children who undergo painful procedures are more susceptible than others to experiencing iatrogenic effects, such as anxiety, pain and stress. Clowns in the clinical setting have been found to be effective in reducing childrens experiences of these effects during hospitalization and before procedures.

The AMACode of Medical Ethics Opinions Related to Iatrogenesis in Pediatrics. Although any patient can experience an iatrogenic outcome, pediatric patients are the most vulnerable to life-threatening complications. The AMACode of Medical Ethicsdoes not have any opinions that address iatrogenesis in pediatrics specifically, but it does offer guidance on pediatric decision making, preventing error and harm, and disclosing errors.

In the journals August podcast, Robert Nelson, MD, PhD, MDiv, a senior pediatric ethicist with the Food and Drug Administration, discusses strategies for communicating about iatrogenic outcomes with the parents and guardians of pediatric patients. Later in the episode, Gigi McMillan, the mother of a pediatric brain-tumor survivor, discusses how networks of peer mentors can help families navigate these painful situations.

The journals editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians.Submit a manuscriptfor publication. The journal alsoinvitesoriginal photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The journal is accepting applications from medical students, residents and fellows (MDs or DOs) in U.S.-based programs to serve as theme issue editors for monthly issues to be published from November 2018 through October 2019. Learn more.

Upcoming issues of theAMA Journal of Ethicswill focus on incarceration and correctional health care as well as clean-water access and the roles of clinicians.Sign upto receive email alerts when new issues are published.

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Pediatricians must address adverse outcomes with compassion, resolve - American Medical Association (blog)

Map A: Distribution by county of recorded presence of Lyme carrying ticks across the US between 19071996 (from Dennis et al. 1998). Map B: between 19072015 (from Eisen et al. 2016)

Research Triangle Park, NC (PRWEB) August 03, 2017

Global Lyme Diagnostics has announced that Dr. Mark Filidei, and Dr. Jodie Dashore have joined GLD's Scientific Advisory Board.

Dr. Filidei is an Internal Medicine physician and is the Director of Integrative/Functional Medicine for the Amen Clinics. Dr. Filidei is highly experienced in integrative/functional medicine modalities as well as conventional medicine and sees patients in person at the Amen Clinics Southern California. He was previously the medical director of the Whitaker Wellness Institute, the largest Integrative Medicine clinic in the United States where he spent over a decade treating thousands of patients for multiple complex medical issues. Dr. Filidei is an ILADS trained physician, which is the largest group of Lyme literate doctors in the world. He also has a special interest in diagnosing and treating CIRS (chronic inflammatory response syndrome) which is caused by toxic mold exposure. Dr Filidei lectures nationally on topics including the integrative approach to mental health, hormone replacement therapy, brain health, memory loss and Alzheimers disease, and mold and Lyme disease related issues.

Dr. Filidei correctly diagnosed Kris Kristofferson with Lyme Disease, after Kristofferson was misdiagnosed numerous times, with maladies ranging from Alzheimer's to fibromyalgia. The story was covered by news organizations such as CBS and was posted on the CMT website on July 8, 2016.

Dr. Jodie A. Dashore - Dr. Dashore has been a Lyme Literate Clinical practitioner since 2010. She specializes in an Integrative, alternative and plant-based medicine approach to Tick Borne Diseases and has been helping patients with Tick borne Infections from 11 countries around the globe. Dr. Dashore has given numerous national and international lectures on an integrative approach to Tick Borne infections. She is internationally recognized as a pioneering scientist and researcher who has coined the term "Complex Autism" (TM) to include Autism complicated with Tick Borne infections and other comorbid conditions.

Global Lyme Diagnostics has developed a breakthrough diagnostic solution specific to Lyme Disease that is grounded in science. The GLD test, developed by Dr. Marconi, is designed to significantly decrease the number of patients being misdiagnosed.

Dr. Marconis research has led to a novel breakthrough called chimeritopes which increase sensitivity by eliminating proteins that are not relevant to a Lyme infection (non-OsPC targets) and can further reduce false negatives by targeting Lyme causing bacteria variants across the North American spectrum. After licensing this technology platform and related intellectual property developed in Dr. Marconis lab at Virginia Commonwealth University, GLD focused on creating a highly accurate and reproducible solution.

"We are very pleased to have Dr. Filidei and Dr. Dashore join our Scientific Advisory Board. Their clinical advice will be extremely valuable in furthering GLDs science to help the global Lyme community, " stated Mickey Ramchandani, CEO of Global Lyme Diagnostics. "Misdiagnosis is a core issue, as Lyme Disease can masquerade as many things - juvenile arthritis, fibromyalgia, chronic fatigue syndrome, multiple sclerosis and a host of other diseases. We are passionate about providing a diagnostic solution that decreases the misdiagnosis of Lyme Disease."

After years of research GLD has also just launched the GLD test, specific to Lyme Disease, which can be requested by clinicians at physician kit request. Patients that would like to request a kit to take to their clinicians can do so here. Note: The GLD Test is not yet available for CA, FL, or NY residents.

More information about GLD, including the science behind the new test and the Global Lyme Diagnostics team is available at the website at https://glymedx.com.

About Global Lyme Diagnostics:

GLD was formed with the sole purpose of providing a solution to the Lyme community including, physicians, clinicians, patients, advocates and families. Its initial focus is to develop and launch a test that is grounded in science and provides an answer to the challenges related to tests on the market. In addition to launching of their new test, GLD is working with the Lyme community and physicians to develop screening opportunities for worried individuals in Lyme endemic areas to help reduce long term complications. GLD is also researching methods to detect co-infections, as well as, assays that could differentiate early stage versus late stage infections for clinicians to better manage their patients.

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Global Lyme Diagnostics Welcomes Dr. Mark Filidei and Dr. Jodie A. Dashore To Scientific Advisory Board - PR Web (press release)

Its the fourth most common cancer for women in the U.S., but doctors say 80 percent of the time endometrial cancer is caught in stage one.

Dr. Fadi Abu Shahin, a gynecologic oncologist on the medical staff of Lee Health, says endometrial cancer can be caused by age, genetics, or medication. Endometrial cancer is cancer of the endometrium, which is the lining of the uterus on the inside. The most common is what we call unopposed estrogen where the womans body is producing estrogen only and not producing progesterone to counter act the effects of estrogen in the uterus.

That can lead to overgrowth of the lining of the uterus and can become cancerous over time. Women who are at risk for endometrial cancer may have a genetic predisposition or polycystic ovarian syndrome, where they dont ovulate regularly. In both cases doctors may prescribe birth control or hormone therapy as a preventative. The best treatment for those women is to put them on birth control pills or some form of hormonal therapy to prevent and protect the uterus from exposure to estrogen, said Dr. Abu Shahin.

Theres no regular screening for endometrial cancer, but doctors say if women experience symptoms they need to call their physician. In women after menopause any bleeding is abnormal. In women before menopause any irregularity in their periods or bleeding outside their period is abnormal, said Dr. Abu Shahin.

Endometrial cancer is the most common gynecologic cancer in women. If women are at risk, doctors may use genetic screening, biopsies, or ultrasounds to look for precancerous changes in the uterus. 70 to 80 percent of all women with endometrial cancer are diagnosed at stage one, which means the cancer was contained to the uterus, which means its highly curable, said Dr. Abu Shahin.

Patients may undergo a hysterectomy or choose to have only the high risk lymph nodes removed in a shorter, less invasive procedure.

Original post:
Health Matters: Detecting and Treating Endometrial Cancer - NBC2 News

Jennifer Brea, who has Chronic fatigue syndrome/myalgic encephalomyelitis,reveals her story in her film, Unrest.

By Giorgia GuglielmiJul. 31, 2017 , 3:00 PM

After a 5-month road trip across Asia in 2010, 22-year-old college graduate Matthew Lazell-Fairman started feeling constantly tired, his muscles sore and head aching. A doctor recommended getting a gym membership, but after the first training session, Lazell-Fairmans body crashed: He was so exhausted he couldnt go to work as a paralegal for the Federal Trade Commission in Washington, D.C., for days. Lazell-Fairman has never fully recovered. He can now do a few hours of light activitycooking, for exampleper day but has to spend the rest of his time lying flat in bed.

Lazell-Fairman is among the estimated 17 million people worldwide with chronic fatigue syndrome (CFS), a disease whose trigger is unknown and for which there are neither standard diagnostic tools nor effective treatments. In the largest study of its kind, researchers have now found that the blood levels of immune molecules that cause flulike symptoms such as fever and fatigue track the severity of symptoms in people who have received a diagnosis of CFS. The results may provide insight into the cause of the mysterious illness, or at least provide a way of gauging its progress and evaluating treatments.

This work is another strong piece of evidence that there is a biologic dysfunction at the root of the disease, says Mady Hornig, a physician scientist at Columbia University whose research has also identified potential biomarkers for CFS.

People with CFSmany patients and advocates prefer to call the condition myalgic encephalomyelitis (ME) because of the complex set of symptoms that are not limited to fatigueexperience prolonged, extreme exhaustion that doesnt improve with rest. The fatigue may worsen with physical or mental activity and often comes with brain fog, a feeling of mental clouding, and sensitivity to noise, light, or other stimuli like taste and smell. Patients may also have memory impairment, muscle pain, and gut problems such as diarrhea, bloating, and nausea.

For years, CFS had been dismissed as a psychological disorder, and some physicians advocated treating it primarily with psychotherapy or a gradual increase in physical activity. But many researchers, and funding agencies such as the National Institutes of Health, increasingly view it as a physiological problem. Its a medical mystery, says Mark Davis, an immunologist at Stanford University in Palo Alto, California.

For this reason, Davis, together with Stanford immunologist Jose Montoya and their teams, recently evaluated whether an imbalance of the immune system may trigger CFS/ME, as previous studies have suggested. By analyzing the blood of 192 people who had met one of the established criteria for CFS/ME diagnosis and 392 healthy individuals, the team found that the levels of 17 cytokines, substances produced by immune cells in response to infection, correlated with disease severity. They were higher in patients with the severest symptoms than in patients with milder symptoms or healthy people. In patients with the mildest symptoms, the levels of those same cytokines were lower than in healthy people, and in patients with moderate symptoms they were comparable to individuals with no disease. Of these 17 immune molecules, the vast majority is known to stimulate inflammation and produce flulike symptoms, the researchers report today in the Proceedings of the National Academy of Sciences.

I found surprising that so many cytokines are altered in the patients, Davis says. It seems like the disease is leaving no cytokine untouched. The work adds to our understanding that there are complex alterations of the immune system, Hornig says.

A few immune molecules drew particular attention because their levels didnt correlate with disease severity. The researchers have found that the blood level of TGF-, a cytokine that is involved in myriad biological processes, such as inflammation and cancer, was higher in CFS/ME patients, regardless of the severity of their symptoms, than in healthy people. And the blood levels of resistin, a hormone produced by immune cells, were lower in patients compared with individuals with no disease.

These molecules might drive the disorder, scientists speculate, but they could also simply reflect the patients immune system fighting back against an inflammation of different origin. These are deliberately agnostic assays, Davis says. First you look for correlation and then you try to understand why these things correlate with the disease.

Nonetheless, the new study is a tremendous step forward, says Gordon Broderick, a systems biologist at Rochester General Hospital in New York. Being able to examine so many CFS/ME patients and identify which immune molecules are associated with more intense symptoms is a big deal, he says.

Although it is important to rule out that altered levels of cytokines arent linked to factors such as allergies or sex hormones, which can also influence the immune system, the large number of patients showing an imbalance in these immune molecules suggests that it is either a cause or result of CFS/ME, Broderick says.

In the future, the scientists hope to use these immune molecules as diagnostic tools for the puzzling condition, and also figure out the role of cytokines and the immune system in the disease. I hope to see more research along those lines, Hornig says. Theres a lot of patients waiting for some answers.

See more here:
More clues link immune system imbalance with chronic fatigue syndrome - Science Magazine

1. Cross-sex hormone therapy (CSHT) may be associated with worsening cardiovascular risk factors in transgender men.

2. CSHT may not result in increases in cardiovascular morbidity or mortality.

Evidence Rating Level: 2 (Good)

Study Rundown: Understanding the unique health care needs of the transgender population is highly important; approximately 1.4 million persons identify as transgender in the United States. One important area of study involves the role of sex hormonesincluding hormone blockers and cross-sex hormone therapyand cardiovascular disease (CVD). Sex hormones may be used to help transgender persons fully realize their gender identity. Despite the importance of this area of research, one of the barriers to providing appropriate care to transgender persons is the lack of physician training and clinical guidelines within this area. Additionally, there is limited health care research within this population. The authors of this study, therefore, conducted a systematic review that highlights research on the association between hormone therapy and CVD in cisgender adults, in addition to summarizing the association between CSHT and CVD in transgender adults. This study has several limitations. First, many studies included in this review focus on younger persons, limiting the generalizability of CSHT in older transgender adults. Additionally, there are few randomized controlled trials with respect to CSHT, which limits knowledge of any associations between CSHT and CVD.

Click to read the study, published in the Annals of Internal Medicine

Relevant Reading: Hormone therapy for transgender patients

In-Depth [narrative review]: The authors of this study systematically searched PubMed and EMBASE databases, of which 13 met inclusion and exclusion criteria. Of the articles, 3 reported findings only in transgender women, 3 only in transgender men, and 7 looked at both populations. Based on the articles reviewed, the authors observed that CSHT is associated with improved psychological functioning of transgender persons. While studies looking at CSHT and cardiovascular risk factors in transgender men are limited, several studies, including an early prospective study and an observational longitudinal study, suggest that CSHT increases CVD risk factors. These risk factors include blood pressure values, lipid levels, and insulin resistance. Furthermore, in transgender women, CSHT may increase thromboembolic risk. However, due to the lack of randomized controlled trials and prospective cohort studies found in this review, it is clear that further research is required to determine the cardiovascular effects of long-term CSHT for transgender adults.

Image: PD

20172 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Read the original here:
More research needed to determine cardiovascular effects of long-term hormone therapy for transgender adults - 2 Minute Medicine

There's no shortage of weird tips and tricks on the Internet for everything from making your kids eat vegetables to getting your newborn to stop crying,but the latest trend in DIY is truly something else. Apparently, women are putting urine in toothpaste based on claims in a viral YouTube video that you can use this "natural" method as an alternative way to tell if you're pregnant.

The toothpaste pregnancy test works like this: First, you squeeze a small amount of plain white toothpaste into a cup, then you add a few drops of urine, mix it up, and wait three minutes. If the toothpaste starts to froth or turn a bluish color, that means the "test" is positive.

More from CafeMom: If You're Pregnant & Your Toilet Seat Turned Blue, You Are Not Alone

The video has more than 2 million views and Us Weekly notes it's a mainstay on Google Trends. As the websitebabyprepping.com explains, the toothpaste pregnancy test came about "decades ago when pregnancy tests weren't easily found in stores, especially for women living in rural settings." Now, they're mostly used as a cheap alternative to store-bought pregnancy tests.

Of course, not everyone is sold. The comments on YouTube range from grateful and enthusiastic to people saying this is total BS to men claiming they tried it and got a positive result (LOL).

So, is the toothpaste pregnancy test legit?

Sort of, says Dr. Napoleon Maminta, a primary care physician at Naptown Priority Healthin Indiana. If done correctly, this test may give a woman "reason to believe that she is pregnant," he says. But that positive result is not a guarantee.

More from CafeMom:How This Weird Purple Line on Your Booty Might Reveal When Your Baby's Coming

"While over-the-counter tests are difficult to compromise and taint, this homemade option can be easier to compromise if a person fails to take certain precautions," Dr. Maminta tells CafeMom.

If you're just seeing this for the first time and simplyhave to try it, Dr. Maminta offered some tips to get the best results.First, he says, it's vital to use clean cups so that no contaminants come into contact with the toothpaste. Second, women should use their first morning urine rather than using urine later in the day.

"First morning urine in pregnant women has higher concentrations of the pregnancy hormone hCG, which reacts with the chemicals in the paste to cause a color change," he explains.

Lastly, the toothpaste used must be naturally white and not one that is striped or artificially colored. "The natural white paste has the correct chemical composition to react with the hCG in the urine to cause a change in the paste's color and structure," Dr. Maminta explains. "Paste that is dyed will not react in the right way to give enough of a reading for a woman to know if she could be pregnant."

Even with all the precautions in place, Dr. Maminta still cautions that this should be viewed as an "initial test" and pregnancy should be confirmed via traditional, well-tested methods.

Long story short? Toothpaste pregnancy tests are not the most reliable method of finding out if you're pregnant. But, if you're trying to conceive and looking for some preliminary results before you shell out for another test? It might be worth a shot. As with all things related to pregnancy and our bodies, take the "alternative method" with a grain of salt -- and make sure you see a doctor!

Originally posted here:
Toothpaste Pregnancy Tests Are a Thing -- but Do They Work? - The Stir