Saturday, November 9, 2013

Response to Negative Media Portrayal of Restoring Testosterone Levels

Life Extension® immediately recognized errors in this anti-testosterone study that render its findings meaningless.

This study was designed by physicians who apparently don't know how to safely restore testosterone levels in aging men.

The media's portrayal of this flawed study will discourage aging men from properly restoring their testosterone levels. To help spare the lives of testosterone deficient men, we have prepared an extensive rebuttal to this erroneous report.

For those who choose not to read our extensive rebuttal, I've prepared the following brief summary:

1) In order to protect against heart disease, total testosterone blood levels need to be raised higher than 500–550 ng/dL. Life Extension believes that optimal youthful total testosterone is in the 700–900 ng/dL range.

The men enrolled in this flawed study only boosted their mean total testosterone levels to 332 ng/dL. Previous studies show this low testosterone level (332 ng/dL) is associated with an increased heart attack risk compared with levels above 500–550 ng/dL.
2) The men in this study were not properly individually dosed and monitored, which explains why the testosterone treatment they received failed to restore their blood testosterone levels to anywhere near cardio-protective ranges.

3) Estradiol (an estrogen) blood levels were not reported in this study used to discredit testosterone drugs. A subset of aging men, often with increased visceral body fat (body fat around the internal organs of the abdominal cavity), have a tendency to convert testosterone into excess estrogen. This excess estrogen may alter the balance of anticoagulant and procoagulant (clotting) factors in the blood, and potentially enhance the risk of heart attack and stroke. Any man treated with testosterone drugs should also have his estradiol blood level tested to ensure that the testosterone is not excessively converting to estrogen. If estradiol increases excessively, then low-dose aromatase-inhibiting drugs (such as 1 mg/week of anastrozole [Arimidex®]) can be prescribed to reduce the conversion of testosterone to estrogen.

A subgroup of overweight men with excess visceral body fat treated with testosterone in this study would be expected to excessively convert (aromatize) their testosterone into estrogen, which may help explain why more men in the testosterone group suffered a greater percentage of heart attacks.

Research published in 2013 shows profound cardiovascular benefits in response to higher testosterone levels (in men). The media conveniently ignored these positive reports and narrowly focused on the egregiously flawed study published in the Journal of the American Medical Association (JAMA).
Based on many published studies, Life Extension has recommended for decades that aging men restore testosterone to a youthful range. We've always warned that for some men restoring one's testosterone to more youthful levels could create excessive levels of estrogen, which is readily detectable by blood testing and reversible using aromatase-inhibiting therapies.

What's most frightening is that most mainstream doctors today are blindly prescribing testosterone drugs and omitting any kind of estrogen testing. This creates a very dangerous environment for men who excessively convert their testosterone into excess estrogen!

To read Life Extension's full rebuttal to this flawed study used by the media to discredit testosterone therapy, just click here.
For longer life,
William Faloon

Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol

Wednesday, August 28, 2013

Frequently Asked Questions From My Female Patients who are on Cyclic Hormone Therapy

I wanted to reprint some of the frequently asked questions regarding Cyclic Hormone Replacement therapy from many of my patients and answered quite well by TS Wiley herself. I will add my own comments to her answers as well.
Q. Why do I have a period?
A: The obvious scientific response is to prevent endometrial cancer with the rhythmic growth and death of the lining, insuring apoptosis. However, it is important to add that there are over 3,000 gene products and more than 300 physiological processes that ride on the wave of rhythmic estrogen production in healthy young women, not the least of which is the inevitable growth of a normal uterine lining. So, yes, if your hormones are at reliable healthy levels, you must have a period if you have a uterus to be healthy and safe.
Q: Why didn't I get a period?
A: Not enough estradiol (E2), perhaps too much testosterone, DHEA, or not a sharp enough differential drop in the progesterone from day 21 to day 28.
Q: Why is my period so light, long, early, late, missed, heavy etc?

A: Not enough estradiol (E2) in general, or preferential shunting for stress to the brain that deprives the uterine lining of growth potential for 72 hours, which is what re-population requires; or, perhaps too much testosterone or DHEA.
Q: I can't handle the anxiety, hot flashes, insomnia, sore breasts, and depression in the first three months.
A: These symptoms usually occur in the beginning when the receptors are, literally, appearing on the landscape. The fluctuation of these receptors can accentuate "firing disorders" like anxiety, incontinence, hot flashes, heartburn, etc. Spread out the daily dose from twice a day into 3 or 4 times a day and allow the receptors to "catch up". Adding a transdermal estradiol patch can also help reduce these annoying symptoms. This can sometimes feel like puberty all over.
Q: I felt great at first and now after 1 yr, 2 yrs, etc, I DON'T.
A: You're older. As time passes the sand shifts under our feet when the waves of the beach retreat. Eventually we all need a higher dose as SHBG rises concomment to Insulin.
Q: Why can't I get my numbers up?
A: More estrogen may be needed or more progesterone, raising the entire curve of either is kinder to the receptor anticipation mechanisms. RBC adhesion may be a factor in the progesterone only, meaning the hormone is actually in there and can clinically be seen, but not in the blood work numbers. Insulin and SHBG are in inverse curves. The more insulin reception, the lower the serum numbers, so in thin patients the numbers may be lower. Always remember that the clinical picture takes precedent over anything a lab might turn out.
Q: Why are my animals showing sings of estrogen?
A: You touch them with hormone on your hands, they lick their fur. The dose then becomes oral, which is much stronger and, considering their body mass vs. an adult human, far more potent.
Q: Doesn't estrogen cause cancer?
A:NO,it "controls" cancer, not "causes" cancer. If high circulating levels of estrogen caused cancer young women would be dead, and pregnant women would be deader. High levels of estrogen cause G-1 arrest of the cell cycle.
Q: Why can't I just do progesterone?
A: It has no receptor to be effective, without one of it's own for apoptosis, without estrogen preceding its arrival. The progesterone that you may have taken in the past made you feel better, because progesterone can occupy the cortisol receptor.
Q: Isn't progesterone toxic?
A: No, or pregnant women would be deader than fertile young women. So unless one uses the whole syringe at each dose this is not possible. The fear-mongering rumor coming from a group of women on the internet, who truly believed that they were harmed by natural progesterone and may have, indeed felt horrible, much as women report that they do on synthetic Provera is not accurate. Those women were not on the Wiley Protocol at the time and were taking the hormones that they were taking in olive oil drops. Heavy hormones sediment in oil, so that they are over-dosed themselves on Day 14-21 by drawing an inaccurate dose from the bottom of the bottle, promoting nausea, hair loss, headaches and maybe even kidney problems. Such a situation is not possible with the Wiley Protocol, because the progesterone is thoroughly blended and suspended in cream base and tested to prove that there is 20 mg of natural progesterone in every small line on a purple plungered syringe.
Q: Why can't I take herbs, flax, soy, etc?
A: If you mean with the Wiley Protocol, because all effective natural treatments are effective by occupying, blocking and or using second messenger pathways of hormone receptors. We are trying to reinstate with the dosing of the protocol, a receptor waveform reminiscent of youth. Natural substances, just like drugs of Pharmaceutical origin, are still statically dosed, thus destroying what we are doing. Women on flax often lose or never attain their period.
Q: Can my daughter, mother, husband do this?
A: Yes, of course anyone with deranged hormonal rhythms or needing replacement can.
Q: How can everyone start at the same dose, isn't it individualized?
A: We all re-instate a normal baseline and then it becomes individualized as your doctor increases your dose in a standardized way. "It's not"one size fits all", it is "one size starts all".
Q. What to do when they don't get a period on Day 28 or 29.
A: Just call Day 29, day 1 and start over.
Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol

Thursday, May 16, 2013

71 year old Man with Hx of Prostate Cancer I'm Currently Replacing His Testosterone

My dear patient who I see regularly for chronic medical conditions including diabetes and blood pressure monitoring presented with an elevated PSA (prostate-specific antigen) of 5.9 in February 2012. Family history of prostate cancer is negative. Voids 5-6 times a day and was getting up every hour a night to urinate for a couple of years prior. Variable stream. I referred him to a urologist for further evaluation. He was advised to do an in office trans-rectal ultrasound and biopsy of the prostate which he completed 3/14/2012. The biopsy showed extensive prostate cancer Gleason 3+3, clinical stage T2b with perineural invasion which did correspond to an abnormal digital rectal exam. His bone scan and CT scan was not suspicious for metastatic disease. Treatment options included active surveillance, however in light of his age his options may be more limited if he decided on more aggressive treatment in the future. Radical prostatectomy, cryosurgery, brachytherapy and or external radiation therapy or Calypso system hormonal therapy. My patient chose Brachytherapy which is a type of radiotherapy, or radiation treatment, offered to certain cancer patients. There are two types of brachytherapy – high dose-rate (HDR) and low dose-rate (LDR). LDR brachytherapy is the type that is most commonly used to treat prostate cancer; it may sometimes be referred to as ‘seed implantation’ or it may also be called ‘pinhole surgery’. In LDR brachytherapy, tiny radioactive particles the size of a grain of rice (see Figure 1) are implanted directly into the site of the tumour. These particles are known as ‘seeds’, and they can be inserted linked together as strands, or individually. Because the seeds are inserted or implanted directly into, or very close to, the tumour, they deliver high doses of radiation to the tumour without affecting the normal healthy tissues around it. This means that the procedure is less damaging than conventional radiation therapy, where the radioactive beam is delivered from outside the body and must pass through other tissues before reaching the tumour. He was told that he would need to reduce his testosterone levels before the implant to zero. The side effects were discussed with him and included, hot flashes, painful gynecomastia, erectile dysfunction, loss of libido, metabolic syndrome, anemia, bone loss, fatigue, depression, and weight gain to name a few. He was given Prosteon Oral tablets and told to take 2 tablets twice a day to replace calcium and vitamin D3 due to the side effects of the medication to reduce his testosterone to zero with a medication called Lupron. Now lets discuss his labs. In February 2011 his PSA was 3.7 and Testosterone 197 and his Vitamin D3 zero! His PSA in February 2012 was 5.9 and his testosterone was 213 In November 2012 (post hormone ablation procedure) his PSA was 0.3 and his Testosterone Zero and Vitamin D3 21.2. His symptoms were horrible in November 2012. At his office visit he told me he was experiencing horrible fatigue, depression, not sleeping, crying easily. He was scheduled to have the pellets inserted end of November 2012. He returned to see me in February 2013 and was regretting getting the surgery done because now he was experiencing urination about 10 times every night and he was not sleeping well, very fatigued, no appetite, getting hot flashes, dribbling and leaking and had to apply pressure to his bladder to urinate and was wearing diaper pants for leakage during the day. He was also having joint pain. He was taking antidepression medications, anti anxiety medications, diabetes and blood pressure medications and had just gotten a lupron injection by the urologist. We discussed his symptoms in great detail and that they were because of the Lupron injection and the zero testosterone level. I suggested a transdermal testosterone cream as well as Vitamin D3. He was willing to try it. He said to me that if he had a choice to live like this the rest of his life, he'd rather not. I understand!! Now this 71 year old man completely understood how menopausal women feel. It's horrible. Let's fast forward now to April 9, 2013, His PSA is 0.3, Testosterone is 1135, and Vitamin D3 is 58.1 He is feeling great. Sleeping again. No joint aches. No depression. Has his energy again. Has a scheduled trip with friends and family and feels amazing. He has had follow up exams with the urologist and his urologist is aware of the treatment plan my patient has chosen and is okay with it. I just saw him today and he is doing wonderful. He leaves Sunday for his trip and I know he will have an amazing time. Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol

Thursday, May 2, 2013

HCG Testimonial

Dr. Jones, I am very close to completing Phase II of the HCG protocol and I have had some very good success, both in losing weight but also in feeling 1000% more energetic. I know that you prescribed 47 days worth of HCG for me, but I am a bit confused as to how I am supposed to approach Phase III. All of the documentation that I am reading has the HCG injections ending after 25 days and then the maintenance phase begins. question is: Do I remain on 500 calories per day for the full 47 days of my HCG supply or do I begin maintenance on the 26th day and continue injecting the HCG? As of today (my 22nd day on Phase I), I have lost 23.5 lbs. I have been keeping a daily food, weight, calorie intake and exercise diary as well as a chart on daily body weight vs daily calories. I was going to send it all to you on Saturday if, in fact, I am through with Phase I. Please let me know how to proceed. I really have not had any problem with the 500 calorie diet or the foods that can be eaten. I have come up with some very creative and delicious recipes using steam, poaching and grilling chicken, shrimp and tilapia. Actually, I have only hit 500 calories twice so far. All other days are between 470 and 498 calories. I hit a plateau on days 16, 17 and 18 so I did the "prescribed" 6 apple day and lost 2 lbs. Thanks...Terry Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol

Wednesday, February 6, 2013

Hormone Replacement Therapy HRT Does NOT Cause Breast Cancer, New Study

Hormone Replacement Therapy HRT Does NOT Cause Breast Cancer, New Study by Jeffrey Dach MD This month, a shocking new study concluded Hormone Replacement (HRT) is safe and DOES NOT cause breast cancer. This new Lancet Oncology reports on long term follow up for the Women's Heath Initiative Study which was originally published in JAMA in 2004. (1-4) The Original 2004 WHI Report - 6.8 years of Follow Up The original WHI study (second arm) enrolled about 10,000 women after hysterectomy. Half were given placebo, and the other half were given a horse estrogen called Premarin (see above left image courtesy of wikmedia commons). Premarin is also called CEE for Conjugated Equine Estrogen. This is estrogen from pregnant horses. 23% Less Breast Cancer The original report in JAMA 2004 included 6.8 years of follow up showing 23% Less Invasive Breast Cancer in the Premarin Hormone (CEE) group than in the placebo group . There were 94 breast cancer cases in the hormone (CEE) group and 124 cases of breast cancer in the placebo group. This comparison narrowly missed statistical significance. In addition, there was 9% less heart disease, and 39% less hip fracture in the hormone treated group. The Premarin pill caused increased clotting (hypercoagulable state) resulting in increased stroke and pulmonary embolus in the Premarin Pill users, which caused early termination of the study. This is one reason why topical estrogen is preferable to pill form estrogen. Topical delivery of estradiol (bioidentical estrogen) does not cause increased coagulability, does not increase risk for CVA or stroke, is safer and the preferred delivery route. 11.8 years of Follow Up on the WHI Women- Still 23% Reduction The original WHI group of women were followed for an additional 6 years, for a total of 11.8 years of follow up, and this data was reported in Lancet Oncology by Garnet L Anderson PhD, and Rowan T Chlebowski (3,4). Here is what they found. After 11.8 years of follow up, the Premarin (horse estrogen) had 151 cases of invasive breast cancer and the placebo group had 199 cases. This represents a 23% reduction in breast cancer in the hormone treated group. This was statistically significant. (P=.02) 63% Reduction in Mortality From Breast Cancer In addition, in the hormone treated group, there was a 63% per cent reduction in death from breast cancer. 16 women died from invasive breast cancer in the placebo group, compared to only 6 in the hormone treated group. Editorial by Howell and Cuzick In an editorial in the same issue of Lancet Oncology, the Drs Anthony Howell and Jack Cuzick review the findings and conclude that the benefits of estrogen HRT include: 1) reduced risk of coronary artery disease and reduced risk of heart attacks 2) Reduced Risk of All Cause Mortality with improved survival numbers in the hormone treated group. 3) They advise women to avoid PremPro (the combined HRT pill ) which adds in a synthetic progestin, as the synthetic progestin IS associated with increased breast cancer. Here is the quote: "Young women (50—59 years) taking oestrogen were significantly less likely to have coronary heart disease, myocardial infarction, and death from all causes, not only with respect to older women but also placebo controls of the same age. Observational and WHI studies agree on the increased risk of breast cancer with combined hormone replacement therapy (including a progestin). " "The WHI investigators should be congratulated for providing insight into the value of conjugated equine oestrogens and young women can be reassured of the low risks and potentially striking benefits," Chemical structure of Premarin (left) compared to Human Bioidentical Estrogen (rught)courtesy of wikimedia commons: Above Left Image: Equilin -Premarin (Horse) Above Right Image:Human Estradiol The NIH Should Study Human Bioidentical Estradiol and Progesterone The WHI study showing the Estrogen reduces risk of breast cancer, reduces heart disease, reduces risk of hip fracture, and other and health benefits was done with Premarin, a horse estrogen. You might ask the obvious question, "Why Did The Study Not Use Estradiol", which is a human hormone (a bioidentical hormone)? Why use estrogen from a horse when human estradiol in available? The answer is obvious. The NIH is a branch of the government and the government is controlled by the Pharmaceutical industry which makes Premarin. We need the NIH to do studies for the benefit of the people, not the drug industry. We need to repeat the WHI study using estradiol and progesterone, and never again victimize women with the carcinogenic PremPro pill ( Premarin and Provera) which was shown to cause breast cancer and heart disease. Bioidentical Hormones Are Safe and Do Not increase Risk of Breast Cancer In retrospect, the Lancet Oncology findings have been known for decades. Bioidentical Hormone users are healthier and live longer than non-hormone users. Bioidentical Hormones do not cause increased breast cancer risk, and are associated with all the health benefits shown in the Women's Health Initiative (second arm) for women using estrogen alone. Premarin is not human, but it is natural. A much more better HRT program is the combination of human bioidentical estrogen available as a patch or transdermal cream, with the addition of Progesterone a human bioidentical hormone. Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol

Birth Control and Pregnancy

Long-acting Reversible Birth Control Methods More Effective Than Pills, Patch, and Ring Print This Post Print This Post A study just published in the New England Journal of Medicine[1] to evaluate birth control methods has found dramatic differences in their effectiveness. Women who used birth control pills, the patch, or vaginal ring were 20 times more likely to have an unintended pregnancy than those who used longer-acting forms such as an intrauterine device (IUD) or implant. Birth control pills are the most commonly used reversible contraceptive in the United States, but their effectiveness hinges on women remembering to take a pill every day and having easy access to refills. The hormonal IUD (Mirena) is approved for five years, and the copper IUD (Paragard) can be used for as long as 10 years. Hormonal implants are inserted under the skin of the upper arm and are effective for three years. Many women, however, cannot afford or decline to pay the up-front costs of these methods, which can be more than $500. The study involved over 7,500 women enrolled in the Contraceptive CHOICE project. Participants were between the ages of 14 and 45 and at high risk of unintended pregnancy. The women were either not currently using contraception or wanted to switch birth control methods, and none wished to become pregnant within the next 12 months. The women were counseled about the contraceptive methods, including their effectiveness, side effects, risks, and benefits, and all methods were provided free of charge. Participants chose among the following birth-control methods: IUD or implant (n=5781), birth control pills, patch, or ring (n=1527), and contraceptive injection (n=176). Overall, there were 334 unintended pregnancies. Of these, 156 were due to contraceptive failure. Overall, 133 (4.55%) women using pills, the patch, or ring had contraceptive failure, compared with 21 (0.27%) women using IUDs and implants. In age-adjusted analyses, pregnancy risk was significantly higher among women using birth control pills, the patch, or the ring than among those using IUDs or implants (hazard ratio, 21.8). Participants younger than 21 years who used short-acting contraceptives had nearly twice the pregnancy risk as older participants using the same methods, while risk did not differ between age groups for long-acting contraceptives. Although IUDs are very effective and have been proven safe in women and adolescents, they are chosen by only 5.5% of U.S. women who use contraception.[2] According to the authors, this study may represent a shift in how patients should be counseled about birth control, which could greatly affect unintended pregnancy rates—and can have negative effects on women’s health and education and the health of newborns. The authors also note that when IUDs and implants were provided at no cost, about 75% of the women chose these methods for birth control. Unintended pregnancy is a major problem in the United States. About 3 million pregnancies per year—50% of all pregnancies—are unplanned.[3] The rate of unintended pregnancy in the United States is much higher than in other developed nations, and past studies have shown that about half of these pregnancies result from contraceptive failure. My only comment on the above study is if you are going to chose an IUD, non hormonal option is a better option, however, you will need to ask for the Paragard or most doctors will automatically give you the Mirena which has medroxyprogesterone in it and is not healthy for you. Call my office in Lombard (630) 627-3700 to set up an appointment or email me at hormone replacement therapy, hormone imbalance, women to women, bodylogicmd, hormone replacement after hysterectomy, bioidentical hormones, HRT, women's health, men's health, TS Wiley, The Wiley Protocol