Full Transcript Hormone controversy and aging basics 0:04 So, you know, seeing how the news shapes our views is part of why we're here tonight talking about hormone controversy. 0:13 Because, really, there is no controversy about hormones. 0:18 We have very clear understanding of what part of hormones are dangerous and what parts of hormone are safe and how to make utilization of the hormones 0:27 safe for you and without risk, without any increased risk. 0:31 Do women get breast cancer? 0:33 Oh, yes. 0:34 One in seven, one in eight women will get cancer. 0:37 Is it because she's on estrogen? 0:40 No. 0:41 toxins in the environment, excess body fat, poor diet, no exercise, all of those things. 0:49 Those are the reasons that feed into it. 0:52 And so something like that happens very frequently. 0:56 The question is, does the hormone cause it? 0:58 That's the issue, not whether it happens or not. 1:01 So we're going to talk tonight about some of the other confusions that people have about hormones and where they come from. 1:13 So what we're gonna do is I'm gonna tell you some about hormones, and some of you have already found your hormone truth or myth quiz that's in your folder, 1:22 we'll be doing that later. 1:24 And having a little like truth, or, truth? 1:28 Or myth? 1:29 Truth or Myth? 1:34 And this is myth versus reality, but it's really myth vs. 1:37 truth. 1:38 So I want to tell you a little bit about what hormones are, because that's fundamental to understanding why we talk about them. 1:47 The only way to get information from one part of your body to another is to send a messenger. 1:53 And this was the messenger that ran the first marathon to, you know, to the tell the troops what was going on. 2:02 He was a Messenger. 2:04 We have Messengers all over our bodies, so how does A gland in our brain tell our thyroid to make more thyroid hormones. 2:13 How does the gland of our brains tell the adrenal glands to create hormones? 2:17 And how does our Thyroid gland tell every cell in the body to speed up metabolism? 2:25 With messengers. 2:26 And the messangers are the hormones So there are many different types of hormones. 2:32 We're gonna talk particularly about a few hormones tonight, the ones that are controversial. 2:37 I don't think anybody has a big controversy about thyroid. 2:40 You know, we all know we need it and there hasn't been all this stuff in the media about it, but I wanna talk about the one that bring up questions and 2:51 doubt in your mind. 2:54 So hormones also function, am I standing in front of the screen for people? 2:59 Can you see better now? 3:01 Hormones also function as our thermostat and metabolism regulator. 3:08 So that would be a lot thyroid. 3:11 Also insulin, the hormone, controls metabolism of sugar. 3:21 Hormones regulate aging, and this is the most important thing. 3:26 And starting with when we're about 25, when were hormonally at our optimal, begins the downward So by the time we're in our mid-40s, 3:39 one of the most important energy and vitality hormones, DHEA, is about half of what it was when we were 25. By the you're 60, it's a quarter. 3:49 So a lot of things that are felt to be changes due to age, you know, what do you expect at your age? 4:01 Are really hormonal declines. 4:04 And this is the other thing, you know, people say, well, we don't have like 20 or 30 year studies. 4:08 Well, really, it's just been in the last 20 to 25 years that we've really started utilizing hormones for maintenance of health, 4:15 slowing down the aging process, and aging what I call successfully, having healthy longevity. 4:22 This is a new thing. 4:23 You know, in 1900, the expected lifespan was about 45 to 50 years old. 4:29 Nobody ever lived in the latter part of their lives. 4:31 Women didn't live in menopause. 4:34 Men didn' t live during a time of life when their testosterone levels went down. 4:38 And when people say, well, I think we should just let nature take its course, Well, you know before insulin, diabetics used to let Nature take it's course. 4:46 It didn t have a very good outcome for them. 4:50 Diabetes is basically a disease of premature aging. 4:53 The sugar ages your blood vessels, ages you brain. 4:56 Diabetics have accelerated heart attacks and strokes at a much younger age than the general population, and they have a higher rate of Alzheimer's disease. 5:07 So that's an example of accelerated aging, so if we can slow down the aging process, we will age more healthfully. 5:16 We've done a whole lot to expand our lifespan, right? 5:21 So it went from age 45 or 50 in 1900 to here we are 200 years later. 5:23 No, 114 years. 5:24 I'm not good at subtracting. 5:25 And we've added another 30 years But we haven't improved the quality of the last part of those years at all.
Hormones, inflammation, and menopause changes 5:45 And that's come from academic centers that have looked at it. 5:49 So people are living longer, but not better. 5:52 The real question is how can we live better? 5:54 And really, the baby boom generation is the first generation to have the opportunity to do something about their aging. 6:03 Because it's only like I said in the 25 years that we have an understanding of why we decline as we get older. 6:10 And with that knowledge, you can do something about it. 6:13 A large part of it is hormones. 6:15 There are other things. 6:16 there's oxidation, rusting from the inside out. 6:21 It's diet dependent and exercise dependent. 6:25 You know, there are a whole lot of different processes. 6:28 Sugar abnormalities, like with diabetes. 6:31 you don't have to be a diabetic. 6:34 to undergo adverse effects from too much sugar. 6:37 Don't wait till they call you a diabetic to control your sugar, even if your sugars elevated but not diabetic, you have a higher risk of dementia. 6:47 So we have this understanding about the aging process and that's allowed us to develop programs and supplements and approaches to slowing down that process, 6:58 and decreasing our risk serious chronic illness. 7:02 We know that all chronic illnesses, and what do I mean by chronic illness? 7:08 Cancer, heart disease, including strokes, Alzheimer's disease. 7:13 Parkinson's Disease. 7:14 Those are all Chronic Illnesses. 7:16 And they are caused by inflammation. 7:20 What modulates inflammation? 7:22 What you eat, your exercise, Your mental, emotional, spiritual part of you, And your hormones. 7:31 So all of those things modulate inflammation and you want to be on an anti-inflammatory path in everything you do. 7:42 So that's what we're about and tonight we are going to talk about the hormone part of things. 7:46 Hormones do regulate aging. 7:48 Our wrinkling, sagging skin comes from diminished estrogen levels and growth hormone levels. 7:56 our loss of muscle comes form diminishing testosterone levels Dementia, we have great evidence that estrogen and testosterone in women and in men decreases 8:10 risk of Alzheimer's disease and dementia. 8:15 Depression. 8:16 is very much hormonal in men as well as women and has other causes aswell. 8:21 It's a really complex one. 8:23 And cardiovascular disease can be looked at as a hormonal disease. 8:27 Hormones like testosterone and estrogen help to keep the linings of your blood vessels in healthy condition. 8:35 The linens of you arteries is where cardiovascular diseases start. 8:39 That's where plaque starts. 8:41 And you want that lining kept velvety and soft and supple. 8:45 You don't want it stiff and hard like a pipe with calcium deposits. 8:50 Hormones help to keep it like that. 8:53 So hormones definitely regulate our aging, not to mention Symptoms, you know, low libido, mood, energy, a whole variety of things that we're aware of. 9:07 There's a lot that goes on that were not aware, but there's lot we know about in ways that don't feel well that is hormone related. 9:16 So when we have somebody on a hormone restoration program here, we use a number of different products, eight of them. 9:28 We're going to talk about testosterone, progesterone, and estrogen, because like I said, that's where the controversy is. 9:34 The other hormones that we use, pregnenolone which is a hormone that converts into a lot of these other hormone, but it also acts as a neurotransmitter 9:46 in the memory center of your brain. 9:47 So some of that diminishing of cognitive ability, of thinking ability as we age, oh well, it's just your age is diminishing pregnenolone level, 9:59 something that can be restored. 10:02 Thyroid is a whole other topic but huge numbers of people have low functioning thyroid that contributes to weight problems, 10:10 energy problems mood problems thinking problems. 10:13 DHEA I talked about is this tremendous energy and vitality hormone. 10:18 Melatonin levels diminish as we age and so people tend to have more sleep difficulties as they get older and sleep is absolutely foundational to your good health. 10:29 And vitamin D, I talked about, which functions more like a hormone. 10:32 And like thyroid, there is a receptor or a spot on every cell in your body for it to have an action. 10:40 So a receptors like, a lock. 10:43 Vitamin D is the key, or thyroid is key that goes into the lock, turns the locked, and causes something to happen inside the cell. 10:51 If vitamin is everywhere in you body, thyroid's everywhere you're body. 10:55 Some of the other hormones are more targeted. 10:58 They're not everywhere. 10:59 They don't have actions everywhere, so we're going to talk about these three because that's where the big controversy is. 11:07 Like I mentioned, hormones decline as we age. 11:14 We're at our best at about age 25 to 30. You know, that when people are too young to know how good they have it, right? 11:23 decline in midlife and continue declining and then of course women have this really abrupt change when they go through menopause and lose a bunch of hormones 11:36 like all of a sudden, which is a very tumultuous thing to have happen for many women. 11:43 So, menopause, the average age is age 51, and there is this period that we call perimenopaus, which, when I got started in OBGYN, 11:53 you know, 30 some years ago, there wasn't even a term. 11:56 That didn't exist, perimanopau. 12:00 And it's traditionally said to last two to five years, but quite honestly, the changes start happening to women in about their mid-30s. 12:08 So women, in their 30s, their periods start changing, things start change. 12:14 It gets more and more apparent in the 40s but it is probably more like a 15 year lead up. 12:23 In men, testosterone declines little bit by little every year. 12:27 The young men growing up now particularly have a problem. 12:33 Sperm counts are going down worldwide. 12:37 Toxins in the environment have hormonal actions in our body, but not in a good way. 12:43 And we think one of the reasons why young men have lowered sperm counts is because of these what are called endocrine disruptors. 12:52 They disrupt proper endocrine function. 12:55 All the things that are in plastic. 12:56 The adhesive that's used to lay the carpet.
Symptoms of hormone decline in men and women 13:04 The organic solvents that are in paint, all of that, are doing horrible damage to us. 13:11 So, best thing is eliminate plastics from your life. 13:19 And then as far as men go, looking at who's affected, because a lot of times people think it's only very old men who have low testosterone levels, 13:29 this chart shows about 2% to 3% of men in their 20s even have lower testosterone. 13:32 20%-30% men between 30% and 40%, and more than 50% in men their 60s and 70s have very low testosterone. 13:37 So it is very prevalent. 13:51 So in men, there's this new term that was developed called andropause, because andro is the Greek name for the male hormones. 14:00 Testosterone and some of the other male hormone are called Androgens. 14:03 So this was called endropaus in man and menopause in women. 14:08 And sometimes we call it manopaus. 14:12 But we're going to talk about menopaths and manopath. 14:15 It probably should be womanopas and manual pause, but anyhow. 14:21 So these are a list of things, a partial list, and it's in your handout of symptoms. 14:27 Remember I talked about symptoms? 14:28 There are things that go on that you're not aware of in you body, but then there are symptoms you are aware. 14:33 And, you know, I know I see a skewed part of the population because people that come to see me come because they have a problem by and large. 14:41 Occasionally people come cause they want to maintain good health and they're feeling pretty good, But most people comes because their feeling terrible. 14:48 and have any number of these problems with energy, sex drive, moods, they're not sleeping well, not as strong, thinking not clear, 15:01 higher body fat, you know what happens is you get older is even if you don't gain weight you Shapeshifting, where you get more fat around the middle and 15:13 your muscles start going away. 15:14 So your body fat increases and then your muscle mass decreases. 15:17 And it is really, it's part of healthy longevity. 15:21 You must exercise and maintain your Muscle mass. 15:25 Low muscle Mass, there's a medical name for it. 15:28 It's called Sarcopenia. 15:30 And people who are sarcopenic, who don't have enough muscle mass, have much higher mortality. 15:37 So you will die earlier if you don''t maintain your muscle math. 15:44 Elderly people that are kind of bird-like looking, they're very tiny. 15:49 For the most part, the have skin and they have bones. 15:51 They may not have that much fat, but they don' have muscle, and you need the muscle. 15:58 And exercise performance, people notice, men a lot notice this, they can't do what they've been accustomed to doing as far as exercise on the racquetball 16:07 court or playing tennis, you know, really active sports. 16:09 They're not able to perform as well. 16:11 And some women too, women that are more vigorous exercises will start seeing that they cant lift weights as heavy, it takes them longer to recover when 16:21 they do exercise. 16:23 A lot of this is hormonal, some of it is nutrient deficiencies aswell. 16:28 So this is the reality of manopause, and it's pretty much the same thing for women in menopausal. 16:40 The risk of being in manapause with low testosterone is premature aging, Higher incidence of heart attacks and strokes. 16:51 I think you guys will be able to answer this quiz really well by the time we get there. 16:56 Increased dementia if you have low testosterone. 17:02 Higher body fat. 17:03 Like I mentioned, testosterone helps you maintain your muscle. 17:06 Your muscle is the tissue in your body that metabolizes the nutrients that you take in, the calories that Fat is not metabolically active. 17:15 So if you lose muscle and gain fat, what you eat is going to get converted to fat rather than getting used sufficiently by your muscle. 17:27 Is that clear? 17:27 I think I didn't say it clearly. 17:30 I'll say it again. 17:32 Your muscle is your metabolically active tissue. 17:35 So if you have lost muscle because you're not physically active, you can eat the same thing. 17:44 You know, people say I'm eating the thing thing I've been, I always eat same amount, same kind of foods for the last three years and I keep gaining, 17:49 gaining gaining because your losing muscle that would be metabolizing those calories. 17:56 if you're not physically active. 17:58 And more of those calories are going to go on your body and get stored as fat rather than getting used by your muscles for energy. 18:09 What you eat either goes, you know, some of it goes to your brain because your brains needs a lot of calories to function. 18:16 But other than that, it either go to you muscles to provide energy or it gets stored here. 18:26 And men also have risks of bone thinning. 18:29 So men with low testosterone get into problems with osteoporosis just like women do with their low estrogen. 18:38 And Menopause risks are essentially the same. 18:43 You'll age more quickly. 18:44 We know that women before menopause have a relatively low amount of cardiovascular disease, and shortly after menoppause, 18:52 we catch up with men. 19:02 Estrogen is important in terms of people. 19:04 For a long time, it's not so much anymore, but people used to say, I'm worried about being on estrogen because I am afraid it is going to make me fat, 19:10 because they think about the chickens that are, you know, goosed up with hormones to makes them fat. 19:17 And in fact, estrogen helps you keep from laying on this mid-abdomen fat and estrogen also very importantly helps make you more resilient to stress. 19:29 So all the changes that go on when you become stressed that make you store more fat are mitigated by estrogen, which keeps you from suffering those physiologic 19:40 effects of stress severely. 19:44 Estrogen is anti-inflammatory, like I said, in your arteries. 19:54 So what are the options? 19:55 Like I said, you can either let nature take its course. 19:59 And we see that a lot, where people are not maintaining and advocating and working on their own behalf. 20:06 We were just having a little conversation up here earlier about the conventional medical system and how they will just kind of let you go down the tubes. 20:19 I'm sure we've all had experiences. 20:22 And I was sharing with Gretchen, I had an experience like that this year about my knee, which I happen to be a woman who tends to get torn ligaments in
Patient stories: libido, mood, and fatigue 20:32 her knee. 20:32 So I have my second torn legament last year and got it repaired. 20:37 And first of all, the doctor said, you know, we hardly ever do these in people over 40. Well, there I, was 67. He said we, 20:44 hardly, ever, do, these and people, over, 40 and I'm like, really? 20:47 Why? 20:48 And he's like they're just not that active. 20:51 And I'm like, well, I, you know. 20:53 I need to get this fixed because I am not sitting around. 20:57 And so he did a fabulous job. 20:59 I had an incredible recovery.I went to physical therapy. 21:02 Everything was just totally like smooth and as beautiful as it could be. 21:07 i was happy. 21:08 everything healed well. 21:10 started working out with my workout class again and I did it slowly. 21:14 didn't do anything crazy. 21:16 walked and then I walked faster and we did lunges and squats and things like that to build the muscles up. 21:21 and then I tried a little bit of jogging on the grass. 21:25 You know, very soft surface, just a few jogs. 21:28 And the next day, my knee was in excruciating pain. 21:31 I was like, wow, I don't know what I did. 21:35 So I waited a couple of weeks. 21:37 It was just something weird. 21:39 so I tried it again. 21:41 Tried stairs, and the day I had excuciated pain, so i went back to the orthopedist and I said, something's really wrong. 21:48 All I can do is walk slowly. 21:50 Like, i can't exercise at all, can you figure out what's happening? 21:54 He said, well, you know, at your age, osteoarthritis. 22:01 And I said well I didn't have oste arthritis eight months ago when you did my surgery. 22:05 I don't any pain then. 22:07 He's like well you I don't know. 22:13 We'll send you to physical therapy." And so I got to Physical Therapy. 22:16 All due respect to Gretchen as a physical therapist. 22:19 And the physical therapists started telling me her story of her bad knees and her osteoarthritis. 22:24 Then I said, you know what? 22:25 I need to see somebody else. 22:27 I want to somebody who's not going to write me off because of my age, who is going do an evaluation. 22:33 So I've lived it myself. 22:37 who I knew from the first knee surgery I had worked with. 22:41 He didn't write me off because of my age. 22:43 And so I said, I want to see Russ. 22:46 Set me up with him. 22:48 And he like looked at my knee and he really evaluated me. 22:50 He's like, oh, your IT band is really tight and this is real tight. 22:56 And your kneecap is not riding properly on the joint. 22:59 It's pulled over to the side. 23:00 That's what's giving you all the pain. 23:02 So we need to really work on stretching. 23:04 You did all this manual stretching and I did stretches. 23:08 I'm running again. 23:09 If I had listened to an orthopedist and the first physical therapist, I would have been mostly sitting around and taking a few walks and not exercising 23:21 as vigorously as I like to. 23:23 So I see firsthand what happened to me in the conventional medical system. 23:29 And so we were just talking about, I mentioned that I'm writing a book called the patient revolution, why doctors are blind to the solutions that will 23:38 get you well. 23:39 Because I started thinking about, you know, Why was I so resistant for so long to learning about alternative forms of medicine? 23:45 What is it about doctors? 23:46 what is that about our training?What is about the whole medical system?what is It about pharmaceutical companies and hospitals and insurance companies 23:55 that feed into this rigidity of thought that takes us to pharmaceuticals or surgery. 24:01 And that's it. 24:02 That's all we know how to do. 24:05 And it takes a lot of times a personal experience to get doctors to look at alternative medicine, or somebody in their family where they go searching, 24:18 looking for another solution and finding it. 24:21 And so this whole view of aging is, well, what do you expect at your age? 24:25 And there's not much of anything you can do about it, how many people are deteriorating more and more, and Gretchen was saying she does physical therapy 24:34 at home with the geriatric population. 24:37 They are just one thing after the other adds on to help them go down, down down. 24:44 Not the good food that they need, not the activities that the need not, the supplements they I mean, there was a study that showed very minimal doses of 24:55 vitamin D in a nursing home population cut the risk of falls by 50%. Like, why would you not give that to everybody? 25:05 Why don't all doctors know that? 25:07 why isn't everybody on vitamin d if they're in nursing homes or if their elderly? 25:13 You know, so that kind of thing just, you know Drives me crazy. 25:18 It's a low-cost intervention. 25:20 Well, it's not going to make money for the insurance companies. 25:22 And it is not gonna make for pharmaceutical companies, It'll make a nutraceutical company some money. 25:27 That's gonna drive the whole system. 25:37 Yeah, why are vitamin D levels so low? 25:39 A few reasons. 25:41 One is people try not to get too much sun exposure because of melanoma concerns and really about the only way you can get vitamin d is through conversion 25:49 of sunlight in your skin and as we get older our conversions not as good. 25:54 So there are very few foods. 25:56 There's, you know, vitamin D fortified milk, which I don't think is great. 25:59 Some mushrooms have vitamin B, but not the kind of amounts that you really need to get. 26:05 And it's amazing to me when I got into anti-aging medicine, being in Southern California, and seeing how virtually everybody's vitamin-D level is, 26:14 I mean, just like 30 or 20-something. 26:17 I see people who had less than seven. 26:19 15, 12, such an increased risk for chronic disease. 26:26 I'm like, I am so happy when I see them and I know we're going to do something about it because I now that we are preventing some serious illnesses down 26:33 the line. 26:35 So the whole issue of how is aging viewed? 26:38 So your regular doctor, when you talk about hormones, first of all is going to think that hormones only mean those three hormones that I mentioned, 26:48 estrogen, testosterone, and progesterone. 26:51 So that's what they think of with hormones. 26:53 And if anything, they're going think about relief of immediate symptoms, like hot flashes in women. 27:01 They have no knowledge of the overall health benefits, nor do they really believe that you can slow down the aging process. 27:09 So without that belief, you are not even going to look for things that help people maintain good health, right? 27:17 You have to believe it can happen. 27:19 And I see it over and over again. 27:21 Don't we all know people who didn't smoke, stayed physically active, eat well, Many of them live a really long, healthy time. 27:30 They don't get sick. 27:33 But if you're a doctor and you don�t really believe that you can slow down or change the aging process, you�re not interested in hormones. 27:42 with all the media hype that I talk to you about and you succumb to the same doubts about hormones and hormone safety and promote that to your patient. 27:52 So that's one of the things I deal with like the doctor today with the vitamin D. 27:56 I'm dealing with that all of time with estrogen, progesterone, testosterone. 28:03 Like I said, there are many components to good health. 28:06 Your health is like a three-legged stool. 28:09 Lifestyle. 28:11 what you're eating, what your activity level is like, your sleep, you mental, emotional, and spiritual. 28:19 And with that, I would also say community, because we know social interactions are very important to healthy longevity, are two of the legs. 28:28 Then the third leg is the physiologic and hormonal one. 28:31 That's a lot the area that I really delve into. 28:38 I want to tell you, A few stories. 28:41 I want to give you some examples of some of the things that we end up dealing with here in patients who come here. 28:48 So you have an idea of what we do and how it goes. 28:55 So low libido is a very common problem I see. 29:01 And I have special expertise and training in women's sexual function, and of course, by virtue of getting involved in that men's sex function. 29:11 I was active for quite a while in the International Society for the Study of Women's Sexual Health, which is wonderful organization that brings together psychologists, 29:20 psychiatrists, gynecologists, endocrinologists researchers who research on rats so we had like these people talking about their rat studies and then we 29:29 have other people taking about women sniffing t-shirts with men's sweat on it and you know haha it was really eclectic it's great So I know that, 29:41 especially for women, their sexual function and libido is very complex. 29:45 It really depends on a lot of factors, self-esteem, mood, the relationship, but also hormonal. 29:53 And early on in my practice, I met a really lovely woman named Maureen. 29:58 She actually had come to be in a clinical trial that I was running, and she didn't qualify for the clinical trail. 30:03 And I said, well, you know, the bad news is you don't qualified for clinical trials, but the good news, since you do, if you'd like to become a patient 30:10 here and start working on some of these issues, we can do that. 30:14 She was in her 50s, she had recently gotten remarried. 30:18 She said, my libido's horrible, I feel dead down there. 30:23 If I never had sex again it would be okay with me, but it's not okay my husband, and besides I just got married. 30:29 So we did testing.
Women's Health Initiative and hormone misinformation 30:33 We did restoration with estrogen and testosterone because estrogen's important for sexual driving women and testosterone and the other hormones. 30:43 And her interest in sex returned. 30:46 She developed a nice sexual relationship with her current husband and she said to me really wistfully, she says, you know, 30:52 if I had known about this years ago, my first marriage would have never ended. 30:59 So I was like, whoa, the power of hormones And then mood disorders are a major problem that we see here, depression and anxiety. 31:11 And a patient came to see me a couple years ago. 31:14 She was 48 years old. 31:15 she was brought in by her very concerned husband. 31:18 He was so depressed, she made no eye contact with me. 31:20 and she kind of sat huddled in a corner, barely said anything to me, and had previously been this high-level executive in human resources done volunteering, 31:31 loved to cook at home, you know, had a vibrant life, very active, and now she hadn't worked for two years. 31:38 She didn't cook anymore at homes. 31:41 Her kids were kind of like fending for themselves. 31:43 Their husband was trying to like keep it all together. 31:45 And her goal for her treatment was to be able to at least get back to work part time and maybe start doing some charity work again. 31:54 And again, we did testing and started her on bioidentical hormones. 31:59 And shortly after I started treating her, she became so depressed, the husband had to take her in to get admitted to the hospital. 32:09 I kept saying, you need a psychiatrist, I'm not a psychologist. 32:12 She was absolutely resistant to seeing a psychiatrists and ended up getting admitted. 32:18 Well, then she got a psychiatric. 32:22 They diagnosed her as being bipolar and put her on just a touch of medication because with the bioidentical hormones and the things that we were doing 32:34 to balance her neurotransmitters, she became balanced and functional very quickly in a matter of a few months, which anybody, 32:42 any of you that know about bipolar disorder, it's usually months or even years until people's meds get balanced, and they become functional. 32:54 She really got functional in a matter of a few months. 33:00 And the first thing she did was cook dinner for the family. 33:03 That was a big landmark. 33:08 By the end of eight months, she had a part-time job. 33:12 She was back to volunteering. 33:15 And she really, she felt like a new person. 33:18 She looked like totally different person, She look me in the eye, engaged. 33:23 So that was a somewhat unusual problem. 33:26 Most of the people I see have depression, not bipolar disorder with manic depression. 33:33 But she made a really quick turnaround in talking to her psychiatrist. 33:36 We both discussed the fact that getting her hormones and all these other brain chemicals balanced really facilitated her recovery. 33:47 Anyhow, the last story I want to tell you about has to do with fatigue. 33:51 Harold, who's a 51 year old gentleman, came to see me and he was really overweight diabetic, was really concerned about his cardiovascular health. 34:04 He had stopped exercising, stopped riding his motorcycle because he was so fatigued, stop playing tennis. 34:10 And the most, the thing that really propelled him to come here was that he had a girlfriend who was 30 years old, 20 years younger than he, 34:20 who is pregnant and going to have a baby in two months, and he said, how am I going have the energy and the wherewithal to be a daddy to this new baby 34:28 the way I feel. 34:29 You know, I've got to do something. 34:32 And so we did testing. 34:34 His testosterone level was really low and I was anxious to work on his cardiovascular health and other things, but that's not what he wanted. 34:42 He wanted his energy and his libido and erectile function back. 34:46 And so his thyroid was very under-functioning, his DHEA level was low. 34:53 It was a quarter of what it should be. 34:56 He was 50, he was on the really downward slope. 35:00 And he took my advice, got started on a program to get his hormones replenished, and actually within a month he said, wow, 35:10 I'm feeling so much better. 35:12 So he really was relieved because he could see The baby was on the way and he was doing better. 35:19 So that's our fatigue story. 35:23 We talked about sources of medical information. 35:26 When the Women's Health Initiative came out in 2002, when the results of it broke, We doctors were not informed. 35:34 That was the study that showed that women had, you know, a greatly increased risk of breast cancer on premarin and that synthetic progesterone provera. 35:42 And here's how it came down. 35:44 This was in July of 2002, July 9, 2002. It was a Sunday night. 35:50 They called a press conference and gave out the results The preliminary results was supposed to be an eight-year study. 35:57 They stopped it after three years because they had a much higher rate of breast cancer in the women using Premarin with Provera. 36:04 And they held a press conference. 36:06 So it got blasted out across the airwaves and in newspapers. 36:10 I came to work on Monday morning and didn't know what hit. 36:14 It wasn't put out in a medical journal. 36:16 We weren't given advanced information. 36:21 What study, like, you know, what were the results? 36:24 What were statistics? 36:26 And so that was a really incredible example. 36:29 It was the National Institutes of Health, and I had the opportunity at a women's medical conference to ask the director of the Women's Health Initiative 36:38 from the NIH whether she would do that again. 36:41 I said, You have no idea what it created, it create a pandemonium. 36:46 Women went off their hormones, wholesale, I never had the opportunity to talk to people. 36:51 They just got scared and went off. 36:54 And it's actually estimated that in the first 10 years after that result came out and women went of their hormones, there was anywhere from an excess 20,000 37:07 to 90,00 excess deaths in women aged 50 to 59 due to cardiovascular disease because they were not on their hormone. 37:14 Nobody thought about that. 37:20 it was horrible you know and I had like I said all patients didn't contact me so I saw some people like for their annual exam a year later and they'd be 37:28 like oh I haven't slept in a here these hot flashes are horrible I went off my hormones let me tell you sleep deprivation It's not good for healthy longevity. 37:38 It will shorten your life and cause premature aging. 37:41 So things that everybody makes fun of, you know, the hot flash, oh, there she goes again, get the fan, really has serious health implications. 37:49 If not just an inconvenience. 37:52 So I had a particular bone to pick about how the Women's Health Initiative results came out. 37:57 It did not come out in a professional way. 38:00 And it put the country in pandemonium and women couldn't find out fast enough from a limited number of people who could give them information what to do 38:08 and they went off their hormones. 38:12 Big Pharma, the pills in here are little dollar signs. 38:17 They are really trying to close down compounding pharmacies. 38:22 The makers of Premarin have been on a work path for the last 15 years to close down compounding pharmacies, trying to get legislation in place, 38:34 not wanting people to have the ability to choose what they want to do. 38:39 So big pharma plays a very big role in this whole issue of hormones. 38:45 You asked about low T centers and low-T. 38:49 Everybody wants to cash in, right? 38:51 So the pharmaceutical companies, Rob and I just looked at something. 38:54 You found a very nice website online talking about the effects of low T. 38:59 And I said, Robin, this is like really slick. 39:01 Let's look up who these ABV people are. 39:03 Sure enough, it was the manufacturers of androgel, which is one of the commercial androgen testosterone preparations. 39:10 So you've got like the pharmaceutical companies fomenting the low T. 39:13 You've this low-T clinic, which as far as I could tell, maybe there are physicians involved, but mainly it's physician assistants and nurse practitioners 39:23 that staff those clinics. 39:24 And they have a formula. 39:27 You get it done, you know, really fast, and you're back out. 39:31 And they said, oh, here it is. 39:33 At low T center, your testosterone replacement therapy is performed in a comfortable, casual atmosphere, not a stuffy doctor's office. 39:42 We can usually get you in and out quickly. 39:43 Anyhow, I think being in the stuff doctor office, if it's a doctor that looks at your overall health, is a good thing. 39:53 Okay, oh then who else do we have in the mix? 39:55 We have the lawyers. 39:56 So I told you there were a couple of studies on testosterone that came out earlier this year. 40:01 And one of them was from the VA Medical Center. 40:07 It was published in The Journal of the American Medical Association, called JAMA, J-A-M-E. 40:18 it had men who were on testosterone they did not measure their levels they didn't follow them up with levels or really any blood test they just gave testosterone 40:28 I used to work at the veterans hospital I can tell you that is a very ill population and so they gave these really ill guys testosterone and some you know 40:39 the older age group had higher incidence of heart attacks it turns out that And there was another study that showed older men had a higher incidence of 40:48 heart attacks. 40:49 One of the studies was published in JAMA, and a group of knowledgeable doctors, some of them anti-aging doctors got together and really delved into the 40:58 statistics and found that the statistic were so poorly done, it actually showed the opposite, that it cut down on heart attack. 41:06 forced JAMA's editors to retract the article. 41:10 That never happens. 41:11 I can tell you that never happened that medical journals retract articles. 41:15 that article got retracted. 41:17 Well, who knew that? 41:18 Was that splashed all over the front pages? 41:20 No. 41:22 So who gets in the mix? 41:23 The lawyers. 41:24 Low T complication? 41:26 Give us a call. 41:29 Testosterone therapy heart attacks? 41:32 give us the call contact us today So you've got the lawyers, they're all over the internet. 41:39 So of course you get scared. 41:40 Oh my God, my testosterone is going to give me a heart attack. 41:45 You know, is it any wonder that people are confused? 41:50 Female hormones are only for reproduction. 41:54 Myth or truth? 41:56 Myth. 41:56 Very good. 41:58 We talked a lot about this. 41:59 You don't have any questions about that, do you? 42:01 Okay. 42:02 Low testosterone is only a problem for old men. 42:14 Hormones should only be used in menopause for relief of hot flashes. 42:18 They should be at the lowest dose for the shortest time. 42:22 Myth? 42:23 Truth. 42:25 Yeah, estrogen has over 400 functions in the body.
Myths vs. truth about hormone safety 42:30 It does help with hot flash and night sweats, but it does a lot more than that, and we talked about that. 42:35 Helps to maintain muscle, enhance sleep, improve mood. 42:39 Only men need testosterone. 42:45 Testosterone, you know, muscle building is important for women, libido. 42:50 Women have an overall sense of well-being when their testosterone levels are adequate. 42:56 This rather nondescript well being. 42:59 What does that mean? 42:59 I don't know. 43:00 They just, they feel good. 43:03 Let's see. 43:04 Myth versus truth. 43:05 Estrogen is dangerous. 43:06 It causes breast cancer. 43:09 Okay. 43:09 The wrong estrogen is dangerous, especially if it's paired with the wrong progesterone. 43:16 And that was the Premarin and the Provera that were in the Women's Health Initiative. 43:22 Definitely increased risk of breast cancer. 43:25 Okay, so that is the first thing that came out, you know, got blasted all over the place July 9, 2002. What then came, I don't know how many years later, 43:33 four years Oh, we reworked the data and looked at it, and the women who were only on Premarin, they didn't have any increased risk of breast cancer. 43:43 That didn' get blasted all over the place. 43:45 So it turns out it really wasn't the Premrin. 43:47 It wasn' the estrogen. 43:49 it was that progesterone. 43:51 A product that causes like double to triple the rate of cancer, why is it still on the market? 43:59 Ask yourself that, the Provera. 44:01 Why is that not off the mark? 44:03 It's a known carcinogen. 44:05 Big Pharma. 44:08 Okay. 44:09 Estrogen causes heart attacks and strokes myth or truth? 44:14 Okay, the wrong estrogen causes heart attacks and stroke. 44:19 Premarin was given as a pill. 44:22 You had asked about oral testosterone. 44:24 Well, oral estrogen for women ends up causing increased blood clotting. 44:29 It thickens your blood. 44:31 And so what the Women's Health Initiative did, um, The average age of the women that were enrolled was age 67. So remember I said the usual age in menopause 44:39 is 51. 16 years into menopause. 44:44 Remember what I said about once you hit menoppause for women, your protection against cardiovascular disease really drops. 44:52 So there were 16 year into manopaus, they probably had a bunch of plaque. 44:55 Now we're giving them a pill that thickens their blood and yes, the had an increased risk of clot, venous thrombosis in their legs, 45:03 heart attacks, and dementia, not Alzheimer's, dementia caused by mini-strokes. 45:10 So why is that estrogen still on the market? 45:13 That's the question. 45:16 Okay, testosterone is only involved in sexual function in men. 45:21 Myth or truth? 45:23 Myth. 45:24 OK, Testosterone is dangerous. 45:27 It causes prostate cancer. 45:32 Okay, this is where it gets a little muddy. 45:35 Okay. 45:36 What we do think is like what your oncologist said about breast cancer is that if you have a prostate cancer, testosterone may help it grow. 45:44 It does not actually cause it. 45:46 But then there are all of these contradictions. 45:51 Men with low T have more prostate cancer. 45:56 Giving testosterone after prostate treatment when things are stabilized does not increase recurrence. 46:04 So it's a little hard to figure out and there are some theories about either very high levels of testosterone or very low maybe the problem and in the 46:13 middle is okay. 46:14 It hasn't all been worked out. 46:15 So I agree with if someone's been, we just had a gentleman who got started on hormones who had high PSA at his first visit and I said you really, 46:24 you need to get this checked and he has an early prostate cancer. 46:27 His doctor said come off testosterone. 46:29 I agreed with that. 46:31 But after a period of time, if his PSA goes down and stays down, I would feel comfortable reinstituting it. 46:38 Okay, now the last myth. 46:41 Bioidentical is just a marketing term. 46:43 Biodentical hormones are the same as synthetic ones. 46:47 Yeah, that's a myth. 46:49 And I used to think that before I got into this field, I was like, oh, and I tell my patients that, Oh, bioidentical hormones, 46:55 it's just a marketing term. 46:57 It's no different than, than the commercial product. 47:00 There are some commercial products that are bio identical. 47:03 Prometrium is a progesterone that is bioidentical natural progesterone. 47:09 And there are some of the skin gels in women that are bio identical estradiol, but they don't have a balance with the protective estrogen in them. 47:19 The androgel in men, that's a bio-idental testosterone. 47:23 So I don' necessarily knock that, But to say that they're the same as the synthetic ones, like the oral testosterone, That is not true. 47:30 Their risk breakdown is totally different. 47:35 So, let's see, any other things that I wanna, oh yeah, the Premarin only users in the Women's Health Initiative actually had 20% reduced breast cancer risk. 47:46 So they had less breast on estrogen. 47:51 50% reduce Alzheimer's risk in estrogen users.
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