Book Review – The End of Alzheimer’s

Book Review – The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline by Dale E. Bredesen, MD.

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

older couple taking a walkAlzheimer’s disease is a grim disease that causes both the mind and body to deteriorate. In 1906, Dr. Aloysius Alzheimer identified plaques in the brain autopsy of a patient who had suffered from dementia, and in doing so he discovered what is generally thought to cause the symptoms of the disease that bears his name. These plaques, made from a protein called amyloid-beta, are thought to interfere with the functioning of our brains.

Since Dr. Alzheimer’s discovery over a century ago, the focus has not been in pinpointing the cause of Alzheimer’s disease, but rather in finding an effective treatment for the related symptoms. Theoretically, if we can find a drug that will stop the formation or contribute to the removal of plaques in the brain, we will be able to prevent or reverse the development of the symptoms associated with Alzheimer’s disease. We have been using this line of thinking to develop drugs since the 1980s, without success.

Dr. Dale Bredesen has turned this thinking upside down. His book, The End of Alzheimer’s, poses the questions: What if the amyloid proteins are there to protect the brain rather than disrupt the brain? Is it only when plaque formation is excessive that it interferes with nervous tissue signaling?

A Leaky Roof

Dr. Bredesen uses the metaphor of a leaky roof for Alzheimer’s disease. The roof has approximately 36 “holes,” though a few more may yet be identified. These holes signify the number of contributors he and his team have identified as playing a role in the development of dementia and Alzheimer’s disease.

The size of the holes—that is, the probability of developing Alzheimer’s disease–depends on the impact of genetics and the environment. Because each hole is a different size (depending on genetics and other factors) for each person, not every single hole needs to be patched; however, if you only patch one hole in the roof, you will still have a leaky roof. Our pharmaceutical model only has touched on one pathway—trying to stop the formation of plaques—and overlooked other possible causes, which is why our attempts at treating Alzheimer’s disease have failed.

What Causes Amyloid Production?

Among the 36 “holes” that contribute to developing Alzheimer’s disease, there are three major categories. These categories contain conditions that can be grouped together. The three major categories are inflammation, deficiencies in hormones or nutrients, and exposure to stress or environmental toxins. All of these conditions force the body to defend the brain by producing amyloid plaques, thus leading to Alzheimer’s disease.

Inflammation is the first category that may increase amyloid production. While inflammation is often related to infection, it may be caused by other things such as food or food sensitivities. Dr. Bredesen uses the example of ingesting trans-fats or sugar, substances that are known to be inflammatory.

The second category includes hormones and nutrient deficiencies and imbalances that interfere with neuronal repair in the brain. For example, vitamin D deficiency may be a critical trigger for amyloid production. See below for a more detailed description of this category.

The third category includes exposure to significant stress, poisoning with heavy metals and mold toxins, or other environmental or chemical exposures. Even the stress of menopause may instigate the disease. Because this category tends to present psychological symptoms (such as depression), which mask the symptoms of Alzheimer’s disease, these contributors can be easily missed.

Alzheimer’s Disease By the Numbers

The Alzheimer’s Association has gathered these statistics about this increasingly-prevalent disease:

  • An estimated one in ten of people over the age of 65 is affected.
  • Two-thirds of those diagnosed are women.
  • It is the sixth leading cause of death in the United States.
  • Life expectancy after diagnosis is 4 to 8 years.
  • The cost of care for Alzheimer’s disease and other dementias in the United States is estimated at $277 billion for 2018 alone.
  • One-third of seniors die with Alzheimer’s disease or another form of dementia.
  • 7 million Americans are living with dementia as of 2018.
  • In the United States, every 65 seconds a patient is diagnosed with Alzheimer’s disease.

Hormones Are a Key

As mentioned above, some of Dr. Bredesen’s findings show that the key to preventing or recovering from Alzheimer’s disease may be restoring depleted hormone levels. Of the 36 and more contributors identified, several involve hormonal imbalance. Dr. Bredesen states, “Reaching optimal hormone levels is one of the most effective and most critical parts of ReCODE (reversing cognitive decline protocol).” Based on his observations, Dr. Bredesen recommends optimizing:

  • Insulin secretion and signaling
  • Estradiol
  • Progesterone
  • The ratio of progesterone to estradiol
  • Free T3 (the active thyroid hormone liothyronine)
  • Free T4 (the thyroid hormone thyroxine which is the precursor to T3)
  • Thyroid stimulating hormone (TSH), made by the pituitary gland to stimulate the thyroid gland to produce T3 and T4
  • Pregnenolone
  • Testosterone
  • Cortisol
  • Dehydroepiandrosterone (DHEA)

Dr. Bredesen takes great care to explain the development of his ideas and the work in his laboratory. With decades of research behind him, he presents a theory addressing everything we do know about Alzheimer’s disease, and as a researcher and physician, he has been able to practically apply this theory to successfully treat patients.

Connection with Insulin

Another contributor to inflammation—and by extension, developing Alzheimer’s disease—is insulin resistance. Insulin resistance, metabolic syndrome, and diabetes all involve abnormally high levels of insulin. Some even call Alzheimer’s disease “Type 3 diabetes” because of the problems high insulin levels cause the brain. Dr. Bredesen explains that the enzyme, insulin degrading enzyme (IDE), helps us break down excessive insulin. This same enzyme can break down amyloid. If we follow a lifestyle and eating program that constantly elevates insulin, IDE may not be available in amounts needed to break down and help stop amyloid overproduction.

Sex, Adrenal, and Thyroid Hormones

A common factor of aging is the depletion of adrenal hormones (although cortisol is sometimes high), sex hormones, and thyroid hormones. The loss of hormones parallels an increased risk of Alzheimer’s disease as we age.

For each of the markers that Dr. Bredesen has identified, he also describes how to test or evaluate hormone levels, and presents what he believes are the optimal parameters. Replenishing these depleted hormones may help patients prevent or recover from Alzheimer’s disease. To restore proper hormone function, bioidentical rather than synthetic hormone replacement must be used, as bioidentical hormones are equivalent in structure to the hormones our own bodies make.

Diagnosing Alzheimer's Disease

Alzheimer’s disease used to be diagnosed only after the patient had died. An autopsy would reveal the presence of amyloid plaques, explaining the decline in the patient’s health and eventual death. Now we have testing that can identify the presence of plaques during the patient’s own lifetime. These include scans of the retina, brain scans, and checking the cerebral spinal fluid. A genetic test for Apolipoprotein (APO)E also shows potential to predict susceptibility to this disease.

Mending the Holes in the Roof

Alzheimer’s disease does not follow the “one disease, one treatment” model our current medical system relies upon. Each patient should be evaluated for their individual needs. Successfully treating Alzheimer’s must involve a personalized, complex therapy program, but the reward—giving patients the ability to reclaim their brains and their lives—makes the effort more than worthwhile. The End of Alzheimer’s presents an opportunity to forestall and correct the onslaught of this devastating disease. Thanks to his groundbreaking work, dedication to making this information available, and training practitioners to use his guidelines, Dr. Bredesen demonstrates that patients with Alzheimer’s disease do have treatment options.

© 2018 Women’s International Pharmacy

Edited by Michelle Violi, PharmD; Women’s International Pharmacy

For any questions about this article, please e-mail

Carol Petersen at carol@womensinternational.com

Book Review – The End of Alzheimer’s2018-10-08T10:45:16+00:00

Book Review – The LDN Book edited by Linda Elsegood

Book Review – The LDN Book, edited by Linda Elsegood

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Linda Elsegood’s personal success story tells how using low-dose naltrexone (LDN) to treat her multiple sclerosis restored her quality of life and gave her hope for the future. Now she is a woman on a mission to help others learn about LDN and to promote further research into how it may be used to treat a variety of diseases. In The LDN Book: How a Little-Known Generic Drug—Low Dose Naltrexone—Could Revolutionize Treatment for Autoimmune Diseases, Cancer, Autism, Depression, and More, Elsegood has compiled chapters written by practitioners who have become experts in the use of LDN.

History

Pharmacist Stephen Dickson provides a comprehensive history of the opium poppy and the subsequent creation of synthetic drug compounds called opiates, which are all active at the opioid receptor sites. Opioid receptors are meant to be activated by hormones produced in the body called endorphins and enkephalins, which can relieve pain and contribute to wellbeing. However, these receptors can also be stimulated by opiates. Naltrexone was originally developed to block these receptor sites in order to assist people addicted to opiates. The developers of naltrexone reasoned that when opioid receptors were blocked, there would be no need to use or abuse opiate drugs. While a logical theory, in actual practice they had little success.

However, in low doses, naltrexone acts to temporarily block opioid receptors. The body responds by producing increased amounts of endorphins and enkephalins. The opioid receptors also increase in sensitivity and number.

Multiple Sclerosis and Lupus

Dr. Deanna Windham begins with a thorough explanation of multiple sclerosis and lupus. While she recognizes that we do not currently have drugs that treat the complexity of these diseases, LDN has been shown in a number of studies to stabilize and stop their progression. The use of LDN is a pillar in Dr. Windham’s treatment plans, though she maintains that each patient must be treated individually for their toxic load, hormone imbalances, nutrient deficiencies, and sleep issues.

Inflammatory Bowel Diseases

Dr. Jill Smith was the first to publish a study on LDN and inflammatory bowel diseases. There are opioid receptors in the gut and on immune system cells. There are a number of different types of opioid receptors and naltrexone may target different opioid receptors depending on the dose.

Dr. Smith provides case studies of remissions of inflammatory bowel diseases, Crohn’s disease and ulcerative colitis with the use of LDN, both alone and with other commonly-used drugs. LDN blocks opioid receptors for about six hours, during which the body increases its endorphin and encephalin production. After about six hours, the LDN is removed from the opioid receptors by the body and the elevated endorphins and enkephalins can act at the receptor to block cell proliferation or reverse inflammation. LDN also sensitizes and increases the number of receptors. Remission may be confirmed with radiology showing healing of the intestinal tract.

Few of Dr. Smith’s patients have experienced side effects, however, one possible side effect is sleep disturbances, which can be alleviated by changing to a morning dose or using a lower strength.

Thyroid

Dr. Kent Holtorf, president of the National Academy of Hypothyroidism, explores LDN treatment with thyroid disorders. He explains how LDN can be used effectively in both Grave’s Disease (hyperthyroidism) and Hashimoto’s Disease (hypothyroidism). He believes LDN can potentially improve abnormal inflammation and immune dysfunction seen with thyroid disorders, and thus, improve the reduced tissue T3 (active thyroid hormone) levels inside the cells that these conditions can cause. Normal thyroid tests cannot predict the activity of thyroid inside the cell, and so this can go unidentified and untreated.

Chronic Fatigue and Fibromyalgia

Dr. Holtorf also addresses chronic fatigue and fibromyalgia.  He writes about phases of treatment with LDN:

  1. Stabilize the patient. This stage is where pain and sleep disturbances are addressed.
  2. Enhance mitochondrial energy production with nutrients.
  3. Balance hormones as these patients typically have deficiencies.
  4. Enhance the immune system function and treat the infectious components. LDN is often part of this stage of treatment.
  5. Address issues like heavy metals, leaky gut, mold toxicity, and coagulation problems.
  6. Maintain health and balance.

An integrative approach has shown success, with treatment plans adjusted to the individual needs of each patient.

Restless Leg Syndrome

Dr. Leonard Weinstock is a gastroenterologist and internist, with a special interest in restless legs syndrome (RLS) and has identified an association between RLS and small intestine bacterial overgrowth (SIBO) and other inflammatory conditions in the gut. He used LDN to treat patients with and without antibiotics for infection. In each case he found some positive results, and has used LDN for long-term remission.

Depression

Endorphins are very psychoactive, and account for the warm feelings of falling in love, coping with stress, and bringing joy and contentment. Dr. Mark Shukhman describes the symptoms of endorphin deficiency as including:

  • Discomfort with disturbances such as changes in sound, light, temperature, or touch
  • Immune system problems such as frequent infections, allergies, and autoimmune disease
  • Crying easily, and have difficulty with painful situations
  • Craving chocolate, wine, marijuana, and alcohol

LDN helps in these conditions by increasing the levels of endorphins. Many people who have turned to opiates describe that it is the first time that they have felt normal. Although his chapter focuses on depression, psychiatrist Dr. Shukhman has also used LDN in his practice for treatment of autism, post-traumatic stress disorder, multiple personality disorder, anxiety, obsessive compulsive disorder, psychosis, and even sexual dysfunctions.

Autism

Dr. Brian Udell has a special needs pediatric practice and has found a common theme with autism to be inflammation and gut disturbances. He cites Dr. Jacquelyn McCandless’ work with children using LDN as a cream, rather than tablets, because of its bitter taste. He has seen LDN increase speech and communication, decrease aggression, and improve social development. Beta endorphin levels can be measured to confirm LDN activity.

Cancer

Dr. Angus Dalgleish, an oncology practitioner in the UK, writes that, while there is very little in the published literature, LDN seems to be universally useful across all tumor types. He writes of his personal experience treating patients with metastases, achieving stability and long–term, disease-free status. He finds that LDN affects more receptor sites than just the opioid receptors. Naltrexone in large doses actually promotes tumor growth in the laboratory, so the best effects occur when it is used in low doses and used intermittently rather than continuously. Its anti-inflammatory action can be helpful in cancer. Dr. Dalgleish reports that the use of LDN also increases the production of natural killer cells. Finally, LDN can produce positive effects on mood that help in combatting the disease. He writes that failure with LDN may be linked to low vitamin D levels.

Conclusion

The LDN Book is just a part of Linda Elsegood’s work. Under her direction, the LDN Research Trust has an incredible number of accomplishments, including organized conferences, LDN radio, and crowdfunded documentaries. This outreach has stimulated investigation into endocrine and immune system activity that was hardly known before. This book is a window into the large body of knowledge we have gained in the last ten years.

Book Review – The LDN Book edited by Linda Elsegood2018-02-26T12:09:00+00:00

Book Review – The 6-Week Cure for the Middle-Aged Middle by Mary Dan Eades, MD, & Michael R. Eades, MD

Book Review – The 6-Week Cure for the Middle-Aged Middle by Mary Dan Eades, MD, & Michael R. Eades, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

scale and measuring tapeHow many middle-aged adults experience weight gain in their midsection?  Even with no changes in diet or exercise, weight gain is commonplace, particularly around the middle. Worse, this area of weight gain is the very abdominal obesity associated with heart disease. Drs. Michael and Mary Dan Eades address ways to eliminate unhealthy fat that accumulates around the organs in their book, The 6-Week Cure for the Middle-Aged Middle.

Drs. Michael Eades and Mary Dan Eades gained fame in the 70s for their weight loss success and their bestselling book, Protein Power. Both physicians lost a considerable amount of weight by incorporating principles they learned as they researched their weight problem. In turn, they successfully helped many others lose weight.

After decades of success, however, a problem arose. As the Eadeses prepared for a televised show, although they continued to follow their own prescription for success, the cameras zeroed in on a problem: a middle-aged spread around the middle. They wondered how they could promote the success of their program with this weight concern.

The Eadeses went back to what had worked for them the first time: research. They set out to find what had sabotaged their program for successful weight loss.

The answer? Hormones.

 

Cortisol and Estrogen

During middle age, the adrenal glands may increase their production of cortisol. This may be provoked by a number of factors including stress or sleep disturbances. The increased cortisol levels send signals to store fat, particularly in the abdominal area.

Weight can be affected by both high and low estrogen levels. With aging, estrogen (the hormone associated with curviness in women) decreases, and may contribute to midlife weight gain. The Eadeses recommend using only bioidentical estrogens, estradiol or estradiol with some estriol, as non-bioidentical therapies may not help with weight and may even worsen it.

The Liver and Hormone Deficiencies

6 week cure for the middle aged middle bookIn middle age, the pancreatic hormone insulin rises, signaling the liver to store more fat. Additionally, as we age, the liver creates more sex hormone binding globulin (SHBG), a protein carrier for hormones. When the hormones are bound to this protein, they are not available for use by the body.  While SHBG levels increase with age, the sex hormones carried by SHBG such as testosterone, DHEA, and estrogens decline with age. Hormone deficiencies can occur as lower levels of hormones are produced overall and more SHBG binds the hormones that are produced, making them unavailable for use by the body. These hormone deficiencies can lead to loss of muscle and bone mass and an increase in body fat percentage.

According to the Eadeses, what happens in middle age is a combination of a number of factors: loss of sleep, increased stress, a diet lacking in fat (due to concerns with cholesterol levels), hormones imbalances, introduction of new medications, and difficulties with nutritional intake. Their book is not a weight loss plan, but a path to “body-rehabilitation,” as fat stores leave the middle and the body becomes leaner and stronger.

A dietary plan to address abdominal weight gain is spelled out in The 6-Week Cure for the Middle-Aged Middle. The Eadeses report great success for themselves and their patients. For those that are struggling with middle aged weight gain, this book may hold the resources needed to help combat it.

Book Review – The 6-Week Cure for the Middle-Aged Middle by Mary Dan Eades, MD, & Michael R. Eades, MD2018-01-22T10:50:12+00:00

Book Review – Bursting With Energy by Frank Shallenberger

Book Review – Bursting with Energy by Frank Shallenberger, MD, HMD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

Bursting with Energy Book CoverDo you have an energy crisis? Dr. Frank Shallenberger poses this question on the back of his book, Bursting with Energy.[i] How many people tell their practitioners that they feel fatigued or lack energy? How many illnesses, such as multiple sclerosis, involve debilitating fatigue? How many teenagers are unable to keep up with their peers because of fatigue? How many individuals notice a lack of energy as they age? Studies show that 15% percent of women and 10% of men often feel very tired or exhausted.[ii]

Dr. Shallenberger argues that diminished energy production is the primary cause of many diseases, including allergies, obesity, diabetes, heart disease, infections, and even aging. “Chronic fatigue syndrome (CFS)” and other fatigue-related illnesses exist, yet are difficult to diagnose and understand.[iii]

Energy production occurs in specialized structures called mitochondria in all cells in the body. It is inside the mitochondria that the molecule, adenosine triphosphate (ATP), is produced to store the energy created. Energy levels are affected by how well the mitochondria function, as well as how many and how efficiently ATP molecules are produced.

The sun is required to begin producing energy in the body. The plant world picks up the sun’s energy and uses it to convert carbon dioxide into oxygen. Once oxygen is inhaled, the lungs help deliver it to the blood stream. The heart and circulatory system distribute the oxygen to the cells, where the mitochondria busily produce energy and the ATP needed to store the energy for the body. Energy production also depends upon our nutrient intake of carbohydrates, fats, and proteins.

What exactly is interfering with this cycle of energy production? Conventional practitioners may have a difficult time evaluating a patient’s symptoms when they complain of fatigue and low energy. They will likely test to determine the level of fatigue, the causes, and what may help alleviate the lack of energy.

Dr. Shallenberger has pioneered a testing procedure called “Bio-Energy Testing,” which can measure how much oxygen the body uses and how much carbon dioxide the body produces. From these values, mitochondrial function is determined. His book thoroughly outlines how this new method allows for the assessment of energy production and identification of issues that can affect fatigue. The success (or lack of success) with treatments can be measured with repetitive testing.

Bursting with Energy presents eight secrets to achieve optimal mitochondrial activity. Of particular interest is Secret #8, which is restoring depleted hormones with bioidentical hormone therapies. Throughout the book Dr. Shallenberger explains how the energy production process is directed by hormones. Cortisol, growth hormone, insulin, progesterone, testosterone, and thyroid all contribute to this process. Hormones are intimately intertwined in the energy production in every part of the body.

For example, the adrenal glands function to control the blood sugar, glucose, which feeds energy production in the mitochondria. Stress depletes the adrenal glands. Adrenal hormones, such as cortisol and DHEA, assist in managing stress.  Patients may not seek professional help for fatigue until the functioning of the adrenal glands is exhausted. Dr. Shallenberger writes that a clue to early adrenal exhaustion is the presence of normal energy at rest but a decline in energy when challenged with exercise. Restoring depleted hormones can be an essential part of recovery.

Dr. Shallenberger has condensed decades of his clinical work and research into Bursting with Energy. A primer for the successful operation of your body, this book contains many secrets that anyone can start to apply. The best secret of all is that you can turn back the decline in energy and bring back life’s exuberance.

Book Review – Bursting With Energy by Frank Shallenberger2018-04-07T11:11:17+00:00

Book Review – Venus on Fire, Mars on Ice

Book Review – Venus on Fire, Mars on Ice: Hormonal Balance – The Key to Life, Love and Energy by John Gray, PhD

Written by Carol Peterson, RPh, CNP – Women’s International Pharmacy

In his book Men are From Mars, Women are From Venus, Dr. John Gray focused on the differences between men and women; in Venus on Fire, Mars on Ice he delves into why those differences occur. Dr. Gray explains that, not only do we need a balance of hormones for managing PMS, post-partum depression, menopause, and andropause, but hormone balance also has a great impact on our relationships. Specifically, coping mechanisms for stress affect our relationships, and hormones play a vital role in the different ways men and women use to deal with stress.

Cortisol

Due to unrelenting demands of life in the modern world, many men and women are constantly stressed. As a result, cortisol production–which is designed to reach peak levels when challenged with an emergency and then quickly drop down–stays at a high level. A chronic high level of cortisol may contribute to emotional instability (among other things), which can affect relationships.

When trying to reduce or deal with stress, men release testosterone and women release the pituitary hormone oxytocin. High cortisol levels may interfere with normal production of both testosterone and oxytocin, hampering both men and women from their attempts at stress reduction.

Testosterone and Oxytocin

When a man’s testosterone level is adequate, it allows him to react in urgent situations where he needs to focus keenly, step up, and solve a problem. In fact, solving problems may cause some men’s testosterone levels to actually rise, while simultaneously lowering stress hormones like cortisol.

While small amounts of testosterone will also help women feel good, too much will actually increase their stress levels. Higher testosterone levels in women might be useful for competition, such as in the workplace, but sustained high levels of testosterone take a toll. When women get home from work, their stress levels may rise as they face the pressures of all the things that need to be done.

In contrast with the use of procrastination to increase testosterone in men, planning ahead stimulates oxytocin release in women. For women, a release of oxytocin makes them feel safe and nurturing, feelings that in turn encourage oxytocin levels to rise further. On the other hand, oxytocin doesn’t help men deal with stress and can even bring their testosterone levels down.

Insulin and Serotonin

Other fundamental substances that play an important role in relationships include the hormones insulin and serotonin and their interaction with glucose (blood sugar). Every cell in the body needs a consistent supply of glucose to function, and insulin controls how it is utilized. The brain is particularly sensitive to fluctuations in blood sugar, altering our moods, decision-making abilities, and other aspects of behavior that can affect interpersonal relationships.

When blood sugar drops, the production of serotonin (which has a calming effect) also drops. To make matters worse, the body responds to the low serotonin levels by producing more cortisol, which increases anxiety.

Conclusion

Dr. Gray believes that understanding these basic hormonal differences in each other is the key to maintaining loving relationships. Aging leads to lower levels of testosterone and oxytocin, as well as increased insulin resistance and low serotonin levels. This creates even more difficulty in dealing with stress, and makes hormonal balance even more critical. Dr. Gray suggests that diet and lifestyle are important building blocks to producing and maintaining these hormones in proper balance.

Book Review – Venus on Fire, Mars on Ice2018-07-10T17:41:01+00:00

Book Review – The Upside of Stress by Kelly McGonigal

Book Review – The Upside of Stress: Why Stress is Good for You and How to Get Good at It by Kelly McGonigal, PhD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Stress is bad, right? It damages our body, causes depression, shortens our lives…the list goes on and on. We say things like, “All this stress is giving me an ulcer!” or, “This stress is killing me!” Your practitioner, if unable to pinpoint the source of your malady, may advise that you reduce your stress level. We have whole industries designed to decrease stress in our lives: yoga classes, meditation courses, massage therapy, breathing exercises, exercise, and life style coaching.

Dr. Kelly McGonigal urges us to rethink the idea that “stress is bad” in her book, The Upside of Stress: Why Stress is Good for You and How to Get Good at It. Dr. McGonigal is a health psychologist who teaches at Stanford’s School of Medicine Health Improvement Center and the Stanford Center for Compassion and Altruism.

A Little History
Dr. Hans Selye, an endocrinologist, found that introducing any sort of unpleasant experience produced a loss of muscle tone, ulcers, immune breakdown, and ultimately death in his lab rats. Having already seen human patients who experienced similar breakdowns in their health, he drew from his observations and his rat experiments to define stress as any demand made on the body. Further, he felt that just about anything that happened to someone in life (good or bad) was toxic.

Dr. McGonigal argues that Dr. Selye’s definition is much too broad. She believes there is a huge difference between the body’s response to near death experiences and electric shocks as the lab rats endured (she calls it The Hunger Games for rats!), and the everyday stresses of living life in the modern world that humans commonly experience.

Fight or Flight
The classic description of the body’s response to stress is “fight or flight.” The body reacts to a stressor by stopping all non-essential processes, like digestion and fertility, and releases a flood of energy and oxygen needed to flee a dangerous situation or to fight for survival. Although this process has served human beings and other animals well throughout millennia in their survival efforts, “fight or flight” may not be always appropriate in modern life. It isn’t very effective to run away from a disagreement with your boss or an argument with your spouse, and it isn’t possible to fight for survival against past due bills or an IRS audit. Dr. McGonigal points out our stress responses have adapted over time and aren’t limited to this one “fight or flight” response. We have developed many more coping strategies.

A More Finely Tuned Stress Response
Dr. McGonigal describes three types of stress responses in addition to “fight or flight,” which all serve to handle stress in such a way that may have a positive effect on the body:

  • Rise to the Challenge: This stress response allows us to focus our attention, heightens our senses, increases motivation and mobilizes our energy. This stress response is of benefit, for example, to an athlete who is about to compete.
  • Connect with Others: This stress response activates the need to protect our tribe and dampens fear and increases courage.
  • Learn and Grow: This stress response helps us integrate experiences and helps the brain learn.

The Main Stress Hormones
The hormones cortisol (also called hydrocortisone) and DHEA produced by the adrenal glands are considered the primary responders to stress. The outpouring of these hormones can affect the body positively rather than negatively. For example:

  • Research has shown that supplementing these stress hormones to enhance the stress response has been beneficial to those with post-traumatic stress disorder (PTSD) and panic attacks.
  • Psychiatrists have begun using these stress hormones before a therapy session and surgeons before surgery to improve outcomes.
  • Experiments designed to measure stress hormone responses find that those with the largest increase in DHEA are the most resilient under stress. DHEA can act as a neuro-steroid and actually help your brain grow stronger after stressful events.

Many More Hormones
While cortisol and DHEA are the main stress hormones, there are a number of other hormones involved in the body’s stress response.

  • Adrenaline (also called epinephrine) pours out of the adrenal glands with cortisol and DHEA, and serves to activate and focus our senses. The pupils of the eyes dilate to let in more light and hearing sharpens. The liver starts to dump fats and sugars into the blood stream to provide more energy for the brain and the muscles.
  • The release of endorphins, testosterone, and dopamine, along with adrenaline, actually provides a feeling of exhilaration that many find enjoyable. This “adrenaline rush” is the feeling thrill seekers are after when they skydive or ride roller-coasters.
  • Oxytocin is produced by the pituitary gland. Oxytocin increases our ability to bond with others and during times of stress, it allows our courage to dampen our fear. Interestingly, heart tissue contains many receptors for oxytocin which allow for regeneration and repair. Many believe that stress will give you a heart attack; however, the outpouring of oxytocin may actually strengthen your heart.

The Mindset
Early in her career, Dr. McGonigal , like many, believed that stress produces negative effects in the body. Then she came across a study that she just couldn’t reconcile with her belief system. This study documented that people who were exposed to stressors had different outcomes dependent upon their mindset about stress. If people believed stress was bad and produced unhealthy effects, it was so. If people believed stress was a part of life and a challenge to meet, they were healthier and even had enhanced life spans when compared to those with low levels of stress.

After this, Dr. McGonigal turned her career around. She no longer teaches fear of stress and stress management. She sums up her change in mindset in the introduction of her book: “The latest science shows that stress can make you smarter, stronger and more successful. It helps you learn and grow. It can even inspire courage and compassion.” She shares the tools to change one’s mindset in her book. Better yet, science shows that mindset is malleable for all of us.

Book Review – The Upside of Stress by Kelly McGonigal2018-05-02T11:18:19+00:00

Book Review – The Statin Disaster by Dr. David Brownstein

Book Review – The Statin Disaster by David Brownstein, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

In this latest of Dr. David Brownstein’s books, he clearly states that statin medications fail to prevent or treat heart disease for nearly everyone who takes them. He also points out the shortcomings of the “cholesterol equals heart disease” theory. Dr. Brownstein is concerned because most busy practitioners do not take the time to fully understand the statistics used in drug studies well enough to critically examine the findings. This leaves practitioners to rely solely on the conclusions presented by the study investigators, who are often funded by pharmaceutical companies interested in bringing new drugs to market. Because of this, we are exposed to exaggerated claims of effectiveness when the actual facts may show otherwise.

What Are Statins?
Statins make up a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Statins reduce production of cholesterol in the liver by blocking an enzyme responsible for cholesterol production.

Statistics
Dr. Brownstein introduces us to a statistical concept known as the “number needed to treat.” This number can be calculated from data provided in studies, telling us how many people need to be treated with a medication for one person to benefit. The ideal number is one. When the number needed to treat is one, every person treated benefits from the treatment. Examples of therapies with a very low number needed to treat include patients with type 1 diabetes using insulin and patients with low thyroid function taking thyroid.

However, many of the drugs currently in use have a high number needed to treat. Numbers of 200 or more are seen regularly in studies using statins. In other words, 200 people need to be treated before one person will benefit. This might be acceptable if statins had no adverse effects and were completely without risk. Unfortunately, this is not the case. Adverse effects associated with statin use include muscle pain and damage, digestive problems, memory loss and confusion, increased blood sugar levels and Type 2 diabetes, and liver damage. These adverse effects may not happen to everyone, but if the number needed to treat for statins is 200, 199 people out of 200 using statins are taking the risk of experiencing an adverse effect while experiencing no benefit at all from the statin drug.

Based on Dr. Brownstein’s evaluation of the studies that have been done using statins, he states statins are effective for approximately 1% who take them. In other words, statins fail 99% who take them.

Is Cholesterol Good Or Bad?
The current perception about cholesterol is that there is “good” cholesterol and “bad” cholesterol. Cholesterol is neither good nor bad. We forget how important cholesterol is to our body’s daily functions. Cholesterol is an essential substance needed by every cell in the body. The human body uses cholesterol to make hormones, vitamins, and substances that help digest foods. If cholesterol levels are too high, our body is telling us something is not right. It would make sense to pay attention to our body’s signals and try to find the underlying cause of the elevated cholesterol levels rather than using medications to artificially lower levels. In addition, driving our cholesterol levels too low may create a whole new host of problems including problems with our immune systems and our resilience to infection.

How Do Hormones Play a Role?
Let’s zero in on hormones. Cholesterol is the source material for all sex hormones including estrogens, progesterone, testosterone, and adrenal hormones such as DHEA, and hydrocortisone. Our brains depend upon the hormones made from cholesterol as much as the rest of our body does. Progesterone and pregnenolone protect the nervous tissue throughout our body. Elevated cholesterol may simply be a signal the body is working hard to replenish these hormones in the event hormone levels are low. Cholesterol levels may also increase when thyroid hormone production is inadequate. Correcting sex hormone deficiencies and hypothyroidism for patients may bring their cholesterol levels down. Dr. Brownstein says he often sees patients in his practice where supplementing with sex or thyroid hormones brings cholesterol levels back into the normal range.

Dr. Brownstein says evidence-based medicine should be used and embraced. He feels the information is out there to expose statins as “one of the greatest failures in modern medicine.” According to Dr. Brownstein, our acceptance of such poor standards is mediocre medicine. We can and should determine what really makes a difference in our health. Reading his book will get us started.

  • Brownstein D. The Statin Disaster. West Bloomfield, MI: Medical Alternatives Press; 2015 www.drbrownstein.com
Book Review – The Statin Disaster by Dr. David Brownstein2017-12-12T17:36:15+00:00

Book Review – An MD’s Life Saving Health Solutions by James A. Schaller

Book Review – An M.D.’s Life-Saving Health Solutions by James A. Schaller

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Although not apparent from the title of this book, An M.D.’s Life-Saving Health Solutions: A Gynecologist’s Advice, Dr. James Schaller shares some very interesting thoughts about hormones from his long clinical practice in obstetrics and gynecology. He writes in an engaging fashion, almost like you were sitting in his office and having a conversation with him.

He is very clear that progestins (which he calls castrating drugs) are not progesterone. He calls the large Women’s Health Initiative (WHI) study ill-conceived and and says it fails to answer the question that that they sought. The question asked by the study was “Can hormones delay the onset of chronic disease in women?” Because the study used only Premarin and Premarin with medroxyprogesterone (progestin), we only learned that the synthetic or non-human identical hormones do not delay the onset of chronic disease in women.

Dr. Schaller discusses the relationship between hormone balance and body fat at great length. He states ideally, a woman should have about 22% body fat. Less than 13% body fat and low estrogen at menopause is a real concern because there is not enough fat to allow for adequate estrogen storage. Consequently, very thin women have more sensitivity to swings in estrogen which occur throughout the cycle or in perimenopause. “Fat cells store, produce and release estrogen. The number of fat cells affects all hormonally-related effects,” Dr. Schaller claims.

Very thin women can experience stopped monthly periods because there is not enough estrogen available to build up the endometrium. Recall that cycling begins in a young woman who has at least 13% body fat. These women are also at higher risk for osteoporosis.

On the other hand, women who are overweight with more than 30% body fat, store plenty of estrogen in their fat cells. They have a life-long imbalance in progesterone needed to balance the estrogen they accumulate and store. Periods may also stop for obese women but they will likely experience abnormal bleeding.

It is important women understand normal ovarian function. Young girls usually experience pain during the first one to two days of their periods indicating that an ovulation has occurred. After a vaginal delivery this pain may stop. Pain can also occur at mid cycle or two weeks before bleeding begins. This pain can be stabbing or a dull ache and represents the pain of the follicle bursting through the ovary wall. He recommends avoiding strenuous activity when this happens. The ovaries can actually sway with rigorous exercise and prevent healing of the rupture in the ovarian wall.

Dr. Schaller’s book contains many more practical hints. He warns against using psychoactive drugs, medications that have an effect on mood, behavior, or thinking processes, for PMS when progesterone addresses the underlying issue and is less expensive too. He says statins are very dangerous. He notes that cholesterol-lowering drugs do not save lives but actually increase mortality and produce depression and memory problems.

Dr. Schaller is accepting of some doses of NSAIDS (non-steroidal anti-inflammatory drugs) for ovulation pain; however, he says using NSAIDs in excess can cause serious problems because of their potential for gastric ulceration. Drugs which are used for excess stomach acid actually prevent absorption of critical nutrients and bisphosphonate drugs used for osteoporosis interfere with normal bone metabolism.

It was a privilege to read this book and reap the benefits of the observations of a physician in practice for over 40 years. I am sad to see our medicine system turning into one which allows patients only a few minutes with a practitioner and uses treatment plans based on algorithms instead of treating people like individuals and tapping into the vast stores of knowledge and experience from physicians such as Dr. Schaller.

Book Review – An MD’s Life Saving Health Solutions by James A. Schaller2018-01-22T10:56:17+00:00

Book Review – Adrenaline Dominance by Michael E. Platt, MD

Book Review – Adrenaline Dominance: A Revolutionary Approach to Wellness by Michael E. Platt, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

We know what a surge of adrenaline feels like. It is the hormone that gives us the strength for “fight or flight.” Our hearts beat harder, stronger, faster. Blood is diverted from less important things like digestion to our muscular tissue. Thought processes seem to happen at lightning speed. There are many stories of superhuman feats performed under extraordinary circumstances with surges of adrenaline.

Dr. Michael E. Platt has written his book Adrenaline Dominance because he feels that practitioners and their clients lack understanding of this very important hormone. He finds that knowing how adrenaline functions enables him to successfully guide his patients towards wellness.

Adrenaline is produced by an inner part of the adrenal glands. Dr. Platt explains that there are two reasons for adrenaline to be released: One reason is in response to stress as described above, and the second reason is to ensure that the brain has received enough sugar (glucose). The body uses adrenaline to help create more glucose from protein as well as stimulate the release of glucose stored in the liver. Consequently, as glucose releases, insulin releases. These two hormones are intimately involved with adrenaline.

Dr. Platt organized his book according to “The Good, the Bad and the Ugly,” the classic Clint Eastwood western, to illustrate that adrenaline has both desirable and undesirable effects. He believes that right-brained creative thinkers acquire those qualities from plenty of adrenaline ensuring lots of glucose to the brain. Superb athletes also get their edge from adrenaline. These are “good” mental and physical effects of generous amounts of adrenaline.

It starts to get “bad” when adrenaline output is too generous or our bodies don’t have the ability to moderate the high adrenaline. High adrenaline can be tied into depression, anxiety, irritable bowel syndrome, hypertension, diabetes, obesity, headaches, restless leg syndrome, addictions, and bedwetting. It gets “ugly” when syndromes such as fibromyalgia, interstitial cystitis, road rage, autism, or post-traumatic stress disorder appear.

Progesterone, which is also produced by our adrenal glands, is the natural modifier of excess adrenaline. Dr. Platt recommends progesterone in men and women, as well as children. Along with progesterone, Dr. Platt guides his patients with their food choices. Dr. Platt recognizes the relationship between glucose and insulin and claims the timing and types of foods ingested can make significant changes in the presentation of excess adrenaline.

It is not difficult to imagine the ramifications of adrenaline being out of balance since Dr. John Lee introduced us to the concept of “estrogen dominance.” Many practitioners surprisingly don’t recognize the significance of progesterone in moderating both the effects of estrogens and adrenaline. Thanks to Dr. Platt, we can raise our awareness on an ever enlarging picture about hormone balance. He reveals his evidence and thinking in great detail in his book, which is sure to expand every reader’s thinking about our bodies.

  • Platt ME. Adrenaline Dominance: A Revolutionary Approach to Wellness. Michael E. Platt, MD; 2014.
Book Review – Adrenaline Dominance by Michael E. Platt, MD2018-04-03T16:34:47+00:00

Book Review – The Bulletproof Diet by Dave Asprey

Book Review – The Bulletproof Diet by Dave Asprey

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

In “computerese,” to hack means to devise or modify a computer program, usually skillfully. Dave Asprey challenges us to use the concept of “biohacking” in his 2014 book, The Bulletproof Diet.

Dave Asprey is an early Silicon Valley computer engineer who made millions with Internet hacking. He describes hacking as needing to make complex systems work even when all the pieces of the puzzle are not available. In that respect, he came to understand that the human body is very much like a complex computer program, with some data that is missing or misunderstood. He speculated that it would be possible to use “biohacking” to solve his own health problems.

At the start of his quest, Dave Asprey writes, he was in miserable shape. He weighed 300 pounds and was unable to lose the extra weight, even though he followed various diets and a strenuous exercise program. Other health issues included chronic sinus infections, strep throat, foggy brain and difficulty maintaining focus. He was always tired and overwhelmed with the stress in his life.

Asprey came to look at his body as a complex system. He engaged in what he calls “biohacking,” or “the art of using technology to change the environment inside and outside of your body to take control and make it what you want.” His endpoints of success would be measures such as how he felt, how he performed, the success of his relationships with others, and overall happiness. Just as programmers look to find potential flaws, he took to “troubleshooting” his environment, evaluating what was working and what was not in a scientific manner.

In the end, he concluded that inflammation, toxins, hormones, neurotransmitters, gut bacteria and more play huge roles in the efforts to nourish our bodies and our brains. He asserts that the strongest variable in achieving top performance is—far and away—our diet.

In his “biohacking” journey, Asprey discovered that he had thyroid (Hashimoto’s), adrenal, testosterone and estrogen problems. Realizing that saturated fats and cholesterol are the building blocks for the sex and adrenal hormones, he deviated from the low-fat philosophy being promulgated and started eating butter from the milk of cows who had been raised eating grass. Magic happened as his focus increased, while his weight and inflammatory markers decreased.

Asprey discovered the importance of a molecule called vasoactive intestinal polypeptide (VIP) which, when depleted, disturbs our master glands (pituitary and hypothalamus). This leads to problems with insulin and glucose regulation, causing a craving for sweets. Paying attention to the proper functioning of VIP is one of the cornerstone ideas in The Bulletproof Diet.

Because our medical system prefers to use techniques such as double blind, crossover studies (which tend to limit the variables as much as possible), we are prevented from understanding our human functioning as a system. What usually evolves is something like the conventional treatment for hypothyroidism. Practitioners are taught to test for thyroid stimulating hormone (TSH). If the TSH gets too high because of the effort to stimulate more thyroid hormone production from the thyroid gland, a single thyroid hormone, l-thyroxine (T4), is prescribed. When the TSH level comes down because of the presence of T4, the treatment is considered a success. In truth, for vast numbers of people, the low thyroid symptoms are not relieved. Their practitioners are unable to shift from their linear thinking to a systems analysis, which requires “biohacking” until the other variables are revealed.

It has taken the efforts of an individual who is systems-minded (and who is trained to collect and evaluate data points in a scientific manner) to open our minds to a new approach to optimal health. Practitioners who have embraced using bioidentical hormones in a symphony of hormones have broken away from their linear thinking and learned to “biohack” for their patients. It’s revolutionary and exciting. Dave Asprey presents much more in his book, inviting us all to learn how to “biohack” our way to greater energy, focus and well-being.

  • Asprey D. The Bulletproof Diet: Lose up to a Pound a Day, Reclaim Energy and Focus, Upgrade Your Life. Emmaus, PA: Rodale Books; 2014.
Book Review – The Bulletproof Diet by Dave Asprey2017-12-11T17:42:55+00:00