Foot Fat Pad Atrophy

Foot Fat Pad Atrophy

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


Here’s another one to add to the number of signs and symptoms of declining hormones: Is the heel or bottom of your foot causing you pain? Are you finding yourself seeking relief in the Dr. Scholl’s section of the pharmacy? It could be due to foot fat pad atrophy.

The foot fat pads are the tissue that protects your foot on the ball of the foot and at the bottom of the heel. Atrophy means shrinking or disappearing. The foot pad tissue under the foot does decline with age. Menopause and surgical menopause increase the rate of decline. Obvious mechanical issues, such as being overweight, can also have a negative impact and hasten the loss of the plumpness of this tissue.

If plantar fasciitis (painful inflammation of the bottom of the foot) has been an issue, your practitioner may have used one or more injections of “cortisone” to relieve pain. Unfortunately, this “cortisone” is not the same as the cortisone hormone the body produces; it is actually a synthetic analog that can lead to even more atrophy of the foot pads.

In addition, as Dr. Sergey Dzugan points out in The Magic of Cholesterol Numbers, cholesterol levels elevate when the body senses a deficiency of the sex and adrenal hormones, which are normally produced from cholesterol. So statin users beware! When taking statins, not only do cholesterol levels fall, but the ability to make hormones drops even further. Statin drug use may be a source of foot pain from accelerated foot fat pad atrophy.

If you are experiencing foot pain, have your practitioner check for hormone deficiencies, including vitamin D (which is also made from cholesterol). These deficiencies may be the underlying cause of your foot pain.

Foot Fat Pad Atrophy2017-12-14T15:16:50-05:00

Book Review – Moods, Emotions, and Aging by Phyllis Bronson, PhD

Book Review – Moods, Emotions and Aging: Hormones and the Mind-Body Connection by Phyllis Bronson, PhD

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

Dr. Phyllis Bronson’s book, Moods, Emotions, and Aging, could not have been published at a better time. Brisdelle, a version of Paxil or paroxetine, has just been approved by the FDA as a treatment for hot flashes, despite an advisory committee vote of 10-4 against it. Hot flashes, a symptom of menopause believed to be an effect of hormone deficiencies, may now be treated with a potent and highly addictive SSRI (selective serotonin reuptake inhibitor) that has extremely dangerous side effects, including suicidal thoughts.

It is time for the “silver tsunami” that is the powerful baby boomer demographic to wake up to the fact that we don’t have to drug ourselves into oblivion to address the consequences of age-related hormonal changes. Hot flashes are NOT the result of an SSRI deficiency! There are better answers and we have the power to demand them.

Dr. Bronson’s book will equip anyone facing the challenges of hormone deficiencies. Because she works with and writes about real people with serious mood and hormone imbalances, her readers may see themselves in the patient stories she tells and be inspired to take action to resolve their own health issues.

Phyllis Bronson is a rare individual who brings science to practice in her role as a clinical biochemist. Too often, the science and studies are readily available but clinicians don’t or won’t seek them out. Or, if they do, they are ostracized by their peers for stepping out of the box their medical education has defined for them.

Dr.  Bronson asks the hard questions of our organized medical providers:

  • Since the WHI studies (which are discussed at length in the book) revealed significant problems with the use of Premarin and Prempro, why are patients still being prescribed these products (albeit in “lower” doses)?
  • Why are women being offered antidepressant drugs instead of estrogen hormones, when she has seen women with low estradiol levels resolve their complaint about brain fog within an hour after supplementing with estradiol?
  • Why are women systematically being denied the use of progesterone when their ovaries are removed, when the bioidentical hormone progesterone has been shown to be protective of nerve tissue and potentially protect against cancer?

In addition to the hormones made from cholesterol in our bodies (e.g., the sex and adrenal hormones), there are also hormones derived from amino acids. Amino acids are the building blocks of the proteins we eat, and they become available to the body when protein is digested. Dr. Bronson found that it is easy to supplement amino acids to help balance hormones such as dopamine and serotonin. Here’s a radical thought: Instead of blocking the metabolism and reuptake of serotonin in the nerve synapse, which is what SSRIs do to raise serotonin levels, what if we supplement the body with the building block amino acids needed to make more serotonin? This is the path Dr. Bronson prefers, and she describes in her book how this has worked successfully for her clients.

In the book Honest Medicine, Dr. Burt Berkson describes how medical students are not encouraged to question or think. Their education is now just “training” consisting of whatever the current consensus determines to be the current standard of care. Unfortunately, standards of care can be influenced by people with motives that are not necessarily in line with what might be best for individual patient care.

Is your practitioner willing to go beyond the “training” received in medical school? Is she or he ready to partner with you to achieve optimal individualized care? Then Dr. Bronson’s book will be an asset to both of you as you jointly evaluate your biochemical individuality and consider treatment accordingly.

Another valuable facet of Dr. Bronson’s book is the discussions of how emotional issues can both provoke and be a result of hormone disarray. With the myriad of tools provided in this book, people who may have “lost” themselves emotionally may be able to find a pathway back.

Book Review – Moods, Emotions, and Aging by Phyllis Bronson, PhD2017-12-14T12:27:47-05:00

From WHI to KEEPS: Two Studies on the Effects of Estrogen Therapy

From WHI to KEEPS: Two Studies on the Effects of Estrogen Therapy

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

The much heralded (and widely criticized) Women’s Health Initiative (WHI) was the largest study involving women’s health to date. It investigated differences between the two most frequently prescribed hormone therapies at that time: Premarin, composed of conjugated equine estrogens, and Prempro, a combination of Premarin and the progestin medroxyprogesterone—none of which are bioidentical to the hormones produced by the human body. To much alarm by the media, the WHI study was halted after increased incidences of breast cancer and heart disease among participants. As a result, many people came to view all hormone therapies as suspect, leaving perimenopausal women with few other options for symptom relief.

Fortunately, a group of researchers at the Kronos Longevity Research Institute recognized an opportunity to improve on the WHI study and, in partnership with the National Institute on Aging at the National Institute of Health, initiated KEEPS, the Kronos Early Estrogen Prevention Study.

A four-year project, KEEPS involved women between the ages of 42 and 58, who were within three years of menopause. The two arms of the study evaluated 1) markers of cardiovascular risk and 2) effects on memory and mood, among three groups of participants:

  • One group received oral conjugated equine estrogens (Premarin) at a dose of 0.45 mg/day, which is lower than the dose in the WHI study
  • A second group used a Climara patch dispensing 50 mcg/day of bioidentical estradiol, equivalent to the estradiol produced by the ovaries
  • A third group did not receive any estrogen therapy

All three groups also received micronized oral progesterone (Prometrium) cyclically. This is equivalent to the progesterone produced in the human body, unlike the progestin used in the WHI study.

The KEEPS team released initial results at the annual meeting of the North American Menopause Society in October 2012. The highlights concerning cardiovascular markers included:

  • Those in the estrogen groups reported improvements in hot flashes, night sweats, mood, and sexual function, with no changes in atherosclerosis progression and no significant changes in blood pressure
  • Bone density also improved with estrogen therapy
  • Oral conjugated estrogens had some effects on lipid profiles, but transdermal estradiol was neutral in that aspect
  • Insulin sensitivity improved with the transdermal estradiol

Results from the ancillary Cognitive and Affective Study arm of KEEPS at the University of Wisconsin were also encouraging. Their data demonstrated that hormone therapy had positive effects on global cognition, verbal and visual memory, executive functioning, mood, and quality of life. Participants also reported significant improvements with regard to depression, anxiety and tension, according to lead researcher Dr. Sanjay Asthana.

Both arms of the KEEPS project resulted in good news for perimenopausal women. In essence, the preliminary data suggests that hormone therapies—especially bioidentical hormones—can provide significant symptom relief without posing additional cardiovascular risk. 

From WHI to KEEPS: Two Studies on the Effects of Estrogen Therapy2018-04-09T13:01:36-05:00

Oral Progesterone Improves Hot Flashes and Night Sweats

Oral Progesterone Improves Hot Flashes and Night Sweats

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


A recent study supports the common belief that oral progesterone helps with post-menopausal symptoms such as hot flashes and night sweats. The study included 133 healthy women, ages 44 to 62, who received either 300 mg oral progesterone or a placebo for a twelve-week trial period.

The women who took progesterone described significant decreases in the frequency and severity of both day and night-time vasomotor symptoms. In addition, they reported significant improvement in their sleep quality.

  • Hitchcock CL, Prior JC. Oral micronized progesterone for vasomotor symptoms-a placebo-controlled randomized trial in healthy postmenopausal women.
    2012 Aug;19(8):886-93. doi: 10.1097/gme.0b013e318247f07a.
Oral Progesterone Improves Hot Flashes and Night Sweats2018-04-05T12:22:10-05:00

Hormones in Your Fingernails

Hormones in Your Fingernails

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

A study published by Fay Marnock, et al., suggested using fingernails to measure hormone status. As a nail’s matrix builds up with keratin, hormones passively diffuse into the nail from capillaries in the blood. The authors suggested measuring DHEA and cortisol in the nail to gauge hormone status over a prolonged period. This could have advantages over tests using serum, saliva, and urine, which reflect only a point in time or only a single day’s hormone level.

Aside from the possibility of actually measuring hormones, the appearance of your fingernails reveals a lot of information about your overall health. For example, one of the symptoms of osteoporosis is brittle fingernails. A clinical trial is currently comparing nail structure with bone integrity over the course of chemotherapy treatment.  The investigators are also comparing the nails of individuals who have had a bone fracture with those who have not.

Just like hair, fingernails are mostly composed of a protein called keratin. However, not all fingernails are alike.  A study by Dittman, et al., showed that not only is there a gender difference–women have more sulfur and less nitrogen in their nails than men–but that carbon levels in fingernails increase with age in both sexes.

First and foremost, healthy nails require an adequate supply of nutrients. However, Dr. Jonathan Wright notes that adequate supplies of stomach acid are equally important to nail health because of its role in the absorption of amino acids (the building blocks of protein) and minerals. So, in addition to eating enough of the right nutrients, the state of your digestive health will determine whether or not the nutrients are actually absorbed and usable. Dr. Wright also checks for testosterone levels because it is also needed for protein (i.e., keratin) synthesis.

Dr. Thierry Hertoghe observes that vertical lines on fingernails are typical of a growth hormone deficiency. Some believe that this may also be a sign of nutrient deficiency.

A hallmark of menopause can be dry, brittle nails can. Healthy fingernails must be hydrated. Since estrogens are responsible for keeping water in body tissues, lowered estrogen levels contribute to less healthy fingernails. Dehydration is also a common problem with aging, which helps explain why the elderly often have fingernails that look dull and yellow.

Dry, brittle nails are also a sign of hypothyroidism. With low thyroid function, circulation to the extremities is impaired, which means that the nutrients in the blood may not get all the way to the fingernails. The nail bed can also become very pale because of poor circulation.

The parathyroid glands, located in the neck near the thyroid gland, regulate calcium and vitamin D. If the glands are not producing enough parathyroid hormone, brittle nails may result. Calcium and vitamin D must be supplemented to restore nail health.

Those little white spots that appear on your fingernails may originate from stress. The white spot indicates a drop in zinc caused by a stressful event. Since a fingernail takes about six months to grow, you can even estimate the time of the stressful incident. Dr. Carl Pfeiffer noted that about 30% of schizophrenia patients had these spots. He then treated them with zinc and B6 (because B6 will be ineffective without enough zinc) and had very favorable responses.

Hormones certainly play a role in maintaining healthy nails, and the tidbits mentioned here just scratch the surface of what can be gleaned from looking closely at your fingernails. The shape, colorings, pitting, lines, thickness and splitting can all be clues to the state of your body’s health. If you have concerns about your fingernails, be sure to discuss them with your healthcare practitioner. Fungal infections and psoriasis can be a direct cause of a diseased nail.

Additional Resources:
Hormones in Your Fingernails2018-04-09T14:47:30-05:00

Dry Eyes

Dry Eyes

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


Dry eyes can be very uncomfortable. People with dry eyes complain of burning, grittiness, redness and ironically, excessive tearing. Wearing contact lenses may be irritating, or even impossible, for people with dry eyes.

Why do eyes get dry?

Medical conditions such as arthritis, lupus, diabetes, sarcoidosis, and salivary gland disease can lead to dry eyes. In addition, the tendency to drink less water as we age, the dependence on soft drinks for fluid replacement, local water shortages and hot, dry weather can all lead to dehydration in the eyes.

Many medications also contribute to dry eyes. Antihistamines often cause dry and irritated eyes. Antidepressants like Prozac can cause dry mouth and eyes, causing vision problems. Drugs for dizziness, birth control pills, diuretics, and blood pressure medications all increase the chances of dry eyes.

Behavioral and environmental issues also contribute to dry eyes. Drinking lots of coffee, being around cigarette smoke, wearing contact lenses, spending time in buildings with air conditioning or heating, traveling in airplanes, being in ultraviolet light, staring at a computer screen, and not blinking can also cause dry eyes.

What are tears made of?

Tears are comprised of three different types of secretions:

  • Oil, produced by the meibomian glands located in the eye lids, floats above the watery portion of the tears and keeps the eyes from drying quickly
  • Mucous, produced by the goblet cells inside the eye lids, forms the layer in direct contact with the eye
  • The watery portion, produced by the lacrimal glands, is sandwiched between the other two layers

Most of the products sold over-the-counter to treat dry eyes only replace the watery portion of tears and must be used with great frequency.

Hormones to the rescue?

It is becoming more apparent that disorders of the oil-producing meibomian glands may be the reason behind up to 75% of the complaints of dry eye.  Research (and even United States patents) point to the lack of androgens, such as testosterone and DHEA, as the underlying problem with oil production in tears.  Androgens control lipid production of the sebaceous glands in the body, including the meibomian glands. Eye drops and ointments or gels to be used around the eyes containing testosterone or DHEA have been the focus of studies, and have produced encouraging results.

What about estrogen?

Postmenopausal women tend to be more afflicted with dry eyes than men of the same age, which suggests that estrogens may be a contributing factor in dry eyes. However, the subject becomes much more complicated when considering different types and amounts of estrogens, estrogen mimics, xenoestrogens, and disturbances in estrogen metabolism. For example, a study published in the British Journal of Obstetrics and Gynecology (BJOG) involving a group of postmenopausal women found that estradiol drops were effective in relieving dryness, reddening, excessive blinking, itching, and feelings of foreign bodies among women in one group, while the oral estradiol valerate in the artificial tears group was not sufficient to relieve their symptoms. Another study evaluated tear production throughout the menstrual cycle and found that there were significant changes associated with hormonal fluctuations. However, dryness and inflammation seemed to be the most significant during estrogen peaks.

And in our canine friends?

More than 60 species of dogs suffer from dry eyes and have constant problems with mucous accumulation. A veterinarian discovered that cyclosporin (an anti-rejection drug used by organ transplant patients) can be very effective when applied as an eye drop to a dog’s eyes.

Dry Eyes2018-04-09T12:13:55-05:00