December, 2004

 

• PHYSICIAN’S ASSISTANT JOINS PRACTICE
• STAY HEALTHY IN WINTER AND BEYOND
• PROGESTERONE FACTS

 

 

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PHYSICIAN’S ASSISTANT JOINS PRACTICE

 

Dawn LaBarbera, PhD, PA-C, joined our practice this year. Dawn is a Physician Assistant, a health care professional that is licensed to practice medicine with physician supervision. As part of their comprehensive responsibilites, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventative health care, assist in surgery, and write prescriptions. Dawn does everything that Dr. Elvove does including prenatal and postnatal care, except she is not involved in actual labor and delivery. Dawn works in our office on Tuesdays and Wednesdays. On other days Dawn works as an assistant professor at the Rosalind Franklin University of Medicine radiation physics and physician assistant departments, where she teaches, performs research, and acts as a clinical coordinator. We are very proud to welcome Dawn to our staff!

 

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STAY HEALTHY IN WINTER AND BEYOND

The panic generated by the influenza vaccine shortage this year demonstrates that we Americans are very concerned about how to stay healthy in the winter season. The flu vaccine is modern medicine’s quick answer to maintaining a healthy condition. To me this seems like a shortsighted approach. It doesn’t make sense that in order to remain healthy that we will all require a flu shot every year for the rest of our lives. Even the cumulative dose of mercury from the flu vaccine preservative taken annually worries me. I wish to present here a more common sense approach to achieving wellness–a plan that even our wise grandmothers would approve. The following plan will not only prevent illness, but also promote a state of wellness, which should help to prevent chronic diseases.

GET ADEQUATE SLEEP. Thomas Edison invented the electric light bulb only 125 years ago. For the preceding fifty thousand years people went to sleep at dark and awoke at dawn. It is obvious that our bodies require more sleep in the winter season. We have completely lost track of this obvious fact due to the omnipresence of electrical lights and appliances. It is during sleep that the body repairs and regenerates itself. Chronic sleep deprivation is responsible for immune system dysfunction. This explains why infectious diseases are far more prevalent in the months having shorter days. If you contract the flu your natural tendency is to sleep and rest extra hours, which allows your immune system to combat and remove the viruses. Most adults require 8-10 hours of sleep for optimal functioning.

STAY WARM. We have all experienced how becoming wet or chilled in the winter brings on cold or flu symptoms. Modern medicine rejects chilling as a cause for illness. I do believe that a lowered body temperature increases susceptibility to infections. The body develops a fever in response to an infection in order to help it clear the invaders from the system. Studies have shown that children who are given acetaminophen to lower their temperature during chicken pox will take a full day longer to recover than those children who are allowed to run a fever. The fever helps them to overcome the virus. For example, before penicillin was invented, syphilis was cured by inoculating the patient with malaria, because the resulting high body temperature would kill the syphilis organisms. The malaria was then treated with quinine.

TAKE YOUR FISH OIL. Purified fish oils contain EPA and DHA, long chain omega-3 fatty acids that keep inflammation in check. The immune system is responsible for keeping harmful bacteria and viruses from multiplying in the body. If the immune system becomes over-active this can result in widespread inflammation. Inflammation can lead to tissue damage in the arteries, brain, joints, and internal organs. The result of chronic inflammation can be premature aging, heart disease, allergies, arthritis, diabetes, hormonal dysfunction, cancer, and Alzheimer’s disease. The omega-3 fatty acids in fish oil promote a healthy balance in immune system function. A well-balanced immune system keeps pathogenic microbes in check while preventing an over exuberant inflammatory response.

CLEAN YOUR NASAL PASSAGES. The portal of entry for the respiratory viruses that cause colds and flu is often the nose and mouth. Ayurvedic medicine of India long ago developed a simple method for cleaning the nasal passages with warm slightly salty water. The neti pot nasal cup looks like a small teapot. You place the spout in your upper nostril while tilting your head over the sink. The warm saline runs from the upper nostril through the nasal passages and out of the lower nostril and into the sink. Repeat this process on the other nostril then you blow your nose. Since the water is warm and slightly salty, it does not sting your nasal linings. In fact you hardly feel the water flowing through. The procedure may sound complicated but in practice is actually quite simple. Nasal passage cleaning should be a daily habit akin to brushing your teeth. It removes allergens and microbes from the nasal passages before they can create annoying symptoms. This is a great preventative for those prone to sinus, nasal, or ear infections. We have neti pots with their usage instructions available at the office.

EAT HEALTHILY. Your immune system utilizes gamma globulins to create antibodies that render pathogenic microbes harmless to your body. These antibodies are complex protein structures that require a steady supply of dietary proteins for replenishment. This is why a moderate amount of lean protein with each meal and snack is important to maintain healthy immune function. Fruits and vegetables in large quantities are necessary to provide vitamins, antioxidants, phytonutrients, and fiber necessary for healthy cellular function. Grains on the other hand contain plenty of sugars, starches, and calories but very little vitamins or fiber so should be used only sparingly. Monounsaturated oils present in olives, avocados, and nuts are important for creating healthy cell membranes. Trans fatty acids (partially hydrogenated vegetable oils) should be completely avoided. Polyunsaturated oils, which are rich in omega-6 fatty acids, should also be avoided. Examples of oils to avoid are corn, safflower, soybean, and cottonseed oils. In general, balance and moderation is the key to a healthy diet.

SUPPLEMENT VITAMIN D. Vitamin D is synthesized by our skin upon exposure to sunlight. A full body exposure to direct sunlight in summer can create the equivalent of 10,000 IUs of an oral vitamin D supplement. Vitamin D has long been known to improve the absorption of calcium from the gut and thus improve the quality of bone and tooth formation. Recently scientists have also discovered vitamin D receptors in the brain, breast, prostate, and lymphocytes. We now believe that adequate levels of vitamin D can provide protection from diabetes, osteoporosis, osteoarthritis, hypertension, cardiovascular disease, depression, infection, autoimmune diseases, and cancers of the breast, prostate, and colon.
Due to reduced sunlight exposure in the winter months, most of us need to supplement with vitamin D. Sunscreens also block the skin’s synthesis of vitamin D. The natural form of vitamin D comes from fish oils and is called vitamin D3 or cholecalciferol. Vitamin D2 or ergocalciferol is obtained by irradiating yeast cells, and I do not recommend this kind for supplementation. A reasonable supplement would be 1,000 IUs per day of pure cholecaliferol. You can take higher doses in deficiency states if we monitor your serum 25-OH-vitamin D and calcium levels. The optimal level for 25-OH vitamin D is 40-65 ng/ml.

SUPPLEMENT WITH VITAMIN C. Vitamin C has long been recognized as an anti-oxidant and connective tissue strengthener. It also improves iron absorption and has an anti replication effect on viruses. Vitamin C is water-soluble and can safely be taken in high doses. Linus Pauling, the Nobel Prize winning scientist, recommended 5-18 grams of vitamin C per day to prevent or to reverse degenerative diseases.

WASH YOUR HANDS. Frequent hand washing prevents the transmission of pathogenic microbes between people. I do not recommend anti-bacterial soaps because they are too strong and remove the healthy protective bacteria from the skin.

EXERCISE AND REMAIN ACTIVE. Our bodies are designed to be physically active throughout life. The adage “use it or lose it” applies. Exercise strengthens muscle, bone and connective tissue. Exercise helps remove accumulated toxins from the body. Activity also keeps you psychologically and mentally healthy by releasing endorphins in the brain.

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PROGESTERONE FACTS

Progesterone is sadly neglected in the curricula of medical schools. Even though this hormone is essential to life, its importance to health is unknown or misunderstood by many doctors. Following is a list of little known facts about this wonderful hormone.

1. Progesterone is essential to maintaining a pregnancy, hence its name: “pro-gestation”. Synthetic progestin pills, manufactured by pharmaceutical companies to be similar in structure to natural progesterone, will kill the embryo if taken during early pregnancy.
2. The ovarian follicle that releases the egg at ovulation synthesizes progesterone. If a conception occurs, that follicle becomes a corpus luteum and continues to produce progesterone until the placenta develops and takes over the synthesis of progesterone.
3. Progesterone raises the body temperature and is therefore responsible for the temperature spike seen on basal body temperature charts following ovulation and during pregnancy.
4. Progesterone is rapidly absorbed from the skin when applied as a cream. The best areas to apply the cream are in areas that blush and therefore have a rich supply of blood vessels beneath the skin. The hormone is rapidly absorbed from the face, neck, upper chest, palms of the hands, and soles of the feet. Any excess cream can be wiped off if desired after several minutes. Oral micronized progesterone such as Prometrium™ is unsatisfactory, because the liver breaks it down into toxic metabolites after oral ingestion.
5. PMS symptoms such as mood swings, water retention, headaches, and breast tenderness result from insufficient progesterone. Normally progesterone balances the effects of estrogen. If ovulation does not occur, or if the corpus luteum fails prematurely, symptoms of estrogen dominance will result. These problems gradually increase after the age of thirty-five.
6. Estrogen causes proliferation of the uterine lining and glandular development of the breasts. If estrogen circulates without the moderating effect of progesterone, the result is excessive menstrual flow and cystic breasts. If estrogen dominance continues for many years, then endometriosis, uterine fibroids, and breast cancer may develop. Supplementation with bioidentical progesterone as a transdermal cream during the last fourteen days of the menstrual cycle can prevent or reverse these problems.
7. If a premenopausal woman is having regular periods, she is not estrogen deficient because it is estrogen that is creating her menstrual lining. Therefore giving her estrogen supplements as HRT (hormone replacement therapy) is wrong. Giving physiologic doses of bioidentical progesterone would be more appropriate.
8. Estrogen prevents bone loss while progesterone stimulates new bone formation. Therefore both hormones are necessary to prevent osteoporosis.
9. Most postmenopausal women continue to make small amounts of estrogen in their body fat, ovaries, and adrenals. Saliva tests can quantify hormonal levels and help to determine whether physiologic supplements of bioidentical hormones would be helpful.
10. The prostate gland in the male originates from the same embryonic tissue as the uterus in the female. The prostate, similar to the uterus, responds to estrogen dominance by growing in size or by developing cancer. Men manufacture increasing amounts of estrogen in their fat cells and in their testes as they age. Small supplements of progesterone can inhibit prostate enlargement or cancer development.
11. Bioidentical progesterone can be converted by the body to other hormones that the body needs. Synthetic progestins are not biodegradable in the body and are thus difficult for the body to convert or remove.

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