biobalancehealth's podcast
BioBalance Health is a medical practice that specializes in Bio-Identical Hormone Replacement, Weight Loss, and Medical Esthetics. Each week Dr. Kathy Maupin discusses important medical topics, and offers advice on hormone replacement and anti-aging strategies. See the full video at www.biobalancehealth.com Dr. Kathy Maupin, M.D. is a leading expert in bio-identical hormone replacement therapy, and in treating the symptoms of aging. She is also the author of “The Secret Female Hormone“, the seminal work about hormone replacement therapy for women.
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Reversal of Advice for Breast Cancer Patients Experiencing Severe Menopausal Symptoms
04/08/2025
Reversal of Advice for Breast Cancer Patients Experiencing Severe Menopausal Symptoms
See all the Healthcasts at Menopausal Symptoms I waited to announce the emerging research regarding the safety of post-menopausal hormone replacement therapy for breast cancer patients suffering from severe menopausal symptoms until the research finally supported my belief that women have the right to receive the treatment that they need if they accept the risks of that treatment. The past year of research (2024-2025) has produced a significant amount of research demonstrating the health risks associated from not taking hormone replacement therapy, as well as the safety of using testosterone after breast cancer and the limited risks of hormone replacement therapy following breast cancer. I have practiced women’s medicine for over 40 years, and I believe that female patients should have the right to receive post-menopausal hormone therapy if they understand and accept the associated risks and benefits, as long as it is administered safely. Let me pause here to discuss how doctors ethically make decisions about treatment. First, the aim of medical treatment is to improve health and longevity while alleviating symptoms. It is a doctor’s responsibility to evaluate, treat, and advise patients on the best course of therapy based on their medical training, practical experience, and the latest research. However, the third factor is often overlooked when advising patients about hormone replacement therapy after breast cancer. Doctors determine the best course of treatment by using this information and weighing the benefits of a treatment against its risks. We are trained to provide this information to patients to facilitate informed decision-making with the patient, not for the patient. This process requires time that doctors no longer have. Ah, and therein lies the problem. Doctors are trained to follow research related to the diseases and conditions they treat and to integrate that research into their practice. The basic decision-making process involves weighing the benefits of treatment (or no treatment) against the associated risks. When the benefits of a treatment outweigh its risks, it is recommended to the patient. “Recommended” means the doctor, based on current knowledge, believes it to be safer and more effective for the patient’s health to pursue a specific treatment. However, this does not imply that the patient must follow the doctor’s advice. A patient is autonomous and can assess the risks and benefits once informed, allowing them to refuse a treatment or request one that falls outside current medical guidelines. Doctors do not have to embark on a treatment they do not believe is beneficial or safe. Doctors have autonomy as well! Doctors in mainstream medicine adhere to “medical guidelines” established by our specialties, which represent the minimum level of care expected from a physician. However, these guidelines are often decades behind current research, meaning that the risks and benefits communicated to a patient may be outdated. A legal requirement known as informed consent mandates that a doctor inform the patient or include this information in a consent form that the patient reads and signs, detailing the procedure or treatment. If the treatment is newer than the guidelines, it is categorized as “off-label.” It is essential for the doctor to inform the patient that the treatment does not conform to current guidelines, and the patient must acknowledge the known risks associated with the treatment. At BioBalance Health®, we often find ourselves ahead of the guidelines, and my experience indicates it may take up to 20 years for the guidelines to catch up with us. Much of our treatment is considered off-label because it is current and ahead of the guidelines. It is superior to other treatments and remains safe, but risks are inherent in every treatment! Now, let’s return to breast cancer and the roles of estradiol, testosterone, and progesterone replacement. Here are the facts about breast cancer: Most breast cancer patients are post-menopausal, and have symptoms of menopause Not all types of breast cancer are stimulated by estradiol or progesterone, and therefore for these cancers hormone replacement therapy is safe. Breast Cancer patients with negative nodes who have had a bilateral mastectomy are candidates for hormone replacement therapy after their treatment. The risks of estrogen replacement for ER+ breast cancer patients may promote the growth of cancer cells, while testosterone replacement lowers the risk of recurrence and alleviates certain menopausal symptoms. When testosterone is combined with estradiol, the risk of developing breast cancer in all women is reduced. Testosterone enhances the quantity and activity of cancer-fighting T-killer and T-helper white blood cells. All breast cancer patients can manage menopause symptoms using testosterone pellet therapy and vaginal estrogen without an increased risk of recurrence. Do you remember when I mentioned that the risks of treatment should be balanced with the benefits of that same treatment? Recently, numerous research articles have outlined the benefits of estradiol treatment, which I included in my 2017 book, “The Secret Female Hormone: How Testosterone Replacement Can Change Your Life.” In early 2025, the safety of taking estradiol for menopausal women confirmed the less publicized research that had come before. The Journal of Endocrinology and Metabolism reported that women who underwent estradiol replacement after the age of 60 live 20% longer than those who do not take hormone replacement therapy. This challenges the guideline that advises OB-GYNs to discontinue hormone replacement therapy before the age of 60. The Benefits of Estrogen replacement after menopause, based on multiple research studies over the last 20 years is as follows: ERT alleviates symptoms such as dry vagina, painful intercourse, insomnia, hot flashes, and night sweats. Estrogen replacement prevents and treats osteoporosis in women. Testosterone replacement in women with osteoporosis can reverse the process of bone loss, bringing bone back to normal strength and decreasing fracture risk. Non-oral Testosterone and Estradiol can prevent arteriosclerotic heart disease. ERT and HRT decreases the risk of diabetes with aging. Estradiol replacement during the first decade after menopause can delay the onset of Alzheimer’s disease and dementia by ten years. If you are genetically predisposed to developing Alzheimer’s or dementia by age 80, E2 replacement may postpone this onset until you turn 90. Testosterone replacement in the first 10 years after menopause postpones the onset of Alzheimer’s disease and dementia for an additional ten years. Testosterone boosts immune function in both sexes and diminishes the onset and severity of infectious diseases. Aging causes cognitive decline, marked by challenges in memory and thinking, and menopause speeds up this process. Testosterone and estradiol replacement therapies may aid in reversing this decline. Muscle mass decreases after menopause due to a decline in testosterone but replacing testosterone with bio-identical pellets restores muscle mass to premenopausal levels. The latest medical article that inspired me to create this podcast was published in the journal Menopause, which discussed the challenges many women face after breast cancer treatment without hormone replacement for their severe menopausal symptoms. Here are the quotes I think you should hear: (MHT = Menopause Hormone Therapy) “Among 226 breast cancer survivors.. the menopause symptom burden was high and women’s experience of menopause-related breast cancer after-care was poor. Few women felt actively involved in menopause treatment decisions. The NICE breast cancer guideline (NG101) states that women with a history of breast cancer can be offered MHT in “exceptional” circumstances if other treatments have failed (off-label use). However, NICE does not define what “exceptional” circumstances are or who gets to decide. Up to 50% of breast cancer survivors, especially those with debilitating menopausal symptoms, may choose to accept a small increase in risk in exchange for an improved quality of life and/or to mitigate future health risks associated with chronic estrogen deficiency. “Allowing”. women to have MHT only in “exceptional” circumstance undermines patient autonomy and limits a clinician’s ability to integrate clinical knowledge and judgment with the best currently available evidence (which is decades behind clinical guidelines). Clinicians have a legal and ethical responsibility to patients to make informed treatment choices. If you have had breast cancer and are experiencing symptoms you no longer want to endure, my advice is to find a doctor with whom you can make an informed decision based on the latest research. It’s important to understand and accept the risks and to sign a High-Risk Consent for HRT. If you aren’t that brave, then seek a physician who will prescribe testosterone pellets along with vaginal estradiol to alleviate some of your post-menopausal symptoms. Life is too short to follow guidelines that are 20 years out of date when you are suffering.
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Reasons Why You Can’t Interpret Your Own Lab Results – Part II
04/08/2025
Reasons Why You Can’t Interpret Your Own Lab Results – Part II
See all the Healthcasts at Last time we reviewed why interpreting your lab may lead you to the wrong diagnosis and treatment. Today we continue our review of each lab panel and why the reference ranges on your lab results may not be the “Healthy Normal Range” that you should compare your results to. Lab reference ranges are established with a one-size-fits-all mentality, ignoring the numerous variables that influence blood results. Have you ever tried on a “one-size-fits-all “ANYTHING? Those clothes may fit 20% of the population but for the rest of us, the garment doesn’t fit our width, weight or height! All one-size-fits-all lab reference ranges are much the same. For example, the standardized “reference ranges” in the US serve as a one-size-fits-all “ideal range” applied to everyone, despite genetic differences, varying latitudes, and the diverse diets that characterize the American multiethnic population. This presents the first problem with using a single range for all people: variations among individuals based on differing genetic needs. The second issue is that the ranges on the lab report indicate the minimum levels necessary for survival, not necessarily the healthiest blood levels for most individuals. Another example of one size doesn’t fit all is the reference range for women’s hormones. A range is displayed for cycling women, but there is no healthy range for menopausal women. Does the range displayed refer to menopausal women with HRT, or menopausal women without HRT to treat their menopausal symptoms? Is the range based on what is healthy, or what is average? We aren’t sure. Labs don’t ask patients questions that could help interpret lab values. Therefore, they cannot provide a truly diagnostic reference range for any illness. They only consider gender and age, as reference ranges are solely adjusted for these two factors. A doctor must interpret individual lab results alongside a patient’s medical and surgical history, including established diseases, medications, supplements, hormonal treatments, and past lab values. For instance, laboratory companies should offer reference ranges based on whether a patient is menopausal, a woman is undergoing ERT, a man is receiving testosterone, a patient is on thyroid medication, a person is being treated for diabetes, or the diabetic tests are performed to diagnose diabetes. Some Reference Ranges are Based on comparing results to Misleading formulas The best example of this issue is the Lipid Panel. Doctors use this panel to determine a person’s risk for heart attacks caused by atherosclerosis. Most doctors don’t know the formula for determining Total Cholesterol. This test doesn’t predict heart disease in most patients, as the formula used to arrive at that number is not indicative of the disease. However, doctors have been advised that when total cholesterol levels are high, a patient should start taking a statin, a drug that reduces blood cholesterol and sometimes lowers the rate of heart attacks in certain individuals, though it is rarely predictive in 50% of the population. The problem with the lipid panel is twofold: the LDL level indicates future atherosclerosis in only about 50% of the population and is not a specific test for future heart disease risk. Total cholesterol is even less predictive of heart disease because it stems from a flawed formula. Doctors interpret a high Total Cholesterol level as an indication that a patient may be at increased risk for heart disease in the future. When I test patients with elevated Total Cholesterol or high levels of LDL using a Cardiac Calcium Scan to measure plaque, only half of them actually produce plaque, and consequently, are not at risk for atherosclerotic heart disease. I believe that the Total Cholesterol number is derived from an inaccurate formula for determining a person’s risk of future heart disease. The Total Cholesterol number is calculated using a flawed equation. The equation is as follows: LDL + 1/5 Triglycerides+ HDL = Total Cholesterol Total Cholesterol = LDL (bad cholesterol) + 1/5 Triglycerides (high risk factor) + HDL (good cholesterol) Let’s examine this formula simply like this: Bad + Bad + Good does not equal Bad. Due to this incorrect formula, thousands, if not millions, of patients have been prescribed statin drugs for a lifetime without justification! Statins carry risks. The list of side effects is extensive and includes muscle deterioration and statin-associated dementia. Unfortunately, most people who experience statin side effects are women. Women tend to have higher HDL levels than men. Additionally, they typically do not have atherosclerotic plaque until menopause and usually do not develop it after menopause if they undergo estrogen replacement therapy! This gender issue is just one of the problems with laboratory reference ranges that are not adjusted for sex. The total cholesterol values were developed solely from the blood levels of men, who typically have lower HDL levels. Women were excluded from the tests conducted to create this blood panel. For women, I dispel the myth that high total cholesterol predicts heart disease by recommending a Cardiac Calcium Scan to check for plaque. If a woman has no plaque by the age of 50 and is taking estrogen, she is unlikely to develop plaque in the future. I still test them every 2-3 years to ensure that no metabolic changes have altered their risk, but I don’t put much faith in the unreliable cholesterol blood panel. There is another blood test that has deceptive reference ranges: IGF-1 How about the GH-IGF-1 test, the test for Growth Hormone? IGF-1 is a metabolite of GH that we can measure to determine how much the patient produces. This hormone aids in healing and replenishing aging cells in patients after their growth is complete. The healthy normal range with which I was trained, (150-350 MIU), has been changed to an age-adjusted normal that compares a person to others in her age category who had their blood drawn the previous year. What is wrong with this? Growth hormone (GH) decreases with age and contributes to the declining health people experience as they grow older. Similarly, IGF-1 diminishes with age and illness, which means that the “reference range” essentially reflects that you are “average for the sick individuals who visit Quest to have their IGF-1 levels checked. ” IGF-1 levels can be enhanced through weight loss, testosterone replacement, and an increase in muscle mass. The current reference range does not indicate health or illness; it merely shows whether you fall within the average for your age group. This non-scientific method of determining “health” is widespread in contemporary medicine. By comparing aging individuals to others within the same age group, for hormones that decline with age, based on samples from sick patients who visit a specific lab in the past year, these labs label patients as “healthy” even when they are as ill as other individuals their age who go to that lab! This practice constitutes age discrimination! Regarding hormones, the levels we maintained during our fertile and youthful years correspond to the blood levels indicative of health in all individuals ages. For example: People who check their IGF-1 (Growth Hormone) levels and see a low “52 ng/ml” might feel satisfied that they are within the standard range (50-280 ng/ml). However, they may not realize that this range applies to older, unhealthy individuals, not to healthy young ones (150-350 ng/ml). This is just one example of the issues that arise when non-medical individuals, who do not monitor these tests regularly, draw conclusions from the numbers. Some illnesses require more than one blood test for diagnosis If you consider only one of the three tests for diabetes or prediabetes (Fasting Blood Sugar, HbA1c, and Insulin), you cannot self-diagnose as diabetic, prediabetic, insulin resistance or healthy. Diabetes is a disease that has coincided with the rising number of obese individuals. Both conditions affect nearly 50% of the American population. Blood tests cannot be interpreted accurately unless a patient has fasted for 12 hours; all three tests should be evaluated. When diagnosing diabetes and insulin resistance, we perform three tests to assess whether a patient has insulin resistance, prediabetes, or diabetes. These tests guide our diagnosis and inform the treatment we provide based on their results. Fasting insulin is a highly misleading test. Over 15 years ago, a significant study was conducted that was believed to change the reference ranges for fasting insulin. The new range set for normal fasting insulin was less than 10 mIU/ml. By publishing the reference range less than 18 mIU/ml, they miss diagnosing many patients with insulin resistance HBA1C is a test that gives a value of average blood sugar over three months. The results are often used alone to determine prediabetes and diabetes; however, considering all three aspects makes the diagnosis and treatment plan more specific for the patient. FBS (fasting blood sugar) is the third diabetes test. It is generally used as a screening test that prompts the ordering of the other two blood tests; however, some patients exhibit symptoms of diabetes and insulin resistance without having elevated fasting insulin levels. Many medications can raise diabetic test values, causing a patient to seem diabetic when they are actually experiencing a side effect of the drug. One such medication is Atorvastatin. The solution is not treating diabetes but rather adjusting the medication. Hormone tests are especially challenging to interpret, Especially when testing free Testosterone in women Here are the problems with the free Testosterone test itself: Women have extremely low levels of free testosterone and testosterone compared to men. I have been informed by Quest that women’s free testosterone levels are not reliable with current methods because they are not always reproducible when a test is conducted twice on the same day. This leads me to believe that hormone levels do not always reflect the actual blood levels of free testosterone and estradiol. The levels of testosterone in women are based on menopausal levels of T. Women have long been thought to not produce testosterone, so the “normal” levels are quite low, and 0 used to be considered normal- until one day I managed to persuade a medical director at Quest to increase it to 0.2! Women’s testosterone is influenced by their production of E2 and E1, which inactivate free T. Women vary in how their cells respond to testosterone and estradiol. Receptor sites and their genetic acceptance of hormones can mean that the same blood level of testosterone in both sexes does not produce the same effects in all patients. Some women (and men) are resistant to E2 and T, or to one of the two. This indicates that the hormone-free T level may be optimal for one woman while being ineffective in alleviating any low T symptoms for another. The latter individual is T resistant, and we currently have no means outside of research labs to determine which women are sensitive and which are resistant. This requires that doctors and NPs look beyond typical reference ranges to effectively manage E2 and T replacement for women. Lastly some labs use the total testosterone level through a formula determine the free T. This carries inherent risks of reporting the wrong active level of testosterone. Total and free testosterone blood levels for men, are derived from results of older men, rather than from the blood levels that indicate health and the levels at which men experience no symptoms. This leads men to believe they are normal, even though they are symptomatic, and they can’t get treatment. There is no time to discuss the reference ranges for LH, FSH, Estradiol, and Estrone; these topics will be addressed in a future blog. I hope I have encouraged you to review your blood work with your doctor or Nurse Practitioner, and not to act as your own doctor by interpreting your blood tests.
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Reasons Why You Can’t Interpret Your Own Lab Results
04/08/2025
Reasons Why You Can’t Interpret Your Own Lab Results
See all the Healthcasts at There is a new federal rule for lab companies that requires them to report your blood tests to you as soon as they are finished, often even before your doctor has seen them. This rule, deemed unreasonable, was established by individuals without medical expertise (politicians), who know little about interpreting lab data or the workings of doctor’s offices. Sending your lab results to you before doctors can assess them is not a decision rooted in sound medical practice but rather in the notion of individual freedom. While this is important, it does not compare to having an expert interpret your results with you. The law requiring that your lab results be sent to you as soon as they are completed does not consider the fact that these results are not designed for laymen to interpret. Additionally, lab results are meant to be analyzed alongside a patient’s medical history, age, gender, and medications. The results are not tailored to report information specific to your situation, which is how a doctor would interpret them. Lab results often lack layperson-friendly explanations. This new protocol can cause anxiety, as patients may panic over results that appear abnormal, even if they are normal for their specific medical condition and treatment. Furthermore, lab companies only request your age and gender. The factors that doctors evaluate when interpreting your results are diverse and numerous, each influencing the overall interpretation. What are the considerations that doctors add to their interpretation? Menopausal status Medical conditions Healthy normal for young and healthy adults The newest recommended ranges for health Body weight Other lab values seen on the same report The problem with you getting your own lab and interpreting it as written is multifactorial: The lab is sent to you digitally with very little explanation except for reference ranges. There is no information about who you are being compared to. Other women, both men and women? Old women? Young women? Women with symptoms or women who are well without symptoms. The reporting of the lab results to a patient directly may hide problems that need action or create fears that are unnecessary. Anxiety over your results will continue until your doctor’s appointment to discuss … so you may experience unnecessary worry in many circumstances. Reference ranges make many assumptions, but labs don’t input vital information about you into their computer. your age of menopause, your weight your height (or BMI) previous illnesses and your medications. if you are on hormones or testosterone Here is a good example. The test for pituitary hormones FSH and LH. When a woman aged 45 is menopausal, and has a very high FSH and LH, the lab says it is “normal” (in the reference range), yet the woman is having severe hot flashes, night sweats, anxiety, and insomnia. That is not healthy or “normal”. The same two tests can be used to determine if a person is menopausal. Let’s say a 42-year-old woman has elevated FSH and LH, but her estradiol is very high (200-300). To the layperson, this looks like menopause, but in reality, it is the picture of ovulation, not menopause. One has to look at another test, estradiol, to determine whether she is premenopausal and ovulating or menopausal (her estradiol would be very low, and FSH and LH would be high). See the problem? Reference Ranges don’t tell you what the doctor is looking for. The same two tests, FSH and LH, are used to diagnose polycystic ovaries (PCO) too. In women without PCO, the FSH is higher than the LH, but if the LH is greater than the FSH, the diagnosis of PCO should be considered! There is no information about this interpretation in the lab report. Falling within the reference range doesn’t guarantee health or absence of symptoms. If patients are to interpret their own lab results, reference ranges should reflect health in every possible scenario. FSH and LH are influenced by BCPs and menopausal HRT. Lab results should be interpreted considering the information regarding BCPs or ERT that the patient is taking. When women are on BCPs and HRT or ERT, their FSH and LH levels are suppressed to an extremely low point. If you are unaware that the patient is taking these hormones, it may appear that the diagnosis is pituitary failure affecting estrogen levels and ovulation. Only doctors can interpret this test. There should truly be a “normal” range for those undergoing hormone replacement therapy, along with a reference range that reflects overall health, rather than merely the average for your geographical area in the US or your age group. Please make an appointment with your doctor to review your lab results so you can understand how they are interpreted. If you have questions about your lab results that are concerning you, schedule a time to discuss them with your doctor. Doctors don’t have the time to explain results over the phone or through email—that is what appointments are meant for. Phone calls to doctors’ offices are not intended for lab result interpretation. You or your insurance will not compensate the doctor or NP for this service over the phone. The reference ranges for many tests and medical situations are actually wrong. If you aren’t trained as a doctor or Nurse practitioner who interprets metabolic lab results every day, you could get the wrong diagnosis!!! For example, when evaluating a patient for insulin resistance, the reference range was officially changed almost two decades ago. Still, the lab companies have left the normal range very high (insulin> 18). In the revised range, fasting insulin diagnoses insulin resistance if the value is > 10. The resulting outcome is that many people are not diagnosed at a time when they can be easily treated without drugs and are told that they are “normal” when they are really experiencing insulin resistance. This is misleading and just wrong! Lab values are not adjusted to your individual situation. Many tests are adjusted for gender; however, some are specifically adjusted for women who are menstruating regarding H/H. In other words, men and women have different “normal” H/H levels in the reference range. Women who do not menstruate or who are menopausal should be compared to the same reference range as men, but that does not happen. This leads to menopausal women, who are normal, often being told they have too many red blood cells when that is not the case. Conversely, menopausal women who are truly anemic are told they are normal, which means it takes longer to diagnose their anemia from colon cancer! The H/H should have a reference range that is considered “normal” for a woman’s stage in life, depending on whether she is experiencing menstrual periods or not. Many reference ranges are averages for regions of the US and vary between lab companies; therefore, they are not reliable values for comparing patients. For instance, the Homocysteine test has a normal range that is relatively high, and each lab has different reference ranges. This test serves as a screening tool for MTHFR genetic risk related to embolic stroke and heart disease. The suggested treatment involves methylated B vitamins; however, the interpretation on the lab printout advises taking B12 and folic acid, which, in my experience, tends to increase the number rather than decrease it. Reference ranges for nutrients, vitamins, and minerals reflect the minimum levels needed for survival, not optimal health. For example, B12 reference range levels for B12 blood levels are listed as 200-1100 pg/ml, yet I was trained to try to achieve 400 -1500 pg/ml. The lower range of the written reference range (200-400) is not healthy. The desired blood levels for vitamins are often controversial, and various medical colleges issue new recommendations on Vitamin D levels each month. Consequently, doctors must determine which level of Vitamin D to recommend for their patients. These institutions not only provide changing reference ranges but also offer differing advice on how frequently to test Vitamin D. This inconsistency arises primarily from the ongoing debate about the minimum acceptable level of Vitamin D. I have more information about your lab results next week that your doctor may not share with you. There is a lot of controversy surrounding the reference ranges on the lab sheet, and you should know the truth in case your doctor doesn’t.
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GLP-1 Weight Loss Medications’ Biggest Side Effect
04/08/2025
GLP-1 Weight Loss Medications’ Biggest Side Effect
See all the Healthcasts at The newest miracle drug for weight loss is changing the lives of thousands of people who have battled obesity for extended periods of time….These GLP-1 medications are also treating or preventing the diseases that go with long term obesity: Diabetes, Heart Disease, Joint replacements, Arthritis, Sleep Apnea, and Alzheimer’s Disease. Researchers are finding more indications every day for patients to take these weight loss medications. But like anything else there is no perfect answer to any problem. Among the few side effects of this drug, the most frequent side effect is reflux, also called acid indigestion, or GERD (gastroesophageal reflux disease). Often my patients don’t even know what their diagnosis is, they just tell me about their symptoms. The symptoms of GERD include: Asthma symptoms A bad taste in the mouth Difficulty swallowing Dry, hacking, cough Chest pain after meals These symptoms are worse after a big meal, at bedtime, after spicy food, or dose related. Most of my patients don’t want to discontinue the GLP-1 inhibitors because they are finally losing weight! We manage the GLP-1 side effect of GERD by decreasing dose of the medication and slowly increase the dose back to an effective level. We also offer lifestyle and dietary treatments before we offer prescription medication. Therefore, if reflux is not constant, and is not causing any lasting damage to the patient’s esophagus, we can treat it with lifestyle changes and over the counter medication, to lower the stomach acid that is refluxing into the esophagus. The lifestyle changes patients can employ on their own are described below. Lifestyle changes needed to avoid or treat Gastric Reflux caused by GLP-1 agonists. What can you do to prevent and treat this side effect: Eat smaller meals: Large meals expand your stomach and put pressure on your lower esophageal sphincter (LES). Don’t go to bed less than 2 hours after eating Avoid trigger foods see below Sleep on your left side Elevate the head of your bed Avoid tight clothing: Chew your food well– chew each bite for 20 seconds. Quit smoking: Smoking weakens your LES and makes your stomach more acidic. Stop drinking alcohol Chew (non-mint) sugar-free–gum In addition to changing your active lifestyle, changing your diet is necessary as well. There are trigger foods to avoid minimizing your reflux symptoms. tomato sauce and other tomato-based products high fat foods, such as fast food and greasy foods fried foods citrus fruit juices soda-diet and regular Caffeine Garlic onions mint of any kind milk based products My patients ask me, “So what can I eat?” …I admit I did take away some of the most exciting foods, however my patients ask me what they can eat so the list of foods that help avoid and treat GERD are listed below. High-fiber foods: vegetables, fruit, and whole grain bread. Alkaline foods. Foods fall somewhere along the pH scale (turns litmus paper blue). Drink alkalinized water (PH > 8) Ginger—fresh sushi Ginger from Asian food stores. Apple cider vinegar on salads and a Tablespoon in water every morning Lemon water—just squeeze a slice of lemon in your water. Coconut water Honey. Lean Protein including meat Low-Fat and Nonfat Dairy Products. Non-Citrus Fruits like apples, pears, bananas, and melons Vegetables like broccoli, Carrots, Corn, Cucumbers, Green Beans, Green peppers, Potatoes and Sweet potatoes For my patients who take herbal and other supplements, the following is a list of the supplements that may decrease your symptoms of GERD. Chamomile Tea Licorice Marshmallow Slippery Elm Tablets Probiotics-Mega Brand Prebiotics-Mega Digestive Enzymes Aloe Vera Juice Baking Soda Magnesium glycinate What happens when you have made all the lifestyle changes you can and have lowered your GLP-1 dose or changed to a different type of GLP-1 Agonist, and you still have GERD? As a physician I prescribe medications to help my patients treat their GERD, however most of the medications have been placed over the counter so I can recommend them to my patients, and they can buy the medication without a script. The class of medication that treats GERD include Antacids, H2 Blocker, and Proton Pump Inhibitor. Antacids neutralize stomach acid, but they typically only work for short periods. They are generally made of calcium. This type of medication is best used prn for symptom relief. Side effects of antacids may include constipation and diarrhea. The second option for treatment of GERD is an H2 blocker. These drugs reduce the amount of acid the stomach releases. Eg. Pepcid, Tagamet, Gaviscon. Proton pump inhibitors (PPIs): These drugs are available by prescription from a healthcare provider, and now some doses are over the counter. PPIs help reduce the amount of acid the stomach makes. They should be used for a two-week period only for severe attacks and then you should change to an H2 blocker or antacid. WHY stop a PPI after 2 weeks? Omeprazole is an example of a PPI. Theses medication kill the good bacteria in your intestines, change your breath and can affect how you absorb your nutrients. If you must take them chronically to treat and prevent the progression of damage to the esophagus. What if I did everything and GERD is still a problem: If your condition is severe, your doctor may recommend a consultation with a GI doctor for an endoscope or other diagnostic procedure. In addition, you may have to hold your GLP-1 Agonist for a period of time while you treat your esophageal inflammation. Just as in all medical issues there are many ways to treat side effects of drugs. Your provider will prescribe the medication that she or he is most comfortable with. What next? So if you have reflux and are on a GLP-1 inhibitor, you may be advised to decrease your dose or switch to Tirzepatide medication (Mounjaro, Zepbound). There are many steps you can take before you need prescribed medication. Your doctor may even change your GLP-1 agonist prescription or refer you to a GI doctor, but before this is necessary you should try the lifestyle and dietary changes that I recommend in this Blog first. This side effect of GLP-1 agonists doesn’t affect every patient and can be managed as you see above, however the lifestyle changes and dietary changes can only be done by you, so the ball is in your court!
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This is for the Men! Too many RBCs after Testosterone? It is easily Treated.
04/08/2025
This is for the Men! Too many RBCs after Testosterone? It is easily Treated.
See all the Healthcasts at Almost every week I hear from my male patients that their PCP doctor has scared them by telling them to stop taking testosterone pellets because their Hematocrit is too high. Alternatively, their doctor recommended a lower dose of T. These two recommendations are those doctors who don’t understand all the good that the testosterone is doing for these men. My male patients come to me for Testosterone pellets to treat their ED, lack of libido, loss of muscle, inability to think, weight gain, lack of motivation, anxiety attacks, poor stamina, arthritis, loss of balance, and basically everything that makes a man a man! The most amazing thing is that I can treat them with ONE hormone, Testosterone in pellet form, and cure all these problems! If a man stops taking Testosterone, they get these symptoms again and have to take a multitude of drugs to feel just a fraction better! The treatment for a high H/H is simple…it is a routine removal of blood, either a blood donation or a phlebotomy (removal of 500 cc of blood) in the office, every 2-6 months to keep their H/H under control. The advice their doctors give them is going to cause them great pain and actually shorten their lives and there is little risk if any to removing blood every few months! In the event that a man demands that I lower their dose…..and I do it…the next inevitable phone call is to complain that their symptoms are coming back! They literally blame me for the advice of their PCP! I would like to tell these men that the same doctors who could not help them with their low T are the same ones who are giving them the advice to lower or stop their testosterone therapy with T pellets. It is human nature and especially that of doctors to try to criticize the advice of the doctor who got better results with a patient than they did! So, if you develop a condition called erythrocytosis secondary to your testosterone replacement, then you can keep your T therapy, if you are compliant and follow your testosterone doctor’s directions and get your blood removed when it is scheduled. This should prevent any severe reaction from your doctor. This is a typical response to my patient who has concerns. However, I have given my patients many sources of written and video information about every aspect of testosterone replacement, the risks and benefits including erythrocytosis. These include my book, Got Testosterone? was given to them on the first visit. We also have over 650 informational blogs and videos on You Tube, FAQs and a very extensive handout given to each of them on the first visit. They just have to read! I have read your concern about erythrocytosis and testosterone replacement that was brought up by your PCP. It is true that T replacement increases the H/H in both sexes. It is useful if you are anemic, but if you have a genetic response to testosterone that elevates your H/H above what is considered normal, then we advise blood donation or phlebotomy every 2-6 months. It is true that the dose of T can affect the H/H, but men often need a high dose of T to feel normal. The removal of blood is low risk and effective. I am a Specialist in Hormone Replacement Medical care with a 38-year history of replacing bioidentical hormones and 23 years of experience replacing bioidentical hormones with T and E2 pellets. You came to me because your doctors were not helping you with the symptoms of testosterone deficiency and because I have the most experience in the Midwest. #1. The first issue that we must always consider while we treat anyone is the primary goals for treatment, the relief of low testosterone which is why you came to me. You made an appointment with me because you had un-addressed issues that your PCP (Primary Care Doctor) didn’t treat satisfactorily Your symptoms were treated with testosterone pellets successfully at a dose that is individual to you. Your health as you get older is also dependent on your blood level of free Testosterone (the total T is not significant) by delaying the diseases of aging. The level that is required to treat your symptoms is the young healthy Free T blood level of a young and healthy man. Most labs give a reference range for older men which reflects the fact that free testosterone levels drop with age. Old men don’t feel well BECAUSE they have low free T. The low free T level is why you don’t feel well. Our practice has found that everyone has an ideal free T level that we try to maintain, and these are young-healthy level but not old-man level. That is what we have been trying to achieve for our patients. #2. The second issue is a side-effect that you, as an individual, have experienced with pellets and will experience with any T replacement that you receive that is a high enough dose to treat your symptoms. Erythrocytosis is a side effect that some men experience on any form of testosterone, however its occurrence doesn’t mean you are on too much testosterone, it means you have a side effect of having a normal free T level. Erythrocytosis is genetic, and your free T blood level stimulates the production of too many red blood cells. We don’t stop the treatment that is making you better, to treat the side effects of it. We treat the side effects. We treat this side effect with phlebotomies to keep your H/H within the safe range. Did your medical doctor/cardiologist tell you why this is important? We tell you: too many red blood cells can increase the work of the heart, however the Hematologists that we consult with give us the HCT% number we should stay below is 58%. We like to keep your HCT% below 52% but that requires you to be compliant with your regular blood donated or phlebotomized in our office (that takes an appointment). You must be compliant to keep your H/H normal. These 2 issues are at odds with one another. I cannot give a man enough testosterone to treat his symptoms, without stimulating some production of RBCs. I have no other low T treatment that doesn’t stimulate your bone marrow to make red cells BUT I do have a simple treatment to remove your extra blood cells routinely to keep you from having too many blood cells circulating. Only you can make the decision to choose health with T pellets and do phlebotomies regularly as recommended, or to stop T and allow your blood count to decrease., and your symptoms will come back. I want you to read your post-pellet instructions, locate my book Got Testosterone? and read it especially the section on Erythrocytosis, and look at FAQs (frequently asked questions) on the website, read related episodes of my 677 blogs and or listen to my health casts for your answers. You can imagine how I feel when my patients don’t read what I provide to them in multiple forms to answer their questions. In the future you should read the information I have given you or come in for an appointment to discuss these matters.
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How To Prevent a Stroke..Start Early!
04/08/2025
How To Prevent a Stroke..Start Early!
See all the Healthcasts at I am not sure if you play THE “WHAT’S THE DISEASE THAT I DON’T WANT TO HAVE GAME with yourself, but since I am a doctor I have spent a lot of time thinking about what diseases I do not want! I started my list in medical school when I witnessed what certain diseases can do to your life. Medicine has many cures and treatments, yet some diseases that are treated still can negatively change your life forever. Even though losing a limb and amputation were at the top of my list there is one disease that tops my list. Of course, I also have under stroke the usual scary situations like paralysis, or having an incapacitating heart attack that prevents an individual from taking care of himself or herself. However, my most feared diagnosis is having a STROKE! You may not fully comprehend how a stroke can change your life, but it can affect your speech, your ability to move, to think, to go places, to have a sense of humor, to write and communicate, even to have a sexual relationship with your loved one. A stroke essentially can take away your ability to be the person you have always been, AND it requires that someone must become your caretaker. That helplessness is something I am most afraid of….We all have our personal fears, but whether you fear having a stroke or not, you should try your hardest to avoid having one! DEFINITION: a stoke is a medical emergency that occurs when blood flow to the brain is blocked or a blood vessel bursts. This can damage or kill parts of the brain, which can lead to long-term disability, brain damage, or even death. This can cause s a loss of function, physical, mental, and emotional, and loss of one or more of the senses like sensation, speech, sight, hearing and taste and smell! In my practice at BioBalance Health we always work with our patients to prevent them having a stroke and or heart attack. These two conditions are the biggest villains that steal the joy of our “golden years” from us. From the start of my BioBalance Health practice, I have incorporated healthy diet training, exercise options and encouragement, how and what to take to supplement my patients’ diet and how to outsmart their genetic makeup so they can be healthier than their parents. All of these lifestyle changes can decrease the risk of stroke and heart attack in a person. So what is it like to have a stroke? First let’s go over what symptoms are typical of someone having a stroke. The symptoms of a stroke are multiple, and a person might not have all of them. Weakness on one side of the body Facial drooping on one side of the face Dizziness Numbness Loss of balance Sudden loss of vision. Trouble making sense when speaking Trouble talking, reading or understanding Sudden nausea and vomiting Brief loss of consciousness such as fainting, seizures, confusion, or coma. When someone has one or more of these symptoms it is an emergency, and you should call 911, then start asking the patient to open their eyes, smile, raise both arms and hold them up. Ask them to talk to see if their speech is impaired. Your findings will be helpful to the EMTs who come to the scene. An event is called a stroke, when there is a deficit in physical or mental function and that deficit continues and doesn’t go away. If it the symptoms completely resolve, it is called a TIA- a transient Ischemic attack. It is a warning to see a doctor and make sure you don’t have a stroke in the future and it is a wakeup call to stop all poor lifestyle choices. PREVENTING A STROKE: This last month, the American Heart and Stroke prevention Association released new Guidelines on how to prevent a stroke. I think talking about the risk factors for stroke and discussing how to prevent having one, is worthy of discussion. Recently the medical guidelines for stroke prevention have been revised, and even though I think a few more things should have been included, the fact that they made the first change in the guidelines in 10 years is a first step. Here is what they advise all people who are aging should do. #1 See your internal medicine or Family physician regularly, at least yearly #2. Stop sedentary behavior—walk/exercise/ do Yoga, just get out of the chair for the majority of your day! #3. If you are diabetic, they advocate going on Ozempic/Mounjaro to lose weight—that will lower your risk of a stroke, and heart attack.. #4 If you are hypertensive, take your BP medicine every day #5 Follow these lifestyle changes called Life’s Essential 8: Your behavior and lifestyle put you at risk for having a stroke: Healthy diet, low carb Mediterranean diet, no junk food! Physical activity every day Achieve a healthy weight, Make sure your sleep is restful Stop use of tobacco products, No smoking or vaping Achieve healthy levels of blood glucose, and blood pressure. Don’t drink more than one 4 oz glass of wine a day I add these recommendations to theirs for the care of my patients: Drink ½ your weight in water every day Wat at least half your weight in grams of protein a day Get a Cardiac calcium scan to see if you have arterial plaque. If you do have plaque (arteriosclerosis) then you are at risk for stroke as well. See a cardiologist to be treated preventatively and tested. Option other than a cardiac calcium scan, get a carotid ultrasound to make sure you don’t have plaque in the neck vessels that lead to your brain.. Make sure your Homocysteine level is normal (<8.0) by taking Methyl B12 and Methyl folate to lower your risk of embolic stroke. Take vitamin D3 and K2 to lower your risk of stroke. Women should take non-oral estrogen after menopause Take Testosterone pellets to decrease your risk of stroke caused by loss of elasticity of the vessels. Take Arteriosil® or Neo 40 every day to improve the nitric oxide in your arteries so they dilate, like when you were younger. Make sure you take electrolytes when you are sweating or working outside in the heat. Every third bottle of water should have NUUN sport or another electrolyte additive to prevent dehydration which raises pulse and lowers blood pressure (in a bad way) causing you to faint or have a stroke. Lower your cholesterol by treating a low thyroid, and or limiting your intake of carbohydrates (food from animals is ok, so are eggs and milk products) Decrease inflammation (which damages your blood vessels) by losing weight, exercise, supplements that lower inflammation. If you have done all of these things then monitoring your arteries with yearly cardiac calcium CT scans and blood work is a good way to see your improvement!
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Do you need antibiotics with your pellet insertion?
04/08/2025
Do you need antibiotics with your pellet insertion?
See all the Healthcasts at If you are receiving testosterone or estradiol hormone pellet therapy, BioBalance Health wants to know if you have any of the following medical conditions that may require you to take antibiotics before any medical or dental procedure that breaks the skin, including pellet insertions and dental cleanings. BioBalance Health is dedicated to providing safe and effective hormone replacement with pellets for both men and women, and we want to ensure your health and safety throughout the process. We use sterile procedure guidelines, but certain conditions still require antibiotics to prevent local infections. Conditions That May Require Pre-Procedure Antibiotics: If You Have Had a Joint Replacement.Some orthopedic surgeons recommend that patients take antibiotics before dental procedures to prevent infection in the joint that was replaced, while others may not. It is important that you follow the advice of YOUR orthopedic surgeon regarding antibiotics before any procedure. If your orthopedic surgeon has advised you to take antibiotics, please let us know. We can provide you with an antibiotic injection or a prescription to take the day of your pellet insertion that will prevent infection. If You Have Uncontrolled Type 1 or Type 2 Diabetes. If your blood sugar is not well-controlled, you may need antibiotics before your pellet insertion to prevent infection of the pellet insertion area. If you are treated and keep your sugars in good control you may not need antibiotics, however if your diabetes is in poor control, you are more likely to get an infection. It is important that you take antibiotics before your pellet insertion. The following blood sugar levels are considered indicators of poor diabetes control: HbA1c > 9.0 Fasting blood sugar > 150 mg/dL If your blood sugar exceeds these levels, or if your primary care doctor has recommended that you take antibiotics before dental cleanings or procedures, you should also take antibiotics before your pellet insertion to reduce the risk of infection. If You Have an Autoimmune Disease and are on Immunosuppressive Treatment. If you are receiving treatment for an autoimmune condition that suppresses your immune system, you may be at higher risk for infection at the insertion site. In this case, you will need to take antibiotics before each pellet insertion. If your Rheumatologist does not believe antibiotics are necessary for you, you may proceed without them. If You Are Receiving Cancer Treatment. Certain cancer treatments, especially those that suppress white blood cell production, can compromise your immune system. If you are undergoing such treatment, you should take antibiotics before or with your pellet insertion to prevent infection. In Summary: If a doctor has advised you to take antibiotics for procedures, such as dental cleanings, you should also take antibiotics before your pellet insertion. Please inform us of any conditions or treatments that may require this precaution, and we will ensure you are properly prepared for your procedure.
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Myths About Post Menopausal Women That Block Women from What We Need:
04/08/2025
Myths About Post Menopausal Women That Block Women from What We Need:
See all the Healthcasts at If you feel ignored and unheard by your doctor or nurse practitioner, your feelings are correct! As a group women are not listened to and often dismissed as emotional and not smart enough to understand “complicated” medical information, by the Misogynistic American medical community, the US governmental agencies who make the rules for what women need. If you feel unheard and dismissed by your doctor, your impression is probably right, and you need to vote with your feet and leave that doctor for someone who listens to you and treats your symptoms and conditions that undermine you and your productivity. The Myths that the majority of people believe are created by men and broadcast by premenopausal women and the media who have no first-hand knowledge of the problems that women contend with when they become pre-menopausal. Here are just a few of the lies and Myths that we must contend with. Women love the freedom of being in menopause! No worry about pregnancy or bleeding. LIE Women can’t become president’s companies or the President of the United States because we are going to hit the red button to destroy the world because we experience PMS before menopause, and after we just can’t think or make educated decisions. LIE Symptomatic Menopausal Women are Over-reacting to a “normal” Phenomenon that “strong” women take in their stride. LIE Women complain about menopausal symptoms to get attention. LIE Women’s menopausal symptoms are really from psychiatric disease. LIE Women who complain of bleeding all the time don’t need a hysterectomy! Just use medication (that doesn’t work). LIE Women’s menopause symptoms are from behavior problems. They need counselling! LIE Menopause should be a wonderful time of your life! Right! LIE All these LIES are damaging to the women who need medical treatment. We don’t need name-calling, subtle dismissal of our symptoms by our doctors, one size fits all non-medical treatment like vitamins and herbs, or basically categorizing our physical symptoms as imaginary or mental which allows doctors to be excused from treating our hormone deficiencies. No sex drive, painful sex, insomnia, fatigue, brain fog, weight gain, fatigue, hot flashes and sleep disturbances, migraines, loss of muscle weight gain and fatigue, depression and anxiety are physical symptoms of menopause and pre-menopause, that can all be treated with estradiol, testosterone and in some cases progesterone replacement. Menopause and the years leading up to it CAN BE TREATED safely and effectively but we aren’t offered treatment by the doctors who work for our insurance companies! Refusing to provide the hormones you need at menopause is denying you the treatment for literally losing the hormones that made you, YOU is not only disturbing but scary! Medical care includes the replacement of waning hormones The only differences between menopause and testosterone loss and hypothyroidism, Cortisol deficiency (Addison’s disease), Parathyroid deficiency, Growth hormone deficiency in children are all paid for by insurance and doctors willingly treat these illnesses because they are not only paid to do so but they have taken a Hippocratic oath to treat the symptoms and diseases of the patients who come to them. However, in my office I hear the struggles that women have had getting treatment for their symptoms. Their doctors generally use the excuse, “I don’t believe in hormones.” So, they get out of treating half of their patients over 50. Hormonal treatment isn’t a religion, it is a condition that 50% of the population will have in their lifetimes. If your doctor is a PCP Primary Care Physician or OBGYN, then they have the training and the duty to treat you. Sadly, these lies have sculpted how women are looked at in the American and English-speaking countries. Misogynistic beliefs are meant to keep women in a second-class status. The result is ignoring the simplest and the most affordable menopausal treatment -Estrogen and testosterone- and profit from our menopausal pain by serving up very expensive treatments for each of the many complaints secondary to menopause that no women can afford. eg: one drug for dry vagina, another for just hot flashes, a third for4 the mood changes that occur with menopause, and another for osteoporosis. All these symptoms can be treated with a combination of testosterone and estradiol, and you can get your sex drive back too! If you think that your government is going to help you , remember the leaders in US government are mostly men who buy-in to the destructive misogynist group think! Lie #1: Women love the freedom of being in menopause! No worry about pregnancy or bleeding anymore. Menopause might have been a relief from bleeding every month however, we no longer worry about childbearing before menopause since the birth control pill was created in the 1960s. In contrast the women of the first half of the 1900’s before Birth control, because menopause stopped women from having unwanted or unaffordable numbers of children. In reality, women living 100 years ago rarely lived past age 45 for women so most women didn’t live to experience menopause! Women suffered then but they were gagged by societal rules, and no one cared how they felt after childbearing years. Now we are very integral to society at any age, not just for childbearing, and menopause is not freedom or enjoyable! We need one all encompassing answer. The answer is long-acting estradiol and testosterone pellets that can resolve all these symptoms and make the years of a woman’s life after menopause like any other era. Lie #2. Women can’t become presidents of companies or the President of the United States because we are too emotionally unstable. Women are portrayed as unreasonable, hysterical and unreliable. LIE! The belief that women can’t be a CEO or president of an organization, or of the US, because we are too emotional before menopause, and after menopause we are not competent to make decisions, is based on uneducated beliefs and old wives tales (really old husband’s tales). We are more competent than men before menopause because we can think of more than one thing at a time, and act on the information, and because we have outstripped men in high school and college class status for decades. As for after menopause, we are at least as competent to lead if we have our menopause treated as men who are aging and becoming addled. If we had the information that has been kept from us about the treatment for menopause, and if we were encouraged to get treatment instead of disparaged by our doctors of both sex in the US, and the US government, then we could hold any position we are qualified for, probably better than men. Even the “Societies” that say they are for women don’t seem to be when they publish articles like the one, I read last week from the Medical Journal called “Menopause” women need counselling not medical treatment for the symptoms that we “imagine”.
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Interview with my patient Ms. Missouri Senior Darla Behlmann
04/08/2025
Interview with my patient Ms. Missouri Senior Darla Behlmann
See all the Healthcasts at During our interview I reviewed her path through recovering from years of no hormones and discussed how dramatic her recovery was. Her symptoms included no libido and no orgasms, Painful intercourse from a dry vagina, fatigue, depression, troubles with memory, Insomnia, lack of motivation, dry wrinkled skin, alopecia, osteopenia, weight gain, loss of muscle mass and weakness, fibromyalgia, migraines, hot flashes, insomnia and poor of quality of life. Her symptoms impaired her ability to have a quality life. During the years after her hysterectomy, she developed hypertension and Rheumatoid Arthritis. After she was treated with Estradiol and Testosterone pellets, her recovery was dramatic and fast! It amazed both of us, and she has continued to improve her health and now she is very healthy, without hypertension and she had almost a decade free of Rheumatoid Arthritis. It turns out that the recovery of her energy, confidence and strength was well timed. She needed all the health and strength she could get to take care of her husband who finally succumbed to brain cancer in 2019. The same year she had the strength to become VP of Paramount bank as her employment. It seemed that the more life-disasters that she overcame, the stronger she got! As generally happens when people are overly stressed, even hormone replacement is overwhelmed. In 2018 had a recurrence of rheumatoid arthritis, and she developed Hypothyroidism and Insulin resistance. Grace, my NP at BioBalance Health, helped her treat her thyroid and weight gain and guide her to overcome these medical problems including losing the weight she gained with insulin resistance. In 2022 she met, and married Mark Behlmann, who she served on the same charity boards with, but she had never met before. She got her second chance with Mark at finding love and fulfillment in her partnership with him. He encouraged her to compete in the. Ms. Missouri Senior, and she employed her energy, talent for singing, her own passion for success and service to become the 2024 Ms. Missouri Senior. In her role she encourages women to use their gifts to achieve everything that they can in life and to find a doctor to help them survive loss of hormones after menopause, so they can continue their service to family and society throughout their lives…she is the best example I can think of living your life to the fullest every day, no matter how old you are!
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Getting Old and Frail? Getting Frail MEANS Getting Old
04/08/2025
Getting Old and Frail? Getting Frail MEANS Getting Old
See all the Healthcasts at Do you ache all over? Are you weaker every year? Shorter and more bent over? Are your clothes hanging off your shoulders? Do you walk slower and hold on to things as you walk? If you notice these signs in yourself or someone you love it means you, or they are becoming frail. As a physician I had to become a people watcher…. or more accurately an observer of the people around me. Even if you aren’t medical people, I am sure many of you are as well…. but being very observant is a requirement for a physician because there are many signs of illness that can be observed just from observing a patient who we I am treating. I always pay attention to how the patient I am consulting with walks, shakes my hand (their strength), and how well they care for themselves, the quality of their speech, whether they look well nourished, over-nourished or frail. All of these individual observations and more, become automatic to me as a doctor. They help me diagnose and treat my patients without a stethoscope or even an x-ray… Today I want to talk about frailty, what it is, and what it means to your doctor and you as a patient. Frailty can be defined as the visible qualities of loss of muscle mass, bone mass, energy, as and strength, as well as thinning of the skin, kyphosis of the spine (standing with your head looking down and your shoulders rounded), slow movements, weakness of strength and voice. Frailty is the visible sign of aging. The opposite of Frailty is the Quality of being robust. When we are young we are strong, energetic, our muscles are visible, our skin is clear and taught, our posture is straight and we appear healthy and strong….when we are young we are Robust! Frailty is the quality of being old and weak, in a catabolic state (or a state of tissue breakdown and “shrinking”). You can equate Frailty with aging, or physically being old. What does frailty mean to a doctor? When we take care of a patient who comes to us for the first time in a frail state we rule in or out a list of diseases of aging and physical problems. These include: Arthritis Osteoporosis Sarcopenia or severe loss of muscle mass and strength Inflammatory diseases like arthritis Heart disease Diabetes Dementia Inability to be independent Doctors must look for illness and decide on a treatment to remedy a disease, but frailty is not considered a disease that has a treatment. It is a sign that a patient is going through the last stage of life. Many studies have been done that equate frailty to a limited life span and a loss of quality of life, but no treatment has been employed by mainstream medicine to delay, avoid or treat frailty. Up to now this is all very depressing, however it is my well founded belief that the loss of testosterone after age 45 in women and 55 in men is the first step toward frailty, however if adequate testosterone is replaced soon after the symptoms of T deficiency starts, then frailty can be avoided as we age, and the eventuality of loss of quality of life will be delayed or avoided all together. It is a fact that nothing other than the hormone testosterone can reverse frailty and stop it from progressing. With T treatment my patients increase their muscle mass, create stronger muscles, and improved their mental and physical stamina. To me this is such an easy one-hormone-answer to actually improve my patients lives, at any stage in the aging process, however the pharmaceutical companies that control American medicine much prefer to treat each symptom with a different drug. There are millions of aging folks in nursing homes who could have maintained their independence, and avoided the use of many drugs if they were treated with testosterone before their frailty reduced their mobility so they need help to perform daily activities of living independently. Sadly, medicine in the US basically gives up on frail and aging patients and we doctors are taught to make frail patients “comfortable”, just treating their symptoms without hope of reversing frailty and the outcomes of that condition. Of course, it is much healthier to prevent frailty by replacing the essential hormone testosterone early on, however your doctor will have to think out of the box to arrive at the Testosterone treatment, rather than follow the medical protocols that involve just keeping aging patients “comfortable”. Research studies and articles to be read by doctors like the recent one in the New England Journal of Medicine that draws a direct line between aging and frailty, but only concentrates on the fact that frailty portends early death and discussed the best ways to make patients comfortable dictated by the severity of frailty. There is no treatment other than high protein diet and vitamins with physical therapy which will not “treat” this disease. I want to tell you about two very different patients in my practice. The first is a very successful man in his late 70s who came to me seeking weight loss because he had been an athlete and still enjoyed playing golf, but he was complaining of weakness and other symptoms of frailty, in addition to looking borderline frail when he first came to me. We did a body composition test, and he had a higher fat mass and a lower that ideal muscle mass which is the way frailty begins. We discussed the fact that weight loss (fat loss) obtained by more exercise and less carbohydrate in his diet might improve his Pre-diabetes and inflammation, but would not make him stronger, or increase his physical and mental stamina, in other words reverse his beginning frailty. He chose to embark on an exercise-based weight loss program combined with a high protein low carb diet. In the end he did not take my advice about the best way to lose weight without losing muscle which would have been to add Testosterone and Metformin to his treatment plan, however he wanted to be the one directing his own care (he was a business man and not a doctor) without a basic knowledge of physiology, or nutrition, or any training about aging and frailty. Let me note that if he was younger than 55, and he tried this weight loss program while he was making adequate Testosterone, he might have had a successful fat loss program and gained muscle density and strength while he lost fat, however, this gentleman is 78. You can guess the end of the story. He did lose weight, however he lost as much muscle as fat and was even weaker after 6 months. This is sometimes what happens when very successful people in one area of life think that makes them brilliant in all disciplines. Now, the flipside of the coin. I will tell you about an 82-year-old doctor who came to me almost too late. His much younger wife was already my patient, and she encouraged him to have a consult with me to see what I could do for him. He had the right attitude, but was already frail, and I could feel the humorous bone of his arm, when I ushered his into my office for his consultation. I explained what observing him and his lab told me more while he told me that he had almost every symptom of aging, and frailty. He told me that he was an athlete in college and that he always had a lot of muscle, and he watched every day as his muscles “melted away”, despite his exercise daily. He was frustrated and had trouble with his memory as well because he had lost his testosterone long ago and he had done well for as long as he had because he had eaten a nutritious diet, taken supplements and worked out daily. We discussed his other medical problems, and some treatments for them, additional supplements to assist in building muscle and bone strength. He came back 5 months later after he had his T pellets inserted and he walked in with confidence, and the difference in his muscle mass was visible! He was no longer “frail looking”. He told me he was thinking better, not completely yet, but his mind was getting progressively better. He had lost fat and gained muscle. He had turned the clock back 15 or more years. Testosterone in the right dose and delivery system can erase frailty and give a quality of life back to my patients who had no help from other doctors. Look around you if you aren’t yet at the age that carries with it frailty or if you are without Testosterone and are experiencing frailty…look at those around you in the doctor’s office or when you are waiting to board a plane…look at the pre-borders who can’t walk the length of the ramp to the airplane and see if they have the visible characteristics I am talking about. If you are over 45 and female or 55 and male and not on Testosterone maybe you should consider having your testosterone replaced so you can keep your muscle mass and independence as long as you live.
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Dispelling the Myths about Hair Thinning as we Age.
04/08/2025
Dispelling the Myths about Hair Thinning as we Age.
See all the Healthcasts at In my Anti-Aging-Longevity practice, one of the complaints my new patients tell me about is the fact that their hair is thinning, falling out or changing to a brittle texture, as well as the fact that their hair is turning grey. Hair DOES get thinner, coarser, and greyer as we age! That is a fact, and one I can’t fully explain to you, except that it happens to everyone! My philosophy is that each of us should work with what we have, and optimize it, as well as treat any condition that makes hair loss work instead of wishing and wishing we had the hair we did when we were 25! Accepting the fact that your hair gets thinner after 40 and working with the hair you have takes knowledge to determine what is normal and what is not. Some of the things that everyone should know before looking for the best path forward to healthy hair. Aging and Slower Hair Growth Low Growth Hormone Lack of Estradiol and T in women and lack of T in men Aging causes Growth Hormone (GH) to decrease, which slows the growth of hair, fingernails, bone. Your hair falls out at the same rate as it did when you were young, but the growth slows which results in losing more hair than you replace which thins your hair! If you started your young life with fine, thin hair, then this difference between growth and loss of hair can make your hair very thin. To get to the root of the problem (I apologize) increasing GH will make your hair grow a bit faster. Testosterone replacement and Estradiol replacement both increase the growth of GH. Both hormone replacements increase hair thickness. Testosterone has a second benefit. Testosterone makes your scalp oiler, which in turn increases the longevity of your hair. At menopause the lack of these two hormones causes a big change in hair thickness. Loss of hair in specific areas—Balding Genetics Scarring alopecia Androgenic alopecia Extensions Dread-locks Balding and alopecia both cause a person to lose hair follicles, not just slow the rate of hair growth. Balding usually is genetically determined, so look at the older members of your family to determine what is in your future. This type of hair loss is very difficult to treat. 50% of men have some balding by age 50, and 1/3 of women experience it sometime in their lives. Until recently there was nothing to stop this process or grow more hair in those areas, however both men and women can resurrect their hair follicles (if they haven’t been gone too long) and make them grow with the TED hair restoration painless ultrasound treatment by Alma. Other options are Hans Weiman hair transplants or weaves, both of which are extremely expensive, don’t necessarily look natural (President Biden and his son) and must be redone every couple of years. Women can just cover over the problem with a wig, but even that answer has drawbacks—they are hot and itchy until you get used to it. Women can also get extensions to make their hair look thicker, but it ruins the quality of the hair you have which in the long run causes even more hair loss from scarring of the scalp. Women of color have traditionally used tight braids, cornrowing or dreadlocks to control their hair. This cultural process causes them to break their hair off at the scalp and damage the hair follicle from tension, which results in hair no longer growing in multiple areas of the scalp. Change in Hair Texture and Dryness At menopause for women and when men’s testosterone gets very low, we notice a change in texture of our hair. The cuticle area that covers the hair shaft becomes fragile and stops protecting the hair shaft, so the texture becomes frizzy, and hair breaks causing a dull look similar to what my mother used to call a “birds nest”. Our scalps become dry, and the oil glands dry up with age and loss of sex hormones, so hair is dry and frizzy, making us look like we just stuck our fingers in a light switch. You can read about many “natural remedies” but beyond taking collagen, Biotin and B vitamins most supplements don’t work in a dramatic way that would be noticeable. The remedies for hair loss include all the following and you will have to do most of them to improve your aging hair! Hormone replacement of Estradiol and Testosterone Conditioners (which only work a little) Hair color which covers the shaft with pigment and strengthens hair Brazilian treatment that drives straightener into the hair shaft and seals it with heat. Take supplements of Collagen every morning Take methyl B12 and Biotin daily Stop bleaching your hair Eat a diet with healthy fats and protein Wash your hair every 2-3 days Take the fat soluble vitamins A.E.K,D If you are anemic take iron supplements Avoid statins if possible Other medical causes of frizzy, broken hair can be found in low thyroid hormones which slows hair growth, decreases oil production, and results in brittle hair all over the head. Replacing your thyroid hormones and supplementing your iodine can overcome this obstacle. All medicine changes should be managed by your doctor. Many drugs cause hair loss, and you can’t change some of them: Metoprolol or any Beta blocker Blood pressure medication Prednisone and all steroids Cancer treatments Anything that inhibits your B vitamins like some autoimmune diseases What can you do to fix what you can fix! Nutrition: Hair is protein; however hair requires oil (fat) to grow and be beautiful—a diet rich in protein, and healthy fats give you the building blocks to make healthy hair and skin. Add Vitamins of A/E/K/D, vitamin C, Multi Methyl B vitamins with methyl folate and Biotin because our diets aren’t perfect! Hair care: Get hair products without sulfides. They break hair and make it weak! Wash your hair as little as possible. Decrease the use of hot hair tools like flat irons. Color your hair and or Brazilian it to make it stronger. Medications not to take are listed above. But the medications to take to help your hair are your sex hormones, Estradiol, Testosterone, and make sure your DHT doesn’t get too high which can cause hair loss in the male pattern. You may need Finasteride or Minoxidil if you have male pattern hair loss. Sun damage is important to maintain your hair in sunny areas. Wear a hat or scarf when outside and comb some conditioner through your hair at the pool to “cover your hair from sun damage”. Summary: Now that you know the possible causes and treatments for hair loss, you can do everything possible up to seeking medical care, and then medical care may be necessary. Hair thinning is often familial and also due to our estradiol and testosterone hormones decreasing after 35-40 years of age. You may need a scalp biopsy from a Dermatologist if your hair loss is in patches or severe over a short period of time, which implies an autoimmune disease. When you see a doctor be prepared with a list of your hair products, your diet, a list of medicines and a timeline for your hair loss. This preparation will get you the best treatment per doctor visit, and your doctor will appreciate not having to ask you all those questions!
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Common Excuses for Delaying Hormone Replacement
04/08/2025
Common Excuses for Delaying Hormone Replacement
See all the Healthcasts at Are you menopausal and have any of the following symptoms? Hot Flashes Night Sweats Dry Vagina Painful intercourse Dry skin Lack of sex drive Lack of motivation Fatigue Depression and or anxiety Change in body composition, with fat collection in the abdomen Loss of Muscle Mass and strength Irritability Inability to remember names and places Decreased ability to problem solve Insomnia Arthritis Body pain These are all symptoms we currently are aware of associated with menopause and low testosterone. These symptoms can be treated and reversed with bioidentical estradiol and testosterone pellets. Menopause should be treated like an illness that is universal but more severe in some women compared with others. If your symptoms affect your lifestyle, relationships and work then you should see a doctor who treats hormone deficiency and accept treatment! However, if you allow yourself to be manipulated by a male-dominated medical system that teaches all doctors to believe that menopause is normal as women age and don’t seek out hormone replacement, then you just may be setting yourself up for years of symptoms that are treated with handfuls of medications, but never get you back to normal. Just think about this for a minute: Men develop erectile dysfunction and experience muscle loss as they age, but medicine doesn’t consider ED or Sarcopenia a natural aging process for men, they advocate and endorse treatment with testosterone, ED medications, injections for ED and therapy for ED, and in most cases pay for it! If the male mentality would include women we would all be treated with estrogen and testosterone when we got to age 50 (or menopause). It is not just about the symptoms that E-T replacement can cure, but the diseases that you can avoid by taking estrogen and testosterone after menopause. These avoidable diseases of aging include: Osteoporosis leading to broken bones and spinal stenosis. Heart disease and stroke Diabetes Alzheimer’s Dx and dementia Obesity Low muscle mass and inability to walk or move independently. Autoimmune diseases Loss of blood flow to Lower extremity, resulting in amputations and inhibiting walking and running Severe arthritis Gout Worsening depression and anxiety Frailty which is what causes most older people to be placed in a nursing home. Just think it is not fate that gives you these conditions. It is genetics plus lifestyle plus whether you replace your sex hormones or not! This decision is in your control. If you really want a life free of debilitating disease and symptoms that are require constant medical care, then you must buck the system (that was designed to keep us from maintaining our mind and body) and look for a doctor to replace your testosterone and estradiol in a non-oral delivery system and maintain it for life. By stopping ERT or Testosterone like the ACOG doctors tell you to, you will start the symptoms all over again. My job is to offer you the right type of help to reverse the effects of menopause…both symptoms and diseases. Your job is to decide whether you want to get help and become healthy by taking non-oral estrogen and testosterone for the rest of your life. Think of menopause as a disease and you will be more prepared to fight for your right to be treated by the medical system.
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Healthcast 669 - Five More Myths about Weight Loss and Your Health
09/16/2024
Healthcast 669 - Five More Myths about Weight Loss and Your Health
See all the Healthcasts at The second set of myths about weight loss involve what we have been told by our federal government through the FDA and surgeon general, that is believed by most of us, but the motivation of the government is not generally for your well-being. Myth #7 Salt is bad for you, and you should limit your intake of salt to minimal amounts. A large study found that eating less than 3 grams of salt a day increases one’s mortality by 25% when compared with moderate intake. It is a fact that salt is vital to life, this contradicts the AHA who preaches that a low salt diet is what is required for health. Myth #8. Replacing hormones at menopause, estradiol and testosterone, will cause women to gain weight. The advent of menopause changes a woman’s metabolism and makes every woman in industrialized nations insulin resistant which slows their metabolism and causes women to gain fat and lose muscle which lowers the metabolic rate even lower because muscle mass burns 90% of our calories, and as it shrinks the Basic metabolic rate drops. The only way to counteract this cataclysmic change is to replace estradiol and testosterone in a bio-identical and non-oral delivery system (pellets, patches, topical applications and vaginal tabs. Even with sex hormone replacement, insulin resistance is Still a factor in weight gain, so a low carb, high protein diet and medical treatment with Metformin, or Wegovy or Mounjaro may be necessary to regain ideal weight after menopause. Myth #9 Milk products are bad for you, and you should take them out of your diet. Milk is not metabolized in the same way and does not have the same metabolic effects as milk products like yogurt, cottage cheese, ricotta cheese, and all cheeses. The majority of Americans can tolerate, and even need milk products as a valuable source of protein. There is a small minority of people who cannot tolerate milk products, and even fewer who respond to milk products with inflammation. If you do not have GI symptoms, or joint aches when you eat milk products then you are not necessarily healthier to cut them out of your diet. Not only is milk good for most Americans, but it has been proven to decrease oxidative stress and inflammation….the very things it is accused of increasing! Myth #10 Skim milk is better for everyone than whole milk, and those people on a diet should opt for skim milk. This myth is born from the myth that we should eat low fat diets to lose weight. It is a fact that Whole milk has more fat than skim milk, but skim milk is higher in carbohydrate, is generally consumed in larger amounts and is not as satisfying as whole milk. Skim milk is 55% carbohydrate/43%protein/5% fat while whole milk is 50% fat/20% protein and 30% carbohydrate. Unfortunately, the processes we use to make milk safe to drink (Pasturization and Homogenation) remove the necessary enzymes (Lipases, and Lactase) that help humans tolerate lactose sugar in milk. The process of skimming milk removes the Vitamin D and A that are in unprocessed milk. If you can drink milk, choose smaller volumes of whole milk, not skimmed, if you like milk products like listed above, then add them to your high protein diet. A 64 million person- year study recently revealed that whole milk drinkers, milk product eater had a significant decrease in all-cause mortality. Skim milk drinkers did not have a decrease in all cause mortality. Myth #11 Cutting animal products in your diet will decrease your cholesterol and therefore prevent heart attacks. So why do we follow fads? I believe it is because we are human and we look for the easiest path to a goal, and easy diets appeal to most of us who want to lose weight, however losing weight is complex and involves a good medical based plan and a change in your lifestyle. Your plan should start with seeking the right kind of medical advice that fits the diet to your blood work, medical history and in some cases your genetics.
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Healthcast 668 - Six Popular Myths About Weight Loss
09/16/2024
Healthcast 668 - Six Popular Myths About Weight Loss
See all the Healthcasts at My medical practice, BioBalance® Health, allows me to hear all of the myths about how to lose weight, when I am in consultation with a new patient. All of my female patients and some of the men have at one time, or multiple times been fooled by the false promises of friends, doctors, and advertisers, about quick and easy ways to lose weight. If you have bounced around trying every diet out there on the internet and failed to lose weight, then I can help you stop the pointless trial and error process, and help you embrace the difficult and time-consuming process of truly losing body fat and keeping it off! If you thought that all we do at BioBalance Health is replace women and men’s testosterone with long-acting bioidentical pellets, you are partly right! In addition to treating our patients’ hormone deficiencies we also have the goal of attempting to guide them toward a healthy long life! This involves treating “pre-diseases” like prediabetes that other doctors don’t treat until damage has been done and guiding our patients as to the right way to achieve their ideal weight. One of the important roles we have in assisting our patients with “fat-loss” is to disprove all the lies our patients have been told over the years by nearly everyone about how to lose weight. Some of these myths are actually believable (unless you are a doctor and understand the physiology of weight loss), but still never work. Other diet plans work for some people with specific genetic qualifications, but not for the majority of the population. Then, there are diet plans that are so bizarre and illogical, that they literally make me giggle when my patients describe the protocol (or advice) they have been following without results. Why are these myths so prevalent? It is because we have been programed since childhood to eat in a way and in amounts that are inevitably going to cause us to be obese. It takes a lot of work to turn those lifestyles, habits and food choices around to lead my patients to lasting fat loss and long-lasting health. Hard work never “sells” and a time-consuming diet doesn’t either so businesses make a lot of money keeping you fat! You may or may not have heard these! I will tell you why they #1 Myth- If you eat fewer calories, you will lose weight, and all calories are the same. This is one of the myths that is spoken by doctors every day because they learned it 30 years ago in medical school, and it just isn’t true! To begin with calories in food are metabolized differently depending on whether they are Protein, Fat or Carbohydrate. It takes more calories to metabolize Protein, and more than fat and the food that burns the least calories to be metabolized are carbohydrates. So, food calories are different depending on which food group they are from. Eg. There is a vast difference between the weight you might lose, or gain based on the food group your calories came from. For example: If you eat a steak with 500 calories verses a slice of birthday cake/icing that contains 500 calories, it takes more calories to breakdown protein so you USE calories to make it into blood sugar, while the birthday cake takes almost no energy to make BS and readily makes fat if it is not used in exercise. Another factor that causes counting calories to be a losing proposition, is that every food stimulates insulin differently, and insulin that is over stimulated over time gives a person insulin resistance which causes them to be so efficient that they can go a day and not eat anything, and still fail to lose weight. If you have tried a low-calorie diet and that happened, then you are not alone. Going back to the steak and birthday cake example, steak does not stimulate insulin very much and birthday cake is likely to over stimulate your insulin making insulin resistance worse and doesn’t make energy but is stored as fat! The third reason limiting calories cannot be the basis of a weight loss diet is that an individual human body has a vast number of factors that influence how you as a unique individual burns calories, therefore any one calorie limiting diet will not work for the majority of humans. We are all different with individual requirements for the types and amounts of food we need which is based on our genetics, our history of healthy or unhealthy diets, our daily exercise, and how obese we are when we start to lose weight. What that means simply is that there is no easy way to attain your ideal weight and stay there but limiting your calories. Weight watchers tried this method for years and I never found a person who lost weight by eating a certain number of any type of calories (candy, dessert, or fruit and vegetables with the equivalent number of calories) in one day, who lost weight and kept it off. If you eat 1200 calories of fruit, veggies, eggs, fish and or meat throughout the day and have an active lifestyle, you will lose fat that day. If you eat 1200 calories you save up all day to eat one dessert you will probably gain weight because it will overstimulate your insulin and make your calories into fat and not energy. Weight Watchers changed their program several years ago when their clients realized their system didn’t work. Counting calories to lose weight is a myth you should avoid. Myth #2: The promise: “If you just eat _________ (one food like grapefruit/cabbage soup/ salad/juice take your pick) for ____ weeks you will lose 20 lbs. The cabbage soup diet is an example of this failed “theory” which invaded the US female population in the early 2000s and my patients embraced it completely believing that they would lose 20 pounds in 4 weeks. I objected and told them that eating only one food for 4 weeks was unhealthy, a baseless fad which was unlikely to work, but very few of them listened. It turns out that Cabbage is a food that slows the metabolism of people with A blood type, and the majority of citizens in my city, St. Louis, have A blood type! At their next GYN visit my patients were all moaning over the fact that they had GAINED 20 pounds on the cabbage soup diet! Not eating a variety of foods is unhealthy and this proves that even an unhealthy diet doesn’t promise weight loss for everyone. So please don’t follow fads. they are baseless, and you might gain weight and not lose it! Myth #3 You can exercise your way to fat loss, eat whatever you like and still lose weight. I believe exercise should be part of every human’s healthy lifestyle, and exercise is necessary to speed up the metabolism while you eat a low carb, high protein diet and refrain from bad habits like alcohol consumption. However, eating like you normally do and exercising hours daily will not bring about weight loss for 90% of the population of the US. Lasting weight loss doesn’t occur unless you add eating a healthy diet, stopping bad habits and taking the required supplements necessary to decrease your fat mass, and exercise. Yes, you have to do it all! Increasing muscle increases our metabolic rate and exercising muscles increases the loss of fat, but both muscle building and muscle strength require high protein diets, with a moderate amount of fat, and without a lot of carbohydrate. Eating carbohydrates unchecked can cause the weight loss promised by exercise-based weight loss programs to fail, over and over again. After the age of 45 your muscle will not be preserved while you lose weight if you do not replace your low testosterone and exercise too. So it is not ONE factor that facilitates weight loss, it is complicated and there is a perfect fat-loss plan for everyone…you just have to find it! Myth #4 Low fat diets are a good way to lose body fat and prevent heart disease! Every study has failed to support this idea! Low fat diets don’t lower cholesterol, but low carb diets do! We were told by cardiologist for the past 30 years that low fat diets would lower the cholesterol and the atherosclerosis in your arteries…but they lied! It is now accepted by most doctors that low fat diets leave people hungry which causes them to eat too many carbs resulting in an increase in cholesterol and weight gain. Re-introducing fats into your diet should include healthy fats (fat from seafood, vegetables like olive oil, milk fat and other omega 3,6, and 9 ) are necessary for brain health and good body composition. The advice by the US FDA and Medical specialists to eat a low-fat diet has contributed to over 50% obesity, dementia, and diabetes in America. If your cardiologist tells you that a low fat diet is going to prevent heart disease, then look for a more up to date cardiologist. Myth #5 High protein diets are not effective for weight loss. High Protein-Low Carb diets are the best diet for the majority of people in the US. This diet is the most effective type of eating plan for your weight loss. If you want to know what % of protein, fat and carbohydrates you should eat, then go to our website, and become a weight loss patient with genetic guidance and you will learn how to distribute your foods based on your unique genetic map. High protein diets keep you “full” longer after a meal or snack, so your calorie intake is naturally lower. Reserve your intake of carbs to supply you with physical energy before and after exercise. Otherwise, your diet should consist of high protein and fat, and limited carbs, with plenty of fresh vegetables and fruit (these food are not considered carbohydrate). Myth #6 Diet soda is a “free food” because there are no calories, so I can drink as much as I want to and lose weight! Diet soda contains many chemicals, salt and includes a chemical sweetener called aspartame. Salt causes swelling, and all chemical sweeteners stimulate insulin and act to make you hungrier than if you drank unsweetened iced tea, water or anything sweetened with stevia. Stevia is a plant that does not contribute to insulin resistance and diabetes. The majority of diet sodas stimulate insulin just like carbohydrates do and contribute to weight loss failure. Every time you drink one you should consider it just like eating a carbohydrate! Summary: Following the advice above will prevent so much frustration with future weight loss attempts, and will help you achieve your ideal weight through avoiding these myths about weight loss. Remember that weight loss fads have been around for a long time without a public refute of the obvious myths above. Fads should be ignored if you want effective weight loss. Remember that Instagram and Facebook posts are only motivated by profit, even though they spread crazy diets as based on fact. There is no one monitoring the “fads” validity. Please don’t listen to fads of people who are not doctors or nurses trained in weight loss! More Myths about weight loss next week!
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Healthcast 667 - Dr. Maupin Radio Interview with Dave Glover
09/16/2024
Healthcast 667 - Dr. Maupin Radio Interview with Dave Glover
See all the Healthcasts at Dave Glover, the most listened to talk radio voice in the Midwest, invited me on his show last week to talk about BioBalance Health Testosterone Pellets for men and women and BioBalance Skin my medical esthetic spa. His show is on KMOX, the voice of the St. Louis Cardinals. Dave Glover and I have worked together for 10 years, and he is unabashedly my patient who has experienced the superiority of our medical care that is unique, and preventive, in addition to being the best testosterone pellet therapy in the Midwest. We go far beyond to direct our patients to a healthier life. Dr. Maupin Radio Interview with Dave GloverWhen patients have their first appointment our doctors have already reviewed their lab amd medical history, and the first appointment is chocked full of information about the meaning of their laboratories, diagnosing medical problems such as insulin resistance and prediabetes to finding diseases they were unaware of. At the same one-hour long appointment we work with our patients to develop an individualized diet and exercise program for their unique situations. The secret to our success in bringing 95% of our patients back to health is the foundation of replacing testosterone in the most effective and safest method with replacement non-micronized testosterone estradiol pellets. We do much more in a short time to direct our patients to reversing the symptoms of aging (the symptoms of testosterone and estradiol loss) while we prevent future illnesses like diabetes and help our patients move to healthier lifestyles. Dave asked me what is new about BioBalance Heath. We are always improving our knowledge, based on new medical research, and our newest offering is a simple genetic Diet and Metabolism Test called Nutrigen. This test is done by simply doing a self-cheek swab and never has to be repeated! Right now we are offering this test for $300 (a discount of $150). If you have tried many diets and still don’t know what type of food you should eat, our test is meant to be a ONE-TIME test to tell you everything you genetically need to lose weight. Or if health is your goal and not weight loss and you want to know how to eat for the rest of your life, this diet is a necessity! It comes with a 60-page report. What % of your diet should be fat, carbohydrates or protein? What times of day should you eat? Should you eat snacks? Does exercise help you lose weight or not? Is a low carb diet the best one for you? a low-fat diet? A low-calorie diet? Is a high fat diet the best for you to be healthy? What supplements do you genetically need? Everything you have ever asked about your individual path to ideal weight! Everyone who elects to take this test will get a 60-page report about every genetic factor that affects their diet, metabolism, exercise and weight loss. It even includes what genetic factors are working against them and their ability to lose weight. When their test comes back, our Nurse Weight Loss Specialist, Sarah Hooper RN will be ready for them to make an appointment to go over the report and explain a healthy eating plan. We always have used the INBODY machine for following body composition and not just weight for ALL our patients, pellet, weight loss, and non-pellet patients. Dave then asked about what was new in our BioBalance® Skin Office? We are always looking for ways for our patients to look younger, and healthier as they age. Dr. Maupin and Sullivan’s criteria to adding services is that they are TRULY EFFECTIVE, as well as painless, and the service is affordable compared to other pathways to the same outcome. This year we have added a painless hair growing ultrasound treatment called TED. It can treat any form of hair loss, as long as there are some follicles left to stimulate. Women and men come in for 4 to 6 45-minute treatments, that feel like a scalp massage. There are no necessary serums or vitamins to buy. You just have to keep the areas treated out of the sunlight for the month following the treatment. This is a real breakthrough and compared to very costly hair transplants and painful PRP treatments this is a game anger! For women who have lost weight and ask us every time they come in for weight loss or pellets what they can do about sagging and crepey skin, now we have a variety of treatment s to offer them: Opus treatments for the chin and jowls, Juvashape to tighten areas all over the body. EM Sculpt to build muscle, lose subcutaneous fat and tight skin, and EM Face to take the place of a Facelift! Our patients are encouraged to come in for a free consultation to help them decide what they can do to “SHAPE UP” after successful weight loss! We offer episome treatments with our Aqua Gold treatments to rejuvenate tighten, smooth out and lift facial skin….It is a step up from microneedling for more mature skin. We literally offer the MOST EFFECTIVE, MOST ECONOMICAL TREATMENTS with the least pain and best results anywhere! BioBalance Skin Staff will guide you to the appropriate choice of treatments so you can be assured you have the best esthetic treatment for your individual problem. Our Goal is to help our patients look as good as they feel with their BioBalance Pellet treatments!
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Healthcast 666 - Heat Stroke – How to Stay Healthy in the Heat.
09/16/2024
Healthcast 666 - Heat Stroke – How to Stay Healthy in the Heat.
See all the Healthcasts at 2024 has been the hottest summer of the decade and it is causing many of you to go to the ER with heat related sickness. There are several risk factors that may put you at high risk for illness relating to the heat. I have been present several times when someone collapses from heat stroke which is the most severe heat related illness. The heat can kill you if it progresses this far. It is interesting, athletes who won’t back off from their outdoor activities, and will work out in the highest heat of the day. Heat stroke can cause a person to collapse, drop their blood pressure, act out, or pass out, or even seize, all of which are signs to call 911, and start emergency procedures: elevate their legs, if possible, place ice packs under the arm pits, around the sides of the neck, and on their groin. The highest risk patients: Babies and toddlers are over 65 On multiple medications Taking a diuretic Obese patients People with anemia and other blood conditions Patients with coronary heart disease Patients with atrial fib Those people who don’t drink water, just caffeinated drinks-dehydrated people Who have just been flying (dehydrated) Who are hung over (dehydrated) Who have been nauseated and vomiting in the days before going out and working or playing in the heat. Ask the heat stroke victim to drink fluids if possible. Of course, make sure they stop the activity they are engaged in outside in the heat. Move them to a cool place while you are waiting for emergency help to arrive. Heat stroke can cause a vascular stroke or death, so emergency treatment is necessary. If possible, offer the victim water with electrolytes in them (NUUN-Sport) and some sugar in case they are also hypoglycemic as well. If they can’t drink, which is a side effect of heat stroke, put a wet washcloth in your mouth to suck water from it slowly. My husband and I went on a trip to Cinque Terra, Italy with another couple last fall to hike the trails between the 5 towns that line the cliffs over the shores of Liguria. The hike was supposed to start at 8 am so we could avoid the heat of the day….and it was in the 90s and humid…but as luck would have it the transportation we had arranged for wasn’t able to take us to the starting point and we didn’t get there until 10:30. We packed several water bottles and a few snacks but we were not prepared for the 4 ½ hour trek high above the mediterranean on a trail that was 3 feet wide and involved thousands of steps up and down…we had drunk most of our water in the first 2.5 hours and were very hot and sweaty the whole time….about 40 minutes from the town of Vernazza, my husband started stumbing, and talking nonsense…he had stopped sweating and couldn’t walk….There was no place to lay him down without blocking the path and we found a shady spot for him to recline and put his feet up. I had some Nuun-sport electrolytes which I had put in my water and had been drinking, so I put 2 electolye tablets in ½ bottle of water and tried to get him to drink it…..he was delirious and refused, and I had to force him to drink…he fell asleep and we received water and cold water bottles to put around his neck from passersby. Ideally, we would have gotten ER help which he really needed, but there was no way to get emergency care to him and at 6-4 and 230 he was too heavy to carry/drag…and remember we were on the edge of a 200 ft cliff. When he had slept 20 minutes I kept my finger on his pulse and he was thready and fast…..Thankfully he rallied and we got to Vernazza and he walked into the ocean after drinking several glasses of water to cool off and fell asleep on the beach for an hour until he was ready to get on the train back to our hotel….This was one of the scariest times of my life because I knew what to do but didn’t have the IVs, or water or ice or anything to help him. Remember this and make sure you are always prepared for the worst scenario when you are active in the heat! So how do you know when you are getting close to heat stroke? You feel weak and out of breath. Your pulse rises, you stop urinating, and you STOP sweating. You are getting close to heatstroke when you start to feel cold even though the ambient temperature is high. When you feel dizzy and unstable on your feet…the next thing to happen is vascular collapse See the stages of Heat Related Illnesses below, which we are all at risk for! This is from the NEJM. Heat-Related Illness Description Treatment Severe illness Heat stroke A multisystem, life-threatening illness characterized by elevation of the core body temperature (to >40°C) and CNS dysfunction Classic heat stroke: most often occurs among older persons with compromised behavioral and physiological compensatory responses to heat exposure Exertional heat stroke: most often occurs among healthy persons during extreme physical exertion, which results in excessive metabolic heat generation, often but not always with concomitant ambient heat exposure Move patient to cool environment; manage airway, breathing, and circulation; administer rapid cooling with cold-water or ice-water immersion or other means; administer intravenous rehydration; and evacuate to emergency department after on-site cooling is performed. ICU admission is warranted for management of end-organ sequelae. Moderate illness Heat exhaustion Profound fatigue, weakness, nausea, headache, or dizziness (or a combination of these symptoms) resulting from a decrease in body water content or blood volume due to water or salt depletion from heat exposure; mild elevation (<40°C) in body temperature may be present, but no altered mental status Remove patient from heat; treat with rest in supine position, evaporative cooling, and intravenous or oral rehydration; monitor mental status. Delayed response to treatment warrants further evaluation. Mild illness Heat syncope Brief loss of consciousness due to vasodilation and pooling of blood in the limbs as a result of physiological compensation to heat exposure Remove patient from heat and treat with rest in supine position, passive cooling, and oral or intravenous rehydration. Prolonged recovery or a medical history or physical examination arousing concern for a cardiac cause if the patient has cardiac risk factors should prompt further evaluation. Heat edema Swelling of the limbs caused by peripheral vasodilation and interstitial pooling resulting from physiological compensation in response to heat exposure Remove patient from heat and elevate the legs. Diuretic agents are not indicated. Heat cramps Painful muscle spasms in the abdomen, arms, or legs during or after activity in the heat, which often occur when excessive amounts of salt are lost during sweating from physical exertion Remove patient from heat, treat with rest, oral electrolytes, and fluid repletion. Heat rash An inflammatory disorder of the epidermis that results from blockage of sweat glands; may be followed by superimposed bacterial soft-tissue infection. Remove patient’s clothing; treat with evaporative cooling and glucocorticoid and antibacterial creams as needed, but avoid topical emollients; monitor for cellulitis. Advise patients to avoid hot environments and to wear loose clothing. * CNS denotes central nervous system, and ICU intensive care unit. What medications increase your risk of Heat Stroke: Agent Mechanism Alcohol May reduce alertness and affect judgment and perception of heat; exacerbates dehydration and affects vasodilation and cardiac contractility Amphetamines May increase metabolic heat production Anticholinergics May decrease sweat production Antihistamines May cause peripheral vasoconstriction, limiting radiative cooling Antipsychotics Interferes with hypothalamic thermoregulation Benzodiazepines May reduce alertness and affect judgment and perception of heat Beta-blockers Decreases heart rate and contractility Calcium-channel blockers Decreases cardiac contractility and compromises vascular compensatory mechanisms Diuretics May increase risk of dehydration and hypovolemia Illicit drugs (e.g., cocaine, heroin, phencyclidine, and MDMA) May increase metabolic heat production and reduce alertness and judgment Laxatives May increase risk of dehydration and hypovolemia Lithium May reduce alertness and affect judgment and perception of heat and lead to nephrogenic diabetes insipidus; levels may rise to dangerous levels and cause kidney injury in the context of dehydration Serotonin-reuptake inhibitors May interfere with hypothalamic thermoregulation Thyroid agonists May increase metabolic heat production Tricyclic antidepressants May cause peripheral vasoconstriction, thereby limiting radiative cooling, and may affect central thermoregulation Weight-loss supplements that may increase metabolic rate (e.g., carnitine and green tea extract) May increase metabolic heat production If you are someone who plays or works outside in the heat you should think about your risk of heat stroke and the risk of those around you. If you have heart disease, have had a stroke, or have arrhythmias, especially atrial fibrillation, you should choose not to be outside in the heat and or humidity for any length of time. Any dehydration will increase your risk of heat stroke. For those of you who choose to continue to work, exercise or play in the extreme heat, you should have double the water you would drink on a normal day, bring electrolytes to put in every third bottle of water while you are in the heat and afterwards to recover. Remember to eat and have enough calories to maintain your blood sugar, because hypoglycemia will make it worse. Stop and rest and go inside an air conditioned room every hour if possible, make sure you have cold packs available in case you need emergency care before the ambulance gets there. Arm yourself with enough hydration and electrolytes, cold packs and carb+protein snacks if you are not close to a place to hydrate and eat…. We all feel invincible and forget we are human…but if you stay aware of the risk you will prepare for the worst outcome and hope for the best!
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Healthcast 665 - The Male Orgasm and Testosterone
09/16/2024
Healthcast 665 - The Male Orgasm and Testosterone
See all the Healthcasts at In general, I spend my time defending women and the fact that our problems and sexual physiology is ignored, by the governmental powers and physician organizations in the US, so I try to do my part to bring information to women about their hormones and the aging process. Today I am changing my focus to men and the way men’s normal sexual function is considered a “normal” and rarely discussed outside the men’s locker room and or porn sites. So here goes…The fact is that men’s sexuality isn’t just the act of sex, but men spend a lot of their sexual energy on fantasies and just thinking about having sex. Men’s ability to have an orgasm is not just a wham- bam—thank you…well you know the phrase…and there are many physiologic factors that must work, in the background to bring a man from thinking about sex or desire, to an orgasm. Sadly, in the current environment couples don’t talk about sex….they don’t tell their partner what makes them excited or even what they want…. because none of us can read minds, too many of us don’t get what we want when it comes to sex. With lack of communication between partners, leads couples to trial and error without a map. Neither sex knows how the other sex “works”. I decided to describe the normal series of what men go through on their way to orgasm to educate them and their partners. In addition, the process is not always the same in each person and as men age the time between the first sexual thought to completion gets longer and longer…sometimes these detours include episodes of losing an erection, sometimes getting it back and sometimes not which leads to frustration of both partners. In youth when a man’s free testosterone is high and his arteries are free of plaque, between puberty and age 35, erections may occur often, and they last a long time if the man is stimulated for a long period of time. At this point sex is automatic and easy to complete to orgasm and ejaculation. As time goes on, free Testosterone starts to decrease with age, as does the diameter of a man’s arteries…blood flow doesn’t rush to the pelvis to create an erection like it did in youth. The things that lower free testosterone. What happens with age that cause erections and ejaculation to be less and less automatic and easy? T and free T drops after age 35 in most men and becomes critical by age 55, even in healthy men. Ejaculate decreases due to lowering of free T Vasectomies decrease the volume of ejaculate by 1/3 Stress causes free T to decrease. Hypertension causes arteries to contract and deliver less blood to the pelvis for an erection. High blood sugar and diabetes destroys the arteries in the pelvis making blood have a more difficult time getting to the penis. Stress causes Cortisol to rise and free T decreases, Obesity increases the estrogens in men and that decreases free T by binding it with sex hormone protein and inactivating it. Any medication the constricts blood vessels (ADD medicine, Phentermine, speed, etc) decreases blood flow to the pelvis. Some medications that lower blood pressure lower It in the pelvis too low so that men are impotent (e.g. Lisinopril). For men who don’t know all these medical, aging changes that happen to most men, these changes cause fear and anxiety which of course makes it worse. Men who have this issue (most men) are even reticent to talk to me about it and they haven’t talked to their spouse either. So here is what I tell them: You are aging like everyone else, and that fact can’t be changed, however, your lifestyle and your medical health, or poor health is affecting your orgasms and your ability to have sex. These factors CAN be changed. You can change your BP medicine to one that doesn’t impair erections. You can get your diabetes or obesity under control, and you can improve your erections. However, to get it all back you will need testosterone replacement if your free T is under 129 ng/dl. The safest way to accomplish this is with my practice BioBalance® Health…we do it better and know all the tricks to making you healthy productive and potent! What is in the ejaculate? mature sperm are mixed with whitish, protein-rich fluids with prostaglandins are produced by the prostate. These fluids nourish and support the sperm so they can live after ejaculation for a limited time to fertilize an egg. This mixture of fluid and sperm, known as semen, and is what is moves through the urethra in the form of ejaculate. Sensory stimulation travels from the skin to the brain and stimulates dopamine and endorphins which are neurotransmitters that make a man fee happily ecstatic during and after an ejaculation. These neurotransmitters also stimulate the Hypothalamus to make oxytocin, a bonding hormone that binds couples together. Many nerves, vessels and the brain are involved in a successful sexual encounter. The culmination of a sexual encounter is complex and involves the whole body. I find it interesting that the “medical view” of orgasm is still divided into 4 different steps when, if you are a male (or even a female who has had sex with a male) the divisions seem very arbitrary and is ALWAYS connected to ejaculation. It is a fact that men and women can have sexual intercourse and orgasm without ejaculation. The following is how the practice of medicine describes the male sexual act. In contrast I have educated my patients by comparing sex to a on the fact that men can have orgasms which occur in the brain when endorphins flood the neurons, even without ejaculation. So I will discuss, the male sexual experience to them, not with the “4 easy steps of male sexual response”, but as a “process” of achieving orgasm in men. It is more like a recipe, that requires each ingredient to be added in order, but sometimes you can stop in the middle and start again. It is not always a straight line from sexual desire to orgasm. In general, all men need testosterone to have sexual desire, and sexual desire to have sex, however both men and women can be physically or visually stimulated to be aroused without true sexual desire. If the man has a long history of having sex often, then the habit of having a sexual response can be achieved without enough testosterone, however the erection will not necessarily last long enough. Continued physical stimulation can bypass desire, and therefore testosterone, and a man can be stimulated into having an erection of sorts and into having an orgasm with or without ejaculate An erection requires testosterone to become fully erect, however there is a “work around” now and men without testosterone can have an erection with Viagra, Cialis pills, or prostaglandin injections into the penis itself. Men can also have a penile implant placed so they can have sex without testosterone or Viagra/Cialis. However, let’s talk about sex with testosterone in men who have good pelvic blood flow who don’t require medication to become erect. The second necessary ingredient after testosterone is stimulation, which can be with touch, visual stimulation, auditory stimulation or even imagination that causes a man to be stimulated. The sexual response to any of these stimulations send messages through the nerves from the brain to the pelvis that dilates his veins and arteries. This sends blood to the penis from the arteries and blocks the veins from draining the blood out. This creates an erection. Testosterone’s role is to cause the arteries to dilate by stimulating the production of nitric oxide from the arterial walls. Remember the stimulation? The ongoing stimulation (mental, visual, auditory or imaginary) keeps the erection hard with vascular dilation. At this point stimulation can be changed or paused and other stimulation can prolong this part of the process. Holding the base of the penis can keep it hard, or any tight encircling toy can keep the erection from proceeding to orgasm for some time or the erection can go away without continued stimulation. The third step is the preparation for orgasm which can last from as long as 30 minutes and as short as 2 minutes. A clear “pre-ejaculate” is produced that lubricates the penis for intercourse, and if ejaculation is to take place there is a “loading of semen” that takes place from the seminal vesicles readying the man for ejaculation. At this point the penis contracts the muscles quickly in rapid repeating emissions that shoot the semen out of the urethra. This is the orgasm and ejaculation that occur together, which is typical of normal youthful ejaculation. As men get older the force at which they ejaculate decreases. After ejaculation/orgasm the brain is flooded in endorphins, the feel-good neurotransmitters, that make a human feel happy and satisfied. This is solely the result of the orgasm after a sexual encounter. The feeling of ejaculation does relieve pelvic pressure but is not needed to experience orgasm in most men. Medical science has been able supply an assist for desire (testosterone) and erectile function (vasodilation and release of nitric oxide but they have not discovered the “pill” to make ejaculations occur or to improve their volume. It is important for an aging man to accept that orgasm doesn’t require ejaculation since we don’t have an answer to recreating the youthful ejaculation. Besides age, vasectomy can also limit ejaculation. dehydration, vasoconstrictors, anti-hypertensive drugs and diuretics can limit the volume of the ejaculate as well. After the “process of sexual orgasm” the penis loses tumescence, blood leaves the pelvis and overall relaxation occurs throughout the body. Then a period of time must pass before another erection can occur. Over time some “twice a day men” can turn into once every week…..this can be changed by practicing…..having sex more often. The sexual response in both men and women is more like a symphony with several movements, than a recipe, but it is definitely not a series of steps that is followed in every human in every circumstance. It is the job of the physician to help patients both understand and live with any variations in the sexual process. Much of what I do is act as a teacher to my patients who need to understand their own bodies and any dysfunctions thereof. Understanding becomes treatment over time.
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Healthcast 664 - Two New Studies Confirm That Aging Men Live Longer with Youthful Levels Testosterone.
08/19/2024
Healthcast 664 - Two New Studies Confirm That Aging Men Live Longer with Youthful Levels Testosterone.
See all the Healthcasts at The medically accepted belief that testosterone is bad for men has finally now been superseded by a huge study from Australia that proves that men with healthy levels of Testosterone live longer and healthier than men with low Testosterone! All you men who have been told that testosterone is bad for you or will cause prostate cancer by your doctor, you can tell you provider that he or she is out of date! At BioBalance Health® we have been treating men with testosterone pellets for years and our patients are our evidence that testosterone not only keeps men’s sexuality healthy, but youthful testosterone blood levels keep men healthy in many ways, eg. strong muscles and bones, excellent immune systems, healthy heart and blood vessels, lean muscle mass and it prevents the diseases of aging too! I have been treating men and women with Testosterone for over 20 years and I concur with how this study plays out in real life, in my own practice. When my patients replace men’s low testosterone levels with testosterone pellets and they follow my recommendations for a low carbohydrate diet and weight training exercise, supplements and treatment of pre-diabetes and pre-cardiac disease, they live more productive, longer and more enjoyable lives. My goal for my medical practice is to keep both men and women healthy as they age, and testosterone replacement is the most important necessary element to that end. My intent is to defeat the aging process with interventions that have the potential to delay the onset of age-related diseases and preserve your ability to live life to its fullest, no matter what age you are! We have based our treatment on hundreds of other studies that literally studied one symptom of testosterone deficiency or disease of aging at a time in relation to testosterone levels and found bioidentical testosterone to be beneficial to the health and longevity of men. However, we treat all the symptoms of aging and low T with testosterone pellets. Australia’s Men’s Study found that men who continued to produce normal youthful levels of Testosterone or replace their Testosterone to achieve normal youthful levels lived longer, more active lives than men who let aging take its course and drain them of testosterone! We have known this for two decades and we have treated men and women with testosterone pellets, the most effective and safest way to prescribe T. Many smaller studies have been done that prove the same thing, but none so dramatic as the latest study we are referencing. At this point I have two questions to answer for most of your inquiring minds: Why did all the experts tell you that testosterone replacement is dangerous? and, why are the experts in the field of men’s medicine, Urologists, still advising men not to replace their low testosterone as they age? Let me explain that why everyone is so negative about testosterone and why most medical doctors still believe that prescribing testosterone to men is evil. This all started in the 1950s based on the study of only 3 men, who had had prostate cancer. They said they were testing them to find out if testosterone caused prostate cancer recurrence in men after prostate cancer. During the study one of the men had a recurrence of prostate cancer when he was given testosterone injections. In the “olden days” that provided the basis for the belief that Testosterone CAUSED prostate cancer! The doctor even got a Nobel prize. Based on this minimal and falsely extrapolated information, 50 years of doctors have been taught that prostate cancer is caused by testosterone, when in reality testosterone is only dangerous if a man already has an aggressive cancer already, will testosterone replacement stimulate the growth of prostate cancer. This misinterpretation of a faulty medical study has prevented generations of men from being treated with testosterone to prevent diabetes, heart disease, loss of muscle mass and the ability to walk and lift, as well as the inability to have sex throughout their lives. This has been a grave dis-service to American men, because the world follows us with all of our medical protocols, this misinterpretation and lack of preventive care with T has spread around the world. The second question you should ask is: Why are the experts in the field of men’s medicine, Urologists, still advising men not to replace their low testosterone as they age? Well, this is not just your doctor’s fault. Other than being trained by generations of doctors who believed the inaccurate information about the danger of testosterone causing prostate cancer and passing it on, there is a problem with how we train the doctors who take care of men. Urologists are surgeons first and not particularly interested in anything that has to do with preventive medical care. Their training is based on surgery: they go through a general surgery residency after medical school for 5 years and then do a specialty in urologic surgery which doesn’t include treatment of anything medical or preventive. More than that, their College of Urologic Surgery and their journal has been blinded by supporting the surgical treatment of prostate cancer, so their motivation to prevent prostate cancer is generally opposite their type of practice of medicine. They can only operate on prostate cancer when a man has it. Now if you have a penchant for conspiracy theories you may then jump to the conclusion that both the practice of medicine, the business of pharmaceuticals and the government have monetary benefit from keeping all of us sick, and limiting our longevity, since we are a drain on the system after we stop working and live off Social Security and Medicare. In other words, old Americans don’t provide value to the whole of society. I contend it is only because we don’t help aging Americans stay productive and healthy that they are a drain on the rest of the population…However, that conspiracy theory is just a theory I have heard from my patients. This study is big news because it is the most important study that has been allowed through the blockade of powers, to the public! We at BioBalance Health® can now give you men what you need, and when other doctors criticize our treatment, we can defend our treatment plan with this Australian study and the other hundred studies that came before. You have your ability to ask for what you need from your doctor, based on sound evidence! The second study is below and was in the Journal of Internal Medicine about the same time as the Australian men’s study. A study published in the journal Annals of Internal Medicine found that men with low testosterone levels had a higher risk of all-cause mortality, and those with very low levels also faced an increased risk of cardiovascular mortality. The findings suggest potential links between testosterone concentrations and health outcomes, emphasizing the need for further investigation into underlying mechanisms and potential therapeutic implications.
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Healthcast 663 - A Plan for Health and Longevity to Avoid the Pain and Disability of Aging
08/19/2024
Healthcast 663 - A Plan for Health and Longevity to Avoid the Pain and Disability of Aging
See all the Healthcasts at On the last Heath cast #662 we talked about the choice of doing nothing when faced with symptoms of hormone deficiency and symptoms of aging, versus the choice to actively live a healthy life. I believe that concentrating on yourself as you age can save your lifestyle and or your life! Preventing illness as you age is as important as paying your taxes! An unhealthy living plan without replacing deficient hormones can lead you on a road to illness and early death. If that doesn’t motivate you, then consider yourself warned. Recently I saw a man in his late 70s who I had seen about 7 years before this. He and his wife entered my office, and I could see that some of my medical predictions had come true. This man had developed every disease I told him his blood work and physical self-predicted. Despite the treatment plan I gave him, he ignored me on diet, exercise, supplements, stopping smoking and drinking I gave him 7 years earlier. He admitted that everything I told him would happen, did happen and now he is in constant pain, he is morbidly obese, and has trouble even walking. He now has diabetes and has had a heart attack and 7 ER admissions for his heart since. He did not do one thing I told him, except just recently he stopped drinking alcohol. He now is ready to live a healthy lifestyle however since he has so many diseases, he spends an enormous amount of money on medications and medical care. The cost of care was his reason to ignore hormones, but he ignored my lifestyle advice as well. Even though now a lifestyle change and testosterone pellets will improve his life, he still has done damage to his blood vessels and heart not to mention his joints and back. These aging changes I cannot prevent, just stop the rapid progression. When you become our patient, we ask you a variety of questions that help us design a treatment plan, more accurately named a “longevity plan”. Symptoms of Testosterone, Estradiol and Thyroid deficiency: A combined list of symptoms of aging for men and women include: Loss of Testosterone Symptoms: · Loss of sex drive · Loss of erections, and morning erections · Loss of orgasms for women · Fatigue · Insomnia · Depression/anxiety attacks · Loss of strength and muscle mass · Frailty · Can’t think clearly or remember names of things · Loss of motivation · Loss of efficiency at work · Weight gain · Belly fat increase · Sagging skin · Arthritis · Osteoporosis Loss of estradiol (women): · Hot flashes · Night sweats · Anxiety attacks · Irritability · Dry vagina · Painful intercourse · Sagging skin · Frontal balding · Urine loss · Dry skin · Shrinking vagina · Osteoporosis · Arthritis Thyroid deficiency: · Hair loss · Fat gain · Fatigue · Depression · Feels cold all the time · Very dry skin · All body swelling · Constipation · High cholesterol · Low blood pressure and pulse These symptoms above can be treated and in treating them you will experience not only a lack of symptoms, but a longer healthier life. However, if you also change your lifestyle you can avoid the diseases of aging too! Through replacing your deficient hormones, add only individually chosen supplements and develop a healthy whole food eating plan, with 3-7 days a week of exercise (1 hour/ session). What do I mean? What is a healthy Lifestyle? · If you smoke STOP! · If you Drink more than 15 alcoholic drinks a week, then stop, If you aren’t addicted to alcohol, you should decrease your drinking to < or = 7 drinks a week. · Exercise 30-60 minutes a day (consecutively) · Throw out all the simple carbs in your kitchen: all cereals and granola, use olive oil to cook and no vegetable oils, Processed dry food in boxes or cans should be donated to charity. · Buy fresh fruit, fresh vegetables, cheese yogurt, fresh or frozen meat, fish chicken, turkey for meals at home. · Sourdough bread is the best choice in breads—it has no gluten but still has carbohydrates, so small amounts are advised. · Do something you love every day · Look for opportunities to have fun You CAN turn your bad genes off through a healthy lifestyle! Now we know even your genes can be combatted through healthy living. The diseases of aging can be adjusted or avoided. When thinking about what your risks might be, remember that Family history is a broad and faulty way to determine your risk, but genetic testing is a better way to determine your risk of disease that is found in in your chromosomes and genes. The combination of your genes are uniquely yours. Knowing what your genes are can guide you to an individual healthy lifestyle for avoiding disease and living a long life. We offer this service for our patients who want to know what the perfect diet and lifestyle plan is. It is called the Nutrigen test is optional but a great idea if you are trying to renovate your life! This saliva test (no needles) can determine the genetics you inherited from your ancestors. We then share the information with you and develop a lifestyle plan that includes lifetime changes in eating to decrease carbohydrates from grains and sugar, increase protein, and remove as many processed foods as possible. The Nutrigen test tells you what genes you inherited that impacts your health, but it doesn’t tell me whether you have turn any of your bad genes off or your bad genes on! We offer that test to our patients who are trying to lose fat or just reframe their life so they can live more productively and as much without disease as possible, Now if you aren’t convinced that you need to replace your hormones with testosterone plus estradiol if you are a postmenopausal woman, or if you figure you will Does a future of having Alzheimer’s disease strike your panic button enough to change what you eat and how much you exercise, and to replace your Testosterone with Pellets? Or is it losing a limb from diabetes? Being unable to talk from a Stroke? Would losing your ability to move around as you do today from a Stroke or heart attack make you scared enough to value your health and clean up your lifestyle? Or would the prospect of never having sex again be the trigger that causes you to be as careful with you own health, body, and mind, preserving it for the rest of your life? Medical care is not just about fixing the sick through medications or surgery anymore, although that is the paradigm we have all grown up in. That dated belief may have dominated our belief about what medical care can do for us and how it works because until recently medical experts didn’t understand how diseases sprouted from a bad lifestyle, or because we were taught that our genes determine our health and there is nothing we can do about it…..but we now know that leading a healthy lifestyle, using food as fuel and not entertainment, and being moderate in everything from food, to alcohol to exercise is the key to a long healthy life. New information in the last 20 years has come to light revealing that an individual can turn off bad genes through a healthy lifestyle…. Your genetics do not dictate your fate, but it is your behavior that dictates the diseases you will suffer fromwith through the last half of your life and eventually die from. Let’s talk about the most dangerous lifestyle choices that you can make. You must think about your body as a luxury car that requires a lot of maintenance, the best quality gas to fuel it, and loving care every day to maintain its value and performance. Our bodies are a thousand times more complicated than the highest- performance car, and I contend that the most beneficial maintenance you can do is to think about your health every day especially when you are presented with behavioral choices. For instance, when you wake up you should stretch and make sure your muscles are not spasmed. YThe you should think about the two most important choices you will make all day, “When will I work out for an hour?” and “What shall I eat today?”. . Exercise is key to managing your insulin sensitivity and blood sugar, protecting you from diabetes and heart disease. Why would you avoid this inexpensive protection from these deadly diseases? Planning what you will eat that day (or for the next week) should include healthy, non-processed foods and drinks with plenty of water and protein and limited carbohydrates from grains especially from wheat. But you counter my suggestion ,” Wwhat should I do when everyone around me is overeating processed foods and drinking alcohol and sugared soda?”. My answer is, “Stop and think! Do you drive over a cliff because the guy in front of you does? No! Be brave and don’t make a scene., just choose to eat and drink in a healthy manner…if that is not available, leave and find the food and drink your body needs!” You are no longer a teenager when all the mistakes we make are “forgiven” by our bodies. That stops working after age 20! I think you should look at taking care of yourself like being engaged in working toward a goal, whether it be in sports, climbing the corporate ladder, getting a raise or getting your degree. Health is a goal that will repay you throughout your life. I no longer work in OBGYN not because I didn’t enjoy it, or it wasn’t profitable enough, I stopped running around with my hair on fire, stressed out and exhausted without adequate sleep or nutrition because it was bad for me! My medical practice literally made me sick! I gained weight, felt terrible, looked old, was crabby and depressed, so I made a choice to make my health a priority and a priority for my patients. In terms of how my medical practice changed…from doing insurance paid medicine which is paid for the patient by someone else I was daily faced with patients who didn’t value my advice and didn’t follow it! I now have a medical practice where patients pay for their care themselves. There is something about paying for something that makes you value it more! Instead of seeing patients yearly that I gave the same advice I give to my BioBalance patients today and repeating myself year after year without my patients making any progress, I now recommend lifestyle changes and treat my patients with replacement testosterone and estradiol pellets and they immediately feel better and follow my advice! I am blessed to watch my patients achieve health by changing their hormones, diet, exercise, changing medications and taking supplements to round out the nutrition offered by their food choices. The one most important health goal should be weight loss so you can achieve your ideal weight while you maintain your muscle mass. That change will take effort and sacrifice and if you are over 40 you will need testosterone to make this happen! Here are the diseases that are caused by obesity: · CANCER! All kinds! · Diabetes-Type II · Heart disease, Myocardial infarction and stroke · Alzheimer’s disease · Autoimmune diseases · Endometriosis · Arthritis and joint replacement · Hypertension and kidney disease · Immune deficiency Are you afraid of getting any of these diseases? What is your most terrifying disease that keeps you awake at night? Any of these in the list above? I have always been fearful of Alzheimer’s Disease and stroke because not being able to think and speak is my biggest fear! I have gone so far as to have genetic tests for Alzheimer’s Dx and I have 1 of the 2 genes that cause this devastating condition. However, because I have taken estradiol and Testosterone pellets since I was 47, my chance of getting this disease has been delayed 20 years. Other factors that increase my risk for stroke and dementia are inflammation from being overweight, eating a high carb diet, lack of exercise, hypertension, poor neurotransmitters from a poor diet and bad gut bacteria. One by one I have changed my lifestyle to decrease these risk factors. If I can do this, you can! You don’t have a harder work schedule than I have had or less time to choose foods to eat. I choose to turn down more than one alcoholic beverage, to take my own healthy snacks when I travel and at my office.
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Healthcast 662 - If You Want to Live a Long Enjoyable Life Without Disease, Please Listen!
06/06/2024
Healthcast 662 - If You Want to Live a Long Enjoyable Life Without Disease, Please Listen!
See all the Healthcasts at My goal for BioBalance Health® is to guide my patients to live a healthier life by offering them the newest preventive treatments, and safest hormone treatment available. My patients make an appointment with me and Dr. Sullivan for help with their current symptoms of aging and hormonal treatment to replace their missing hormones. They also receive a plan for unique preventive lifestyle changes to assist them in continuing their lives in health. But first, I believe that treating the symptoms of aging is the first thing on the agenda, and those symptoms are treated by replacing the hormones that disappear with age, testosterone, estradiol and often thyroid hormone. These symptoms are classic and appear within a short period of time, together: This is a combined list of symptoms of Testosterone and Estradiol loss for women after age 38, combined with loss of Testosterone in men after age 50. Symptoms of loss of Testosterone and Estradiol · Loss of normal youthful body, muscle and shape · Loss of sex drive · Infrequent or absent orgasms · Fatigue · Depression or Anxiety · Insomnia · Memory loss/ Difficulty thinking · Loss of motivation · New migraine headaches · Decreased muscle mass · Joint aches/ arthritis · Dry eyes · Loss of balance · ED in men (men) · Poor or decreased ejaculation (men) · Increased belly fat Loss of waistline · Weight gain · Cellulite · Ringing in the ears · Dry vagina (women) · Painful intercourse (women) My patients frequently tell me that they feel so good after getting their first testosterone pellets that they wish they would have come to see me years before because they have been suffering and now their symptoms are improved or gone. They also comment on how great their sex life is, their improved stamina to walk, play golf or run and how much younger they look! That is the enjoyable part of my practice. Replacing these hormones gives my patients their lives back and gives them their energy back so they can make changes in their lives to keep themselves healthy to avoid the diseases of aging. The Diseases of Aging are these: Cancer Type II Diabetes Arthritis Heart Attack Stroke Dementia, Alzheimer’s Disease, Parkinson’s disease Osteoporosis Frailty, inability to walk or climb stairs Immune deficiency Autoimmune diseases Depression and anxiety We find that we get great results with one or two hormones, but because we are preventive medicine doctors and hormone replacement doctors we are not just interested in your current condition and symptoms, but we are concerned about the diseases you are at risk to get when you get “old”. We then go over your family history of diseases with you and use it to determine what you are at risk for. Let me say that family history is only ½ of your risk factor because each parent only carries 1/2 of the genes you own. This means that your risk is usually watered down by the relative who has the disease, and your risk usually goes up if two relatives on opposite sides of the family have the same disease. Even though we use family history as an estimate of your risk for diseases in the future it is not very specific or accurate. The information your family tells you about their history may not be accurate for the real diseases your parents and grandparents had. My family history is a good example of bad information in an individual’s medical history: I thought I was at risk for Adult-Onset Diabetes because my grandfather on my father’s side and my grandmother on my mother’s side had Type II Diabetes. I was worried since medical school that I would eventually get AODM too. When I had my genetics done, I found that I had 4/5 genes that foretell obesity, but NO DIABETES genes! This changed my approach to my own health from avoiding carbs totally, to losing weight until I was at ideal weight. In case you don’t know it, almost all obese people develop Type II Diabetes eventually. If they don’t change their lifestyle soon enough and lose weight as well as get the proper nutrition it is in their future. Diabetes is a disease that will follow them through their lives, putting them at risk for other diseases like cancer, heart disease, Alzheimer’s disease, dementia of all kinds, arthritis, and joint deterioration needing joint replacements. This list includes the most common causes of death. So the moral of the story is, my family history didn’t tell me what I was going to be at risk for! You can plan your healthy living plan based on your family history, or you can get your own genetics done to tell you what you are at risk for based on your genes, OR you can just clean up your lifestyle, receive your hormone replacement using the safest delivery system (pellets) and begin a healthy lifestyle as soon as possible. Get real information based on your individual situation now with blood work and add your genetics or family history to help motivate you to get healthier. Changing your lifestyle is the hardest thing you can do so getting expert advice from a physician, and then follow it. Look for a doctor who will help keep you motivated to follow your healthy living plan and do your half of the path to health and healthy aging without disease. Please join me, Dr. Kathy Maupin, BioBalance Health® next time when we outline a plan for health and longevity to avoid the pain and disability of aging.
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Healthcast 661 - Medications and Nutritional Deficiency
06/06/2024
Healthcast 661 - Medications and Nutritional Deficiency
See all the Healthcasts at I bet you have heard the idiom, “There is no free lunch”, or “There is no medication without a side effect”, but did you know that medications that are prescribed by your doctor can have negative effects on your health that are never even discussed with you….so you should protect yourself by replacing the nutrients that your medications remove from your body, and that must be replaced for you to be healthy. Statins -→ COQ 10 DEFICIENCY= fatigue and depression Beta Blockers -→ COQ-10 DEFICIENCY= fatigue and depression Oral contraceptives and oral estrogen/progestins-→ COQ-10 DEFICIENCY= fatigue and depression Antidepressants called SSRIs-→ COQ-10 DEFICIENCY= fatigue and depression Dosage: If you take any of these medications you need to take COQ10 200-400 mg/day every day! Thiazide Diuretics=HCTZ -→ Magnesium and Zinc Deficiency muscle spasms, prostate issues, constipation Take 50 mg of Zinc and 400-600 mg of Magnesium Glycinate a day to replace what is lost. NSAIDS (Motrin, Advil, Aleve, Ibuprofen, Meloxicam, Naproxen, Indomethecin, Daypro, Mefenamic acid, Voltaren)-→ malabsorption, depression, anxiety, and the vitamin and mineral deficiencies listed: Folic Acid Deficiency- Take Methyl- Folate 500 mg Iron Deficiency—Take Iron Bisglycinate (Ferrabsorb) Vitamin C deficiency—Take Vitamin C 500-1000 mg/day Amino acid deficiency—take Arginine +/- Ornithine. OR change your medication to Celebrex 200-400 BID PPIs=Proton Pump Inhibitors (Omeprazole, Prilosec, Pantoprazole, Lansoprazole, Protonix) are taken for stomach ulcers, H. Pylori infection and gastric reflux PPIs Increase Homocysteine which increases your risk of stroke, MI, and Pulmonary embolism. PPIs decrease the absorption of many nutrients. They actually cause malabsorption of essential nutrients. Replace these nutrients with supplements, but much of what you take won’t be absorbed unless you take daily Probiotics: B12 – take methyl B12 1000 mcg/day Folate – take as methyl folate 5,000mcg/day Vitamin D – take 5,000 IU/day Note: PPIs can even cause the growth of dangerous gut bacteria causing chronic Hemophilus. If you have chronic vaginitis that smells fishy, it could be your PPIs! If you have this stop the PPI, take Pepcid instead (histamine receptor blocker) or nothing and take probiotics to repair the damage the PPIs have caused. These nutrients need to be replaced to keep you healthy, however it is better for most patients to only take PPIs for 2 weeks at a time or substitute a histamine receptor blocker like: Pepcid, Zofran. Surgery It is not just the medications doctors prescribe for their patients; sometimes surgical procedures can cause chronic diseases through preventing nutritional nutrients to enter your body. Removal of the gall bladder must be done, yet patients are not told what they can do to be healthy after the surgery. The gall bladder provides enzymes that help you breakdown foods, primarily fats and absorb fatty vitamins from your food and supplements. If you have had your gallbladder removed you can become nutritionally deficient in A, D, E fat soluble vitamins, and you will promote the growth of abnormal gut bacteria and are at risk for leaky gut, Celiac disease, autoimmune diseases and malnutrition. Everyone who has their gallbladder removed should take digestive enzymes with every meal and take Probiotics daily. Bariatric Surgery for Obesity The last iatrogenic nutritional deficiency that I will discuss is Bariatric surgeries, all kinds that remove part of the stomach, or band the stomach or in any way physically makes the stomach smaller is related to nutritional deficiencies caused by malabsorption of vitamins and minerals. The way to combat these deficiencies include taking: a probiotic daily digestive enzymes with every meal and all vitamins should be chewable or sublingual to be absorbed from the mucosa of the mouth In Conclusion: Remember I am a physician, and my job is to promote wellness in my patients. It is sometimes more important and lifesaving to take the above medications or have these surgeries, than to prevent a nutritional deficiency in the future. We must follow those medical decisions with trouble shooting addition of nutritional supplementation to replace what these necessary medications and surgeries remove. That is preventive medicine and why supplementation is often needed for our health.
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Healthcast 660 - Why You Need an Individualized Weight Loss Program
06/06/2024
Healthcast 660 - Why You Need an Individualized Weight Loss Program
See all the Healthcasts at You are what you eat, and you use what food and drink you eat based on your genetics. Weight loss requires professional advice, direction and oversight. Combining receiving the best advice on what you should eat and drink as well as tailoring it to your metabolism and medical condition is what you should receive from your weight loss program. Before you embark on a weight loss program you need to know the following lessons. Lesson #1: All Calories Do Not Create the Same Energy/Heat/Weight Loss in All People. You can put a gallon of gas into a Maserati and Ford Fusion and they do not provide the same performance (different acceleration or speed, pick up and ride) different MPG or speed because these two engines are not the same. The Maserati burns fuel (calories) faster than the Fusion; it operates at a higher level of speed and performance, and it uses more gallons of gas per distance. Just like the difference in cars, the difference in our bodies is VAST! I explain this truism every day in my office. One of my female testosterone replacement patients returned for her first follow up consultation. The blood levels were ideal and all the symptoms relating to testosterone deficiency were gone! However, the only thing she could think about was the fact that she did not lose weight (although she did gain muscle and lost fat) and her friend lost 15 lbs in the first 4 months! Even though she and her friend were the same age their metabolisms were very different AND the fact that her friend did everything I told her to in regard to diet, limiting alcohol, taking supplements and exercise, but she did not, tipped the scales to cause her not to get the same result as her friend…in other words, her friend had a genetically faster metabolism, AND she put Premium “gas” into her metabolic car, changed the oil and took care of her car so it ran faster and better than the patient sitting in front of me who used regular gas, didn’t care for her car and drove too fast and hard. Two people the same age with different metabolisms, diet, exercise, supplementation, and stress level have widely different responses to weight loss. Therefore, medical weight loss advice must be individualized to fit just you! The individual variables include: Genetic programing Current weight and diet Length of time you have been overweight Age Blood type (also genetic need for certain foods) Medical history/current diseases Medications you are on Supplements that you take or need to take Exercise and physical movement Fad Weight Loss diets are a fraud to sell books or to get attention. If it takes a 300-page book or a Social Media fad to sell a diet that is supposed to be good for everyone…it is a lie and may backfire! When the cabbage soup diet was a fad many of my GYN patients did it. I had access to their blood types and knew that cabbage was bad for A blood types and slowed their metabolism. Despite my advice they still did the diet, and you know what happened? They gained an average of 10 lbs!!!! Their blood type determined whether this particular diet would work for them. This is an example of how important your genetics are to weight loss. What are the genetic variables that affect your approach to weight loss? Inheritance how our body burns calories—are you a Fusion or a Maserati?: there are many genetic variables that make you as an individual require specific foods and exercise programs to get to your ideal weight and be healthy. It is the job of your medical advisor to determine what these are for you and tailor your diet accordingly. Your Blood type determines the best and worst foods for your metabolism and the number of days you should exercise. Do you burn calories at rest, or does it take active exercise for you to burn more than the baseline of calories? If you are warm while you sleep, then you burn calories at rest and therefore will burn more calories than someone who does not, even if you eat the same things and expend the same active calories a day. How much of each type of food do you eat? Protein/carbohydrates/fats. Protein takes more calories to metabolize than carbohydrates, and a lot more than fat, so the most calories are consumed by eating a high protein diet. Mood Determines your Mindless Eating: Genetically are you more apt to eat when you are anxious or worried? This is a behavior that can be changed by counselling, behavior modification, or even just making you aware of your inherited problem. Genetically do you always feel hungry? Genetically are you never full? These are genetically inherited qualities that affect the amount you eat and how often you go back for seconds. There are medications and behavior modification that can counteract this genetic reality. Genetically does exercise or dieting result in the most weight loss? Believe it or not some people just have to diet without a lot of exercise to lose weight, others are programmed to exercise only for weight loss and then most of us have to use both methods to lose weight. Let me say that exercise does use up more calories, whether you are built to burn more with dieting. Genetically how much lean muscle mass do you have? The more the better! Weight loss is aided by weight training three times a week, and the replacement of testosterone when you become deficient. Both of these muscle building methods increase muscle and decrease fat. Did you know that your muscle mass burns 80-90% of your calories. More muscle means more weight loss, but your muscle metabolism must be turned on with testosterone, insulin sensitivity, good blood flow and more metabolic factors. The more fat you have the harder it is to lose weight because body fat doesn’t burn many calories. High muscle mass burns a lot of calories even at rest! The more muscle you have compared to fat the faster your body will lose extra fat. Weight training is helpful to building muscle and losing fat. What percentage of food should you eat of each food type? That is genetically set. Your ideal % of Protein, Carbohydrates and fat are genetically determined. Many of us have discovered our ideal food chart through trial and error, but a weight loss genetic test can tell you as well! Your Age: The older you get the lower your sex hormone testosterone is. As you age testosterone, growth hormone decreases while estrone increases all of which cause and cause weight gain. Testosterone stops being produced from women’s ovaries between 40-50 years of age. Men never lose all of their T but the level decreases from age 35 on to hit a clinically symptomatic level between 50-55 years of age. Estrone increases as Testosterone decreases and causes both sexes to gain belly fat. Do you have your sex hormones or not (particularly Testosterone)? Without T your muscles stop growing and burn fewer calories every day you go without T. This is why people tend to get old and fat as their T stops being produced (in women) or becomes clinically too low a level of free T at a certain age in a man’s life. Growth Hormone decreases with age—adding nonoral T replacement increases Growth Hormone. Menopause immediately makes women who don’t replace their estrogen and testosterone to gain up to 20 lbs without changing diet or lifestyle. Osteoporosis occurs and worsens with age because estrogen and testosterone in women decrease over time. Testosterone in men decreases in men which thins bones. Loss of bone causes loss of muscle and both cause weight gain. More importantly, osteoporosis decreases the activity level of affected patients. Lifestyle impacts your ability to lose weight: How much water do you drink? You need sufficient water to lose fat. You should drink ½ your weight in pounds, in ounces of water to be able to lose weight. That volume of water you should drink increases to ounces of water = weight in pounds if it is hot outside or you are doing work that makes you sweat. Do you eat cleanly- do you eat whole foods? Do you eat one salad a day? Do you turn down sugary foods and desserts. If the answer is yes, then keep it up because it is helping you lose weight! Do you eat fast food cereal, cookies desserts and or doughnuts? If so, stop! All of these foods are massive producers of blood sugar, metabolic syndrome and obesity! These foods are literally bad for everyone! Do you eat a balanced diet? Humans are built to eat a varied diet with some fruit vegetables, meat, fish, eggs, butter, healthy fats (non-meat fats), with some grains and we were NOT built to eat sugar! Do you eat a lot of carbs? A Low carb diet can allow you to improve IBS, prevent cancer, and Alzheimer’s Disease, dementia, avoid bacterial and viral infections, high cholesterol and heart disease, diabetes, obesity….all the diseases that cause us to be sick and age are related to too much carbohydrate in your diet! In Japan, Alzheimer’s Disease is called Type 3 Diabetes! Do you sit all day or exercise and move your body –taking 10,000 steps actually helps you lose and maintain our weight as well as exercising your heart! Do you take vitamins and supplements to prevent deficiencies in your diet? If not then you need to write down everything you eat for a week and have your medical professional review it….My bet is that everyone in America needs supplements ! The minimum daily requirements on a vitamin bottle is the MINIMUM AMOUNT OF A VITAMIN THAT MERELY KEEPS YOU ALIVE! These levels are not the amount of a nutrient you need to be healthy! I bet you think alcohol is a food? It isn’t! Alcohol is a toxin, use it with care. Just because your friends drink a bottle of wine a night doesn’t mean it is healthy…bad habits always want company! Diseases that you currently have affects your ability to lose weight. Are the glands that set your calorie burning rate healthy? If your thyroid is low, you will have to work harder at exercise, and you will have to eat less calories to lose the same amount of weight a person your size who has a normal thyroid. If you have sick glands you are bound to be “over-fat” Diabetes and insulin resistance (abnormal your pancreatic gland) cause weight gain and an inability to lose weight if it is not treated. Metformin recreates insulin sensitivity, as does Mounjaro and Semaglutide medications. Liver and kidney disease your ability to get rid of the fat you are burning and you store up toxins that also slow your weight loss. Follow the directions of your doctor and get the healthiest liver and kidneys you can! Fatty liver is secondary to Metabolic Syndrome, so treatment with Metformin, Semaglutide and Tirzapetide can cure this disease! Heart disease—high carbs not high protein diet causes arterial plaque! You have been lied to because statins make money! Stop eating carbs and eat all the animal proteins you want! One of my patients has only eaten fruit, vegetables, grains, sugar and alcohol his whole life and he has severe atherosclerosis (hardening of the arteries) before he was 60! Avoiding animal products does not prevent heart disease. Endocrine disorders like overactive adrenal (high Cortisol) and hypoactive thyroid, pituitary adenomas can cause an imbalance of the metabolism and they can cause weight gain and fatigue that make it hard to lose weight. I will talk about Medications that cause weight gain—beta blockers, blood pressure medications, Statins, and others in a future blog.
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Healthcast 659 - Iodine: Why You Need this Supplement!
06/06/2024
Healthcast 659 - Iodine: Why You Need this Supplement!
See all the Healthcasts at If you have hypothyroidism (Low thyroid), fibrocystic breasts, fatigue, metabolic syndrome, diabetes, hair loss, obesity, or high cholesterol then taking supplemental Iodoral can improve these diseases. These conditions have become an epidemic in the United States due to Iodine deficiency. My longevity medical practice is all about keeping my patients healthy so they can live not only a longer life but one with quality. In the last 20 years of my BioBalance® Health practice, I have seen a flood of new patients with conditions that are in part secondary to iodine deficiency. Today in America, the majority of people need iodine and other supplements to their diet for many reasons: Food manufacturers don’t supplement our foods as they did in the years from the 1940s to 2000. The food that we eat (even fresh food) contains less nutrition than they did 50 years ago. Fast food diets, processed foods and preservatives remove necessary vitamins and minerals that we need to be healthy. Alcohol leaches nutrients from our bodies and alcohol consumption is increasing. Chemical pollution has entered our food supply and now is stored in our bodies. We have added a chemical to our drinking water, fluoride, which displaces Iodine in our bodies leaving us Iodine deficient. Today I am going to address the symptoms and diseases of Iodine deficiency. This blog about Iodine is to inform you about the need for Iodine and what it does. I hope to never have to remind my patients about taking this supplement again after listening to the associated podcast or reading this blog! Iodine is a micronutrient necessary for life. In a research article in the Journal, Frontiers of Nutrition, March 2024, a very succinct review of the illnesses that occur because of iodine deficiency and that can be treated (partially) with iodine supplementation. I recommend all of my patients who live in my area which has no iodine in the soil or ground water and where all the drinking water is fluorinated. The Iodine supplement, Iodoral, is not a drug, but a nutritional supplement that is sold over the counter. The Iodoral 12.5 mg bottle of 90 is $14.50 for 3-6 months supply. You can’t afford NOT to take it! Why do we need this supplement at this time in America and many first world countries? Governmental intervention in our basic need for water caused most of our deficiencies. Iodine is produced naturally in the ocean by seaweed, and it is contained in the soil and ground water in areas of the country that are near the ocean and those areas that were covered by ocean water millions of years ago. So, if you think geographically, most of the US is in that “map”, except the Midwest. However, man and government has intervened and caused our population to be iodine deprived by adding Fluoride to our water. The government and the FDA make decisions for us without looking at the subsequent damage that might be done by those decisions. In the 1949 the US government decided that EVERYONE needed to be protected from dental cavities so 75 years ago we fluorinated our water and that decision led to the epidemic of iodine deficiency. Fluoride in your drinking and cooking water literally replaces iodine, and takes its place molecularly, leading to generations of people with 25% fewer cavities and 100% increase in the list of diseases I have listed in the first paragraph! Fluoride is the biggest cause of thyroid disease. Wouldn’t it be better to use fluoride toothpaste once a day than drink it? In some areas of the country, called the “Goiter Belt”, we don’t have any iodine in the natural ground water, so locally grown food does not contain Iodine. These regions have had a history of high percentage of the population with low thyroid, and goiters, even before we added fluoride to drinking water. This compounds the problem and the diseases from Iodine deficiency. I live in that area! Before the 1970s iodine was required to be added to bread, salt and a few other foods. Ever since I have been seeing more Eating designer salt has caused people to not even get iodine in the salt they eat, Now we use all kinds of salt most of which don’t have iodine in them,. So now you know what the problem is today as well as the answer, Iodine supplementation with Iodoral® every day! How do you know if you have low Iodine and or Hypothyroidism? Symptoms of low iodine mirror those of low thyroid: fatigue, swelling, Abdominal bloating and pain Constipation hair loss and broken frizzy hair, brittle nails, dry skin, cold body temperature BBT less than or equal to 98 degrees Fahrenheit, weight gain, depression, slow metabolism, slow pulse low BP fibrocystic breasts So what will taking Iodoral® do for you beyond reversing the symptoms above? Improved thyroid function which decreases fatigue, weight gain, hair loss, brittle nails, swelling, and slow metabolism…. The benefits to you and your thyroid gland are immense! Your thyroid hormones control your metabolism and control your thermostat. Every cell in your body requires thyroid, and therefore require Iodine. If your body doesn’t have enough heat, then your enzymes can’t work and our cells can’t do their jobs, heal themselves and skin, muscles and all our tissues suffer. How does that work? Thyroid hormones T1, T2, T3, and T4 are made from one amino acid, Tyrosine, an 1-4 Iodine molecules! The molecular structure of Iodine calls for plenty of iodine nutrient in the blood stream to make thyroid hormones and to attach to iodine receptors on each cell that uses thyroid in your body. Preserve the health and function of your thyroid gland. You will feel warmer, your pulse and blood pressure will normalize. You will lose weight. Your thyroid hormone keeps your body warm by stimulating mitochondria to burn calories. In this way thyroid hormone controls your weight, how fast you burn calories, how energetic you are, how well you think, how your hair and nails grow just to name a few benefits of thyroid. You need to add iodine to your diet to produce thyroid hormones to maintain all these vital functions for you! Prevention of Fibrocystic Breast Disease. Women’s breasts absorb a lot of iodine and need Iodine to be healthy. The absorption by the breasts of iodine steals I from the thyroid and accounts for women having a much higher incidence of Hypothyroidism. The thyroid is starved without iodine and “dies”. Hypothyroidism is a Woman’s disease! Fibrocystic Breast Disease. Women’s breasts are iodine sensitive and years of low Iodine can cause Fibrocystic Breast Disease. This is not a precancerous condition, but it makes it harder to find a cancer in a breast on a mammogram. Weight Loss/Avoid Metabolic Syndrome For both sexes Iodine is needed to maintain blood sugar control and the control of obesity. It is one of the necessary nutrients when it comes to weight loss. More importantly it can prevent Metabolic syndrome which is a combination of high blood sugar (diabetes/prediabetes), obesity, hypertension, and high cholesterol. If you have Metabolic Syndrome, you are at higher risk for Cancer, Heart Disease, Stroke, and early Death. It doesn’t take just iodine to treat this syndrome once you have it, but Iodine is key to making your medical treatments, diet, and exercise work to decrease your medical risks of disease and early death. Lower your LDL Cholesterol Hypothyroidism causes an increase in LDL Cholesterol; therefore it may increase the incidence of heart disease. Organ Systems Other than the Thyroid Need Iodoral: As you can see by the list above, vital organs other than the thyroid accumulate/store Iodine: salivary glands, stomach, pancreas, ovary and testes, which has led to the new realization that Iodine has effects outside of the thyroid. Other Results of Replacing Iodine to what is clinically considered a high level in the US. Blood sugar is lowered by adequate Iodine blood levels (199-299 mcg/L). Insulin resistance is improved by taking Iodoral Hypertension lowered to its lowest point when blood levels were between (300-499) Gout: the higher the iodine, the lower the uric acid in the blood, therefore fewer Gout attacks. Mortality rates increase to 33-75% higher in people with low iodine levels. Inflammation and inflammatory diseases improve with iodine supplementation Immune modulation is one of the benefits of iodine. If you have a poor immune system, it improves your resistance to communicable diseases. If you have autoimmune disease Iodine improves these diseases. How could supplementing Iodine, removing Fluoride, from our drinking water do for us individually and our country? Japan is an example of high Iodine levels that benefit health. What happens in other countries with adequate iodine levels? Japan has the highest level of iodine in the blood because they consume seaweed in their diet and most of their water and food has iodine in it. Of course, Japan is an island surrounded by iodized seawater! They consume 7 x the average amount of Iodine as Americans with healthy consequences. Japan has one of the lowest incidences of Metabolic syndrome and the diseases included in it. A study on Iodine consumption revealed that obese women had a significant weight loss when eating food in Japan. Summary: We all need iodine in our food and water or if we can’t get it, we must supplement it with an over the counter supplement, Iodoral ½-1 tablet a day (12.5 mg tablet). The “normal” reference ranges are skewed to the low iodine level, so many people stop taking iodine when they follow the reference ranges, however in this research paper the ideal blood levels were considered healthy up to 100- 399mcg/L while the Quest and Labcorps reference ranges are 52-109, much lower than what is considered healthy by research studies. Iodine does not cause hyperthyroidism, however if someone has hyperthyroidism there is controversy as to whether Iodine should be supplemented. Make your choice: Health with an inexpensive supplement (Iodoral) or illness with fluoride and without Iodine.
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Healthcast 658 - News Flashes about Menopause, Metabolic Syndrome, Dementia and Cancer!
06/06/2024
Healthcast 658 - News Flashes about Menopause, Metabolic Syndrome, Dementia and Cancer!
See all the Healthcasts at There is a lot of New Medical Information that is important for patients to make healthy decisions about their care or the care of their loved ones that you won’t hear about on the news. For new research to reach you, the public, a researcher or a drug company has to spend a great deal of money for the public relations people to push information into the light. I compiled the research I thought you might want to know about that has been discovered during the past 6 months. I always use these studies to educate my patients and to change my protocols for treatment, although many of them have been part of my practice for quite a while, because they just confirm what I have been seeing in my Integrative and preventive medical practice for years. The First Group of Discoveries Relate to Menopause, and the Risks of Being Menopausal The most recent article in Lancet confirmed what has been obvious to me in my GYN practice for years. I am not sure why this actually required a study to prove that Menopause is tied to a higher rate of depression and anxiety, in conjunction with insomnia, higher stress perception, and hot flashes. This study documented what the loss of estradiol, progesterone and testosterone can do to women in menopause. The sad fact is that this article doesn’t tell the reader what they need to know, how to treat these symptoms. However, I will let you in on a self-discovered fact: The replacement of the hormones that disappear before and during menopause can be replaced in a non-oral delivery system to treat these symptoms. I have 40 years of medical practice that proves my findings that agree with the problem, and my treatment with hormones. The Lancet: A study found that when certain women are menopausal, they increase their risk of Depression, anxiety, bipolar disorder who experienced stressful life events, had poor sleep related to hot flashes, or had previous depressive symptoms of depression were more likely to develop menopause-related mental health problems. Researchers wrote in the journal The Lancet that some women escape the mental health effects of menopause altogether. (3/6) Another recent study about menopause discovers that a lack of estradiol in the post menopause causes women to have trouble thinking. I agree with that revelation, but why doesn’t the research take the next step and suggest a treatment to prevent this result of hormone loss? Why doesn’t the research tell us how to help women think by replacing their estradiol? Many other studies confirm that replacing estradiol will delay the onset of dementia by 10 years. Another study reveals that the replacement of testosterone will delay dementia it 10 more years. These studies occurred over 20 years ago, but this study doesn’t cite them. Poor and worsening cognitive function is one of the most frequent complaints of my new patients coming to BioBalance Health® for treatment of menopause and low testosterone with bioidentical hormone pellets. Dr Maupin: I am continually reminded of the importance of testosterone and estradiol replacement is to aging men and women when they come back for their second pellet insertion and review their list of the symptoms they complained of before they started E and T pellets The most frequent response I witness when I ask if a woman’s ability to think, do her job and stay organized is completely better after 3 months of Estradiol and Testosterone pellets, is crying with relief! Many patients are deeply worried that they are developing dementia, specifically Alzheimer’s Disease when they first come to me, but are able to go back to work and or experience a renewed quality of life because their ability to think, they can now feel confident in their professions and careers. Dr M Estradiol associations with brain functional connectivity in postmenopausal women Testo, Abigail A. BS1; Makarewicz, Jenna BS1; McGee, Elizabeth MD2; Dumas, Julie A. PhD1 Author Information From the 1Department of Psychiatry 2Department of Obstetrics, Gynecology, and Reproductive Sciences, Larner College of Medicine, University of Vermont, Burlington, VT. The results illustrate the relationship between estradiol level and functional connectivity in postmenopausal women. They have implications for understanding how the functioning of the brain changes for individuals after menopause that may eventually lead to changes in cognition and behavior in older ages. © 2024 by The Menopause Society I have another problem with studies that should be shared with patients is that they often imply that menopausal women are “crazy” instead of saying that women after menopause develop mental health issues that can be treated with hormone replacement. Women who are menopausal are not mentally ill they are hormone deprived! I view this as a “slam” and divisive attack on aging women. The fact that if we gave women what they need …hormonal replacement ….they would not suffer the symptoms of mental health disorders. A study found that women who experienced stressful life events, who had poor sleep due to nighttime hot flashes, or who had previous depressive symptoms or depression were more likely to have menopause-related mental health problems. Researchers wrote in the journal The Lancet that some women escape the mental health effects of menopause altogether. Full Story: (3/6) The Second Group of Articles Is About The Loss Of Estrogen In Menopause Causes Heart Failure and Atrial Fibrillation. This article from the European Society of Cardiology reveals that the longer women live without estrogen (e.g. is menopausal), the higher risk of developing heart failure and atrial fibrillation. Once again, there is no mention about how to prevent this disease! Why can’t they study the women who replaced their hormones and compare them to the women who didn’t? Hormone Therapy May Boost Weight Loss for Postmenopausal Women Who are Overweight or Obese On Semaglutide, Study Finds My practice BioBalance Health® has a weight loss program that is very effective for weight loss using Semaglutides, and terzipatide. For women who are menopausal we have found that they lose weight much more quickly if they are on E2 and T pellet hormone replacement. This research article confirms the findings of this study. If you are menopausal and have gained weight after menopause that is hormonal and the faster, you can get on non-oral estradiol and testosterone replacement then you will be more likely to get to your ideal weight! March 18, 2024 Hormone therapy may boost weight loss for postmenopausal women on Semaglutides. (3/18, Welsh) reports, “Hormone therapy was associated with an improved weight-loss response for postmenopausal women with overweight or obesity treated with Semaglutides, according to cohort study published in Menopause.” In the study, “postmenopausal women on hormone therapy had a higher percentage of total body weight loss at 3 (7% vs. 5%; P = .01), 6 (13% vs. 9%; P = .01), 9 (15% vs. 10%; P = .02) and 12 (16% vs. 12%; P = .04) months of semaglutide treatment compared with no hormone therapy.” How and Why to Treat Metabolic Syndrome Metabolic Syndrome is a combination of hypertension, high lipids, insulin resistance, obesity, prediabetes or diabetes, large abdominal measurement. This combination puts patients at risk for heart disease and early death. Many conditions and outcomes have been associated with metabolic syndrome, but now we have a treatment that can prevent one of the outcomes of this syndrome, the generic drug Metformin ER. Metformin, Cognitive Function, and Changes in the Gut Microbiome Endocrine Reviews, Volume 45, Issue 2, April 2024, Pages 210–226, Published: 21 August 2023 Article history Abstract The decline in cognitive function and the prevalence of neurodegenerative disorders are among the most serious threats to health in old age. Metformin can preserve cognitive function by treating metabolic syndrome and improving the gut biome that produces neurotransmitters. I am not naive enough to believe that the only thing that your brain needs to perform well is two sex hormones (E2 and T). This new research from the Endocrine Society describes how the generic, inexpensive medication Metformin ER, can help preserve an aging patient’s ability to think. That is primarily because the brain has insulin receptors, and when a patient has insulin resistance brain cells don’t receive enough blood-sugar to be able to think! By taking metformin ER (extended release) plus replacing estradiol plus testosterone in pellet form, the brain gets what it needs (blood sugar) and patients can think again! The second factor the researchers found to be important to brain health and problem solving, is healthy gut bacteria in the intestines. This requires eating whole foods, especially fruits and vegetables every day, and not eating fast food, alcohol, simple sugars, and preservatives that kill good bacteria. We recommend a daily probiotic by Mega + the lifestyle changes above. If you want to keep your ability to think for your whole life then you need E2 and T in pellet form if you are a woman and T if you are an aging male, plus Metformin ER daily and the above lifestyle changes. Metabolic Syndrome, Obesity, is the Biggest Risk for Cancer People with metabolic syndrome had a 30% higher chance of developing cancer over the course of a decade after diagnosis, according to a study published in the journal Cancer. The researchers also studied inflammation by tracking C-reactive protein, concluding that elevated levels of the protein along with metabolic syndrome were “significantly associated with subsequent breast, endometrial, colorectal and liver cancers.” Full Story: (3/11) The struggle to stay young and healthy is a difficult fight but the most important battle that you will wage as an adult. If people knew the whole truth, would they stop overeating, drinking, smoking, avoiding exercise, or stop taking illicit drugs? I can only hope that if we convince people to take care of themselves better and replace the hormones that are missing as soon as they are clinically deficient, then they will also listen to the truth about the various ways to support their health and prevent disease. I also hope that the doctors who write articles and do research stop treating women like crazy people instead of the gender that actually runs the world and not only nurtures the children but also organizes homes and businesses. We are NOT crazy when we need hormones to be replaced (PMS, MENOPAUSE), we are experiencing symptoms of hormone-deprivation, and we just need to be treated with the hormones that are missing!
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Healthcast 657 - PMS – You are really not crazy!
06/06/2024
Healthcast 657 - PMS – You are really not crazy!
See all the Healthcasts at Last week one of my pellet patients asked me to see her daughter, even though I don’t see young women anymore since I began BioBalance Health for people over 40. I asked her why she couldn’t see her gynecologist and she told me that she was told that she had PMS and that was a condition that was treated by a psychiatrist! I have treated PMS successfully by replacing one hormone that is missing, Progesterone, two weeks a month, the same two weeks that women experience the symptoms of PMS. I agreed to see her although I wish my fellow gynecologists would learn how easily this can be treated and not make young women feel like they are crazy, because they aren’t! NOTE: Before I give you the impression that I treat PMS currently at BioBalance® Health, I want to clear that up: I only treat PMS in my younger cycling patients (36yo. to menopause) who take testosterone pellets for other symptoms. My recommendation for finding a doctor who treats PMS in your area is to contact a local compounding pharmacy and ask the pharmacist which GYNs treat PMS, or contact one of the large compounding pharmacies, eg. College Pharmacy in Colorado Springs, or Belmar Pharmacy in Colorado as well to find a doctor in your area who can treat you. There are many good compounding pharmacies who have pharmacists who can tell you which doctors prescribe progesterone for PMS. What is PMS? PMS symptoms are only present 2 weeks a month, the 2 weeks before menstruation. This condition causes patients to feel different, not like themselves in the ways listed below, and also caused menstrual changes in the menstrual periods that follow the PMS symptoms. The Emotional and physical Symptoms of PMS: All occur monthly, for 14 days Depression Anxiety Anger and irritability Bloating, Migraine headaches, Water weight gain, Pelvic pain Fatigue Insomnia The Menstrual Symptoms associated with PMS: The GYN Symptoms that can occur secondary to PMS (poor progesterone production) include: 1)irregular periods, spotting for a week before the period starts 2) heavy bleeding, sometimes uncontrollable bleeding, 3) infertility, 4) multiple miscarriages 5) lack of ovulation, and lack of periods for months at a time like with PCO Polycystic ovaries My History Treating PMS (skip if you already know this) I have been a gynecologist in private practice in St. Louis County since 1985 when I graduated from my OBGYN residency at Mercy Hospital. My training gave me an excellent knowledge of GYN Surgery and Obstetrics, but a very minimal understanding of the hormonal cycles of women, including Premenstrual Tension (PMS). Since the 1980s when PMS was recognized as a condition of women, OBGYNs have been taught that PMS is a psychiatric disease that must be treated with psychiatric medicines, primarily anti-depressants. Most OBGYNs today still believe that women who have PMS are “crazy”, and either give them an antidepressant which rarely work to treat the symptoms or refer their PMS patients to a psychiatrist. In my case, I do not do either because PMS is a hormonal imbalance that causes emotional symptoms, and because psychiatric diseases are not cyclic every 28 days lasting 2 weeks, followed by 2 weeks of normalcy. The Cause of PMS Since 1988 I have studied the cause of PMS and with the help of a very intelligent compounding pharmacist, Pete Hueseman, I found the answer to the cause and treatment for PMS. I began to treat PMS hormonally and now have successfully treated hundreds of PMS patients with bio-identical Progesterone. It is a simple answer. PMS is caused by a deficiency of the hormone Progesterone during the two weeks after ovulation, from around days 14-28! This is not a complicated diagnostic discovery, and the treatment should be obvious to all doctors who treat young, fertile women. More about that in a minute… From 1980- the present there has been no effective treatment for PMS approved by the FDA (just ineffective anti-depressants) because it is still categorized as a psychiatric disease. When I took my second American Board of OBGYN test in 1999, a question on my test was: “Is PMS a Psychiatric Disease that should be treated with antidepressants?” And the correct answer according to the American College of OBGYN was that that statement was TRUE, they believed and still do in 2024 that PMS is a psychiatric disease! In 1999 I had been treating PMS successfully with bio-identical compounded progesterone for over a decade with bioidentical progesterone in non-oral form (suppositories, vaginal tablets, vaginal cream, and transdermal creams), given only during the second half of the menstrual cycle, from ovulation until the onset of the period. To understand PMS you have to understand how the three sex hormones work during a woman’s 28 day cycle. We count the days of a cycle starting at the first day of bleeding, which is day 1. While we have a period our estradiol, progesterone and testosterone are all at their lowest level in the blood, but by the end of our period estradiol (estrogen) and testosterone start being produced by the ovary. They increase and both peak at ovulation, usually day 14, giving a woman a viable egg and a surge in her sex drive to motivate her to have sex and fertilize the egg. On day 14 the egg is released from the ovary and the corpus luteum (where the egg came from on the ovary) starts secreting progesterone. This hormone increases and plateaus during the next 14 days, while estradiol and testosterone level out. The day before bleeding, when the egg is not fertilized, all three hormones drop precipitously and that causes the uterine lining that was growing under the control of estrogen, to shed and bleed. PMS occurs during the second half of the menstrual cycle when the developing egg is not ovulated or is immature and ovulated but is not “ripe” enough to stimulate a decent progesterone blood level. In the case of PCO, many eggs develop but are trapped and don’t ovulate at all so no progesterone is produced. In all these cases, women with PMS are symptomatic both in the symptoms above and the menstrual abnormalities listed earlier. All of the physiologic changes that take place in the PMS patient indicate an inability to conceive, or to conceive but have multiple miscarriages. The Treatment for PMS: The Treatment is bio-identical Progesterone, but the FDA didn’t have a form of bioidentical Progesterone that worked until the last 10 years, when Prometrium was produced. Prometrium is an oral pill containing natural progesterone in peanut oil. This works well for some women, but not for others. For those women we prescribe bio-identical compounded progesterone in sublingual, vaginal, transdermal and BLA Progesterone oral forms. The most important fact about diagnosing PMS is to remember that the symptoms of PMS only occur 2 weeks a “menstrual” month (28 days of the cycle). The most important fact about treatment is that PMS should be treated with Progesterone the second two weeks of the menstrual cycle at bedtime. Now my patients ask me to treat their daughters who are cycling and whose OBGYN follow the guidelines of ACOG blindly even if the suggested treatment (anti-depressants don’t work or make them worse). I can only hope that the method of treating PMS as a hormone deficiency, instead of a psychiatric disease, will be accepted by American College of Gynecology and that you can find doctors you can be treated by, by finding a compounding pharmacy who will refer you. Compounding pharmacies in St. Louis: Neels’s Pharmacy, and Medical Arts Pharmacy (ask for Brock) in Clayton MO, Jennifer’s Pharmacy in Clayton, MO. Phone number (314) 849-3123 (314) 862-7400
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Healthcast 656 - Vast Difference Between the Benefits of Different Types of Testosterone Replacement
06/06/2024
Healthcast 656 - Vast Difference Between the Benefits of Different Types of Testosterone Replacement
See all the Healthcasts at The Problem: I see women and men every day who are deficient in their own production of testosterone because of age, testicular trauma, removal of their ovaries, chemotherapy, chronic illness, and medications. The cause of testosterone deficiency is as varied as the side effects and benefits of every different type of testosterone. This means that when you hear or read a headline like the one that came out last week: “Testosterone Treatment Fails to Offer Protection Against Fractures in Men with Hypogonadism, Research Indicates” You cannot take It at face value. This headline should read Testosterone replacement in the form of testosterone cream given at a low dose given at a low dose to men who already had osteoporosis doesn’t offer protection against osteoporosis. The headlines that read the way this one is an example of the reality that everyone loves to hate testosterone. This makes informed decision making by a patient very difficult because of the jaundiced view by physicians and drug companies about replacement of one to the hormones that men and women both make when they are young, but which becomes deficient in most of my patient population as they age. Why is there all this subterfuge and confusion about testosterone replacement? I believe it is the fact that allowing American’s to age out of jobs and make room for the younger workers; many people cannot afford testosterone on their own so they are jealous of those people who can and do afford it; The insurance companies don’t want to pay for anything they don’t have to; keeping people youthful and healthy is not a priority for American medicine based on acute care in the ER and operating room; The group of naturalists who think aging is great, are people who either are out of touch or are very young; the use of testosterone by both sexes often makes the use of other medications unnecessary (anti-hypertensives, statins, autoimmune medications, etc, and also prevents patients from getting communicable diseases so the largest industry in the US, pharamaceutical companies cannot make more and more drugs to treat each symptom and disease individually; and lastly the government has made a very safe and natural hormone scheduled like amphetamines and pain killers by the DEA. Now why are these tests misleading? All research studied are manipulated to have a desired outcome. You can do a lot with statistics…you can make a blue sky look black! By given too little of a medication or vitamin, or by treating a disease for too short a time, or by picking the age group such that they won’t respond you can make any drug look ineffective! So when you look at the studies on testosterone, you must look for the type of testosterone: is it a cream (which turns into estrogen as it passes through the skin? Or is it an injection of testosterone cyprionate which is not equivalent to natural testosterone and lasts 2 weeks because it keeps circulating through the liver and making more and more of the byproduct DHT than pellets or pure T injection? Simply if the type of T is not the type that you are taking or are contemplating taking then you should ignore the studies conclusions because each type of T and each delivery system of T has a variety of effects, each different from one another. “One testosterone is not equal to another form of testosterone. Therefore, a study that tests one type of testosterone does not apply to other forms of testosterone.” Dr Kathy Maupin MD The factors that matter as to how much improvement you will get when you choose a form of T replacement are: Testosterone chemical structure (the best is pure testosterone like in sub dermal T pellets) Testosterone delivery systems (subdermal pellet, cream, vaginal tablet, oral, patches) The dose/day or week or month Duration of use What tissue or organ system you are studying (e.g., bone takes many years to show improvement, while muscle increases relatively quickly with T pellets) The age and condition of the patients studied The starting blood level of testosterone Total and Free testosterone. The resultant blood level of free T The length of time a man or woman has been without testosterone before treatment I see research articles every day in the many journals I read that are shared with the public, that denigrate testosterone replacement in general, while in my practice, with the most effective form of T I have found, that T pellets literally transform men and women who have T deficiency, most of whom are recently menopausal or over 55. The successful studies that recommend testosterone seem never to make the front of journals, but this recent study about bone density made all the title pages of the digital version of journals. The result will be that doctors and patients everywhere who should treat their osteoporosis with the safest treatment available, testosterone, will be the victims of VERY expensive drugs that have more side effects and less effectiveness. Research trials no longer look for the truth. They look for “how do we get the answer we want to , so our drug that is not testosterone, will sell?”. These headlines deceive patients and scares them from asking for testosterone treatment, which can relieve their symptoms with one hormone, Testosterone, instead of many drugs. An even greater benefit of testosterone given at the dose that relieves testosterone deficiency symptoms, this one hormone gives my patients back their quality of life. In 2002 the WHI study scared menopausal women from taking their menopausal hormone therapy (ERT and HRT) which caused these women to develop anxiety, depression, frailty, osteoporosis, dementia, poor critical thinking, fatigue and many other symptoms that required treated multiple drugs to relieve just a portion of them. Women also developed marital problems because sex was so painful that they stopped having sex with their life partners. An unproven fear of breast cancer led to the loss of these women’s quality of life! An example of one of my most severely affected patients went off her ERT (estrogen only hormone replacement) that she had been on for decades since her hysterectomy because her doctor refused to prescribe it for her. By the time she came to me she had developed depression, suicidal thoughts, agoraphobia, frailty and osteoporosis and she refused to leave her home. It took her months for her son, a doctor friend of mine, was able to bring her to my office to restart her treatment. Today she is still traveling all over the globe and fully enjoying her well-deserved retirement! It has been estimated that in the 5 years after the WHI demonized estrogen replacement, more than 100,000 women died of diseases related to a lack of estrogen, and more experienced a loss of quality of life. Even now over 20 years later, many doctors have not restarted giving estrogen to their women patients. Medical Thinking and rapidly changing standards of medical care when it comes to sex hormones has affected how we live, if we live, and how many drugs and diseases we get in our lifetime. We have effective inexpensive treatments for loss of hormones, why are we always looking for expensive and non-hormonal answers to the symptoms of menopause. In the last year pharmaceutical companies have developed a new drug with many side effects to treat hot flashes (fezolinetant/ Veozah, another new drug for osteoporosis (Tymlos 1pen, 1 injection/day = $2,134) and even a new drug for waning sex drive (Vylessi injection 2 times a week prn 1 month is $3,066/month) , also exorbitantly expensive! Instead of recommending replacement of relatively inexpensive hormone replacement with estradiol and testosterone (with pellets for women approximately $140/month, and for men $200/month), the Big Pharma companies try to strike it rich with multiple piece meal treatments for the symptoms of menopause and low T. I did not even mention medication for insomnia, migraine headaches, Viagra for men, lubricants for women and many other symptoms and treatments that T and E2 completely resolve. Back to the research article in question about testosterone for men, which employed testosterone as a transdermal gel, at a low dose, and determined testosterone (over-generalization) was not effective, for building bone in osteoporotic elderly men! This was a defective study in every way, but the most important way was that it used T gel which turns most of the T into estrogen, so the effects are really from E2, E1 in men who do not respond well to E2. The abstract is at the bottom of this page for your reading pleasure. I hope you are more selective in the future about what you believe and question the research that criticizes testosterone treatment, estradiol treatment especially the safest delivery system, pellets, when the research is short term, and generalizes the results from one form of Testosterone or estrogen to all forms. Testosterone Treatment Fails to Offer Protection Against Fractures In Men With Hypogonadism, Research Indicates (1/17, Monaco) reports “testosterone treatment didn’t offer protection against fractures in men with hypogonadism, a” subtrial indicated. The research found that “compared with placebo, men who were on a testosterone gel actually had a significantly higher risk for fracture.” The were published in the New England Journal of Medicine. (1/17, Iapoce) reports “the findings showed the 3-year cumulative incidence of all clinical fractures was nearly 4% among those treated with testosterone, compared with 2.8% in the placebo group.” Additional “data revealed the fracture incidence was also numerically greater in the testosterone group for all other fracture endpoints.”
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Healthcast 655 - Painless Hair Restoration is Finally Here.
06/06/2024
Healthcast 655 - Painless Hair Restoration is Finally Here.
See all the Healthcasts at T.E.D. a NEW painless high intensity ultrasound treatment that actually regrows 65% or more of your hair. It is the most effective treatment overall and really the most economic treatment with the least amount of time investment, no pain and best results. Unlike hair implants, you can’t tell you have had a treatment to make your “lost hair” grow again! The Problem of Hair Loss: Many of my patients (most of whom are over 40) complain that they have thinning or balding hair-loss before we even start our hormone treatment with hormone pellets. Testosterone treatments with Testosterone pellets rarely increase the DHT blood level enough to increase hair loss. DHT is the metabolite of Testosterone which is responsible for “male pattern balding” also called hair loss associated with aging in men. Most of my patients have genetic hair thinning or balding, hypothyroid hair loss, or loss from a medication that they take. We treat these metabolic causes, but we can’t make hair grow back metabolically, we can just stop the loss! NOW WE CAN MAKE LOST-HAIR GROW BACK with TED! Features of Alma TED: TED is a FOCUSED high intensity ultrasound that drives serums into the scalp to the level of the hair follicle. Alma has worked 17 years on a serum for hair loss and they have achieved their goal! Only with TED will the serum get to the hair follicles that are “sleeping” and make them grown again! This pairing of ultrasound and specific serums are key to the unique success of TED. Comparison OF TED with other treatments for hair loss: #1 TED is the only FDA approved treatment for regrowing hair! Six months ago, I was looking at various options to help my patients, and my husband, grow back their beautiful hair. After a comparison of multiple available treatment types for hair loss, I chose Alma Laser’s high intensity ultrasound treatment, T.E.D. that combines a unique hair growth serum delivered deep in the scalp to awaken sleeping hair follicles, stimulating growth, even in follicles that are dormant. In 4 treatments that each last 45 minutes or less, TED brings hair follicles back to life without pain… I finally found the “holy grail” of hair restoration! It is affordable and PAINLESS. My medical skin care practice, BioBalance Skin®, offers free consultations to those men and women who want to have TED treatments to bring reverse hair thinning and balding. TED this works for men and women with all causes of hair loss! Total number of treatments: one a month for 4 months Time of each treatment =45 min Maintenance is at least one treatment/ year (average) Cost of treatment package: $3,400 Cost of each Maintenance treatment, after $450 1-2 times a year Pain= None! Effectiveness= 65% of hair lost regrows No down time! Who is a candidate for this treatment> Men and Women, all ages with hair loss of any kind (the younger you are the better) All patterns of hair loss up to Stage 3 hair loss (stage 4 has areas of balding without any follicles) Thinning hair all over the head Hair loss due to medications, genetic hair loss, and androgenic hair loss This treatment replaces the drug finasteride! (finasteride decreases libido and erectile function) without the side effects. This treatment can accompany thyroid treatment (but not replace it) for hypothyroid hair loss. Women with extensions can be treated and will eventually replace extensions. Who is not a candidate/ or will have a less than optimal result: People with metal implants in their brain or skull or metal plates in the skull People with long term complete hair loss (their scalp has no hair and is shiny) > 5 years balding Patients currently on Chemotherapy but is OK after chemo is completed. Patients currently on immunotherapy Trichotillomania- Mental health condition where the patient pulls her own hair out. Patients with skin cancer of the scalp Infections, open wounds on the scalp Information on Hair Loss: All these types of hair loss, except the most extreme will obtain a good result from TED Hair treatments. Hair loss that occurs with age has typical patterns of loss. The examples shown below are examples of male and female age-related hair loss. The same patterns occur from elevated androgens in some people. Some types of age-related genetic hair loss are merely thinning of the hair, where individual hairs are spaced out making hair look “see through”. PATTERN OF HAIR LOSS NORMAL———– STAGE 1———STAGE 2————STAGE 3 TED HAIR GROWTH TREATMENT WILL WORK WELL WITH STAGE 1 AND 2 HAIRLOSS, IT IS ONLY PARTIALLY EFFECTIVE FOR STAGE 3 hair loss THE CONDITION OF THE SCALP IS IMPORTANT IN PREDICTING YOUR SUCCESS: SMOOTH, BALD LONGTERM LOSS OF THE SCALP RARELY RESPONDS THIN AND SPARSE AREAS DO RESPOND! PROGRESSION OF FEMALE HAIRLOSS PATTERN BOTH PATTERN AND CONDITION OF SCALP DETERMINES THE EFFECTIVENESS OF TED TREATMENTS WOMEN’S HAIR LOSS—In general women lose hair all over the head or at the temples and crown of the head. The stages of female hair loss above all respond to TED except the most severe-long term loss. COMPARISON OF OTHER TREATMENTS TO TED I am asked by my patients, “How do I get thicker hair?”…or for the most common questions from those men who have been experiencing their hairline creeping backward every year, “How do I make this stop, I look like my dad!”. Over the years my Medical Health Spa, BioBalance Skin® has attempted to help my aging hormone replacement patients regain their thick and healthy hair and hairline with scalp injections with PRP and Aqua gold injections of serum and PRP, however effective these treatments are in stopping the loss for a period of time, none of our patients were able to tolerate the pain of the injections in their head for an hour, even after topical pain relief. These invasive treatments really hurt not matter how we tried to remedy the pain. It turned out that our patients couldn’t tolerate one hour session, much less a series of treatments necessary to make a visible difference. Hair implants take so much time and money (>$15,000) that it is like taking on another job and is really only effective for receding hairlines, not thinning hair. Patients have to have multiple treatments. There are other options that do not regrow hair but mask the process. These all require ongoing treatment such as hair extensions, hair implants Hans Weiman hair restoration, all of which are prohibitively expensive, and are also painful and time-consuming. The one drug therapy to slow hair loss that is used by men, Propecia® finasteride is minimally effective at stopping the loss of hair, and it does not grow hair where it no longer grows. This drug also has significant side effects that many men can’t tolerate including loss of muscle mass and erectile dysfunction. Our patients who receive T pellets tell me that finasteride decreases all the sexual and muscle improvement they have gained from T pellets. Other new options for hair loss I investigated the required lifetime ongoing supplements (many of them) and ongoing treatment. The other option was significantly painful and not as successful as TED. When I find a new and unique treatment to solve the problems of my patients as they age, I am compelled to find an answer! For hair loss, TED is it! If you have thinning, receding, or balding hair don’t wait, the sooner the better for bringing back hair follicles permanently! If you need visual documentation, please go to the Alma TED results page with this link to see picture proof of the results from TED treatments: Link to example pictures of the results from TED.
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Healthcast 654 - SkinCare II: Treatment of aging skin –You can turn back the clock!
06/06/2024
Healthcast 654 - SkinCare II: Treatment of aging skin –You can turn back the clock!
See all the Healthcasts at Last time I talked about the ways you can keep your skin healthy and the products I have found that medical grade products are effective to keep skin looking young and healthy. My last Healthcast/Blog was about what you can do at home to improve your skin and look younger. This week we are going to talk about how to get the treatment you need to improve your skin if it is damaged and aging at the medical spa, and you may not have been able to be out of the sun or been able to follow the lifestyle changes I recommended that are necessary to avoid skin and sun damage. The problem is bigger, and the treatments are more drastic, and expensive. When you have finally decided to do something to help your skin look younger, you must do an introspective survey of your face and prioritize the problems that you see, placing what bothers you the most as your first priority. I think writing this on a list and taking it to your consultation is the best way to proceed. When nothing is getting better with your own self-care, It is then time to get a consult from an expert who can tell you what you need to reverse your skin problems. Bring your list to the office consultation and decide on how much you can spend a month/or a year, on your own “renovation”. What to know when you have your consultation: When you have your consultation, you should be aware that there are at least 3 different treatments to treat any problem that you have. They have different levels of effectiveness and cost. At our spa you will be able to choose between three levels of treatment, but often, the consultant will weigh in on what the best procedure is for you. The least expensive treatments take the longest time to reach your goal and are usually the least effective. There is generally a medium level treatment, which is a little more expensive and more effective than the least expensive but will take more time to get the results, and finally the most dramatic results and faster outcomes cost the most. If you need fast results and can afford the procedures, then tell your consultant at the beginning of your interview. On the other hand, if you have a limited budget but have an open time frame then tell her that too. This will help you get to the desired treatment fastest and make your consultation the most profitable for you. In case this doesn’t make sense, here is an example: The treatment of age spots or brown spots has three possible solutions. The least expensive treatment is achieved by the use of topical serums at home and a series of facials in the spa. The outcome takes time and is not as effective as the other two options. The medium level of treatment (medium cost and effectiveness) is a VI or TCA Peel that has more immediate results and has some down time, but is less expensive than the most effective treatment, and more effective than the least expensive. The Laser IPL or Pixel treatments are the most expensive outside the operating room, they have some pain involved, but it takes only a couple treatments to rid yourself of the brown age spots that are on your face and decollate. In addition to the excellent results, these two treatments also tighten skin, and diminish wrinkles, while they remove the precancerous skin spots that make us look old. This is the highest price treatment but is faster and more complete than other available treatments. Choosing the Treatment that is right for you: Your Goal, Time to get to Goal, Effectiveness of treatment, Downtime, Pain, and Cost. I think it is best to inform your Skin Consultant about how much time you have before you reach your skin goal, if you can have some downtime or not, and how much money do you want to invest in your skin “re-birth”. In terms of choice of treatments at a med spa, you will get what you pay for. On our website we have the three or four options for each skin problem (wrinkles, brown spots, sagging skin, eye lid droop, poor texture) that our patients present with. I like that method of comparing treatments for each skin care problem. It should be transparent as to what your choices are, and what you get from a particular series of treatments. You should make your opinions known as to your priorities. That means what bothers you most about your skin. Think about it before your consultation and give her a list of priorities in writing which will keep her on track. BTW, none of these treatments work if you don’t follow the instructions given to you for aftercare and follow-up treatments. Ask about before and after care at your consultation. For example, If a patient has chosen a pixel laser resurfacing to remove her brown spots, and after 2 weeks all of her brown spots have come to the surface and peeled off, and she doesn’t use effective skin care products and doesn’t wear sunscreen and stay out of the sun for the appropriate time, then there is no guarantee that her results will remain excellent. You must take control of your own self-care because it is 50% of the treatment, and 50% of the outcome of our treatment. Please don’t use products from Walgreens if we told you to use something else after or before the treatment! Price of each treatment series is usually critical to decision making…..each of us has a budget. However, you should understand that the least expensive treatments generally have a lower cost to the spa and are least expensive. For example, what follows is a comparison between the three choices for improving texture and tone of facial skin are as follows: Least expensive: a series of Hydro-facials (30-45 minutes) one per month for three months, and three months of products, followed by a 3-month maintenance: This is the least expensive and doesn’t transform skin texture and tone as much, and doesn’t last as long as other available methods of treatment. If you have very little damage, are young and healthy, or you just want to maintain what you have, this is ideal for your needs. There is no downtime. Medium price: For example, Micro-needling treatments, are a medium cost and effectiveness treatment. This treatment uses a pen that contains a tiny needle that makes tiny “holes” in the skin’s dermis all over the facial skin, neck and decollate, which then stimulates collagen production over the next 4-6 weeks, tightening and lifting the skin. In general, this treatment is done in a series to achieve the results you are looking for. 2-4 treatments done every 4-6 weeks is the typical number of treatments needed. Maintenance requires a few of these treatments a year. Down time is minimal, there is a redness that occurs for 24-36 hours and peeling of the superficial dead skin for up to a week, but it is not severe and can be covered with makeup. Micro needling is ideal for younger patients to prevent the sagging and loose skin that comes with aging. It also makes the skin look fresh and glowing. Micro needling offers an Add-On of PRP to be applied and “injected” with the needles into facial skin to stimulate collagen production faster and more efficiently. Of course, this increases the price of the treatment. Highest price: The highest price treatments are generally appropriate for older patients, or impatient patients: those women who have a timeline for improving their skin ( a wedding or event), and those who have the most sun damage. You also get extra goodies when you get Laser Pixel treatments. The Pixel resurfacing not only improves texture and tightness of skin, nut it also removes brown spots and helps fill in wrinkles! Lots of extras which makes the price worth it! There are several choices for the top-of-the-line procedures to improve texture and tightness and they are not all lasers. One non-laser treatment is called Aqua Gold treatment which has three choices for what is injected and three prices. It uses a small disposable applicator that has many short gold needles to deliver a serum by “stamping it into the skin”. The injectables are hyaluronic acid injected below the epidermis and which combines the micro-needling technique with filler (very expensive) and Botox (very expensive) with an option to add activated platelets (a blood draw, spinning with an expensive activating compound). This treatment is expensive, but it is immediately effective, and the change is great. There is no real downtime, and the changes are immediate. A series of these treatments can revolutionize the quality of your skin. The last component of getting the most out of your facial treatments includes buying the right products to help you maintain the beautiful results you have achieved through any of the above treatments. It is a waste of your money to buy inferior products that may reverse the improvements you have paid for. This is essential for preserving the improvements you have received from any of the esthetic treatments discussed in this blog. Now if you think you need a facelift, you should see an injector consultant to ask if she can help with a much less expensive injection of Botox, filler, or both. Another treatment which is done without needles is the EmFace which uses magnetic energy to stimulate lift and muscle tone to literally do what a facelift does without a knife. Facelifts total cost is $75,000-$150,000 and has down time of months, and includes drains, and pain. A series of EmFace series of treatments (4) is about $3500, without pain and without downtime. When faced with surgery, always look for another way to do the same thing! Now you know what is ahead of you when you talk to a Skin Care Expert about how to achieve your beauty goals.
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Healthcast 653 - Biobalance Skin—Dr Maupin Knows What Your Skin Needs!
06/06/2024
Healthcast 653 - Biobalance Skin—Dr Maupin Knows What Your Skin Needs!
See all the Healthcasts at You may be like I am, and you took your “young skin” for granted, because it had always looked good, healthy, and glowing. Sadly, the damage that causes wrinkles brown spots, age spots, and sagging jowls occurs years before the damage shows on your face! At age 40 I woke up, looked in the mirror and realized what I had been doing to my skin with baby oil and iodine plus 8 hours of sun a day, every summer, without sunscreen and moisturizer for the 30 years before and I realized I had to do something to reverse that process. I then began my study of skin, skin damage and how to heal it! I still and studying the new advances in skin care, nutrition for skin, and skin-care products. But why is our skin so important? I have two answers, one as a doctor and another as an esthetic specialist. My “doctor answer” is that our skin is the largest organ in the human body, and it provides many benefits for us. The skin not only protects the more delicate organs of the body, but the skin excretes toxins for us from sweat glands, it cools us with perspiration, and protects our muscles and internal organs from trauma and the sun’s rays. Our skin also protects us from cold with hair that grows on our head and body. The condition of the skin also acts as a reflection of our health. It is possible to look in the mirror and determine if you are healthy or not. The skin is also a window for others to judge our general health. This is a double-edged sword. It helps us self-diagnose medical problems or at least determine that something is wrong so we can make changes to our lifestyle or seek medical attention. Our skin also reflects fatigue (dark circles under our eyes, sallow color and lack of glow or shine), BUT it also allows others to discover our age, health status and whether we have cared for our skin or not! Our skin is a window to our internal health, so if you want to appear rested, healthy, and desirable, then you MUST take care of your skin! I am not saying that nonphysicians consciously look at you and say to themselves, “that person’s skin looks sick”, but the condition of your skin determines unconscious judgements of the state of your health. It is for this unconscious knowledge that we have about the appearance of our skin, that drives women to seek out ways to make their skin beautiful and young. When we notice signs of aging, fatigue, and over-indulgence in our own skin we should take action if we want to reflect the impression of health and youth. Very perceptive people can tell what our age is by looking at our skin….that is why women spend time trying to fool them by improving the natural condition of our skin! Our instinct to be and feel young motivates us to seek help. No one wants to look their age! Everyday Instagram and Facebook show ads that say…”Buy this and you will look #—- years younger” are barraging us. Those advertisers know our instinctive drive to turn back the clock and they use it to sell…but in general those “one answer ad campaigns” help the seller make money but won’t do a thing for your skin….Don’t be sucked into their sales job. If you are over 40 you will require a multipronged approach to get your youthful skin back. This process requires a change in your routine, your lifestyle….the very hardest thing for humans to achieve! As a doctor one of my observational skills that helps me diagnose patients before I even interview them Is my first impression of their face and skin—if the color of their skin is dusky, they probably don’t have good blood flow (atherosclerosis, alcohol consumption or illnesses like Diabetes) and if the texture of their skin is thick and “piled up” I know they have poor skin care habits and often are not healthy. I also look at the creases or wrinkles as well as brown spots that give away a patient’s age and sun damage history. There are many more signs of illness that I look for, but skin is like having Hercule Poirot (famous detective) sitting next to me whispering in my ear.” For non-doctors the appearance of your skin gives strangers an impression of your age, and how healthier you are. Think of speed dating….you are introduced to Mr. Right and he immediately is not interested. He doesn’t even care to talk to you. His instincts say to him that you are not healthy and that you are older than you say you are, because of the condition of your skin. The same thing can happen at job interviews….you don’t want to look sick and old when you are going for a job. No one even consciously knows they are judging you…they just know instinctively get the message that you aren’t a candidate for whatever you are trying out for because of perceived old age and poor health….it is an unconscious reason for not choosing you! So why not consider the simple steps it will take to transform your skin, and yourself, from looking old and sick to young and healthy? To get great skin, we must BE HEALTHY, in other words we must develop healthy habits as well as give our skin the attention and care it needs. Here is a list of what is required to heal you skin and begin to look younger and healthier. DIET: whole foods, with a lot of water and fresh vegetables and fruit. No fast or processed food. SUPPLEMENTATION: Vitamin D, Vitamin E, Biotin, Methyl Vitamin B12 and methyl Folate DAILY EXERCISE: Gives your skin a glow with healthy oils and perspiration. REPLACE HORMONES THAT ARE MISSING: Whole body Testosterone (pellets), Estradiol, Thyroid if it is deficient CLEAN AND PROTECT YOUR SKIN: Treatment of the skin itself by washing and exfoliating dead skin off the surface twice daily, using serums specifically for the aging problem that bothers you most, and Moisturizers to keep the skin hydrated. Ok. so you think, you can do this, but here is the kicker—you also need to make harder lifestyle changes, and stop your bad habits: Stop Smoking Stop Drinking more than 4 oz of wine /night Stop fast food Get 7-8 hours of sleep every night. Now I hear the typical negative response coming through the computer…as if I am spoiling your party…I KNOW you don’t want to change your habits….or stop excessive drinking, smoking, and staying out late, so you are already finding excuses why this obvious, simple answer won’t work for you! If that is you, then stop worrying about your skin, because it won’t be any better than it is today….and it will get WORSE with age! But if you will spend an extra 7-10 minutes a day on the health of your skin and you realize that it is time you clean up your act, then continue to listen to the things that you should do to have a beautiful body covered with glowing skin! A little work and change of habits will get lots of compliments and people may ask you how you got beautiful skin! The “happy” side-effect of taking care of your skin is that you are concurrently building a healthier body that will live longer without disease. The above changes are a start but protecting and feeding your skin is important too! In the list below I will share what products and I use, but I have skin concerns that you might not have (I’m 69 and had a lot of sun damage as a teenager). These are examples, however if you are serious about having beautiful young and glowing skin, then using the medical grade skin products (those bought at your spa or dermatologist) are the most effective. Internal Nutrition for Your Skin (Diet)—Whole food diet (lean meat, eggs, fruit and vegetables every day!) + Supplements to give you what you are missing in your diet, in higher doses Stop Bad Habits (see above) and exercise every day Cleansing skin that is exposed to sun, lack of humidity, and air pollution requires daily cleansing and humectants. Cleaning off your makeup from your face, neck and decollate (Face Wash= e.g. Glycolic Renewal- Skinceuticals) twice a day Topical Nutrition (Serums) Skinceuticals e.g. CE Ferrulic, hyaluronic acid (Skinceuticals HA Intensifier) and other serums that feed your skin from the outside. Protect Your Skin from Dehydration (Moisturizers), and drink plenty of water especially in the winter when the heat is on to replenish the moisture to your skin from the inside. My moisturizer is usually Triple Lipid Moisturizer from Skinceuticals®, but AGE Interupter Moisturizer is my favorite during the winter or when I am vacationing in cold or dry climates, because it holds skin moisture in the best. Intermittently I use Defenage Serum and Moisturizer Professional products when I want to take a break and expose my skin to alternative treatment (this makes both types of products more effective). Protect your skin from damaging radiation from the sun (Sunscreen). You should wear sunscreen every day! In Missouri it is winter longer than summer (or so it seems), but until I found the ColorScience tinted sunscreen, I forgot my sunscreen all the time. This sunscreen is easier to remember because it is part of my makeup the I apply daily. It is a combination moisturizer, sunscreen, and foundation, I rarely wore sunscreen in the fall and winter before I found this product…not now! Daily exercise to bring blood flow to your skin, brings healthy oil and blood to the surface of the skin and releases toxins through sweating. Taking care of your skin at home is fairly simple and for the most part can be integrated into your daily routine. Here are the basic skin care steps: Step #1 Cleansing your skin in the AM and before bed when you with a non-drying face wash. (Skinceuticals Gentle Face Wash or LHA face wash). Follow this with a serum specific to the needs of your skin to repair sun damage, to fade age spots, or to improve the texture of your skin. For example, Skinceuticals CE Ferulic— It lasts all day and assists in maintaining hydration and improving the condition of your skin. Step#2 Moisturize and Protect your skin from drying out during the day and while you are sleeping and not drinking water. The 8 hours you sleep is the longest time you go without oral hydration, so your skin needs protection to hold the moisture in. Moisturizers are generally a shield to prevent drying out. The best of these moisturizers both feed your skin and protect it from drying, like Skinceutical’s Triple Lipid Moisturizer before bed. Your morning routine is just like your bedtime steps, except after you moisturize, you should use a sunscreen that is equal to or greater than SPF 30, ideally with a tint instead of foundation. Hint: If you brush your teeth twice a day, then add 5 minutes to your morning and evening self-care you can clean and apply your skin care routine to your dental care. Of course, there are many other types of topical products that preserve the beauty of your skin, but they are directed at specific problems such as acne, rosacea, deep wrinkles and discoloration, but it requires an expert in skin care to help you choose the most effective product for you. My patients ask me what skin care routine I follow, and I give them the following list of products and vitamins I use because I know that skin requires nutrition from my diet as well as topical products. Oral water intake: 80 oz of clear water a day for hydration Diet filled with daily raw vegetables/fruit, and a salad daily High protein and healthy fat in my diet (meat, fish, eggs, cheese, a variety of nuts, olive oil and yogurt) Products I use: Face Wash Skinceuticals: Replenishing Cleanser twice a day Serums: Skinceuticals CE Ferulic to improve skin tone and texture, HA Intensifier to increase Hyaluronic Acid for skin hydration, and Advanced Discoloration Corrector for brown (age) spots. Skinceuticals Triple Lipid Moisturizer, AGE Interrupter Moisturizer, or Defenage Serum and Moisturizer Tinted Sunscreen by Color Science If you have taken excellent care of your skin with medical grade skin care products throughout your life, then all you have to do as you age is continue the care you already established and add some serums. Serums treat the skin with needed vitamins, minerals and peptides that are applied externally. medical grade products cost more because they actually penetrate the epidermis penetrate the epidermis and provide building blocks to repair and supply your dermis with needed “supplies” for healthy “daily reconstruction”. So healthy diet with varied healthy and unprocessed foods, plenty of water, healthy fat and protein to “feed” your skin is a required step toward beautiful skin as you age. In the end most of us have not been aware of the needs of our skin until our skin starts to show aging and damage. Because that is a common occurrence, BioBalance Skin offers a variety of treatments that you can receive at our Medical Spa that are all aimed at reversing the aging process by tightening sagging skin, removing age spots and wrinkles, elevating facial skin, fillers to inject to fill lost fat in our face as well as treating sagging upper arms and skin around our knees just to name a few. Next week we will be talking about the more aggressive methods of improving aging and damaged skin available currently available in our Medical Skin Care Spa and other spas like it.
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652 Healthcast – Do You Feel Dismissed by Your Doctor?
01/15/2024
652 Healthcast – Do You Feel Dismissed by Your Doctor?
See all the Healthcasts at Every day in my office I hear horror stories about how my female patients are dismissed by the doctors they trusted to help them resolve their problems such as: · Hot Flashes and night sweats · Loss of libido · Rapid weight gain · Brain Fog · Insomnia · Arthritis associated with lack of hormones · Anxiety/Depression starting in their late 30s · New irritability · New Migraine headaches · Lack of motivation · Fatigue There doctors dismissed them, telling them they were just getting old, or they were “babies” because they can’t stand a few hot flashes, the doctor changed the subject, or my most unfavorite response to a plea for help, “It is just in your head”. Many other demeaning responses have been recorded, but I am appalled at these responses. For a patient it takes so much strength to ask these questions, and patients are literally at the doctor’s mercy. In case you didn’t get it, the doctor who says these things is covering up for his/her own ignorance. These are methods used by a person in charge who is challenged to answer a question he or she doesn’t have an answer for. In general, these doctors are men and women, however women have been trained by men and they taught women to do what they had been doing for years. These “medical” responses are used to belittle the patient to hide their own lack of knowledge. If you are dismissed in this way you should not put up with it. You can just never schedule with that doctor or practice again or you can find a new doctor who will hear your distress and treat you or tell you they don’t know how to help and refer you to someone who does. You shouldn’t put up with dismissive doctors. Another dismissive phrase used by many doctors since the inaccurate WHI study is you’re your doctor tells you that he doesn’t BELIEVE in hormone replacement. You should respond that hormone replacement is not a religion, it is a medically necessary treatment for menopause! Board certified OBGYNs and Family Doctors should be trained in this treatment. We women have not only been dismissed by doctors, but also by the Colleges (eg. American College of Obstetrics and Gynecology) that tell doctors how to practice. In my OBGYN training I was taught that most of women’s complaints were because they were depressed so they told us to put women on anti-depressants that just make them numb, but that did not treat our symptoms. Misogyny is alive and well in the practice of medicine, even in the group of doctors who are supposed to dedicate their lives to the health of women, Obstetricians/Gynecologists. Discrimination CAN be taught, and I believe medical training still teaches these male oriented beliefs to new doctors who are almost 50% women. Medical schools allow women to become doctors because we are qualified, and they can’t discriminate anymore. When I was trained and for a few decades after I became a doctor, you would think I was a second-class citizen. I was left out of resident training run by the residents (almost all men). Those older male doctors treated me like and. Interloper and some even told me I was not supposed to be a doctor because of my sex. …I was never treated as if I was an equal from the minute, I started medical training and women now practicing over the age of 50-something were all trail blazers and were told all women were hysterical and complainers. I never accepted this view but now know that women complain because we are not believed and not treated with a treatment that really relieves our symptoms. After my hysterectomy 2002 I was in private practice with like-minded women in Balanced Care for Women, and they tried to help me but admitted they didn’t have the knowledge. I had terrible symptoms that I now know was from lack of testosterone. The endocrinologists and primary doctors I sought help from belittled me and treated me like I was making the symptoms up! The worst experience I had was with endocrinologists who were women just saying what their male counterparts had taught them without really thinking. They “drank the Kool-Aid “from their male teachers and treated me like I was crazy because they were unwilling to admit they didn’t know what was wrong with me! I grew up in medicine (1977-now) under a cloud of sex discrimination and when I needed them most at the age of 47 my sister-doctors failed me…I know intimately how my patients feel when seeing doctors that demean them. There has been a Federal Law to protect women since 1972, when the US government passed Title IX a Federal Civil Rights Law amendment, but in my experience the law was violated all the time. Title IX 1972 (my interpretation is simplified and not the actual word for word amendment) Sex discrimination is unlawful in choosing an employee, a medical student, funding for sports at the collegiate level. I am a champion for women and women’s rights. We should require every medical student to be taught about this so the teaching from one generation to another doesn’t contaminate young doctors. Without this action the misogyny in medical care will continue. Recently The DEA required doctors to take an 8-hour course to help them learn to communicate with substance users in a more kind and sympathetic manner. The course’s direction to be compassionate and supportive to substance users should be taken for treating women as well. That would be a giant step for all of us. Wiping out discrimination takes generations but must start somewhere and that should be taught at the beginning of medical training. After we conquer the minds of physicians then we will have to work toward equity in drug development (all drugs are tested on men, but women were not tested on new drugs until 2014), the FDA, the DEA, and Pharmaceutical companies. To make this happen patients will have to take part and not accept dismissive and discriminatory behavior by their treating doctors.
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