Synthetic vs. Bio-identical Hormones

Bio-identical hormones are exactly the same molecules as the hormones we used to produce. Synthetic hormones are similar but have a different chemical structure than our naturally occurring hormones and bio-identical hormones as you can see in the picture above.  Synthetic hormones can cause unpleasant and even life-threatening side effects because they interfere or block proper hormone receptor function in our bodies.

Let's talk about progesterone......
Progesterone is very active and beneficial for breast tissue because it blocks estrogen stimulation of the breast, thereby decreasing breast cancer and breast cancer risk. It prevents the lining of the uterus, the endometrium, from overgrowing and becoming cancerous. Surprisingly, progesterone also decreases the risk of heart disease and helps protect your bones to some extent.

Now let's go over progestins (synthetic progesterone)......
Progestins are a class of progestogen compounds synthesized to act like progesterone does in the body. They DO NOT however reproduce the same actions of natural progesterone in the body. Provera or medroxyprogesterone when added to estrogens will prevent overgrowth of the uterine lining, but it can cause an increase in breast tissue proliferation and cause cancer due to estrogen receptor stimulation. This is why the Women's Health Initiative Study that I mentioned in my last blog was halted early. Women taking synthetic progestins, had a much higher rate of breast cancer than those who did not take them. Synthetic progestin does not protect the heart either.

The dangers of synthetic hormones have been discussed in medical literature for years. In 2007 the lead article in The Journal of the Federation of American Societies for Experimental Biology, stated "There is a crucial difference in the way bio-identical progesterone and synthetic progestins affect the androgen receptor". (E. Friedman). In 2008 the E3N Cohort Study reported on 80,377 women that had been followed for 8.1 years.This study verified that hormone replacement therapy using medroxyprogesterone (Provera) was dangerous and resulted in a 48% increase in the rate of invasive breast cancer compared to the control group! But possibly more importantly, they confirmed that bio-identical hormone replacement therapy does not increase the risk of invasive breast cancer.

Going back to 2005 a meta analysis of 196 studies concluded that: "physiologic data and clinical outcomes demonstrate that bio-identical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bio-identical hormones remain the preferred method of hormone replacement therapy."

I hope this blog has touched sufficientlyon the need to avoid synthetic hormones, and in this case synthetic progesterone (progestins, Provera, medroxyprogesterone, and many others). Bio-identical hormones are preferred, hands down. #progesterone #htca #bhrt #bioidentical #menopause

Anne R Trussell MD
owner/physician
Sei Bella Med Spa
501-228-6237

Literature sources:
Anderson, Carl W., and Ettorre Apella 2005, Postranslational modification of p53: Upstream signaling pathways. In the p53 Tumor Suppressor Pathway and Cancer, New York

Fournier, Agnes, Franco Berrino, and Francois Clavell-Chapelon 2008. Unequal risks for breast cancer associated with different hormone replacement therapies: E3N Cohort Study. British Cancer Research and Treatment 107 (1):103-11

JAMA 2002;288(3):321-333

Menopause and Safe Hormone Replacement

Everyday 3500 women enter menopause. Natural menopause usually occurs between the ages of 43 and 55, which means we could live half our life in menopause! Our hormone levels can start dropping 15 years before that, so we should not wait until we actually stop having menstrual cycles to seek treatment. And 20% of men are in andropause by the age of 50. The symptoms are not fun!!

Menopause impacts 25 million women worldwide each year. Most of you know the symptoms.....hot flashes, night sweats, mood swings or depression, sleep problems, fatigue and no sex drive. Those are just the ones I hear most commonly. Menopause is also associated with an increased risk of cardiovascular disease, dementia, and osteoporosis. Men with low testosterone have the same risks and experience fatigue, depression, moodiness, loss of muscle mass, erectile dysfunction and low libido.

We need estrogen! It has 400 functions in the female body. Estrogen deficiency is a state of accelerated aging.  In a 2013 study, researchers estimated that over the past decade 18,600-91,600 postmenopausal women, ages 50-59 who have had hysterectomies may have died prematurely because they were not given estrogen!

WHY NOT?!

Well, in 1991 a large trial called the Women's Health Initiative was begun by the U.S. National Institute of Health. The study was stopped early due to a 41% increase in stroke, 29% increase in heart attacks, 26% increase in breast cancer and a 100% increase in the rate of blood clots. So all doctors were cautioned about hormone replacement in menopause, and to use the lowest dose possible to control symptoms and to only continue treatment for 5 years at the most. There were HUGE flaws in this study. The estrogen being given to women was synthetic, made from pregnant horse urine. These compounds have about 40 different estrogens, none of which bind to the estrogen receptors in our body correctly. Furthermore, some of these women were treated with artificial progesterone as well (progestins or medroxyprogesterone). Women on these synthetic progesterones had the highest rates of breast cancer. If you're taking Premarin or Prempro or other synthetic hormones, then you are exposing yourself to these risks. Just because they are FDA approved, doesn't mean they are safe!

Fortunately we have very safe, effective ad convenient alternatives to synthetic hormones. Bio-identical hormones are not only "natural"; bio-identical means they are EXACTLY like the hormones we used to produce. They bind to our bodies' hormone receptors EXACTLY like the hormones we used to produce. They DO NOT increase our risk of cancer, stroke, blood clots nor heart attacks. As a matter of fact, bio-identical hormones are protective against these things! Specifically testosterone replacement does not cause prostate cancer in men! The French Cohort Study published in 2002 followed 3,175 postmenopausal women taking bio-identical hormones for 9 years, proving there was no increased risk of breast cancer. There are many more studies out there proving the same facts. Most of us have heard about bio-identical creams, which are very safe. But at least in Arkansas, bio-identical hormone pellets are not as widely known about. In Texas, pellets are standard of care.  I personally have had pellets for almost 4 years. I love them! 

The process is simple. You come in for an office visit with me and I take a complete medical history. You have a panel of lab drawn. When that lab is available in about a week, it is entered into the HTCA computer formula, along with your medical history and symptoms. A dose of hormones is then generated which I can adjust as I need to. The prescription is then sent to Well's Pharmacy who ships your pellets that have been calculated specifically for you. The pellets, which are the size of a grain of rice and smaller, are then inserted by me into the fat of your bottom in a quick, painless in- office procedure. It truly takes all of 2-3 minutes to insert them. Your pellets will last 4-6 months and gradually dissolve. When symptoms return, you know it's time to tell me you are ready to be repelleted. Bio-identical hormone pellets are safe, convenient and effective, not to mention healthy! And although this blog has mostly focused on menopause, pellets are very popular in men as well!
 

You can read more on my website at www.seibellamedspa.net.
Give us a call today and get your appointment set up to start feeling better. 501-228-6237

Anne R Trussell MD
owner/physician
Sei Bella Med Spa

#menopause #andropause #bioidenticalhormones #bioidenticalpellets #bhrt #htca #lowT #hormonepellets #hormonereplacementtherapy
 

Literature sources:
de Lignieres, B., et al "Combines hormone replacement therapy and the risk of breast cancer in a French cohort study of 3175 women." Climacteric, 2002 Dec; 5(4):332-40

Friedman, 2013

Bain J, Maturitas 2010; (66):16-22 Kaufmann JM, J Clin Endocrinol Metab 2001;26:833-78

North American Menopause Society

Birge,S, "The use if estrogen in older women," Clini Geriatr Med 2008: 19(3):617-27

Studd, J.W.W., Cardozo, L.Stanzyck, & Thom

Sarrel, et al, "The mortality toll of estrogen avoidance: An analysis of excess deaths among hysterectomized women aged 50-59 years." American Journal Public Health 2013: July 18

Let's Review the Thyroid

I've talked about hypothyroidism in the past, but I thought now would be a good time to review this again. It seems I've had an inordinate number of patients lately who have hypothyroidism. Some I've found through their HTCA lab work when working them up for bio-identical hormone pellet replacement therapy. Some I've picked up on when they come in for weight loss consults, and others have sought me out specifically to evaluate their thyroid.

I had an internal medicine practice for 20 years and thought I was doing a great job managing hypothyroidism (underactive thyroid). Afterall, I have hypothyroidisim myself. I was always taught that TSH and T4 were all the labs you needed to screen for hypothyroidism. If they were normal and the patients didn't feel well then they were probably depressed or just needed to follow a better diet and exercise regimen. Since becoming a Diplomate of the American Academy of Anti-Aging Medicine, I now know TSH (the pituitary hormone) is not the most sensitive test. A patient's free T3 (active thyroid hormone) is the best clue as to whether or not he/she has hypothyroidism. And most importantly we want hormone levels to be "optimal" not just in the "normal" range. 

There are multiple causes of hypothyroidism, but for the purposes of this blog, let's focus on the ones I see most commonly which are primary hypothyroidism (thyroid failure) and conversion failure of T4 (inactive pro-hormone) to T3 (active hormone). Primary hypothyroidism is pretty straight forward. The thyroid basically poops out. This can be do to an autoimmune process like Hashimoto's thyroiditis, radiation treatments, or just general aging. A number of different factors can impair conversion of T4 to T3 and these include:

• Physiological factors: old age or significant calorie restriction with dieting
• Certain medications:  Amiodarone, steroids, beta blockers and synthetic progestins (by the way.... I HATE synthetic hormones)
• Pathological factors: kidney or liver disease, malnutrition, increased cortisol, postop
• Vitamin deficiencies: Zinc, Selenium and Iodine are essential to normal thyroid function.

Hypothyroidism can also be caused by failure of thyroid receptors on organs in the body to actually take up thyroid hormone. This is often seen in adrenal fatigue and that is a whole other topic for a new blog!

In the 1920's it's estimated that about 10% of the population was hypothyroid. By 1940 that doubled to 20% and increased again in 1976 to approximately 30%. Dr. Jacques Hertoghe, a pioneer in thyroid endocrinology has estimated that by 1990 about 80% of the population had some degree of hypothyroidism. Because of all the genetically modified foods, chemicals, stress, medications and synthetic hormones we are exposed to these days, that estimate is probably pretty accurate.

Symptoms of hypothyroidism are depicted in the photos above. So how do we diagnose hypothyroidism? A good history and physical exam of the patient is always the place to start. After that, some or all of the following labs are indicated.....TSH, T4, free T3, rT3, and TPO antibodies. This is a good place for clinicians to start. Again, we want "optimal" levels, not just "normal". How a patient feels should be the main driver of treatment. Of course we use lab to make sure we do not make someone artificially HYPERthyroid which can have adverse effects on the body, too.

There are multiple medications used to treat hypothyroidism. Most well known is probably Synthroid (or its generic levothyroxine). Synthroid is predominantly T4. I personally prefer Naturethroid, WPThyroid or Armour Thyroid. I take NatureThroid myself. It comes in 13 different doses, is hypoallergenic and is a combination of T3 and T4. I like to have T3 on board first thing in the morning and then the T4 that remains can convert to active T3 through the rest of the day. WPThyroid is for patients with gluten sensitivities. All three are made from dessicated pork thyroid. Regardless of which preparation of thyroid medication you take, I highly recommend brand name only. Since generics can vary by 20% from brand name, that could be a big swing month to month in your metabolism and how you feel. It's beyond the scope of this particular blog, but thyroid hormones can also be compounded with any strength and percentage of T4 and T3 a doctor wants to prescribe. 

And just as a side note....your fur babies can become hypothyroid, too. So if they are fat and lethargic and you haven't been feeding them junk, you might want to ask your vet to check their thyroid. But it's not just about being overweight or fatigued. Optimal thyroid function improves many aspects of our body, not just the ones we can see and feel. It helps lower cholesterol, improves congestive heart failure by helping the heart pump better, decreases inflammatory markers like C-reactive protein and homocysteine, and helps protect the bones from osteoporosis.

This is just a very brief overview of hypothyroidism. Many, many textbooks are devoted entirely to the thyroid and its diseases and metabolism. There are so many other things we could cover, but we'll save those for another day! At Sei Bella we wish you all the best Health|Wellness|Beauty!

Anne R Trussell MD
owner/physician
501-228-6237

SculpSure results from Sei Bella Med Spa

Recent photos from Sei Bella patients. 

www.sculpsureoflittlerock.com

501-228-6237

                                           50 year old female after one treatment of SculpSure

                   54 year old male 6 weeks after one treatment of flanks and lower abdomen.
                                                      4 inches lost with SculpSure

#sculpsure #fatloss #bodycontouring #flanks #backfat

501-228-6237

Sculpsure vs. Coolsculpt

#sculpsure  #bodycontouring  #permanentfatloss

Xymogen Professional Supplements

All of us at some point take supplements. We want to decrease our risk of heart attack, or have more energy or sleep better or take something that helps us deal with the myriad of stressors in our life these days. We buy them at the grocery store or the local health food store, or like me, buy them on Amazon for convenience sake. I buy well known brands, but I've learned that may not be enough to guarantee quality and safety. There have been multiple reports of supplement induced medical crises. In 1989 the FDA began a large scale recall of all tryptophan containing products due to an outbreak of eosinophilia-myalgia syndromw (EMS). Toxic oil syndrome swept Spain in 1981 due to contaminated rapseed oil. So.....when I learned about Xymogen supplements, I decided to make the switch for myself, my family and what I recommend to patients.

All Xymogen products have an ePedigree. What is an ePedigree? An ePedigree is a record, in electronic form, that traces the changes in ownership of a pharmaceutical product. It begins with the manufacturer and documents the transactional history of the product until it reaches the person or organization administering or dispensing it.

Pedigree laws are being enacted because of the increasing prevalence of counterfeit prescription drugs in the U.S., intermingled with the legitimate drug supply. As XYMOGEN’s market presence increases, so does their possibility of becoming a target for product counterfeiting. Although Pedigree laws do not affect natural health and supplement companies, the many benefits to patients were too great to ignore. These benefits are why Xymogen decided to become the first company, that I'm are aware of, in the nutraceutical industry to implement an electronic track and trace program.

Online sales of Xymogen products are prohibited. They must be purchased through a physician.They contain therapeutic doses of nutrients backed by rigourous clinical studies. Many of their formulas are exclusive and patented. I can recommend supplements for you or tell you which products you need to replace your current ones with. There are supplements for many, many conditions...thyroid support, heart, bone or blood sugar support, male and female health, and detox....just to name a few. Not only do you want safe supplements, you want effective ones as well, or you're just wasting your money. You can order them online, directly through Xymogen with my physician access code, which I can give to you AFTER making recommendations......

Call today for a consult with Dr. Trussell! 501-228-6237

Fantastic Raffle For The Children's Tumor Foundation!

Sei Bella Med Spa Supports the Children's Tumor Foundation

As many of you know, I run on the NF Endurance Team for the Children's Tumor Foundation and I serve on the advisory board for the Arkansas Chapter of the Children's Tumor Foundation. Our mission is to raise awareness and research dollars for neurofibromatosis (NF) research. NF is a genetic disease that affects 1:3000 births. It causes tumors to grow on nerves through out the body and can cause blindness, deafness, disfigurement, pain, learning disabilities, congenital heart defects and even cancer. Currently there is no cure. 

I have some great prizes for this raffle as you can see! And 100% of the money goes to the Children's Tumor Foundation! The drawing will be held on July 12th at Sei Bella Med Spa. We are having a big party that day to celebrate the fact I made it to 50!! We hope you can join us then, but you need not be present to win.

You can purchase raffle tickets with cash or check either in person or by mail. Please make checks payable to the Children's Tumor Foundation and mail to me at:

Anne R Trussell MD

10310 West Markham, Suite 202

Little Rock, AR 72205

Why Should I Choose Sculptra?

Volume loss is now recognized as a major component of the aging face. Volume loss is a process that includes fat loss, bone thinning, muscle wasting, collagen loss and gravity effects. Sure you can get a face lift, but this doesn't address the volume loss, only the sagging and wrinkles. Treatments that replace lost volume are used for contouring and rejuvenating. Sculptra is an effective, and extremely safe collagen stimulator for the face that is clinically proven to last up to 25 months, and in some, even longer than that. Sculptra provides a foundation for facial rejuvenation and is easily combined with other injectables and procedures for overall renewal and rejuvenation. As you can see in the photos below, Dr. Trussell can choose exactly where to place Sculptra for the best results. The goal is to give your face the shape of an inverted triangle like you had before age and gravity set in. As we age, we lose fat in our cheeks, skin becomes lax and we develop jowls, thus our face takes on a triangular shape. Sculptra is unique in that it can be injected in areas other fillers can not.

Why would I choose Sculptra over a dermal filler like Radiesse or Voluma or Juvederm?

The great thing about Sculptra is that it can be used alone or in combination with other treatments and injectables. Unfortunately we have to accept the fact that there is not one single treatment or product, a "magic pill" if you will, that will do everything we need as we get older. The other great thing about Sculptra is that it will last at least 25 months. Results are very soft and natural looking. And results are gradual and less sudden.

How soon can I expect to see results?

There is an initial transient correction of your volume loss, but the effects are gradual over a few months. Think of Sculptra as planting grass seeds or a garden. The poly-l-lactic acid of Sculptra is reconstituted in sterile water, injected in the face and then we wait for the collagen to grow. This is much like planting grass seeds or a garden, watering it, and waiting for your beautiful lawn or plants to grow. If you're looking for immediate results, I can always use a little dermal filler like Restylane or Juvederm to treat particularly bothersome areas. You can also continue to get your Botox or Dysport. You will experience minimal or no bruising nor pain with injection and minimal or no tenderness after a treatment.

What kind of results can I get with Sculptra?

Everyone will respond to the collagen stimulationg effects of Sculptra. How well you respond depends on your age, initial volume loss, whether or not you smoke, and sun exposure. Improvement is gradual over a few months and appears very, very natural. Sandy, Dr. Trussell's nurse, has now had four vials of Sculptra over a 9 week period. Her skin looks healthier, more supple, feels thicker and certainly has fewer areas of volume loss. One of Sandy's biggest compaints was about lines that look like ripples in a pond that form outside of the smile lines and marionette lines (see below). You're only long lasting, narural looking, nonsurgical options for this are Sculptra and Ultherapy, which by the way, work fabulously together. 

How much does Sculptra cost?

Each vial is $700. How much you need is something we determine at your consult. Some say you need a vial per decade of life. However, budget is always something we consider and we can prioritize areas we treat. A 50 year old won't necessarily need 5 vials. Everyone is different. We would never do more than two vials per session and we put 4-6 weeks between treatment sessions. It all depends on your budget and level of satisfaction after a treatment. 

Call today for your appointment with Dr. Trussell.....501-228-6237

#sculptra #collagen #antiaging #polyllacticacid