Members of the medical community generally believe that it is dangerous for a woman to get pregnant following breast cancer. However, at the European Breast Cancer Conference, research was presented stating that pregnancy may actually improve survival rates!

An analysis of 14 studies involving over 20,000 women showed that the women who became pregnant after being diagnosed with breast cancer had a 42% lower risk of dying from the disease than did women with breast cancer who did not become pregnant. One theory is that HIGH levels of estrogen may protect against breast cancer, especially the specific estrogen of pregnancy, estriol. This is especially noteworthy, since the currently used chemotherapy adjuvants, such as Tomaxifen, do not yield benefits even close to this.

At WMGI, we fervently hope that more research will be done on estriol. Estriol is not available in the US, except through some compounding pharmacies, for use by women. This would help us provide better guidance to our patients who wish to use various hormonal therapies and also to patients seeking more effective breast cancer treatments.

 

Heavy menstrual bleeding impairs the quality of life for many women and is the reason for many gynecological visits. In the past, large numbers of these women chose to have hysterectomies, though more recently the newer, nicer surgical alternative of endometrial ablation has been more popular. For women preferring a non-surgical option, the choices have included oral contraceptives, the progestin mini-pill, and the Mirena (progestin containing) IUD. To that list we now can add a new non-hormonal medication, tranexamic acid. This antifibrinolytic agent, bearing the brand name Lysteda, is now available by prescription. It reduces blood loss by about 50%. As an antifibrinolytic medication, Lysteda works by inhibiting clot breakdown, accomplishing this through the inhibition of the conversion of plasminogen to plasmin. This "new" medication is actually not new at all, having been available as an injectable agent for use in hemophilic patients for many years. In Europe and in Canada it has been used as an oral formulation, while in Sweden it is actually sold over-the-counter.

In healthy women, the dosage is 2 tablets, 3 times a day for as long as 5 days during a period. In clinical trials, it did not have any significant side effects, but, as a precaution, it is not used in women with a history of blood clots. The Mirena IUD has been found to be more effective in reducing menstrual flow and in England is considered the first-line treatment, with tranexamic acid considered a second-line strategy.

Naturopathic herbal remedies also exist for the treatment of heavy menses. Vitamins A, C, and K aid the re-establishment of normal menses. Bioflavonoids also help, as do several herbs, including ginger, yarrow, greater periwinkle, cranesbill, shepherd's purse, and Life Root. The mechanisms by which these various agents work are beginning to be understood, and include inhibiting the action of estrogen on the uterine lining, strengthening capillary walls, increasing the ability of the blood to clot, and improving uterine tone.

We are glad that so many non-surgical options now exist for women with heavy periods. If you, a friend or a family member suffers from menorrhagia (heavy periods), please come in for a consult. If you've been advised to have a surgical procedure for heavy periods, please get a second opinion.

 

Purchase three skin care treatments of your choice with Kris, our wonderful aesthetician, and receive your fourth one free! These treatments are transferable, so friends or family can share a package if you wish. Personally, we think you should keep them all for yourself. This offer includes a wide array of facials, peels, and microdermabrasion treatments.

Purchase three syringes of any dermal filler and get a fourth one of any type at half the regular price. Dermal fillers can take years off of one's face in about half an hour - nothing else gives you so much "bang for the buck." These are truly amazing products, and our patients are overwhelmingly delighted with their results.

Choose any laser package for 40 percent off our usual great price. If you have ever dreamed of laser hair reduction, or considered using lasers to improve those annoying under-the-eye wrinkles, reduce brown or red spots, eliminate unsightly red blood vessels by the nose, reduce acne scars, and the like, now is the time to take action.

Only $11 a unit, with a 30 unit minimum, for the original wrinkle eraser -BotoxCosmetic! In a matter of minutes, annoying crow's feet and worry lines are reduced to fading memories. Once you witness these wondrous results, you may never again be willing to live without this miracle worker.

If you come in for an annual exam in August, you will receive the option of booking any one of these three skin care treatments - facial, peel or microdermabrasion - for only $25, if it is done during the same week as your annual exam. This is an amazing opportunity to get your skin rejuvenated in time for the fall and upcoming winter seasons.

Nothing compares to the feel one has after a 90-minute massage treatment. Now is your chance to experience bliss. 35 dollars off any 90-minute treatment with Cherie. Call today!

 

Iron deficiency is the most frequent cause of anemia, and results in a decrease in the production of red blood cells. Symptoms are nonspecific and include weakness and fatigue, hair loss, irritability and mood swings, shortness of breath, and restless leg syndrome. While blood loss is the most common cause of iron deficiency, it can also be the result of inadequate iron intake, increased iron utilization (as in pregnancy and adolescence), malabsorption, and hemolysis - the breakdown of red blood cells which can occur with extreme exercise.

Women generally consume less iron than men but typically have a greater need for iron during their lives. Women suffer substantial iron losses from menses, pregnancies and nursing.

Though doctors traditionally tested iron status by doing a blood count, the current preferred means of diagnosing iron deficiency is with a serum ferritin test. This is because about half of all people with iron deficiency will have a completely normal blood count, a measure of iron in the red blood cells. Ferritin levels, on the other hand, reflect total body iron stores. Although laboratories report a very wide range of ferritin levels as "normal," an optimal level is at least 70. A 2003 article in the British Medical Journal stated that in patients complaining of fatigue who had both normal blood counts and low ferritin levels, replacing iron to raise ferritin to ideal levels reversed the fatigue.

The first approach to increasing total body iron stores is by dietary means. Food-derived iron is available in two forms: heme and nonheme. Heme iron is found in animal muscle, while nonheme iron is found in both animal products and a variety of plant-based foods. Healthful sources of iron include greens and legumes. Whereas fruits and vegetables aid the absorption of nonheme iron, dairy products and eggs decrease iron absorption. Tea, coffee, and cocoa should not be consumed with meals, if poor iron status is present, as the polyphenols in these beverages inhibit the absorption of nonheme iron. Black tea appears to be the most potent in this regard. Iron supplementation should be individualized and taken under medical supervision.

Women planning pregnancies in the future and women who are pregnant or nursing must have their ferritin levels checked. This advice also applies to all others who feel fatigued, feel irritable or have mood swings, experience shortness of breath, or have trouble sleeping.

 

Gout is a metabolic disease in which monosodium urate (MSU) crystals form and accumulate in various body tissues, causing inflammation and tissue injury. This results in bouts of acute arthritis, commonly affecting the great toe, knees, ankles, and wrists, while also causing MSU kidney stones. The consequences of gout can be extreme pain and disability, as well as kidney damage.

The prevalence of gout is rising rapidly and has doubled in the US in the past 20 years. Reasons for this increase include the escalating incidence of metabolic syndrome, hypertension, obesity, cardiovascular disease, chronic kidney disease, alcohol consumption, high fructose corn syrup consumption, and the use of diuretics, niacin, and low dose aspirin.

70% of patients with gout have metabolic syndrome - a mix of hypertension, insulin resistance, hyperlipidemia, and obesity. The association between gout and hypertension has long been recognized, with half of all gout sufferers having hypertension, and 20-40% of hypertensives having gout. As mentioned, the use of diuretics such as hydrochlorthiazide, further increases the incidence of this disease. Having gout is also an independent risk factor for cardiovascular disease. Clearly, this is a significant and serious condition.

The first step in avoiding gout is to decrease the underlying risk factors. Dietary changes are a good starting point, as there is a strong relationship between diet and gout. Reducing the intake of red meat, poultry, fish, and shellfish is important. Eliminating high fructose corn syrup is necessary, while losing weight is also critical. Just being over-weight, but not obese, doubles the risk, and a BMI of 35 or higher triples the risk. Avoidance of alcohol is extremely important, as it is a powerful factor in increasing gout. Drinking at least two liters of water per day helps reduce the risk of MSU kidney stones. Bing cherries may be therapeutic, since one report found that eating nine ounces daily significantly lowered blood uric acid levels.

If you have metabolic syndrome or other risk factor for gout, expect to have your uric acid level checked at your next lab testing. Like so many other problems we are seeing more of today, gout is largely a lifestyle induced medical problem. We will work with you to reduce your chances of developing this painful condition.

 

Researchers at Wayne State University Medical School and the University of Michigan School of Medicine published a study in the April issue of the American Journal of Clinical Nutrition concerning the role of zinc in the prevention of atherosclerosis. They worked with healthy older individuals, men and women, aged 56-83, in a randomized, placebo controlled study of zinc supplementation. For 6 months half were given a supplement of 45 mg. of zinc while the other half received a placebo.

The effect on multiple inflammatory markers was impressive - a 26% increase in anti-oxidant power; a 22% decrease in high-sensitivity C-Reactive Protein (an important risk marker for cardiovascular disease); and reduced levels of oxidative stress markers, inflammatory cytokines, and endothelial cell adhesion - all three of which are indicators of atherosclerosis and cardiovascular risk. The lead author stated, "Zinc supplementation decreased oxidative stress in elderly subjects and human vascular endothelial and monocyte cells." (Monocytes are white blood cells believed to trigger atherosclerosis.).

It is now believed that zinc suppresses the inflammatory cycle by inhibiting a specific cell-signaling protein necessary to sustain the cycle. Zinc is also critical for the functioning of vascular endothelium, the lining within blood vessels. Zinc deficiency can cause endothelial dysfunction thereby paving the way for development of atherosclerosis.

40% of older Americans and a significant percentage of younger people may have zinc deficiencies due to inadequate diet and decreased ability to absorb this nutrient. Clearly this is a major issue, one deserving a great deal of attention.

In next month's newsletter, we will discuss how to get more zinc from foods and proper dosing if supplements are used. We will also review special concerns for vegetarians.

For those of you who don't want to wait, remember that the study discussed above used a daily zinc dosage of 45 mg. Please do not take more than this, as higher amounts may deplete the body of copper or have other unwanted side effects. We do carry an excellent chelated zinc at the office....stay tuned!

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

 

I was at a wonderful conference in Portland, Oregon, just last week, where one of the speakers addressed the topic of Lifestyle Medicine. As you might suspect, this revolves around the notion that a healthy lifestyle can both prevent disease, as well as treat disease conditions which result from years and years of poor lifestyle habits. A healthy lifestyle entails proper nutrition; adequate sleep; avoidance of smoking, drugs and alcohol abuse; stress control; exercise; and having lots of loving friends, family, and pleasure in life.

What fascinated me was the speaker's assertion that a healthy lifestyle has now been shown to provide an 80% decrease in a person's lifetime risk of chronic disease. I thought to myself, "If someone developed a drug that could guarantee an 80% reduction in heart disease, arthritis, atherosclerosis, headaches, stroke, diabetes, osteoporosis, sexual dysfunction - the list goes on and on - there isn't a price people wouldn't pay for it. Yet, this amazing remedy is often completely ignored."

Of course, I get very excited by the potential benefits lifestyle medicine holds for our patients. And sometimes I go overboard in my enthusiasm, asking you to do more than perhaps you are prepared to do. But the prospects of reducing your chronic disease load by 80% and avoiding years of pain and disability are sometimes simply irresistible.

We now offer an extensive array of lifestyle therapies, including nutrition, weight loss, acupuncture, exercise, hypnotherapy, and cognitive behavioral therapy. We will work with you to create an individualized program that meets your personal goals.

While I have no desire to become anyone's annoying, nagging mother, I feel a responsibility to gently, but persistently, encourage you to do those things that will help you live better and live longer. I hope you're willing to give me that opportunity.

 

Felice Gersh, M.D.