Ageless: The Naked Truth About Bioidentical Hormones (21 page)

1. Pay attention to perimenopause; a long symptomatic perimenopause might be a risk factor for breast cancer.
   
2. Work with a doctor who not only will advise you on the standard of care, but is also open to exploring other options.
   
3. Replace your hormones using bioidentical hormones given rhythmically because it makes the most biological sense.
   
4. Know your odds if faced with breast cancer. With a mastectomy or with lumpectomy and radiation, there is a 9 to 10 percent chance the tumor will return to the chest wall.
   
5. Treatment for breast cancer is based upon the tumor type and characteristic and the age of the patient. Be informed on these issues as you consider your treatment options.
   

CHAPTER 8
D
R
. M
ARC
D
ARROW:
B
ONE
H
EALTH

Dr. Marc Darrow, a professor of medicine at the UCLA School of Medicine, has an established practice in Los Angeles, where he specializes in sports rehabilitation. As my personal sports doctor, he has never given me a drug for any of my injuries. He is of the thinking that unless a drug is necessary, it is better to allow inflammation to do nature’s work. However, as a Western-trained doctor, when drugs are needed for pain, he will prescribe them
.

SS:
Tell me about bone health.

MD:
Bones are a living part of our body just like the heart, the brain, or the muscles. As pieces of hard material, they are built with calcium in a crystal-like structure permeated with blood vessels, nerves, and specialized cells. For example, bones have active, live cells called osteoclasts that actually chew little canals through the bone to create an opening so that other cells called osteoblasts can bring in new bone. In a process called remodeling, osteoclasts remove old bone tissue, while osteoblasts build new bone.

SS:
So our bones are constantly regenerating?

MD:
Yes. A healthy body is constantly regenerating bones. However, if you don’t keep them regenerating, you are at greater risk for fracture. As we get past age thirty, all the hormones in our body start diminishing, and these hormones include pregnenolone, thyroid, melatonin, and testosterone, among others. For healthy, strong
bones, both men and women need testosterone. Testosterone builds bone.

SS:
What can interfere with the process of regenerating our bones?

MD:
Diet, for one. Eating too many processed carbohydrates has a very bad influence. As a kid, I would drink a six-pack of cola a day. I’d beg my mom for money to buy it. This habit led to osteopenia, or bone thinning, in my hips, because soda leaches minerals from the bones. Osteopenia means there is some demineralization of the bone, whereas osteoporosis is severe demineralization.

Excessive exercise is another problem. All day long, I deal with athletes in my medical practice. Athletes have a lot of stress—the stress to succeed—and as a result, they work out too much, which is not good. The body is not meant to take this kind of treatment; the body will use up whatever resources it has inside—hormones, neurotransmitters, or proteins—to compensate. This situation blows out the adrenal system, along with cortisol and testosterone. Add to this the stress of trying keep up the appearance of looking successful, and then at the end of an athlete’s stressful day, he or she goes to the gym and uses up more biochemicals. The energy that is spent is not replenished with deeper levels of sleep, which is required to regenerate growth hormone.

SS:
What kind of nutrition is best for bone protection?

MD:
I believe in a diet called the Paleolithic diet, in which you eat only foods that you run after, catch, grow, or milk. In other words, real foods. Back in the days of early humans, there were no grains. Yet today, carbohydrates are the “drug of choice,” especially processed carbohydrates such as sweets, candies, snacks, and commercially baked goods. We grab processed carbs because we know they will give us a rush.

SS:
Talk to me about balanced hormones relative to our bones.

MD:
The best bone-management program involves hormone replacement with bioidentical hormones. I like to get people on these hormones as early as possible, and I mean early, like in their thirties. That is because we now know that women start losing bone in their twenties. Our healthiest prime for bones is when we are eighteen or nineteen years old, when our hormones are the highest.

SS:
Where does a drug like Fosamax fit in?

MD:
This is a drug known as a bisphosphonate, and I don’t like bisphosphonates. They block osteoclasts from breaking down the bone, thereby interfering with the remodeling and construction of new bone.

SS:
What about calcium?

MD:
Calcium does only a little good, because the body doesn’t absorb it very well, particularly as we age.

SS:
What about women with those tiny spine fractures along with those large stomachs?

MD:
Multiple small fractures brought on by osteoporosis can cause the spine to form a dowager’s hump, medically known as kyphosis. This condition occurs when the vertebrae actually get squished down, and it can be very, very, painful. Although surgery is sometimes indicated, this area can be pumped up with a new type of glue or cement (for lack of a better description) that will alleviate the person’s pain within minutes after the procedure.

SS:
What is your approach to treating a disabling condition such as arthritis?

MD:
People diagnosed with arthritis have been on painkillers, generally anti-inflammatory drugs supposedly designed to reduce inflammation in the body. The problem with these drugs is that they allow pain to go deeper and deeper into the body. Here’s why: Inflammation is the body’s way of healing itself and rejuvenating itself to its preinjury state. When you constantly take away the inflammation through the use of anti-inflammatories, you drive the pain further into the tissue. These drugs, in effect, block the inflammatory cycle, which in turn blocks the deposition of collagen, the main structural protein of the body. Without collagen holding us together, we would be a bag of nerves just sitting there unable to move. In short, blocking the pain is blocking the healing. We are left with an incomplete healing.

SS:
But isn’t it a part of our culture that we would rather have a painkiller?

MD:
Absolutely. So often, when I get a referral from a pain medicine doctor, all the patients look like zombies. They have been on
anti-inflammatories and antiseizure medication, not to stop seizures but to stop neuropathic pain. They are taking opiates such as Vicodin and Percocet, as well as antidepressants. When I ask them how they are feeling, their response is usually, “Uh, I feel pretty good today.” When I ask them why they are not working, they say they can’t because they are disabled. But the real answer is that they are drugged. What I do is try to get them to think more positively, encourage them to exercise moderately, and put them on a healthy diet of protein, vegetables, water, and some fruit. I try to get them off caffeine and nicotine, both of which weaken bones. And I use prolotherapy to heal the areas that hurt.

SS:
Prolotherapy goes right to the pain. How does it work?

MD:
Prolotherapy is a very simple process of naturally stimulating the body to produce healing by bringing and rejuvenating more tissue to the area of an injury. Prolotherapy uses a glucose (sugar water) solution, injected into the ligament or tendon where it attaches to the bone. This causes a localized inflammation in these weak areas, which then increases the blood supply and flow of nutrients and stimulates the tissue to repair itself.

I use the thinnest needle I can find in the form of a Dermojet, with an anesthetic beforehand. It blows lidocaine (an anesthetic) onto the tissue, under the skin. The injection stimulates collagen growth and cartilage growth. The results are amazing. A person can walk in with intense pain and walk out the door after an injection and play sports.

Prolotherapy is useful for many different types of musculoskeletal pain, including arthritis, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated disks, and sciatica.

Surgery is the very last resort for anything, as far as I’m concerned. Surgery seems to lead to more surgery down the line. If you come to my clinic, my hallways are littered with people who have had surgery that failed. Prolotherapy may not work on 100 percent of the people because they feel so good on it that they overexercise or they sneak anti-inflammatory drugs.

SS:
Give me your top five strategies for optimum health.

MD:
Number one: sleep. Number two: adequate nutrition. By that, I am talking about low-glycemic-index foods that do not cause blood sugar to rise too quickly. Number three: moderate exercise. For some people, this may be a good walk every day for twenty to thirty minutes to oxygenate and get the blood going and raise feel-good endorphins in the body. Number four: hormone replacement using bioidentical hormones. Number five is a philosophy of life: Don’t hurt yourself, and don’t hurt other people. If you can manage to do just these things, you really don’t have to do anything else.

SS:
That’s a great place to finish. Thank you.

DR. DARROW’S TOP FIVE ANTIAGING RECOMMENDATIONS

1. Change your lifestyle: Get enough sleep, adequate nutrition (avoid processed carbohydrates in particular), and moderate, not excessive, exercise. Get off nicotine and caffeine; both can weaken bones.

2. Watch overuse of anti-inflammatory drugs. They block the inflammatory cycle, drive pain farther into tissue, and interfere with the deposition of collagen, the main protein that holds us together. Inflammation is a necessary process that helps the body heal itself.

3. Pursue bioidentical hormone replacement therapy, including testosterone replacement, if necessary, since testosterone is required for strong bones in men and women.

4. Consider prolotherapy as a way of stimulating tissue repair for orthopedic-type injuries, arthritis, sports injuries, or fibromyalgia.

5. Develop a positive philosophy of life: Don’t hurt yourself, and don’t hurt other people.

CHAPTER 9
D
R
. P
RUDENCE
H
ALL:
D
ISEASES OF
A
GING AND
N
ATURAL
H
ORMONE
B
ALANCE

Dr. Prudence Hall is a practicing OB/GYN in Santa Monica, California. Along with her husband, Dr. Howard Liebowitz, she runs the Hall Center for Rejuvenation and Vitality, specializing in bioidentical hormone replacement for men and women coupled with antiaging medicine. Dr. Hall is dedicated and passionate about helping men and women through the often difficult and tricky passage of hormonal decline. She has much to say on the subject, and her passion will win you over instantly. She is also an expert at getting to the root of problems involving the GI tract. Women sing her praises. Her approach is unique and thorough, and she doesn’t need to fill you with drugs to do it
.

SS:
There is a lot of talk about the relationship between our GI tract and disease. What is your take on this association?

PH:
One of my big concerns in dealing with patients for the last three years has been toxicity coming from their GI tracts. European medical practitioners who believe in gastrointestinal health are exactly right, because health begins in the GI tract. That’s where 70 percent of our immunity is coming from, yet every day our gastrointestinal tract is constantly exposed to offending agents that are very bad for it.

SS:
Is this because of what we eat or our lifestyles?

PH:
It has to do with food intolerances, such as gluten, wheat, eggs, soy, and so forth—foods that many people simply cannot handle. In addition, GI health is adversely affected by taking antibiotics that kill off the good bacteria in the gut, leading to intestinal yeast and overgrowth of bad bacteria.

SS:
A lot of women are prone to yeast infections, so taking antibiotics twice a year or more often can upset the balance. Should these women be recolonizing with acidophilus?

PH:
Acidophilus is a wonderful way to recolonize the GI tract and restore healthy bacteria. That approach, however, is not the first action I take when trying to restore health to the GI tract. First, I want to start healing the GI tract for about six to eight weeks in order to kill off the bad “bugs.” Once those bugs are killed, then you recolonize the tract.

SS:
Do you think the primary complaint behind the bloating problem for women is GI tract problems? Or is it intolerance to progesterone?

PH:
That is a very interesting question. The way I got interested in functional medicine (which is getting to the root of the illness) is through the GI tract. What I started to notice was that my menopausal patients had stomach problems and digestive problems, and they would come in complaining of bloating, gas, and a variety of irritable bowel symptoms. As I became more curious about this, I began to realize that as we age, we lose acid in the GI tract, so some of this bloating is that we’re not digesting our food very well. Partly digested food results in a reflux of acid up the esophagus and also causes bloating and gas. In the aging process, our hair loses its luster, our skin loses its elasticity, and our GI tract loses its acid, with bloating and indigestion as the result. Gastric acid is important because it helps protect the gastrointestinal tract from harmful bacteria.