As women age, our DHEA levels fall dramatically after age 35. In fact, by age 65, they have sunk to a mere 10 to 20 percent of earlier levels. DHEA, a hormone produced primarily by the adrenal gland and the most abundant of all hormones, is converted by the body into many other hormones, including testosterone, estrogen, cortisol, and norepinephrine, all of which play a role in bone resorption and bone formation.

In the presence of Vitamin D, DHEA stimulates bone formation through its conversion in bone into a form of estrogen called estrone. In a study out of Japan, higher levels of DHEA in post-menopausal women correlated with increased bone density, while another Japanese study recently found that giving post-menopausal women supplementation with DHEA substantially increased bone building activity and reduced bone resorption.

In addition to the direct effects mentioned above, DHEA has been shown to improve bone health by reducing the levels and effects of cortisol on bone. Often referred to as the hormone of stress (fight or flight), cortisol stimulates bone resorption. In fact, the cortisol-to-DHEA ratio is an excellent predictor of future vertebral fractures in post-menopausal women.

It appears that DHEA is the only hormone which can both reduce bone resorption and stimulate new growth of bone. Although it is not now a common practice, it may be best for women with osteopenia or osteoporosis to have their DHEA levels checked and then receive supplementary DHEA, if their levels are low.

We anxiously await more studies on this subject. As with any hormonal supplementation, there are risks associated with usage. Consequently, we feel that any hormonal supplementation should involve close and careful supervision. If you have more interest in learning about DHEA and wish to discuss possible supplementation, please call for an appointment. If you are living a stressful life, you should probably have your cortisol levels checked as well.

 

Folic acid
Folic acid (one of the B vitamins) may help in the treatment and prevention of depression. Known primarily as an essential vitamin for women before and during pregnancy to prevent birth defects, folic acid now appears to play an important role in maintaining good mental health. Research shows that up to a third of people with depression have low levels of folic acid and that the lower their levels are, the more severe their depression becomes.

Also, persons with low folic acid levels respond more poorly to antidepressants. Two ongoing studies, one at the University of Oxford and the other at Bangor University in North Wales, are currently looking into the effects of folic acid on both preventing and treating depression. Meanwhile, a folic acid supplement, along with eating plenty of fruits, vegetables, and whole grains, seems prudent.

B Vitamins and Arsenic Levels
In Bangladesh, arsenic exposure is a major public health problem due to the fact that nearly 77 million people have been chronically exposed to large amounts of naturally occurring arsenic in the ground water. Dietary factors influencing the metabolism of ingested arsenic, however, may be important modifiers of the health effects of arsenic in this population. A study reviewing dietary intake of certain B vitamins showed that with higher intakes of the B vitamins thiamine, niacin, pantothenic acid, and pyridoxine (B6), there was a much higher degree of excretion of arsenic from the body. This offers the opportunity to reduce the incidence of arsenic related health problems through Vitamin B supplementation.

Metformin Can Lower B12 Levels
A study from the Netherlands followed the Vitamin B12 levels in patients receiving the diabetes drug Metformin over the course of nearly 4.5 years. It was found that patients on Metformin developed reduced levels of B12, as well as increased levels of homocysteine, a marker for cardiovascular disease . As a result of this study, the researchers are recommending that all patients receiving Metformin have their Vitamin B12 levels checked regularly.

 

For those of you who have been thinking about Botox, but just haven't tried it yet, now is your chance. We have never offered this unbelievable price before, but we want everyone interested in giving it a try to be able to afford it. Now ONLY $9 a unit, with a minimum purchase of 20 units - the typical amount to treat the forehead and area between the eyebrows. For repeat customers, we are offering the same deal at only $10 a unit! Usually the effects last about 3 months, longer or shorter for some.

For the entire month of July we are having the best special ever! Choose to rejuvenate your skin with a micro-dermabrasion, cosmetic skin peel, or a fabulous facial treatment and pay only $50!! And as this is a medical therapy, there are NEVER any gratuities to worry about. Your skin is the first thing noticed about you and is a reflection of your inner health and vitality. The largest organ in your body deserves the best.

Buy any 2 syringes of dermal filler and receive the 3rd for half price! There is no faster or more dramatic way to look years younger. And if you're worried that it might be painful, worry no more. The newest ones are mixed with local anesthetic and are nearly painless.

Choose any laser treatment package, have your first therapy in July, and receive an amazing 50% discount off our regular prices!! Call the office for details.

Buy any 2 skin care products and get a third for half price. (Third item must be of same of lesser value than any of other products purchased.)

 

Our wonderful massage therapist, Cherie, performs many different types of therapeutic massage, and will work with you to find the one best suited to your specific medical conditions. This month, we will highlight the Swedish massage, a gentle, soothing type of massage with nearly universal appeal and benefit.

The Swedish massage is characterized by moderate pressure and long strokes that run along the grain of the muscle. Not only is this extremely relaxing, but it has also been shown to provide great healing benefit. This fantastic therapy helps with depression, pain syndromes, immune problems, diabetes, cancer, and HIV. These findings were confirmed by the director of the Torch Research Institute at the University of Miami Miller School of Medicine, who noted that the key to this kind of healing is stress reduction, making this the perfect massage treatment for anyone suffering from anxiety or feelings of being "all wound up."

The Swedish massage is an ideal choice for all patients. For those new to massage, we recommend beginning with the Introblend massage, a 90-minute long, amazing experience, which is fine tuned to accommodate your own specific medical needs. We want to remind everyone that Cherie is available virtually every Saturday! For all massage appointments, call our office at your convenience.

A recent study from the University of Buffalo reported that 40 percent of obese men were found to have lower than normal serum testosterone levels. The percentage of men with low testosterone levels rose to 50 percent when the obese men were also diabetic. Additionally, it was found that as BMI (Body Mass Index) rose, testosterone levels FELL! The study showed that obesity and diabetes exert negative and independent effects on testosterone levels in men.

The Endocrine Society recommends that all diabetic men have their testosterone levels monitored, and with this new published study, the researchers are recommending that all obese men have their testosterone levels checked as well.

At WMGI, we concur with these recommendations and would also include any men who have symptoms of low testosterone. Typical symptoms are low energy, fatigue, feeling weaker, unexplained weight gain, anxiety, depression, hypothyroidism, hypertension, hypercholesterolemia, low sex drive, erectile dysfunction, and exercise intolerance.

 

Preliminary results from a prospective study presented at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology showed that girls on DMPA who had low Vitamin D levels suffered very substantial bone loss. Bone mineral density losses of 5% or more were seen at the hip in 50% of the study participants - this is considered very substantial. Also surprising was the prevalence of poor levels of Vitamin D in the teens. While half of the participants were found to have Vitamin D insufficiency (20-30 mg/mL), 43% had what is considered Vitamin D deficiency (below 20 ng/ml), and only 1% were found to have normal levels of the vitamin. As a side note, most researchers now believe that the goal for one's Vitamin D level is 50-80 ng/ml.

The recommendations from that study were to watch the Vitamin D levels of all teens on DPMA. Levels should be checked before beginning the regimen and at regular 8 week intervals if found to be suboptimal.

At WMGI we rarely recommend DMPA for birth control, as safer options exist for many of our patients. This is especially true, since DMPA is associated with numerous other side-effects such as weight-gain, headaches, and acne. We have been worried for some time about the long-term consequences of placing young women on high doses of synthetic progestin, which is already known to have numerous adverse effects. Becoming pregnant with an unwanted baby is absolutely to be avoided, but it must be clear that there are many safer contraceptive options, and they should be tried prior to using this potentially dangerous drug.

 

Many people have concerns about their finger nails and wonder why they don't look as nice as they would like. They think of their nails only in cosmetic terms and fail to see them as visual manifestations of underlying health issues. Actually, finger nails can be very telling about one's health. Here are a few descriptions of nails and what they may mean about your health.

If your nails have any of these appearances, we urge you to come in to have them checked out. We don't want serious health issues being ignored, nor should they be covered up with "fake" nails. Make your appointment with Dr. Christine Nguyen, or ask any of us at your next appointment to take a peek at your nails.

Pale or White Nails: may indicate anemia, congestive heart failure, liver disease such as hepatitis, or malnutrition.

Yellow Nails: often due to a fungal infection in the nails. However, it can also indicate severe thyroid disease, lung disease, diabetes, or psoriasis.

Blue Nails: can indicate a lack of adequate oxygen, which can occur in cases of lung disease such as pneumonia. Also, a slight blue tinge can occur in the presence of diabetes.

Rippled or Pitted Nails: often indicates the presence of inflammatory arthritis or psoriasis, often of new onset.

Cracked or Split Nails: dry and brittle nails that crack or split often suggests the presence of some sort of thyroid disease.

Puffy Nail Fold: when the skin surrounding the nail bed appears reddish and swollen, this often indicates a connective tissue disorder such as Lupus.

Dark Lines under the Nail: can mean that the person has a melanoma. When such a discoloration is found, immediate medical evaluation is warranted.

Gnawed, Chewed Nails: can indicate the individual has a chronic anxiety problem or has an obsessive-compulsive disorder. Such individuals often benefit from psychological interventions.

 

Obesity in children is truly a medical emergency with severe health consequences, warranting aggressive intervention. A new study recently reported at the annual meeting of the Association of Clinical Endocrinologists stated that nearly half of all obese children have nonalcoholic fatty liver disease (NAFLD).

NAFLD has a number of causes, but the most common is obesity. Significant amounts of fat accumulate in the liver causing inflammation. This can impair the liver's ability to function properly or cause liver scarring, which can lead to cirrhosis and liver failure. Sadly, the current long-term prediction is that by 2020 - given current and projected levels of obesity - NAFLD will be the most common reason for liver transplants, far exceeding all other causes such as Hepatitis B, Hepatitis C, and alcoholic liver disease.

If you have a severely overweight or obese child of your own or within your family, you must intervene on the child's behalf to encourage weight loss. Childhood obesity must be viewed in the same light as would any other potentially life-threatening condition. It is NOT just cosmetic!

Hypnosis is an extremely useful therapeutic tool which is available in our practice. It is offered by our psychologist, Dr. Sharon Phelps. By placing patients into a hypnotic trance, the opportunity for change is enhanced. The trance itself is not therapeutic; rather, in the hands of a skilled practitioner, it can greatly assist in the treatment of many challenging conditions such as insomnia, stress, emotional and binge eating, and cancer therapy.

We encourage our patients who have been facing any of these conditions to schedule an appointment with Dr. Phelps. Your life and your health are precious commodities, and we want to assist you in returning to a state of optimal health, utilizing the safest modalities available.

We hope you've found this issue of our email newsletter informative and enjoyable. We look forward to bringing you more news about opportunities to live better and healthier in the future.

 

If you would like to learn more about the many services provided by WMGI, please visit our Web site at www.wmgi.org.

 

Sincerely,

 

The Healthcare Professionals at
Women's Medical Group of Irvine

 

Several days ago I was in a local market picking up food for dinner, when I ran into a former patient. After greeting each other warmly, she began explaining why, after more than 20 years together, she was no longer coming to the practice. The reason was simple - I had become an out-of-network doctor. Before parting I told her that if she ever needed me in the future, she would always be welcomed back to our office. (I also told her I was proud of her food choices - lots of fresh, organically grown vegetables.)

After our encounter, I was saddened to realize that here was someone who clearly saw the benefit in buying premium priced, organic produce, yet was unable to fathom the value in coming to our high-quality, "organic" medical practice. Or perhaps it was only that she had no idea that we had changed so much, becoming an Integrative Medicine practice in the nearly three years since ending most of our insurance contracts.

In fact, our transition to the green and leafy world of "organic" medicine began with the realization that many of our technology-driven, "processed food" medical solutions just weren't getting the job done. They were expensive, and it was often difficult to tell if their worrisome side effects were doing more harm than good.

So we began looking for more natural solutions, ones that centered on understanding and treating the individual, rather than looking for a set of symptoms that could be dismissed quickly with a prescription or solved with the skilled turn of a scalpel.

We began expanding our notion of quality medical practice without giving up entirely on pharmaceuticals and surgical procedures. After all, eating a healthy diet doesn't mean you can never have cookies and ice cream again. Sometimes drugs and surgery are the very best treatment options we have, and we need to be prepared to use them when appropriate.

But there are also many times when "organic" solutions work best. So we work with you to design treatment plans that include exercise, diet modification, acupuncture, stress reduction, massage therapy, psychological counseling, and herbal supplementation. The results are just as good - sometimes better - and they have no "junk food" side effects.

It still bothers me that not everyone, especially former patients whom I continue to care about, can see the value of this approach. But I suppose that's just the way life is. Some people don't know, and some people don't care. Those of us who do, however, are the ones who will reap the benefits of free-range, organic healthcare.

 

Felice Gersh, M.D.