Book Review – The Edge Effect by Eric R. Braverman, MD

Book Review – The Edge Effect: Achieve Total Health and Longevity with the Balanced Brain Advantage by Eric R. Braverman, MD

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


In The Edge Effect: Achieve Total Health and Longevity with the Balanced Brain Advantage, Dr. Eric Braverman introduces the notion of a series of “pauses” that occur as we age, such as menopause. Some women experience their first menopause symptoms as young as in their 30s, characterized by dramatic drops in testosterone and progesterone. Estradiol losses may also start in their early 30s. Diminished bone density, less abundant hair, and cognitive dysfunctions accompany the loss of these sex hormones. Andropause (the male equivalent of menopause) typically starts around the mid-40s and continues over the next 30 years with similar effects.

Dr. Braverman points out that our bodies go through many other “pauses” as we age:

  • Up until about the age of 30, bone mass increases or is near optimal. After that, osteopause begins. The availability of proper nutrients in the diet typically starts to be a concern, plus the ability to absorb and make use of those nutrients has also started to decline.
  • During the 30s and 40s, dermopause begins to show with diminished skin thickness, flexibility, or elasticity, all of which are related to the ability to make collagen. The skin also becomes increasingly dehydrated.
  • The maximum heart rate achieved during exercise typically peaks in the 40s, marking the beginning of cardiopause.
  • Along with cardiopause is vasculopause, which is characterized by high blood pressure and diminished blood flow.
  • Thyropause starts generally in the 50s, when the production of thyroid hormone and calcitonin is reduced.
  • Thymopause starts even earlier. The thymus gland aids our immune system by directing the function of T lymphocytes (or T cells). Although this continues life long, the thymus starts to shrink and accumulate fatty tissue at puberty.
  • From the 50s to the 70s there is a marked decline in lung function or pulmonopause. In fact, the effectiveness of breathing is a prime indicator of longevity. Stress, anxiety, and exposure to pollutants negatively affect pulmonary function.
  • Adrenopause, which is characterized by diminished DHEA, can begin as early as the 30s and up through the 60s. By the 70s, without adequate DHEA, cortisol levels also soar. This unhealthy state has earned cortisol the title of “death hormone” because there are so many issues associated with diminished adrenal function. Primary health concerns include changes in focus, memory and attention, depression, lack of energy, loss of libido (especially with women), anxiety, panic attacks, and increased appetite, all symptoms that we readily associate with advanced aging.
  • The loss of muscle mass is another hallmark of aging. By the 90s, 20-40% of muscle mass is lost. This is known as somatopause, and includes reduced muscle strength as well as reduced mental ability.

All of the above are physical “pauses” that typically occur; however, Dr. Braverman and most people believe that the “pauses” related to brain function are even more critical to measuring how well we age:

  • Sensory pause refers to the loss of sensory functions. Hearing starts to decline in the 20s to 40s. The sense of smell starts diminishing in the 40s and more rapidly declines after age 65. Nearsighted increases in the 40s but the ability to see fine details starts to decline in the 70s.
  • Pituitary pause refers to the decline in function of the pituitary and hypothalamus, which are the glands that are masters to the sex hormones, adrenal hormones, thyroid hormones, and more.
  • Electropause refers to the loss of voltage, speed, rhythm and synchrony. For instance, just a 10% drop in voltage can signal signs of depression. With a 90% drop, dementia is a reality.
  • Biopause relates to the brain mediated control of the cascade of all the other pauses.

Other neuropsychiatric disorders can occur at any age but they are especially prevalent in those over 85 years of age, affecting as many as 50% of that population. These types of disorders include cognitive dysfunction and dementia, substance abuse, and personality disorders.

The neurotransmitter hormones Dr. Braverman believes are at the center of delaying the “pauses” are GABA, dopamine, acetylcholine, and serotonin. He correlates the dominance of one or the other of these neurotransmitters to personality types, such as those used in the Myers-Briggs test. His book is brimming with questionnaires to help identify your personality type and neurotransmitter dominance. In addition, he provides guidance as to “bending one’s chemistry the right way” with diet and exercise, as well as supplementing nutrients and bioidentical hormones, and making changes to your lifestyle and/or environment. Further, he invites you to explore how technology can positively affect your brain chemistry.

This litany of “pauses” presents a grim picture of aging. However, Dr. Braverman suggests that there is no reason we can’t slow down their progression. He believes that the brain, and our ability to make and make use of the neurotransmitter hormones in a balanced fashion, is the key to doing so.

  • Braverman ER. The Edge Effect: Achieve Total Health and Longevity with the Balanced Brain Advantage. New York, NY: Sterling Publishing Company, Inc.; 2005.
Book Review – The Edge Effect by Eric R. Braverman, MD2018-05-02T12:15:55-05:00

Blood Sugar and the Aging Brain

Blood Sugar and the Aging Brain

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Alzheimer’s Disease is sometimes called the “Disease of the Baby Boomers.” So it is not surprising that current brain research is focusing on this disorder.

A recent study on blood sugar levels and brain deterioration by Dr. Cherbuin and associates looked at 266 healthy, non-diabetic individuals, ages 60-64. The results indicated that high normal-fasting blood sugar levels were associated with brain wasting, particularly in areas relevant to aging. In another study, abnormally high blood sugar levels were associated with shrinkage of parts of the teenage brain as well.

Low testosterone, as well as high cortisol levels and estrogen/progesterone imbalances, can also lead to blood sugar/insulin disturbances.

Although more research needs to be done, controlling blood sugar levels through a healthy diet and exercise may prove to be beneficial in maintaining healthy brain function throughout life.

  • Cherbuin N, et al. Higher normal fasting plasma glucose is associated with hippocampal atrophy: The PATH Study. Neurology. 2012 Sep 4;79(10):1019-26. doi: 10.1212/WNL.0b013e31826846de.
  • Yau PL, et al. Obesity and Metabolic Syndrome and Functional and Structural Brain Impairments in Adolescence. Pediatrics. 2012 Oct; 130(4).
Blood Sugar and the Aging Brain2018-04-03T16:59:57-05:00

Treating Multiple Sclerosis with Sex Hormones

Treating Multiple Sclerosis with Sex Hormones

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Multiple sclerosis (MS) is an autoimmune disorder characterized by inflammation and nervous system degeneration. Both estrogen and testosterone exhibit anti-inflammatory and neuro-protective effects when administered to MS patients in studies.

Male MS patients were treated with 100 mg of transdermal testosterone daily. At the end of the twelve month treatment period, cognitive performance improved while brain atrophy diminished. When female MS patients were treated with 8 mg of oral estriol daily for six months, evidence of lesions on MRIs decreased while brain function increased.

In addition, female MS patients are often plagued with chronic urinary tract infections (UTIs). Intravaginal estriol significantly decreases UTIs in postmenopausal women.

Further studies regarding hormones in the treatment of MS are ongoing.

  • Gold SM, Voskuhl RR. Estrogen and Testosterone Therapies in Multiple Sclerosis. Prog Brain Res. 2009; 175:239-251.
  • Raz R, Stamm WE. A Controlled Trial of Intravaginal Estriol in Postmenopausal Women with Recurrent Urinary Tract Infections. N Engl J Med. 329(11):753-756.
Treating Multiple Sclerosis with Sex Hormones2018-04-05T10:58:22-05:00

Progesterone for Treating Traumatic Brain Injury and Stroke

Progesterone for Treating Traumatic Brain Injury and Stroke

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Recent clinical studies support the use of progesterone in the treatment of traumatic brain injury (TBI). One trial found that the mortality rate of subjects with moderate to severe adult TBI, who were given progesterone intravenously for three days after the injury, was less than half of that among control subjects. These subjects were still doing better 30 days later. A second study found similar results, and neither study found any serious adverse effects.

Studies involving animals also support the use of progesterone in the treatment of acute stroke. This research indicates that progesterone protects the brain against damage caused by lack of blood flow, and it may also reduce the size of the blood clot involved.

  • Stein DG, Sayeed I. Is Progesterone Worth Consideration as a Treatment for Brain Injury? AJR Am J Roentgenol. 2010 Jan;194(1):20-2. doi: 10.2214/AJR.09.3407.
  • Wright DW, et al. ProTECT: A Randomized Clinical Trial of Progesterone for Acute Traumatic Brain Injury. Ann Emerg Med. 2007 Apr; 49(4):391-402.
  • Xiao G, et al. Improved Outcomes from the Administration of Progesterone for Patients with Acute Traumatic Brain Injury: A Randomized Controlled Trial. Crit Care. 2008;12(2):R61. doi: 10.1186/cc6887. Epub 2008 Apr 30.
Progesterone for Treating Traumatic Brain Injury and Stroke2017-12-14T14:56:01-05:00

September is Healthy Aging Month

September is Healthy Aging Month

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


In The Singularity is Near, Ray Kurzweil and Dr. Terry Grossman write that if we manage to keep ourselves going for the next 20 years, there is reason to believe that we will have learned enough about human physiology that the potential for living indefinitely could become a reality.

This interest in healthy, successful aging has spawned several professional medical groups that are actively addressing the issues, including the American Academy for Anti-Aging Medicine (A4M), the Age Management Medicine Group (AMMG), the American College for the Advancement in Medicine (ACAM) and the International College of Integrative Medicine (ICIM).

Although it is not their primary focus, the practitioners in these groups support the belief that adequate and balanced levels of hormones are one of the foundations of successful aging.

Here are some of the health issues they are up against in their quest for understanding how we age, and what might be explored to help improve the aging process:

  • The cardiovascular system becomes compromised as the heart struggles to pump blood efficiently and arterial walls are weakened. High blood pressure, arrhythmias, and heart failure symptoms may ensue. However, testosterone is one of the most heart-healthy hormones, and growth hormone supplementation has proven to be of great benefit to a failing heart. Dr. Broda Barnes reported that, with adequate thyroid supplementation, his patients did not get heart attacks.
  • Bones, joints, and muscles continually weaken, and pain is often a consequence when these tissues become compromised. Sarcopenia, the medical term for loss of muscle mass, also contributes to an overall frailty and weakness. These symptoms are all correlated with low growth hormone, low testosterone, low DHEA, low estrogens, low progesterone, low thyroid, and low vitamin D. The stress hormone cortisol may be contributing to tissue damage as well if it remains high over extended periods of time.
  • The digestive system becomes compromised with low stomach acid, and a tendency toward constipation increases with age. If there is not enough thyroid activity in the body, the entire digestive tract slows and stagnates.
  • Weight gain, particularly around the middle, is very common in people as they age. While proper utilization of insulin and glucose are critical, low thyroid hormones are also typically part of pre-diabetic and diabetic dysfunction. Hormones such as testosterone and progesterone help to stabilize blood sugar levels. Excess cortisol (the stress hormone) encourages fat deposits.
  • Urinary and bladder issues become a major factor in a deteriorating quality of life. Estrogens, particularly estriol, are needed to keep the urinary tract and bladder tissue healthy. Testosterone is needed to maintain the strength and integrity of the tissues.
  • “I am worried about losing my mind” is a very common concern for people as they age. All of the sex and adrenal hormones are “neuro” steroids, which means that they actually concentrate and function in the brain. Thyroid hormones contribute to keeping memory sharp.
  • Losing eyesight and hearing are also debilitating problems associated with aging. The upper eyelids droop when growth hormone is deficient. Tears need estrogen, testosterone and DHEA for an adequate composition of the fatty component. Aldosterone has demonstrated some effectiveness in treating age-related deafness.
  • The teeth may become more brittle and the gums retract. Associated with osteoporosis, these symptoms are linked to deficiencies of vitamin D, the estrogens, testosterone, DHEA and growth hormone.
  • The skin becomes increasingly wrinkled, thin, and prone to bruising. Estrogens maintain the moisture and structure of the skin. Testosterone and growth hormone are needed to retain skin thickness and structure.
  • For many people, sexuality has just about disappeared. With low testosterone and low estrogens, many men and women may not be able to function sexually, and they may not even care because those hormones also control sexual interest (the libido).

This litany of ailments sure paints a dismal picture of what lies ahead. However, this is an exciting time for medicine, and the professional focus on successful, healthy aging shows great promise. After all, what practitioner does not take great joy in seeing patients continually improve?

Our goal is to plant a seed for you—right now, during Healthy Aging month, no matter what age you are—to start exploring the knowledge and tools readily available to better prepare yourself for the aging process.

You can be tested and evaluated clinically to determine which hormones may be deficient and which may be excessive. You can choose to make important lifestyle changes so the basic needs of good food, as well as clean air and water are met. You can keep your body running smoothly by physical activity, healthy play and exercise. And, with the help of practitioners attuned to healthy aging, you can choose to replenish those hormones that decline with age and take steps to moderate the ones that tend toward excess.

September is Healthy Aging Month2019-04-25T17:12:56-05:00