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There is no agreement amongst child psychologists, psychiatrists and other experts on how to be the perfect parent. ( That of course, does not mean some do not write books about what to do to be a good parent). Each person, being infant to old age is different! Therefore, with the intentions of being a good parent,  anxiety and stress can be promoted in the developing youngster and extend into their adulthood from traumatic experiences in their childhood. This is labeled Adverse Childhood Experiences (ACE). This can happen for many reasons to a child too often without the parent (s) awareness or intention:

  1. abused physically, even if it is minor like grabbing; or verbally.
  2. Parents that are separated or divorced
  3. Alcoholism or drugs used by parents
  4. depressed parents or suicidal parent
  5. the child feeling inadequate when watching a loved one be abused
  6. being different and not understood, for ex: a child with ADHD
  7. Excessive arguing especially if there is shouting in the child’ ambience
  8. In other words anything that threatens a child’s security

As an holistic physician and spending a lot of time with each patient I finally learned that what pushes one persons buttons, the same action might not affect another. For instance, a person sitting across from me may be telling me something that they believe is causing them stress; while I am sitting there thinking silently what is the big deal about that event. But if they heard what I would claim causes my stress they may think “Big deal.” Each individual has their own buttons that sets off their stress, anger, and anxiety. Any button pushed for an individual can set off their “flight of fight” cortisol and adrenal hormones. This is true with children and especially teenagers. We read more and more about teenage depression and increasing suicides and especially indulging in drugs.

If it is a constant button pushing stimulus even youngsters  can end up with Adrenal Fatigue or one or more illnesses as discussed in earlier chapters.  But I have also found within myself and clients it can be a one time act or past experience that for some of us ruminates into adulthood and even older age. Of course, once we realize the buttons that do not have to be pushed anymore there are many ways to erase them. For me, and many of my clients this was via hypnosis, self-hypnosis, and different types of guiding imagery. All the latter with a qualified expert that is compassionate and certainly non-judgmental. We learn quickly that we do not need the childhood experience as a teenager nor adult. Some things can even be erased using hypnosis until the individual is ready to deal with the issue.

As is true with most of us it is a lesson to be learned with aging not to judge others by our own philosophies, political feelings, economic perceptions,etc and then projecting them onto anther individual or group. We all have our own agendas which should not be projected to others. And even these agendas often change with age – we do not have to be stagnant as our knowledge and experiences develop. This can also fit into the stress releasing act of not having expectations. Expectations can often be disappointing but goals and hopes can help us grow.

 

Benign Prostate Hyperplasia (BPH)

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Getting old is not for sissies. No matter how good a life style we live now we still “Have to pay the piper” for the many past years we had a different life style. Hopefully we have evolved to a better, healthier life style but certain things still happen to us as it will to any older engine. For men, it is Benign Prostate Hyperplasia; an enlargement of the prostate.

Normally the prostate is the size of a walnut. But as men age the prostate enlarges and causes uncomfortable problems which is designated as BPH (Benign Prostate Hyperplasia): the urgency to “pee”, especially nocturia (the individual has to wake at night more then once to void (i.e. to urinate). This can leave him tired in the AM and maybe throughout the day especially since for some it is difficult to fall asleep immediately again. Besides the urgency to urinate there is the dribbling. This can be embarrassing if it is in the underwear or even coming through certain colored pants like khaki. It can limit the male to activities where he would be away from a bathroom. There is the slowing down of the stream so that he ends standing over a urinal for excessive time, often when there is a line behind him.

All the latter is because as the prostate increases in size it pinches the flow of urine from the bladder to the penis and not only causes the slow flow and dribbling but also stops the bladder from emptying on the first try. The latter can be just from the pinching or causing a backflow of some of the urine as if it was making a “U” turn. This leaves excess urine in the bladder which needs emptying sometimes soon after the first try or at least in the near future. This partially empty bladder leads to the uncomfortable feeling of urgency. This leads to the stress of feeling old, unmanly, loss of confidence for going to places where you have to sit for long periods of time like out to dinner or a movies. It can also increase the occurrence of urinary tract infections since the urine left in the bladder can be like stagnant swamp water to breed unwanted bacteria. This is specially true if the male does not want to frequently interrupt a meeting often to excuse himself to urinate.

In previous blogs and in my book I write a lot about the advantages of testosterone and enumerate the laboratory tests a male should undergo to check his testosterone levels and the hormones that are also necessary to check at the same time. Dihydrotestosterone (DHT) is a very strong testosterone – like hormone that derives from testosterone. This is especially true with very high levels of testosterone and/or with aging. In many cases I do not at first check the DHT unless I feel there are signs or symptoms that require the test. One of these is signs and symptoms of BPH. This is because DHT is believed to be a main causal factor for the enlargement of the prostate. Baldness is also attributed to DHT along with other evolutionary and DNA factors This does not mean that a man on testosterone needs to stop the advantages of it. There are many natural and pharmaceutical ways to interfere with this conversion of testosterone to block higher levels of DHT. Since we know the enzyme 5-alph reductase is what converts testosterone to DHT we can block this process either naturally or with pharmaceuticals.  I do not like to give medical treatments without seeing and examining a client but typically one can try combinations of saw palmetto, zinc with copper, pumpkin seed, beta sterols (which are plant steroids without the negative side effects),pygeum and a few other herbs. A good supplement for BPH will have most in one capsule. Remember each person is an individual so one does not always get the results wanted by following the instructions on the bottle. I usually recommend a loading dose higher then the bottle states. I may maintain this dose according to the results and then tweak them or let the client do so.

I also refer those reading this to my other blogs on prostate and also on testosterone and especially for easy clarification and greaat information to my book; Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.

Stress & Obesity-The Fallacy of Medical Treatment

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As pointed out in my book, a lot of obesity or being overweight is due to stress. It is obvious that so many of us that are stressed turn to fast foods and high caloric foods for comfort (comfort foods). We also overeat (snack) as a coping mechanism since a lot of junk food is high in sugar which stimulates the serotonin centers. Unfortunately this stimulation only lasts a short time with these foods so more of the high sugar foods need to be consumed to keep this happy (but guilty and guilt causes more stress) feeling. Very important is that stress stimulates cortisol (see my other blogs or book on stress for a simple but extensive explanation) which ultimately leads to the liver constantly putting out sugar for the “fight or flight” response. This outpouring of sugar which cannot be used ends up being stored as triglycerides (fat) and therefore weight gain and insulin resistance and then finally the Metabolic Syndrome (another blog on this Syndrome). This is true even if one has dieted and lost weight, the probability of gaining it back is high since the stress still exists.

Synthetic substitutes are even worse then sugar for causing weight gain and evidence suggests strongly many are carcinogenic. There is scientific evidence that diet drinks and sugar substitutes (aspartame, saccharin and others) surpass the detrimental effects of regular table sugar. Here we get into leptin resistance; leptin hormone (Greek for thin) regulates appetite and fat burning and tells us to stop eating.  Fat tissue produces leptin. Therefore the more fat the more leptin which leads to leptin resistance and therefore the appetite is not suppressed. Leptin actually signals the brain’s hypothalamus to signal the body to stop eating and start to burn fat and glucose. This gives more storage space to renew storage of glucose in the muscles thereby taking it out of the blood.  Therefore, the pancreas does not have to produce more insulin and the body is burning more fat and avoiding insulin sensitivity to sugar cell receptors. Obese people have leptin resistance because the fat cells (adipocytes) have produced so much leptin and therefore desensitized the mechanism to stop eating. Red meat and dairy also seem to halt the leptin signaling. There is more complicated biochemistry to leptin but not for this blog. A good source for information is Perter Kash’s book Freedom from Disease.

There is no way of avoiding stress, it is part of our lives:  But it is not the stress itself but how an individual deals with stress. The response to stress is an individual one; something that really freaks out one person may be no big deal for another. As said, it is not the stress itself that is the problem but how we cope with it. There are ways of responding to stress that are not detrimental. I believe that stress is the cause for almost all illnesses as I point out and reference with evidence based scientific research in my book. Eating as healthy as one can and exercising is a must (as now is seen in our children where I of 3 is overweight or obese); but it is not the full solution. One must uncover the reason for their overeating and especially of “dead foods.” Some people are prescribed pharmaceutical(s) for the stress problem especially antidepressants which can cause the side effects of weight gain, depression and sexual dysfunction obviously causing more stress. It is now known they have a possibility of suicide and aggressive dangerous behavior.

Taking pharmaceuticals for obesity or choosing surgery too often gives the patient false belief they can continue a poor life style since they are on medication or had some type of stomach-intestinal intervention. I believe that finding the cause is especially important even before a person is persuaded into doing one of the many stomach procedures such as bypass stomach surgery or balloons: and the education that they still have to deal with their life style. If they keep eating the same way they may not gain weight (or they may) but are still clogging their arteries leading to cardiovascular problems and high glucose consequences such as the Metabolic Syndrome (see my blog or book on this) or diabetes. After all, the sugar and fats have to go somewhere. Also, shortening the digestive tract will not allow for normal absorption for instance certain vitamins like ADEK which depend on fat for their absorption.

Although I am an holistic physician at times pharmaceuticals may be temporarily necessary. Let me explain; if a person has a Urinary Tract Infection (UTI) there are supplements that possibly may cure it; but rather then put the client through the risk of the possibility of getting the sequel of polynephritis or glomerelonephrits I would rather treat that person with an antibiotic to prevent these serious possible problems. What I would do at the same time is double their probiotic and keep them on it (which all people should be forever) for at least two weeks after the infection is gone. Also, I would be seeking the cause of the UTI especially if they get frequent ones. There is room for both types of medical treatments depending on the illness and the client. Discussion and input from the client is essential.

If a stressed person’s belief is in holistic medicine and wants to be off pharmaceuticals like antidepressants they should not spontaneously abort them which can cause withdrawal problems. Also the person may be too scared to stop taking them for fear of the return of depression or other anxieties for which they are using the pharmaceutical. (This is true for all diseases and medications). There are many ways to perform weaning off of a medication and either simultaneously using a supplement or/& an alternative life-style route. But notice how many people on medicines have not changed their life style to help themselves. They believe that the pharmaceutical is their panacea. Also, if on pharmaceuticals it is important to re-examine oneself and for the physician also to do so because If you are one of the smart people, that is pro-active, with your life style you may not need them anymore and can be weaned off of them and on nothing. I have seen this with so many of my clients for many chronic dis-eases. Staying on an unneeded medication or supplement is not only expensive but the chemical may have a long term negative affect.

Now realize that there are some real medical conditions that cause weight gain and obesity. For example, hypothyroidism untreated since one is not metabolizing their food intake. This is not a difficult diagnosis for a physician to make with lab tests and a good interview with an exam of symptoms and signs. But even in this condition a holistic approach can often alleviate or cure hypothyroidism. Again, the patient and the physician must remember that hypothyroidism, and for that matter any illness may carry along with it stress to different degrees depending on the person and the illness. Part of the cure in any illness is the individual’s stress diminution.

I find that hypnosis, learning self – hypnosis, meditation, yoga, exercise etc. are especially helpful. Hypnosis and guided imagery get quickly to the cause of stress, depression and poor dieting problems and is relatively an inexpensive path to follow.

Alan J. Sault MD, AB HM-diplomat

Author: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it

holisticsecondopinion.net/vampires

Natural Alternatives to Cox Inhibitors

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painMany of you were probably among those that found some relief from arthritis or other pain problems with Cox 2 inhibitors. A (COX-2 selective inhibitor is a form of non-steroidal anti-inflammatory drug (NSAID) that directly targets cyclooxygenase-2 [COX-2], an enzyme responsible for inflammation and pain. After several COX-2 inhibiting drugs were approved for marketing, data from clinical trials revealed that certain COX-2 inhibitors caused a significant increase in heart attacks and -Bextra, Viox,  Celebrex were removed.  You  probably were experiencing anxiety and frustration when these drugs had been withdrawn because they contribute to heart problems plus you stil had some degree of pain (mild to severe).  It was already known that Cox-2 inhibitors contributed to ulcers and osteoporosis.  Now there are new anti-pain and arthritic NSAIDS that once again the FDA has approved  to take their place still that are still one of the leading causes of ulcer.

But like so many of the medications used and advertised there are many side affects especially with long term use. For example, opioid addiction and deaths that have become epidemic. Unfortunately the pharmaceutical companies either put the side affects in “quick talk” along with videos of happy grandparents playing joyfully with their grandchildren while skating over all the possible side affects as the CEOs athletically run to deposit their salaries.

The good news is there are natural anti-inflammatory medications -supplements that have been giving relief for hundreds of years. These are some that work well from my own experience and with my clients. I know there are many others including alternatives like going to a qualified and empathetic acupuncturist or chiropractor. Try to choose one that also gives you homework to do so that you learn how you can diminish pain. Also, I like radiographic evidence of what is the pathology to cause the pain. Alleviation is just that-alleviation: we want to try to get to the cause while working to alleviate a health problem.

The following are just two of the natural anti-inflammatory supplements that I have had success with clients, myself and family.

CURCUMIN: (ALSO KNOW AS TUMERIC:  This is the yellow pigment in curry dishes. It is as effective as cortisone and COX 2 inhibitors in reducing inflammation without causing the side effects such as ulcers and osteoporosis. It works by inhibiting the major inflammatory factors ( leuktrienes and thromboxanes) that Bextra and the other Cox 2 inhibitors did not, thus causing the heart problems that made them dangerous. Curcumin  may not take away acute pain but over a short time will bring down the inflammation that is contributing to the pain. That is why at times I will start the client on a stronger pain medication (opioid) along with the curcumin and then in 2-3 days  take them off or wean them off the opioid. That I do only for certain cases if the injury is obviously causing augmented pain. There is now evidence based medicine that curcumin may help prevent certain cancers and help along with cancer treatments when the cancer is already established.

GINGER: – This natural remedy also stops the production of the inflammatory chemicals mentioned above.  It is also a strong antioxidant. Another application of ginger is its use in nausea and vomiting. That is why physicians are recommending it for nausea during pregnancy and for people with moti good gut health but  like any thing that makes the body function properly (hormones, enzymes etc) there exists an optima amount.

These suggestions are effective natural solutions that have no real side effects unless one is allergic to them. There are many more natural ways to inhibit different  arthritis-like problems that also have other benefits for the  cardiovascular system; such as exercise, different types of yoga, different types of meditation. Remember, as I wrote above, there is a place for alternative body work wither by itself or in conjunction with allopathic medicine or your supplements. Just be sure there is a correct diagnosis. It is beneficial to talk to your doctor about the right way to  take them and helpful activities for your specific malady since each person is different.

Self hypnosis and  imaging:   With these techniques one can learn to decrease pain and tension in a very short time. All it takes is a good instructor and practice. Do not forget about the healing effects on arthralgias (rheumatoid arthritis, osteoarthritis, etc.) that the gentle forms of yoga can provide. I believe I have been saved from a shoulder prosthesis operation for more then 20 years doing yoga.

The introduction to  my book: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it, tells my story how I was introduced to hypnosis and imagery 25 years ago and have been using to this day.  I have even sutured  little children just using hypnosis. Both can alleviate pain and cure the cause so often.

 

 

 

 

 

 

But as always whether it be allopathic pharmaceuticals or natural that alleviate inflammation or pain the cause needs to be searched and investigated.

Myth:Testosterone causes cancer

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The belief that testosterone causes cancer of the prostate is a myth from the old school. I was also taught this myth 50 testpsterone mythsyears ago in medical school. If it were true then men at twenty when testosterone is highest would have prostate cancer or at least starting to show differentiation of cells that could be a precursor to cancer. It is now known that it is estrogen [especially in excess] that contributes to the cause of prostate cancer in men and not testosterone: and of course life style. There are many reasons that a male can have higher then normal estrogen levels which I wrote about in my book and in a blog on anti-aging (holisticsecondopinion.net/vampires).

All fetuses at first are female and have a uterus until the genetics kick in to change an individual to a male. At this point the prostate becomes the organ instead of a uterus. However what would have been the uterus now exists inside the prostate as a vestige of the uterus called a utricle that has estrogen receptors. (This is the same hormone that contributes to  breast and uterine cancer in women ). This is why we need to get estrogen levels prior to initiating testosterone therapy and then again months latter to see if the client is converting the testosterone to estrogen, called aromatization due to the aromatase enzyme that does this. We do this even sooner if there are any signs or symptoms that suggest this aromatization so that we can stop it.

While there is a continuing difference of opinion among doctors as to whether testosterone will speed the growth of an already existing cancer of the prostate, since it is a growth hormone (anabolic hormone), it does not cause the original cancer (www.medaus.com, “Testosterone and prostate cancer: an historical perspective on a modern myth”, April 13, 2007).

I believe a short history of how the myth of Testosterone replacement therapy (TRT) and prostate cancer (pCA) evolved. It started in 1941 with a poorly unscientific study by C. Huggins and CV Hodges (Cancer Res. 1941; 1:293-297) in a study on two men. One being castrated and the other on estrogen therapy. They stated that the administration of testosterone (of coarse it was synthetic testosterone) caused the pCA to grow. Actually what they showed was that acid phosphatase increased in these two men when a daily injection of testosterone propionate was given. There was no following of PSA or free PSA in 1941. (Acid phosphate being a product of the prostate that goes up with pCA). Therefore, their conclusion was based on acid phosphatase and not other evidence. Another fault in this paper was the men already had very aggressive and metastatic pCa. For another these studies were able to be duplicated. Unfortunately from this non-evidence based study and (no control done with it) the medical community has traveled down a path that is  definitely contra to the scientific method.

I always recommend certain tests before beginning a person on testosterone and then repeating them in the near future. The latter depends on the client and circumstances. After a long interview I determine if other laboratory tests are necessary besides those below. These are:

  1. CBC with differential

  2. PSA (if male)

  3. Liver function tests (a healthy liver detoxifys any excess estrogens which can occur with a poorly functioning liver.)

  4. Estradiol (for men and women)

  5. Testosterone – both free (to see what will get into the cells) and total. A total T is a waste by itself since like any hormone it is what gets into the cells (free T) that is important.

  6. SHBG-(sex hormone binding globulin)-which can tie up the testosterone if too high. I often get this when I repeat these tests in about 4-6 weeks.

This pCA as stated already is rare in men in their younger years when testosterone is at peak levels. The rebuttal or thought about this may be that it takes many many years for the cancer to manifest itself. This latter statement maybe true but because of the restraint of doing research on this by the National Cancer Institute and the US National Institutes of Health we do not know the answer to this. But if it does take 30-40 years for testosterone to cause pCA then obviously there should be no problem in offering it to men ( especially if they have no symptoms nor signs of pCA) in their 60s and older if they are manifesting the symptoms and signs of testosterone deficiency which could be quite depressing both mentally and physically (see other blogs on testosterone therapy). Also, I wish the reader to keep in mind when I write about hormone replacement therapy I only use human bio-identical hormones and not synthetics such as testosterone proprionate, ciprioante or ethonate which are commonly used in studies.

The studies so far have been scant and synthetic T is the T of choice for the studies.. Also the studies are most often done with men that already have invasive pCA or even metastatic pCA. There have been, however, some studies showing that pCA is not related to the use of T hormone therapy. For example, Prout and Brewer (Cancer. 1967;20:1871-1878) showed that T injections on men with pCA “Most of these individuals experienced an increase in sense of well being and some noticed vague diminution in pain.” The same two also stated that the acid phospahtase response to T injections was “extremely variable.”  Remember that men not taking T supplementation get pCa. There now is  a lot of literature suggesting  that in most cases surgical intervention is not necessary. Still I believe that certain tests should be done if the patient and the physician have any doubts if pCa is present and of the aggressive type.  (See blog on BPH and prostate cancer at holisticsecondopinion.net/vampires).

As I wrote in my book, T developed a bad reputation for side effects because of athletes taking huge doses of synthetic T with other growth enhances. A good holistic physician does the appropriate lab work and studies it so that he can individualize the dose and have it made by a compounding pharmacist so the it is a bio-identical testosterone for the individual.

So to summarize why T is scary to the medical profession and the myth is the following:

1. No reliable marker was used that started this myth such as PSA

    1. Control groups were not incorporated  often in the different studies.

    2. In the past 25 years there have been no studies that replicate the findings that have brought the original myth into the medical field showing that T causes pCA.

    3. Synthetic T is the testosterone that is used in studies which of itself could cause pathologies. An example of this is the Woman’s Health Initiative study done on women with synthetic estrogen and progestin. Progestin  is not a really progesterone) which had to be stopped very early due to all the dangerous cardiovascular and cancer side effects that the  women were getting. The study was stoped early with these synthetics but the FDA still has them on the market and physicians are  using them instead of bio-identical hormones. Human Identical Testosterone (HIT) made by a an experienced compounding pharmacist is what our bodies have evolved to recognize and use.

    4. More studies using bio-identical testosterone on men with pCA both new pCA and advanced and also in men without pCA (the latter in long term studies to see its effects compared to long term non users of testosterone) need to be done.

       Alan J. Sault MD, ABHM-Diplomat

Book: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it

The Placebo Effect

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PlaceboMany years ago in the ER I proved to myself that the placebo affect is real. I had one person that was in the ER very often (who I called a frequent flier). After a few times I emptied samples and gave the plastic shells to her. I gave her specific instructions and also told her that they were of  high potency and therefore could be dangerous so follow my instructions. She always got better and would only come on my shift since I knew the right medication.

Switching to being an Holistic physician and seeing the results of hypnosis (and self hypnosis) and Interactive Guided Imagery taught me that illnesses can heal without drugs in many instances (BP for example). A lot depends if the person has a negative or positive outlook on either the ailment or life itself. It is known that exercise is equal to pills for mild to moderate depression. I believe this is so not only for the increased hormonal affect but due to the socialization of being with others and their energies; and also being proud of oneself for achievement.

Holistic medicine includes the triad of mind-body-spirit and finding the cause and not just alleviating an ailment whether with pharmaceuticals or alternative medicine. I believe one must note that alternative medicine in many instances is successful also due to the placebo affect it is not just allopathic pharmaceuticals that should be accused. There is a place for both allopathic & alternative medicine; but there is always a place for self-exploration of why one has acquired an illness and what they can do to not only cure or alleviate it but also to prevent future occurrences of it and others. This is why I stress the stress factor and the immune system in my book.  One must realize that it is not the stress but how we react to a stress. Also when a person starts to be pro-active with working on stress solutions they are modulating their life style and therefore their health (and working with the healer).

Part of the placebo effect is having confidence and respect for your healer. One that the client can relate and that takes the time to relate to the client. My theory is: the physician is teaching the client and the client is teaching the physician. The physician is their to guide and for being a life-guard when necessary.

The mind can keep us healthy and heal and the mind can make us sick. The choice and options are ours. It takes a lot of work to clean up our inner negativities and fears. I have been working on this for myself for > 40 years using self hypnosis and Interactive Guided Imagery (and slowly progressing – the dance of 2 steps forward and often one step back). I have treated many patients with chronic diseases including cancers for years and have seen the differences when a person is positive or negative. Even if they came to me with a late stage terminal disease prognosis but positive energies they can still die with quality of life playing with their grandchildren. Often with IV alternative treatments they avoid their death diagnosis. I was one of these 10 years ago. So often the physician tells a person that they have a 60% chance of dying and never gives the positive that they have a 40-50% chance of living. I often wonder if the death sentence that is proposed by the healer and the client goes and spends all their savings and then lives another 10-20 years; are they glad about the extension of life, or angry about not having any money due to a the death prognosis (or wrong diagnosis-it happens). I myself am fortunate since my wife is an expert in both hypnosis and Interactive Guided Imagery. For example,I have sent people to her after my interview that just wanted BP meds and have her do hypnosis (for free) on the person. So frequently they drop their BP because stress is the cause of the vascular problem. So we work from that point on with both my medical and her psychology.

Much of the above seems to get off the subject of the placebo effect but the point is that it is the mind  that cures  with a positive outlook on the treatment.  Therefore one can have both, a medicine (whether pharmaceutical or alternative) that helps plus the placebo effect. As an aside, sometimes giving a person a supplement or pharmaceutical does not cure them for two reasons: 1-they feel they have carte blanche to keep their harmful life style and the medicine will be the panacea: 2-They are alleviating a situation instead of finding the cause and working on this.  This is especially true for delving into stress and its relationship to dis-ease.

Alan J. Sault MD, ABHM-Diplomat

Author: “Emotional Vampires and Your Hormones: an holistic physician’s view on how stress affects your well-being and what you can do about it”

holisticsecondopinion.net/vampires

EXERCISE=FUNERCISE (WHY????)

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EXERCISE 

Because I have been an holistic MD for the last 25 years and anti – aging is one of my specialties, I have an interest in both exercise and nutrition. On the subject of exercising for health, it is impossible to separate nutrition, and stress. You can work out religiously but if you are not eating wisely the full health benefit is not reached, because the body is not receiving the nutrients it needs in order to build healthy tissue and the cellular components for energy renewal. By the same token, if you eat healthy foods but do not exercise the health benefits are diminished. Muscle has to work to maintain or increase its mass. Now if one is doing both of the latter but the routines of either one or both are resulting in stress this can also defeat progress and health. For this blog I will concentrate on exercise; the next blog will be on nutrition. Stress is always a factor in health to me. Not the stress itself but how we react to stress.

After years of abuse, both poor nutrition and lack of exercise can have chronic consequences on the body. This is especially true if proper nutrition has not been followed for long periods of time while the body was under physical stress, such as intense sports training. Mental stresses have similar negative effects because of the constant adrenal – cortisol response to mental stress. (Please refer to my other blogs on stress – holisticsecondopinion.net/vampires). A quick reminder is that the body – mind cannot discern between physical and mental stress. The response to both are equal to cause the same output of cortisol for flight or fight protection and the consequences of chronic stress.

I do believe that both aerobic exercise and resistance (weight) training are necessary to keep a healthy body. The resistance is necessary to build strong muscles and bones and to prevent osteoporosis deflating muscles and to keep strong tendons: the aerobic for cardiovascular health. I have  a lot of experience in both and now share my ideas and experience with patients. I find this helpful because many people are either afraid of starting or have no idea of how to start. Stretching both before and after exercise keeps the muscles toned and helps prevent injury. When I was teaching karate I would emphasize to the students that having big muscles is no advantage if the joints do not react properly and are prone to different types of tendon-joint injuries. This is especially true as one advances in age. Exercise does not have to be either strenuous nor boring. In fact, I like to call exercise “funacise.” Today there are many different types from which to choose. Some people would benefit from joining a gym so that the exercise is structured, the equipment is there and varied, instructors are available, and the possibility of a social atmosphere is present. The latter can be especially helpful for those that do not have the incentive to exercise and to those that have depression so they are with other people. (A caveat to this is the many scientifically based studies that demonstrate that exercise is as effective for mild to moderate depression as the pharmaceuticals).There are numerous classes offered in different forms of exercise. Other people prefer to exercise at home, using their own equipment and/or videos. The problem with this is that one may not be using proper form if no one is watching, correcting and teaching and therefore prone to cause injury. It can be beneficial to have an exercise partner so that you can keep each other’s motivation high as well as having time to enjoy the company of each other. The type of exercise that works for you is the one you enjoy. Once in the habit of your choice you may branch out to other forms. Sometimes motivation is diminished because of boredom of the same repetition each time. There is no reason for this. If it is aerobic exercise that one does for 20 minutes or more it is not necessary to do a continuation of the same exercise. One can do 5-10 minutes of bicycling and then switch to rowing or treadmill, Etc.. Of course you can do different aerobic exercises on different days or join certain classes of different types. Walking is still one of the best and least physically invasive forms of aerobics if the person is not a “dawdler.” Your favorite music will help as you can sing with it even if you have a voice no one else wishes to hear (my own personal experience). For myself, I like to combine weights and aerobic by not stopping lifting but rather go right into a different muscle group even if using light weights. This cuts down on the time I spend “funacising” to about 20 – 30 minutes with all the benefits of both. Of course, it is important first to learn good form so you do not injure yourself while trying to improve your health. For those that dislike exercising, especially resistance exercise, you can get around this and be finished quickly if you do the eccentric method. This is done by taking a light weight and doing the extension part very, very slowly. For example, biceps: lift up a weight you consider lighter then normal for yourself but let it down (with good form) to the count of 12 or more. You will ache after 3-5 reps. You can do this eccentric exercise for any group of muscles.

There is a caveat to any form of exercise be it resistance or aerobic.! If you know you are an obsessive and/ or compulsive personality, or competitive personality you need to watch stressing yourself to the point of defeating the purpose of exercising. Why? Because exercising is to relax your mind as you become physically fit. It is not meditation but a form of moving meditation in the sense that you are escaping from the everyday stresses for the time that you are exercising. You do not need to add another stress to the day. When I was running a mile for each round that I fought I would get so aggravated if I did a poor time or was not progressing in my time/mile. This is competitive-obsession. My wife would ask me why do I run and I would say to relax – duh. When I would come home from my emergency-room shift and be “up- tight” and volatile before I was allowed to sit down and eat with my son and wife one or the other would say first go down to the basement and jump rope for half an hour-to-forty-five minutes. It worked every time to get rid of the ER mind trauma so I could enjoy my family meal.

When one starts to do resistance exercise they may get really severe muscle aches the first few times they are working out. Some refer to this as good aches “No pain, no gain.”. This latter is only true if you are going into this for body building and do not care about future osteoarthritis. DOMS (Delayed Onset Muscle Syndrome) is the proper term. They use to believe that these aches were due to lactic acid buildup from the workout. It is really the muscles healing from the nano tears that are a  result of a proper workout. It is the repairing and building up of the muscle. When it occurs be thankful and happy that your body is responding properly. They will not occur after you get through the beginners part except when you decide to start a new plateau or new type of funercise. Sometimes when you leave go of the exercise for a long time and start again DOMS will hit but for a shorter time. Do not forget that form for each muscle group is so important. Above all ”Do no harm!”

Some people tell me that they do not have time to exercise or even relax. Think of it this way; taking time for yourself is doing something.
I point out that they have time to be caretakers each day for their spouse, boss, children, etc, but not an half hour per day for themselves. This is sending a subconscious message to their brain that everybody else is worth their time but they feel they do not deserve time for themselves. “Today I will love myself enough to exercise.”

Alan J. Sault MD, ABHM-Diplomat

Author: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it

holisticsecondopinion.net/vampires

Thyroid Dysfunction – the shape shifter dis-ease

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Hypothyroidism

The thyroid hormone is one of the main hormones that stimulate the furnace of the cells to produce energy. Without it, or when the thyroid hormone is low, food cannot be used and is stored as fat. The most common signs of hypothyroidism are:

  • low temperature below 96.4 (depending who you read). But definitely feeling cold when everyone else is comfortable.
  • fatigue for unknown reason(s)
  • loss of hair and outer 1/3 of eyebrows
  • dry, scaly skin especially of the shins
  • constipation that is new for the person
  • weight gain even though the person is eating normally for themselves. Especially if they are working out to lose weight

The symptoms and signs of low thyroid production can masquerade as depression, menopause, and psychosomatic. The interpretation of reading the laboratory results can mislead the physician thereby masking this diagnosis of the hypothyroid problem. The main blood test used to diagnose this is abbreviated to TSH (thyroid stimulating hormone). TSH is what is ordered by the physician to see if you have a thyroid problem. The numbers that the physician looks at to see if you are in the normal range has been controversial for a long time. Depending on the lab the TSH range was.35-5.5 but has now been changed to .3-4.5. This because it was found that too many cases were being missed by a lot of doctors looking at a high in the normal of 5.5. Doctors have been debating for years whether to lower the upper limit of what is considered normal for TSH since so many people whose blood work shows their TSH close to this upper normal limit still have the symptoms and signs of a low thyroid. Unfortunately, the missed diagnosis of hypothyroidism because of misleading lab results is not the whole story. The Colorado Thyroid Disease Prevalence Study found that when tested for thyroid dysfunction 10% of the study’s 25,862 subjects had abnormal findings (high normal being 3.5). That figure, if extended to the general population nationally, would mean there are about 13 million people with undiagnosed thyroid abnormalities. And if, as recommended by many physicians, the upper limit of TSH for thyroid dysfunction were reduced  to 3, it would mean that 20% of the population is affected.

But when a busy physician takes a history of all the above symptoms and signs s/he may only hear depressed, tired and menopause and see lab results in the normal range. It would be in the patient’s best interest, I believe, to consider the signs and symptoms first and the blood work second.

A low thyroid level is called hypothyroid or hypothyroidism. Hypothyroidism may also be caused by a poorly functioning adrenal gland, since too much or too little cortisol affects the thyroid hormone. The adrenal gland produces cortisol and adrenaline in response to stress, and powers the Stress Response that prepares the body to fight or flee. In the initial stages stress causes higher than normal levels of cortisol: When the stress is chronic the adrenals eventually wear down, a condition known as “adrenal fatigue,” and cortisol production drops below normal levels. Therefore there is not enough cortisol available to sensitize cell receptors to accept the hormone nor to convert the T4 to T3.

As we have seen, production of many hormones, including thyroid, is lowered when the body is stressed. The Stress Response at first triggers the adrenal gland to produce higher levels of cortisol, that signals the body to put all its energy into the systems that will help to fight or run – the large muscles. To do this it takes energy away from functions that are not essential to those life-saving activities such as the sex hormones, thyroid and the GI tract. In the case of chronic stress, the adrenal is overworked continuously and the cortisol production becomes less and this too results in hypothyroidism.

The machinery of the body functions on precise amounts of each chemical, some measured in billionths of a gram, and this includes the hormones. This precise amount for each hormone is known as the physiological quantity (for that particular hormone). All the hormones have to be available in the appropriate physiological quantity in order to function in harmony for optimum well-being. It is like a symphony with each musician playing exactly the right notes in harmony with all the others.

Many women entering menopause not only experience the effects of diminishing sex hormones but also have a thyroid problem. I believe the depression that accompanies both menopause and hypothyroidism comes also from the physical changes: constipation, hair loss, feeling cold, gaining weight, fatigue that disrupt one’s life. I believe that the thyroid should always be explored before starting pre and post-menopausal woment on antidepressants. OK, now, I want to introduce what can go wrong with the thyroid and why conventional treatment may not work or even make the hypothyroidism worse.

The thyroid gland is stimulated by a complex feedback system. The pituitary gland stimulates the thyroid to produce T4 (thyroxin). The pituitary gland then responds to a feedback to the amount of T4 whether to stop stimulating the thyroid gland (enough of it) or to keep stimulating it (too little). In other words, the pituitary is responding to the amount of the primary(T4) hormone produced by the thyroid.. However, T4 is inactive, and must convert to active T3 in order to do its job. The conversion from inactive T4 to active T3 requires the right amount of selenium and cortisol. If selenium and/or cortisol are lacking or levels are inadequate, the feedback of T4 to the pituitary gland can make the level of TSH appear normal, since the T4 is sending the message that all is okay. The physician reading the lab report sees that the TSH is within normal limits, even though the patient is deficient in T3. All this is made more simple and explained with diagrams for the layperson in my book: Emotional Vampires and Your Hormones: an holistic physician’s view of how stress affects your well-being and what you can do about it.

And the plot thickens. Under stress, T4 may convert into what is known as reverse T3 (rT3). The rT3 molecule is just like the T3 molecule , except that one of the three iodine ions is in the wrong position. This tricks the receptor sites of the cells. rT3 binds to the receptors, thus blocking any remaining real T3. But since the rT3 does not have the same active stimulating effect as T3 because it is not of the right molecular arrangement, it will not stimulate the thyroid’s metabolic functions in the cells. Therefore, prescribing T4 will not solve the problem. The more synthetic T4 a patient takes the more rT3 is produced and the patient’s condition either does not improve or gets worse. When the stress levels rise the same enzyme (iodinase enzyme) which is responsible for the conversion of T4 to T3 is also used for conversion of T4 to rT3. Therefore, there is not enough of the enzyme to convert to both reactive T3 and rT3. For some reason the conversion to rT3 takes precedence. As of today, it has not yet been explained why rT3 takes precedence.

let’s say the patient is being treated with synthetic or natural T3 but still does not feel well. It is possible that the T3 is not getting into the cell, because to get into the cell the T3 is again dependent on selenium and a physiological level of cortisol and these may be deficient. Or if the T3 does get into the cell it may not work if zinc levels are low, because here it is dependent on zinc for its performance on the mitochondria in the cell. Mitochondria are the multitude of little factories in the cells that produce energy.

So to summarize: it is possible for a physician to be fooled by lab work. In this case, T4 levels remain normal but are not being converted to the usable T3 or as just explained the T3 cannot be utilized. The feedback of the T4 from the thyroid is still telling the pituitary that all is okay and therefore the TSH remains normal. But if the patient has all the symptoms and signs of hypothyroidism, then I would say the heck with the lab work being in the normal limits. An rT3 test is needed here and maybe some other thyroid tests: T3, FT3 (F=functioning), T4, FT4 and an autoimmune profile for thyroid (It is a possibility that the body has formed antibodies against an aspect of the thyroid hormone or the receptors for it).

Another interesting theory is that when cortisol is low causing the gut does not absorb normally. This can lead to leaky gut syndrome, which means that certain large protein particles that are foreign to the body are absorbed, and other nutrients that the body requires are not absorbed, such as amino acids.

Tyrosine plus iodine are needed to make the thyroid hormone. Therefore, if one has the leaky gut syndrome it may mean that tyrosine, an amino acid, is not being produced by other amino acids it depends on for its productions.

This was a shortened version of a chapter in my book (Thyroid and stress). I do hope though it illustrates how many things that the thyroid hormone depends on. Stress is still the big factor to sabotage a properly working thyroid and needs to be addressed whether the person is on synthetic hormones or more bio-identical thyroid hormones. Of course a good diet, exercise, a physician you can relate to and takes their time evaluating you and your smile and laughter goes a long way.