Dr. Maupin on KMBC in Kansas City on Monday, May 9, in a story about the benefits of bioidentical hormone pellets.
Low testosterone in men causes a variety of poor health conditions.
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Andropause, Bioidentical Hormones, Hormone Replacement Therapy (HRT), Medical Care, Pellets, Symptoms, Testosterone, Treatment No Comments
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Andropause, Anti-aging, Bioidentical Hormones, FDA Regulation, Hormone Replacement Therapy (HRT), Medical Care, Menopause, Pellets, Research, Symptoms, Testosterone, Treatment No Comments
Discussion of a CNN Health article that says anti-aging medicine is risky.
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In episode 62 of the BioBalance Healthcast we continue the discussion we started in the previous episode that reviewed an article titled “The risks of anti-aging medicine” that was published on the CNN Health website on Wednesday December 28, 2011.
The author states that anti-aging doctors are generally not as well trained as other medical specialist. I am an excellent example of the many anti-aging doctors who are well trained and qualified to offer these services that include advancements that make it possible for us to live longer lives. Anti-aging treatments—especially bioidentical pellet therapy that we offer her at BioBalance Health—let’s us enjoy better health and mobility for many years past the onset of menopause in women and andropause in men.
Dr. Thomas Pearl, quoted in the article, was referring to treating geriatric patients, which is not what I focus on. Instead, I normally start hormone therapy long before patients reach that age, and not when they too old for the therapy to make a difference. By offering this therapy, doctors can prevent many diseases that are secondary to hormone loss. Many diseases can be offset for 10-20 years with bioidentical hormone pellets.
HRT is a treatment for a syndrome, not symptoms, and often save money and time. Chelation therapy for heavy metal toxicity is not offered at BioBalance Health. Chelation has risks of renal and liver problems. There are alternative supplements to rid patient of heavy metals. Baby boomers have higher chance of heavy metal toxicity due to lead, mercury, and other harmful substances in food and the environment.
Compounding pharmacies used to be popular 70 years ago before drugs were made by pharmaceutical companies. Current compounding pharmacists have the ability to compound drugs prescribed by a physician. I supervise the use of compounding pharmacies for my patients. My estradiol and testosterone pellets are made at a compounding pharmacy that is reputable and trusted. If your physician writes a prescription for a drug and sends you to a compounding pharmacy, be certain he/she has a relationship with the pharmacy they use. The FDA does oversee compounding pharmacies.
The article sites information based on the Women’s Health Initiative study which since released has been discredited. Dr. Goldstein is using a bad argument, a bad study, bad information and miss-representing the use of bioidentical hormone therapy.
To wrap up our podcast, we discuss the term “the standard of care,” which means the least amount of medical treatment that is acceptable by a physician. It’s the lowest standard of care you can give and not get sued.
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Anti-aging, Bioidentical Hormones, Hormone Replacement Therapy (HRT), Medical Care, Menopause, Pellets, Research, Symptoms, Testosterone, Treatment No Comments
Base your health decisions on reliable information, not just media resources.
People are often influenced by the news media, and sometimes make medical decisions based only on what they read on the internet. A recent article published December 28, 2011 by CNN Health made some statements and quoted some experts that would lead readers to the conclusion that anti-aging medicine is generally unsafe.
In the article, titled The risks of anti-aging medicine, CNN Health reported that a 56 year old California woman injected human growth hormone into her thighs six times a week. Six months after starting the treatment, she died of liver cancer.
The problem with this report is that it allows the reader to confuse correlation with causation, inferring or implying that the treatment is responsible for the patient’s death. The experts quoted do not say conclusively that the HGH treatment caused this women’a death.
In this episode of the BioBalance Healthcast Brett Newcomb and I walk through the article and explain why it may not be totally accurate or objective, and how you might think about medical-related articles you in the future, especially when you are considering healthcare issues.
Episode 62 will continue this discussion.
Visit BBH.com for more info about bioidentical hormones/anti-aging/skin care.
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Bioidentical Hormones, Hormone Replacement Therapy (HRT), Menopause, Symptoms, Treatment No Comments
Of the Ten Million Americans who have Osteoporosis, 80 Percent are Women.
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In episode 59 of the BioBalance Healthcast, Dr. Maupin and Brett Newcomb talk about osteopenia and osteoporosis.
What is Osteoporosis?
- Thinning of bone density over time
- Measure bone density against a standard for 29 year old female averages
- Use of the bell curve as a statistical tool
- If you are more than 1 up to 2.5 SD out from average you have osteopenia
- Greater than 2.5 you have osteoporosis
How to Improve Bone Density
- Testosterone
- Estrogen
- Vitamin D
- Weight Bearing Exercise
- Calcium in the diet
How Do Bones Become Less Dense?
- It is normally a slow progressive change in bone thickness that begins in women before menopause and continues after menopause at the rate of 1% of your bone per year
Why Do We Get Osteoporosis?
- Aging leads to loss of estrogen and testosterone
- Sedentary Life Style
- Poor Diet
- Genetic Predisposition
Marketing Osteoporosis
- Before the advent of a drug to “cure” osteoporosis, doctors rarely diagnosed the problem
- A new wonder drug was developed to fight osteoporosis called Fosamax
- This drug allowed us to focus on treatment rather than avoidance
How to Avoid Getting Osteoporosis
- Be Male: The key hormones involved are testosterone and estradiol, but it is interesting that men rarely get the disease unless they are on steroids for asthma or another disease
- Replace estrogen and testosterone naturally
- Get the best out of your genetic potential
Why is treatment or avoidance so important?
- Osteoporosis leads to disability, poor posture, chronic pain, broken hips and crushed vertebrae
Other contributors to thin bones
- There are lifestyle choices and medical treatments that also increase our risk of thin bones
- Smoking, avoidance of milk in our diet, lack of sunshine and a sedentary lifestyle
- Amphetamine use, Lupron treatment for Endometriosis, corticosteroid use
- Some illnesses like removal of our ovaries, anorexia, or premature menopause can also cause osteoporosis
Do osteoporosis drugs really work?
- Recent studies on bisphosphonates showed that this class of drug that made bones “look” thick on bone density testing. Studies proved that bones were actually fragile and easily fractured.
- I do not recommend the class of drug that includes, Fosamax, Actonel, and Boniva to my patients until further study answers the question.
What to do instead
- Bones are responsive to estrogen and testosterone. With these hormones and an adequate diet, you can protect your bones and yourself from disability and pain, and life threatening fractures.
Visit BBH.com for more info about bioidentical hormones/anti-aging/skin care.
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Bioidentical Hormones, Chronic Fatigue and Fibromyalgia, Menopause, Pellets, Symptoms, Testosterone, Treatment No Comments
Bioidentical testosterone pellets can cure chronic fatigue.
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On episode 58 of the BioBalance Healthcast, Brett Newcomb and I talk about chronic fatigue, the symptoms, diagnoses and treatment with bioidentical testosterone pellet therapy.
The symptoms associated with chronic fatigue are severe fatigue following a flu-like illness, abrupt onset of fatigue after the viral infection, exhaustion after any exertion or exercise. Night sweats occur in half of the patients with chronic fatigue.
The sources of this medical problem are immune system dysfunction, low cortisol, low ACTH and a low level testosterone.
The diagnostic tests essential for evaluation are CBC (blood count), thyroid panel, ANA, 8 AM Cortisol level and ACTH level, testosterone levels, and growth Hormone levels.
If you have been told that you have chronic fatigue, and traditional medical therapy has not worked for you, BioBalance Health Testosterone therapy will improve the immune system, and therefore improve many symptoms of chronic fatigue. Many patients who thought they would have to live mired down with fatigue, have found the answer with us. Patients who have been struggling with this syndrome, tell me that they have their lives back, by replacing the hormone they needed testosterone!
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Good Doctors diagnose with SOAP—Subjective, Objective, Assessment, and Plan.
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In episode 53 of the BioBalance Healthcast, Dr. Kathy Maupin and Brett Newcomb describe the diagnosis process doctors are trained to use when talking to patients about medical issues and creating a treatment plan.
Doctors all go into medical school, normal human beings, or at least mostly normal, and matriculate with minds that think in a deductive way in order to reach an answer to the proble brought to them by their patients. The process of teaching us how to think, completely wipes out our hard drive, and reprograms us. I believe it is important for patients to undersand how doctors think, so as patients you can give them the most important information, in the most efficient manner, so they spend most of their time problem solving and not extracting the information they need to begin to problem solve. In this world created by managed care doctors have very little time with you face to face so why not make that time the most efficient for you?
The structure, or order, of the visit is evidenced in the notes doctors write:
S= Symptoms or complaints of the patient
O= Observations, physical exam, vital signs, what you look like
A= Assessment is the initial thought or impression that the doctor has about your problem.
P= Plan or lab tests, radiology, medications, exercise, diet, and when to return.Help Your Doctor Understand Your Problem Quickly!
That’s it! So, your doctor will enter the room and ask you what’s wrong. At this moment you should tell him or her: 1) Your most problematic symptom, when it started, how severe it is, where you feel or see it, if it is constant or intermittent, and why you are worried about it.That’s very efficient and it does not confuse the doctor with unnecessary information. My mother in law was truly my favorite relative. She lived with us for the most important 7 years of our daughter’s life and was integral to her brilliance and humor, however she was always a difficult patient to pin down. I would go with her to the doctor and it literally took her a full 15 minutes to tell the problem to the doc. It was intermixed with what she ate today, the subjects of her dreams, her friends illnesses and somewhere in there she would tell the doctor what was wrong. Thankfully she was blessed with patient doctors. After 7 years I had coached her to ten minutes of unrelated symptoms, and helped her doctor by handing him a sheet of paper of her symptoms and the important related problems.
So if you want great care you have to learn to play the doctor train of thought game and start with the main problem. If you are helping an aging parent or a child spend the time on the way to the doctor sorting through the flotsom to get to the problem, and then help them rehearse their symptom description. If you are unable to go to the doctor with a talkative relative, or even a non-talkative teenager, it is acceptable to fax or email the problem and the symptomatology (What, where, when ) to the doctor before the visit to help her.
Your Doctor Should look At You, When they Talk to You and When They Examine You
To diagnose your problem, a doctor needs clues, and after taking your history, your clues are contained in your face, skin tone, skin turgor (tightness, or swelling), bumps, lumps, discolorations etc. Your doctor must LOOK AT YOU to get these pieces of information. If you look totally different than you feel, then tell the doctor that you always look better than you feel so they take you seriously!I often see patients who come to me, and complain that their doctor types throughout the office visit and never looks at them. This is a mistake of the modern age, as most of us can write without looking, the majority of us cannot type without paying attention, so doctors aren’t getting the clues needed to arrive at the right tests or diagnosis. Vital signs are a pain but generally essential to a Primary Care doctors diagnosis.
Your Doctor will Come To a Conclusion about what is wrong or a list of what Could Be Wrong.
The third step is problem solving. This is the fun part for me, when I have most of the information and I decide what the problem is, or what possibilities are on my list to rule in or out. This part takes rest and time. Generally your doctor will let you in on the things he or she is looking for, or what it could be. If not, then ASK! It is your visit and even though you have to fit your symptoms into a form that is efficient for the doctor, she should tell you what she is thinking of, and what tests or medications you will require.The Plan: Steps by Step Plan for Diagnosing your Problem
Last but not least, is the list of things you or she needs to do to get to the answer. This is not a secret. Ask for a copy of the plan or take your own notes. It should include drugs needed, expected results, or lab tests, and instructions before the test, radiology scheduling or other testing, and most important, instructions on when to come back and how to get your results and the DIAGNOSIS.
If you came to the doctor’s office with a problem and you leave without a plan, don’t leave. It is like going to the grocery store, spending time picking out your food, paying and then not being allowed to leave with you food!
This is how doctors think—we want to be your doctor-patient type of friend and know what is going on in your life, but if you have a problem, you must switch from a social visit like is common for check ups, to a business meeting, that takes concentration and no extraneous information.
Just like in the service (Marines, Army, Navy) doctors are reprogrammed during training and they are likely unaware that they get the process but you don’t. I believe if you get the diagnostic process you will be much happier with the results of your problem visits and your doctor.
Visit BBH.com for more info about bioidentical hormones/anti-aging/skin care.
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Bioidentical Hormones, FDA Regulation, Hormone Replacement Therapy (HRT), Research, Symptoms, Testosterone, Treatment No Comments
The Federal Drug Administration regulates testosterone as a treatment for symptoms of menopause.
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Episode 52 of the BioBalance Healthcast features a conversation about the use off-label medicines and how that relates to treating symptoms of menopause with bioidentical testosterone. If you missed it, you might want to watch episode 51 titled Testosterone and the FDA.
Bioidentical Testosterone is safe and legal as a treatment for symptoms of menopause.
Off-llabel Drug Use is the common practice of using drugs for purposes not originally approved by the Food and Drug Administration. Terbutaline is a great example. It is an FDA-approved generic asthma drug that was also used an effective way to stop premature labor.
Ramifications of off-label use are sometimes significant beyond the expansion of drug use. Terbutaline is a good example. It has been replaced in the last decade with a similar and more expensive drug for its non-approved use, prevention of pre-term labor. As a result, it was never approved by the FDA for this purpose; until it was replaced, however, it saved the lives of millions of babies.
If a medication has become generic, then it is not patentable, or “own-able” exclusively by any company. As a result, there is no opportunity for profit. It is therefore no longer cost-effective for a pharmaceutical company to pay for this high cost of research on the second use of the drug when the company has no possibility of realizing a return on the investment, much less a profit. And if there is no pharmaceutical company championing a drug for a certain disease, it is unlikely the FDA will approve it for that that purpose, regardless of its proven effectiveness!
Hormones like testosterone fall into a similar category as generic drugs. Because hormones are natural, they are not “unique, and hence not patentable. With no financial incentive to produce unpatentable drugs, there are no investment dollars to support testing in a way the FDA requires. So generic drugs and natural hormones like testosterone remain untested for any but a narrow set of uses.
The first issue centers around the age and medical condition of the patient using it. Most negative reports are related to the use of testosterone in young, healthy men – usually athletes and body builders — who naturally have excellent levels of testosterone, and who are attempting to artificially augment their testosterone beyond normal physiologic levels to increase muscle mass, strength or athletic skill.
This misuse of testosterone is indeed very dangerous, and richly deserving of its bad press, because it turns off the user’s own production of testosterone from the testicles and adversely affects the function of adrenal gland. This can in turn lead to infertility, adrenal failure and a life-long struggle to regain health.
Because testosterone is in demand for these illicit purposes, but can only be obtained legally from a licensed physician, a black market has arisen on the internet where weight lifters and athletes can obtain “forms” of testosterone for injection from the eastern bloc countries. I have interviewed body-builders and lifters who get their “testosterone” to improve their bodies or their competitive edge, but they usually have no idea what is really in these injections except what the “seller” says is in them. Nevertheless, in their desire for a better body than God gave them, or for an illegal leg up on the competition, they inject these knock offs, with risks and side-effects too alarming and too numerous to discuss here.
This, then, is the scariest of all uses of a product labeled “testosterone,” because it is most likely not the same safe, effective, testosterone regulated by the FDA and administered by licensed physicians. It is more than likely a truly unknown testosterone-based substance. Equally concerning is the fact that it is usually administered by an untrained and unlicensed individual, usually a coach or the athlete himself.
If bio-identical hormones like testosterone are essential and helpful, why are they “FDA regulated, but not approved” for hormone replacement in women? The answer is the same as that for generic or other non-patentable drugs: no company has petitioned the FDA to test and approve testosterone replacement for women.
The FDA’s simple regulation of the drug is enough for me at this time. Because bio-identical hormones have been “grandfathered” into the FDA oversight, physicians are free to prescribe them, as I do, for off-label uses. Consequently, millions of women can and do legally and safely use bio-identical hormones, including testosterone, for hormone replacement therapy. Many cannot tolerate any other hormone preparation than pellets.
As the ultimate pharmacists, physicians have the training to look at a drug like testosterone and say, “I know it works for the FDA-approved diagnosis, but this may also work for another condition, or another population (i.,e. women) because of its chemical and physiologic properties.”
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Report says silicone implants are safe, Dr. Maupin says they’re not the best available.
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In episode 50 of the BioBalance Healthcast episode, Brett Newcomb and I discuss breast implants based on a recent New York Times article which quotes Dr. William Maisel from Food and Drug Administration’s Center for Devices as saying silicone breast implants are safe, but more study needs to be done.
Brett comments that in this report, the FDA is sending of “definite maybe” message, and stresses that careful consideration is still required by women and their physicians before implant surgery is performed. The report mentions potential side effect with breast implant surgery as in any surgery, including infection, wound issues, scarring, pain. Asymmetry is a problem unique to breast implant surgery and can occur based the type of implantation being done. There is a new type of implant on the market that solves the asymmetry problem, as long as both breasts are being replaced, mentioned later in this podcast.
Implants are often used by breast cancer patients who have their beasts removed, but are more frequently used for cosmetic reasons. Although I don’t do breast implants, I’ve done breasts exams on thousands of women over the past 25 years, so I know which of my patients have them. I have found no indication of breast cancer occurring more in women who have had implants verses no implants, or with silicone or saline implants.
Sometimes, as a young woman goes through menarche, her breasts grow unevenly. Doctors recommend to waiting until breast development stops, before either performing a reduction on the larger breast, or placing an implant in the smaller one.
Contents of breast implants have changed over the years. Silicone implants are bags filled with silicone with a silicone covering. Implants are placed under the skin or under the muscle based on anatomy or preference of the surgeon. Silicone didn’t age well, sometimes hardening, leaking or rupturing. Additional surgery is needed in these cases.
There was a huge scare about breast implants a while back that incorrectly tied implants to hormonal problems. Women in their forties were complaining of fibromyalgia, chronic fatigue, rheumatoid arthritis, and other problems, thinking these common symptoms of menopause were the result of their implants. Women were terrified, and had them removed; it’s better to have them removed rather than live with the anxiety. Misinformation like this can go viral, so it is up to women to get the correct information.
The popularity of saline implants resulted in bad press that silicone implants received. Many women paid to have their silicone implants replace with saline implants. Due to lawsuits, insurance companies were paying women to have this replacement surgery done. Saline implants didn’t feel as natural as the silicone implants—feeling more like a bag full of water—and cosmetically didn’t look as good. Saline needs to be replaced every ten years.
The newest implant device is known as the Gummi Bear implant, which is by far the most natural looking.
Visit BBH.com for more info about bioidentical hormones/anti-aging/skin care.
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Bioidentical Hormones, Hormone Replacement Therapy (HRT), Menopause, Testosterone, Treatment No Comments
Pellets are the best vehicle for bioidentical hormones.
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In episode 49 of the BioBalance Healthcast, we continue our series dealing with bioidentical hormones in the news. Brett Newcomb and I discuss a recent news report that compared patches and pills. We add important detail to the discussion of these methods and then describe my preferred hormone delivery system, bioidentical pellets.
Patches carrying estradiol, or estradiol and progestin, are applied to the hip or addomen to provide the body with the additional hormones transdermally—or through the skin. Pills that are swallowed go from the stomach to the liver where they are broken down to make estrone—or “old lady estrogen.” Estrone is just what menopausal women don’t need more of because it causes several negative effects. Estradiol pellets that are inserted into the vagina are designed to deliver estrogen just to the vaginal wall so it is not a good way to get the hormone distributed throghout the body.
The best delivery method is—and the one I use almost exclusively—is bioidentical estradiol and testosterone pellets inserted subcutaneously, in the fatty portions of the hip or thigh, three or four times per year.
The overall conclusion in regards to bioidentical hormone therapy is that patches are healthier than pills, but not as good as pellets.
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Bioidentical Hormones, Chronic Fatigue and Fibromyalgia, Hormone Replacement Therapy (HRT), Menopause, Pellets, Symptoms, Treatment No Comments
Symptoms of aging are treated with bioidentical testosterone at BioBalance Health
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In episode 46 of the BioBalance Healthcast we discuss how my practice differs from my competition, and two of the most common symptoms my patients complain about.
Regarding my practice:
- I practiced as an OB/GYN for 25 years.
- I perfected BioBalance Health by listening to my patients
- We charge on a pay-as-you-go basis, not by yearly retainer
- My patients don’t want to come office visits every month, I treat them a few times a year
- I interview my patients, reviewing their blood test results with them before prescribing dosage
- Following the initial visits, they just come in for pellet insertions
- I try very hard to limit waiting times
- My Nurse Practitioners do the insertions; they understand hormones better than most doctors
- I customized my instruments to decrease the size of the insertion, minimizing the size of the scars
- My competition requires monthly lab tests and visits for insertion
- My practice offers the most efficient, cost effective treatment available
About Fibromyalgia and Chronic Fatigue
- Fibromyalgia and chronic fatigue have a connection, so they are often confused
- Both symptoms cause a bone-tiredness that is worse than what can be caused by hormone deficiency
- Fibromyalgia—caused by a virus—is an autoimmune disease that causes your immune system to attack body tissue
- Fibromyalgia causes traveling pain, moving to different parts of the body
- Chronic fatigue is also a virus that compromises the autoimmune system and is generally caused by lack of testosterone
- Both are treated with bioidentical hormone pellets
For more information about BioBalance Bioidentical Pellet Treatment, visit the BioBalance Health website.
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