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Higher estrogen predicts mortality in older women

Dr. Jonathan — Fri, 21 May 2010 00:08:21 +0000

A study published not long ago in the Journal of the American Geriatrics Society is a reminder that even natural estrogen at higher levels than the proper physiological range is detrimental. The authors aimed…

“To investigate the relationship between total estradiol (E2) levels and 9-year mortality in older postmenopausal women not taking hormone replacement therapy (HRT).”

The study participants were a representative sample of 509 women aged 65 and older living the Chianti region of Italy. What did their data show?

“Higher E2 levels were associated with a greater likelihood of death…independent of age, waist:hip ratio, C-reactive protein, education, cognitive function, physical activity, caloric intake, smoking, and chronic disease…The excessive risk of death associated with higher total E2 was not attenuated after adjustment for total testosterone and after further adjustment for insulin resistance…Total E2 was highly predictive of death after more than 5 years and not predictive of death for less than 5 years.”

This study highlights the importance of the functional management of estrogen levels even when HRT is not being used. All the more reason for cautious objective validation with the appropriate lab test (free-fraction bioactive estrogen) if we bear in mind the investigators’ conclusion:

“Higher total E2 concentration predicts mortality in older women not taking HRT.”

Oxidative therapies can make infections worse

Dr. Jonathan — Mon, 15 Feb 2010 02:02:15 +0000

This area of scientific investigation is less well known to both the lay and professional reader, but it has profound practical importance. It concerns how our bodies handle oxygen in health and disease and adapt to low oxygen states. One issue of the Journal of Molecular Medicine is entirely devoted to hypoxia (low oxygen) and human disease. It contains papers encompassing a range of conditions including cardiovascular, gastrointestinal, kidney and lung diseases, cancer and more. The focus here is on one paper that extensively reviews the regulation of oxygen in immunity and the response to infection. This is particularly important because there seem to be many clinicians who assume that increasing oxygen saturation in the locale of an infection helps to get rid of it (through oxidative damage to the pathogen and healthier surrounding tissues). Due to the research over the past several years on the powerful and important role of hypoxia inducible factor (HIF) we can understand that this is incorrect. “The hypoxia-inducible transcription factor (HIF-1α) is a major regulator of energy homeostasis and cellular adaptation to low oxygen stress.” It exerts powerful control over the white blood cells that respond to infection: “HIF-1α has been discovered to function as a global regulator of macrophage and neutrophil inflammatory and innate immune functions.” They refer to HIF-1α as “a master regulator of innate immunity.” This is a fascinating review with references to many other studies if you care to read it, but the main point I want to bring to your attention is this: “A paradoxical result of these findings is that, due to HIF-1α activation, macrophages actually phagocytose and kill bacteria better under hypoxic conditions than they do under normoxic conditions.” This means white blood cells kill bacteria more effectively in a low oxygen environment than they do when oxygen in that location is normal. They go on to explain its role in viral and parasitic infections and the progression of viral infections to cancer. They go on to conclude: “The proof-of-principle experiments described suggest further exploration of HIF-1α augmentation to boost innate defense function. This may be of interest as a therapeutic strategy in infectious disease conditions complicated by antibiotic resistance or compromised host immunity.” Certainly this is a complex system and much more could be said, but the practical message is this: think each case through very carefully before advising or receiving oxidative therapies for infection.

Eosinophilic cystitis: a cause of urinary symptoms in males

Dr. Jonathan — Sun, 22 Nov 2009 00:44:47 +0000

Men, difficulties with urination including pain, retention, even bleeding are sometimes not from the prostate. In a paper published in the Archives of Pathology and Laboratory Medicine the authors state: “Eosinophilic cystitis (EC) is an inflammatory condition of the bladder that has been linked to food allergens, infectious agents, drugs, and other genitourinary conditions…[it] represents a response to a variety of agents and may often be overlooked.” As described in this paper published in Urologia Internationalis, “The clinical presentation of EC is varied. When the lesion is located at or near the bladder neck, it may present as urinary retention.” (Ladies, this condition afflicts you and children as well.)

Dental implants and reactions to titanium

Dr. Jonathan — Wed, 18 Nov 2009 20:53:42 +0000

Whenever metals are implanted in the human body there is a possibility that hypersensitivity will develop which can evolve into autoimmune disease. Two interesting papers in the Neuro Endocrinology Letter investigate the evidence. The authors of Hypersensitivity to titanium: Clinical and laboratory evidence conclude: “These data clearly demonstrate that titanium can induce clinically-relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants.” The study Diagnosis and treatment of metal-induced side-effects documents diagnosis by the lymphocyte transformation test and observes that, “The removal of incompatible dental material (RID) resulted in long-term health improvement in the majority of patients.” Yet another paper in the same journal concludes, “The optimized LTT-MELISA® test is a clinically useful and reliable tool for identifying and monitoring metal sensitization in symptomatic metal-exposed individuals.” Bear in mind that this applies to all kinds of metal implants, including replacement joints.

Insist on truly personalized oncology

Dr. Jonathan — Tue, 10 Nov 2009 20:28:27 +0000

The National Cancer Institute is giving lip service to “personalized oncology”, while tumor cell culture chemosensitivity testing for optimizing chemotherapy has languished in a backwater. See this brief report by Dr. Ralph Moss of Cancer Decisions.

Metabolic syndrome affects sexual function for both men and women

Dr. Jonathan — Mon, 09 Nov 2009 03:15:29 +0000

Metabolic syndrome and it’s associated hormonal, neurological and vascular effects is a major factor affecting sexual function for women too, as described in this recent paper: “The MS is strongly correlated with erectile dysfunction, hypogonadism (predictors of future development of MS), and female sexual dysfunction.” [Note: MS = metabolic syndrome]

Restless Legs Syndrome & Iron

Dr. Jonathan — Tue, 20 Oct 2009 22:25:09 +0000

This study adds more evidence that functionally low iron is one of the causes of Restless Legs Syndrome. The investigators documented significant improvement in individuals if they had a low-normal serum ferritin to begin with. Interestingly, dopamine deficiency is another cause of RLS—low iron is among the factors that can cause insufficient dopamine production. RLS is a brain problem.

Diabetes Drugs Do Not Reduce Inflammation

Dr. Jonathan — Fri, 09 Oct 2009 02:11:05 +0000

This Harvard study shows evidence that although metformin (a commonly used diabetes medication) and insulin lower blood glucose, they do not reduce key inflammatory biomarkers. With these medications the blood sugar goes down, but the inflammation continues. These inflammatory biomarkers are associated with a host of chronic diseases: cardiovascular, cancer, autoimmune, etc. Moreover, “recent-onset type 2″ diabetics were assessed. The damage starts before the diagnosis.

Hello Friends!

Jonathan Miller — Wed, 12 Aug 2009 02:32:18 +0000

This blog is for those of us who are interested in a functional approach to medicine and healing. Look in for (mostly) daily posts on emerging developments that close the gap between science and medicine in ways you can use. You are invited to join in and offer your own comments.