Your Health and Your Staff’s Health: Impact on The School System

1. Your Health and Your Staff’s Health: Impact on The School System Pamela W. Smith, M.D., MPH Center For Healthy Living 313-884-3288 Copyright 2007

2. 3 Tips To Be Healthy And Stay Healthy

3. Tip #1 • Limit your intake of aspartame

4. Side Effects of Aspartame • Dizziness • Visual impairment • Disorientation • Ear buzzing • Altered liver enzymes • Tunnel vision • Loss of equilibrium • Severe muscle aches

5. Side Effects of Aspartame (Cont.) • Numbness of extremities • Inflammation of the pancreas • Episodes of high blood pressure • Eye Hemorrhages (bleeding into eye) • Abdominal cramps • Hives • Memory loss • Headaches • ADD

6. Tip #2 • Be hormonally sound • Andropause • Menopause

7. Symptoms of Andropause • Fatigue, tiredness, or loss of energy • Depression, low or negative mood • Irritability, anger, or bad temper • Anxiety or nervousness • Loss of memory or concentration • Loss of sex drive or libido • Loss of erections or problems during sex

8. Symptoms of Andropause (Cont.) • Backache, joint pains, or stiffness • Loss of fitness • Feeling over-stressed • Decrease in job performance • Decline in physical abilities • Bone loss • Elevated cholesterol • Elevated blood sugar

9. Functions of Testosterone • Sex hormone • Receptors all over a male’s body • Involved in the making of protein and muscle formation • Helps manufacture bone • Improves oxygen uptake throughout the body • Helps control blood sugar

10. Functions of Testosterone (Cont.) • Helps regulate cholesterol • Helps maintain a powerful immune system • Aids in mental concentration • Improves mood • Helps protect the brain against Alzheimer’s disease

11. Stats • Half of healthy men between the ages of 50-70 years will have a testosterone level below the lowest level seen in healthy men who are 20-40 years of age. • Korenman, S., et al., Journ Clin Endocrinol Met 1990; 71:963-69.

12. Estrogen Is A Problem • Elevated estrogen in males increases their risk of prostate cancer and heart disease.

13. Causes of Estrogen Elevation in a Male • Increased aromatase activity • Alteration in liver function • Zinc deficiency • Obesity • Overuse of alcohol • Ingestions of estrogen-containing food or environmental estrogens • Drug-induced estrogen imbalance

14. Drugs That Can Elevate Estrogen Levels • Pain/anti-inflammatory drugs: acetaminophen, propoxephene, non-steroidal anti-inflammatory drugs like ibuprofin, aspirin • Antibiotics: sulfas, tetracyclines, penicillins, cefazolins, erythromycins, quinilones • Anti-fungal drugs: miconazole, itraconazole, fluconazole, ketoconazole

15. Drugs That Can Elevate Estrogen Levels (Cont.) • Antidepressants: fluoxitine, fluvoxamine, paroxetine, sertraline • Anti-psychotic medication: thorazine, haloperidol • Heart and blood pressure medicine: propranolol, quinidine, amiodarone, coumadin, methyldopa • Antacids: omeprazole, cimetidine

16. Drugs That Can Elevate Estrogen Levels (Cont.) • Vitamins and nutrients: high-dose vitamin E, general dietary deficiencies, grapefruit • Abusive substances: alcohol, amphetamines, marijuana, cocaine • Cholesterol lowering medications: statins

17. Andropause • Testosterone replacement therapy for men is safe and can provide significant benefits.

18. Answers to Questions About Testosterone Replacement • Prostate cancer is a contraindication for testosterone replacement. • Incidence of prostate cancer is not increased by testosterone replacement • No evidence that testosterone replacement accelerates prostate enlargement or prostate cancer • Testosterone does not cause prostate cancer.

19. Treatment • Transdermal (on the skin) • More effective for erectile function • Transdermal 81% effective • Oral 51% effective • IM 53% effective • Jain, P., et al., Jour Urol 2000; 164(2):371-75. • Use compounding pharmacy • Less expensive than Androgel • Can titrate to the individual needs of the patient

20. Menopause • Hormone response is as unique to each person as their own fingerprints. • Hormone replacement should not be considered without a thorough understanding of how all of the body’s hormones interact with each other. • References can be found in: • Smith, P. “HRT: The Answers” 2003.

21. Menopause • The normal age to go through menopause ranges from 35 to 55. • Therefore, a woman may live one half of her life without a menstrual cycle. • Cycling after the age of 55 increases a women’s risk of breast cancer.

22. Synthetic HRT • It is estimated that one-half of women quit taking their synthetic hormone replacement therapy after one year because they are unable to tolerate the side effects. • Synthetic hormones waste energy by giving incomplete messages to cells which then fail to produce a balanced hormonal response.

23. Why Consider HRT • Relief of symptoms • Prevention of memory loss • Heart health • Bone production • Growth and repair

24. Hormones That Regulate Growth and Repair • Insulin • Growth hormone • Testosterone • Estrogens • DHEA

25. Symptoms of Menopause • Hot flashes • Night sweats • Vaginal dryness • Anxiety • Mood swings • Irritability • Insomnia • Depression

26. Symptoms of Menopause (Continued) • Loss of sexual interest • Hair growth on face • Painful intercourse • Panic attacks • Weird dreams • Urinary tract infections • Vaginal itching • Lower back pain • Bloating

27. Symptoms of Menopause (Continued) • Flatulence • Indigestion • Osteoporosis • Aching ankles, knees, wrists, shoulders, heels • Hair loss • Frequent urination • Snoring • Sore breasts

28. Symptoms of Menopause (Continued) • Palpitations • Varicose veins • Urinary leakage • Dizzy spells • Weight gain • Skin feeling crawly • Migraine headaches • Memory lapses

29. Estrogen

30. Estrogen • Estrogen has 400 functions in the body, including the following:

31. Functions of Estrogen • Stimulates the production of choline acetyltransferase, an enzyme which prevents Alzheimer’s disease • Increases metabolic rate • Improves insulin sensitivity • Regulates body temperature • Helps prevent muscle damage • Helps maintain muscle • Improves sleep

32. Functions of Estrogen (Continued) • Reduces risk of cataracts • Helps maintain the elasticity of arteries • Dilates small arteries • Increases blood flow • Inhibits platelet stickiness • Decreases the accumulation of plaque on arteries • Enhances magnesium uptake and utilization • Maintains the amount of collagen in the skin

33. Functions of Estrogen (Continued) • Decreases blood pressure • Decreases LDL and prevents its oxidation • Helps maintain memory • Increases reasoning and new ideas • Helps with fine motor skills • Increases the water content of skin and is responsible for its thickness and softness • Enhances the production of nerve-growth factor

34. Functions of Estrogen (Continued) • Increases HDL by 10 to 15% • Reduces the overall risk of heart disease by 40 to 50% • Decreases lipoprotein (a) • Acts as a natural calcium channel blocker to keep arteries open • Enhances energy • Improves mood • Increases concentration • Maintains bone density

35. Functions of Estrogen (Continued) • Increases sexual interest • Reduces homocysteine • Decreases wrinkles • Protects against macular degeneration • Decreases risk of colon cancer • Helps prevent tooth loss • Aids in the formation of neurotransmitters in the brain such as serotonin which decreases depression, irritability, anxiety, and pain sensitivity

36. Symptoms of Estrogen Excess • Cervical dysplasia (abnormal pap smear) • Depression with anxiety or agitation • Increased risk of uterine cancer • Weight gain (abdomen, hips, thighs) • Water retention • Headaches • Poor sleep • Panic attacks • Swollen breasts

37. Symptoms of Estrogen Excess (Continued) • Heavy periods • Increased risk of breast cancer • Increased risk of auto-immune diseases • Hypothyroidism • Fatigue • Irritability/mood swings • Uterine fibroids • Bloating

38. Causes of Excess Estrogen in The Body • Taking too much estrogen • Impaired elimination of estrogen • Lack of exercise • Diet low in grains and fiber • Environmental estrogens • Elevation of 16-OH estrone

39. Synthetic Estrogen (Premarin) • Estrone • Sodium equilin sulfate • Concomitant components • 17 alpha-dihydroequilin • 17 alpha-estradiol • 17 beta-dihydroequilin

40. Natural Estrogens • E1 called estrone • E2 called estradiol • E3 called estriol

41. Estrone (E1) • Is the main estrogen the body makes postmenopausally • High levels many researchers believe may increase a women’s risk of breast cancer

42. Estradiol (E2) • Increases HDL (good cholesterol) • Decreases LDL and total cholesterol • Decreases triglycerides • Helps maintain bone structure • Increases serotonin • Decreases fatigue • Works as an antioxidant • Helps maintain memory • Helps absorption of calcium, magnesium, zinc

43. Estriol (E3) • Considerable evidence exists to show that it protects against breast cancer • Is used experimentally to treat breast cancer with and without Tamoxifen • It does not have the bone, heart, or brain protection of estradiol.

44. Estrogen Metabolism • After menopause, the metabolism of estrogen can change. Consequently a women may respond differently to estrogen replacement.

45. Estrogen Metabolism • Two major competing pathways • 2-OH estrone • 16-OH estrone

46. Estrogen Metabolism • One minor pathway • 4-OH estrone

47. 2-OH Estrone • Good estrogen. It does not stimulate the cell growth. • Blocks action of stronger estrogen products that may be carcinogenic.

48. 16-OH Estrone • Has significant strong estrogenic activity and studies show it may be associated with an increased risk of breast cancer.

49. 4-OH Estrone • Studies show it may directly damage DNA and cause mutations. Therefore, it is proposed to enhance cancer development. • Equine estrogens, such as Premarin, increase metabolism into 4-OH estrones.

50. How Can You Raise 2-OH Estrone? • Moderate exercise • Cruciferous vegetables • Flax • Soy • Kudzu • Indole-3-carbinol taken as a supplement. Daily dose is 200 to 300 mg. • High protein diet • Omega-3-fatty acids • B6, B12, and folate