ARE OUR OWN PERSONAL CARE PRODUCTS KILLING US?
(A Xeno-Estrogen overview)
ROBERT G. Carlson, MD, FACS
I have always tried to remind people that while we can’t change everything in our environment, we can make simple daily changes that can and WILL directly affect the health quality of our future and that of our family. Of course I’m not asking you to go home and peel the paint off the walls or remove the carpet but...simply “Change What You Can”…i.e. personal care products. What, my personal care products? That’s correct!
The Sierra Club tells us that there are already approximately 200 chemicals in the average person’s body fat. It is not a question of ‘if’ we are carrying a burden of toxic compounds, but how much!
One third of all personal care products contain at least one or more ingredients classified as possible human carcinogens.
While it’s pretty scary to think about, experts tell us that most of us come in contact with over 200 toxic chemicals before we get dressed in the morning. That means we are bathing ourselves in toxins! Think about what you used this am…Got up…brushed your teeth (toothpaste), got into the shower (body soap or wash, shampoo, conditioner, shaving gels)…getting dressed (deodorant, body lotion, aftershave)…fixing hair (hair gels, styling gels, hairspray)…Not to mention facial creams, make-up, perfume. The list continues and that’s even before you walk out of the house!
So what is a Xeno-Estrogen? It is a chemical that unfortunately is often found in our daily personal care products, and will produce dangerous artificial Estrogens, not like normal healthy estrogens produced in our bodies. These Xeno-estrogens are ever present, but in some will produce dangerous side-effects. I often tell my male patients, since high estrogen levels in men is very dangerous in men, to avoid estrogens in our environment, like anti-dandruff shampoos, and the a large consumption of chicken and turkey.( They didn’t get large breast naturally?!). We are seeing young girls develop at a very early age, and should wonder what kinds of xeno-estrogens they are being exposed to on a daily basis. And women in their late 30’s and early 50’s who are plaqued with too much estrogen, and have very low levels of the amazing protective progesterone, and who now are being exposed to massive environmental estrogen, are at an increasing risk for developing breast and uterine cancers, as well as uterine fibroids and ovarian cysts.
What is the Risk Factor?
Many skin and personal care products contain carcinogens, fragrances, harmful preservatives and chemicals that can block the skin’s critical natural functions of absorbing oxygen and detoxifying the body. While these toxic ingredients may be present in miniscule amounts, some or all of these chemicals are absorbed through the skin into the fatty tissue and blood stream. Research has shown traces of these toxins are stored in the brain, liver, heart, kidneys, etc. The biggest problems occur when they are repeatedly applied over an extended period of time, which is the nature of personal and skin care products. These ingredients can impact your neurological health, create or worsen allergic reactions, and more acutely affect children and pets as the residue floats down to concentrate 12 inches above the floor where small children and our pets live and play.
According to the National Institute for Occupational Safety and Health, 884 chemicals and synthetic ingredients commonly found in personal care and cosmetic products are toxic and known as irritants, allergens or carcinogens. While they are not prohibited (or have only minimal restrictions) for use in personal and skin care in the United States, in other countries like the Canada, European Union, and Japan, health concerns stimulated laws to ban many of these ingredients.
Most of us think of ‘aging’ as wrinkles that begin to appear on our face. But that word applies to all the diseases and conditions that impact our health . . . breast cancer, heart disease, diabetes, obesity, depression, etc.
What few realize is that skin care products and other topical personal care items we use are significant contributors to these diseases. The products applied to our skin to help us look younger actually contain Age Accelerators.
Linda Chae , an expert dedicated to creating products that have none of these nasty Aging accelerators in them, stated that, “Every day, we apply creams and lotions, use deodorant, brush our teeth, use perfume (or products with fragrance). . . and the small amounts of toxic, carcinogenic and hormone disrupting chemicals add up. In fact, scientific studies have shown these chemicals remain in our blood and fat tissue, and some have been found in breast cancer tumors. The specific chemicals are not in the air we breathe, the water we drink, or the food we eat. They are only found in the products which are then absorbed through the skin.”
I want you to pick up your skin and personal care products and look carefully at the ingredients. See if any of the below Aging accelerators are in your daily products.
The following are the worst of the worst, toxic, carcinogenic accelerators of aging and frightfully so they are commonly found in most skin and personal care products. Below is the brief list and I will go into more depth next week.
Benzoyl Peroxide:
DEA (Diethanolamine), MEA (Monoethanolamine), & TEA (Triethanolamine): Dioxin: .
DMDM Hydantoin & Urea (ImidazolidinylFD&C Color & Pigments: Fragrances: Fragrances can indicate the presence of up to 4,000 separate ingredients including phthalates, many toxic or carcinogenic.
Parabens: (Methyl, Butyl, Ethyl, Propyl) - used as preservatives and aren’t always labeled "parabens." They’re used in deodorants and antiperspirants and have been found in breast cancer tumors. Parabens, as xenoestrogens (hormone disruptors), may contribute to sterility in male mice and humans. Estrogen-like activity causes hormone imbalance in females and early puberty.
PEG (Polyethylene glycol)
Phthalates
Propylene Glycol (PG) and Butylene Glycol:.
Sodium Lauryl Sulfate (SLS) and Sodium Laureth Sulfate (SLES): Detergents and surfactants that pose serious health threats.
Sunscreen chemicals: avobenzone, benzphenone, ,ethoxycinnamate, PABA are commonly used ingredients
Triclosan
Did I catch your attention? Go check your household personal products now and there will be more to come next week! Dr. Carlson.
Showing posts with label aging. Show all posts
Showing posts with label aging. Show all posts
Saturday, February 5, 2011
Monday, June 21, 2010
Vitamin D myths and management-Robert Carlson,MD
THE MANY VITAMIN D MYTHS
Patient EB is a 50-year-old female with a family history of colon cancer and breast cancer as well as a history of arthritis with probable autoimmune etiology. She takes a daily multivitamin which includes 10,000 units of Vitamin A as well as a separate 1000 IU of Vitamin D3 and her 25-(OH) Vitamin D3 level is 36 ng/mL (reference range 33-100 ng/mL). Should EB increase her dose of Vitamin D3? Should she continue her multi-vitamin?
There are so many myths surrounding Vitamin D. First and foremost, is the myth that Vitamin D is
a Vitamin. Vitamin D is not a Vitamin, it is actually a steroid hormone. Vitamin D is produced in one part of the body (the skin), and then travels to a remote site, where it exerts an endocrine effect. Thus, it fulfills the definition of a hormone. Another Vitamin D myth is that its only function is calcium regulation. That idea has been well and truly debunked in recent years. Then there is the idea that 1000 IUs a day is more than enough, which is simply not true. Also many believe that taking over 2000 units a day might cause toxicities. I hear this from numerous health professionals and even from pharmacists who should know better. The literature is very clear…..evidence from clinical trials shows that a prolonged intake of 10,000 units of Vitamin D per day poses no risk of adverse effects for adults 1 ……therefore one can take 10,000 units a day and have no risk for toxicity.
Other myths of interest include:
1) Most people living in the US get adequate amounts of Vitamin D – not true (see below).
2) Extreme care must be taken to avoid toxicity – not true! There have been numerous
studies on Vitamin D toxicity and no toxicity has been seen in doses lower than 30,000
IU/day (200 ng/mL). An excess of Vitamin D causes hypercalcemia, however all known
cases of Vitamin D toxicity with hypercalcemia have involved intakes of 40,000 IU or more
per day.2
3) Spending 15 minutes in the sun each day enables the body to produce ample amounts of
Vitamin D – that may be true if you are sitting on a beach in Hawaii at noon wearing
nothing but a bikini, but for the vast majority of us that is a myth. Unfortunately, once sunscreen is applied the Vitamin D production drops to nothing. If you live above 35 degrees latitude, the body is unable to produce adequate amounts of Vitamin D from the winter sun. In fact the only adequate amount of sunshine in Boston occurs, between May and Sept, otherwise there is inadequate sunlight for Vitamin D metabolism.
4) Eating a balanced diet will provide adequate amounts of Vitamin D – not true! Vitamin D is present, in small amounts, in only a handful of foods – oily fish, eggs, and fortified
foods. Vitamin D fortified Milk and Orange Juice only contain 50 Units of Vitamin D2, not Vitamin D3. Thus it is very unlikely that adequate amounts could be obtained from the diet.
• Vitamin D does not prevent cancer – it does , in fact one study showed the reduction in all cancers by 77 % over a four year period in a well designed study.(see below).
• Vitamin D does not prevent autoimmune disease – it does , reducing Systemic Lupus ,Rheumatoid Arthritis and Childhood onset diabetes(see below).
• Vitamin D does not prevent acute MI and heart disease – it does (see below).
As mentioned above, the notion that most people living in the US get adequate amounts of
Vitamin D is far from true. Research has shown that Vitamin D deficiency is present among all age groups of US citizens from children to the elderly, and especially in African-Americans.3 Studies have shown that the prevalence of low 25-(OH) D levels (<20 ng/mL) is approximately 36% in young adults aged 18-294 ,42% of African-American women aged 15-495 ,41% of outpatients aged 49-83,6 and 57% of inpatients.7
In Europe, it is believed that between 28 and 100% of healthy adults and 70-100% of hospitalized adults have low 25-(OH) D levels (<20 ng/mL).8,9,10
A study we completed examining women age 35-65 in Tampa, Florida in December, demonstrated that 92 % of the women had 25-(OH) D levels less than the low normal range of 32. Can you imagine what the Vitamin D levels are in the same group of women in Minneapolis, Minnesota in December?
Research has shown that the incidence of many diseases could be dramatically reduced by
increasing serum 25-(OH) D levels, and by looking at the list below, it is easy to see why Vitamin D has become a very hot topic in recent years:
1) Increasing serum 25-(OH) D levels to 35 ng/mL could prevent 30% of MI in men11 and
reduce the risk of fracture in elderly people by 50%.12
2) Increasing serum 25-(OH) D levels to approximately 40 ng/mL could reduce the risk of
cancer in postmenopausal women by 35%13 and reduce the risk of falls in elderly people
by 50%. 14
3) Increasing serum 25-(OH) D levels to 50 ng/mL could reduce the incidence of breast
cancer by as much as 80%,15 multiple sclerosis by as much as 60%,16 and type I
diabetes by up to 50%.17
Why is Vitamin D so beneficial? There is no clear answer at present. However, anything that has
such wide-ranging benefits has to possess the ability to modulate inflammation. Indeed, studies have shown that Vitamin D inhibits nuclear factor-κβ (NF-κβ) 18 – a protein that plays a key role in the inflammatory response and in the proliferation of cancer cells. It has also been shown to lower levels of the inflammatory marker CRP.19 Thus, it is vital that we ensure our patients are getting plenty of Vitamin D.
What about Patient EB, does she need to increase her daily dose of Vitamin D3? Yes. The
reference range for 25-(OH) D is 32-100 ng/mL Given the evidence published in the medical literature over the last few years, it is advisable to try and keep patients at the top end of the reference range – so, we should be aiming for 75-100 ng/mL The optimal dose for an average person is 5000-15,000 IU/day; however this should be lowered for people who get a lot of sun exposure. Ideally check Vitamin D leveIs and regularly check serum calcium in patients who take supplementary Vitamin D, just to ensure there is no risk of hypercalcemia.
So what about her multi-Vitamin choice? Some multi-Vitamins may be doing more harm than good. I recommend avoiding excessive amount of pre-formed Vitamin A in the retinol form, as opposed to the beta-carotene form that converts to Vitamin A in your body. The presence of excessive pre-formed actually will neutralize all the amazing benefits of Vitamin D3.20 Unfortunately, multi-vitamins often continue a lot of Vitamin A(average 4400 units) as retinol and very low levels of D3( average 400). Vitamin A and Vitamin D receptors are very close to each other and excess Vitamin A will block the beneficial effects of Vitamin D. Women who took the highest intake of pre-formed Vitamin A actually had twice as many hip fractures. 21 So keep the non- beta carotene Vitamin A supplements to less than 1000 units, and this will allow all the amazing benefits of Vitamin D3.
CONCLUDING REMARKS
There are many myths surrounding hormone replacement therapies, however from the evidence
presented above, we can see that not one of them is true. Hormone optimization provides us with an extremely powerful anti-aging tool to maximize quality of life.
REFERENCES
1. Vieth R. Vitamin D and Cancer Mini-Symposium: the risk of additional Vitamin D. Ann Epidemiol. 2009; 19(7):441-5.
2. Vieth R. Vitamin D supplementation, 25-hydroxyVitamin D concentration, and safety. Am J Clin Nutr. 1999;69:842-56.
3. Holick MF. High prevalence of Vitamin D inadequacy and implications for health. Mayo Clin Proc.
2006;81:353-373.
4. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young
adults. Am J Med. 2002;112:659-662.
5. Nesby-O'Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, Allen C, Doughertly C,
Gunter EW, Bowman BA. HypoVitaminosis D prevalence and determinants among African American and
336 white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. Am
J Clin Nutr. 2002;76:187-192.
6. Malabanan A, Veronikis IE, Holick MF. Redefining Vitamin D insufficiency [letter]. Lancet. 1998;351:805-
806.
7. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM,
Prince RL, Finkelstein JS. HypoVitaminosis D in medical inpatients. N Engl J Med. 1998;338:777-783.
8 . McKenna MJ. Differences in Vitamin D status between countries in young adults and the elderly. Am J
Med. 1992;93:69-77.
9. Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D, Adami S. Prevalence of hypoVitaminosis D in
elderly women in Italy: clinical consequences and risk factors. Osteoporos Int. 2003;14:577-582.
10. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M,
Franceschi C. Low Vitamin D status, high bone turnover, and bone fractures in centenarians. J Clin
Endocrinol Metab. 2003;88:5109-5115.
11. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyVitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174-80.
12. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture
prevention with Vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA.
2005;293:2257-2264.
13. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium
supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586-1591.
14. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of Vitamin d
reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc.
2007;55:234-239.
15. Garland CF, Gorham ED, Mohr SB, Grant WB, Garland FC. Breast cancer risk according to serum s5-
hydroxyVitamin D: Meta-analysis of dose-response. Presented at: American Association for Cancer
Research Annual Meeting; April 12-16, 2008; San Diego, California.
16. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyVitamin D levels and risk of
multiple sclerosis. JAMA. 2006;296:2832-2838.
17. Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of Vitamin D and risk of type 1
diabetes: a birth-cohort study. Lancet. 2001;358:1500-1503.
18. Szeto FL, Sun J, Kong J, Duan Y, Liao A, Madara JL, Li YC. Involvement of the Vitamin D receptor in the
regulation of NF-kappaB activity in fibroblasts. J Steroid Biochem Mol Biol. 2007;103:563-566.
19. Boxer RS, Dauser DA, Walsh SJ, Hager WD, Kenny AM. The association between Vitamin D and
inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc.
2008;56:454-461.
20. Melhus H, Michaëlsson K, Kindmark A, Bergström R,. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Annals of Internal Medicine, 1998;129(10):770-8.
21. Johansson S, Melhus H. Vitamin A antagonizes calcium response to vitamin D in man. J Bone Mineral Res. 2001;16(10):1899-905.
Robert G Carlson, MD, FACS
Patient EB is a 50-year-old female with a family history of colon cancer and breast cancer as well as a history of arthritis with probable autoimmune etiology. She takes a daily multivitamin which includes 10,000 units of Vitamin A as well as a separate 1000 IU of Vitamin D3 and her 25-(OH) Vitamin D3 level is 36 ng/mL (reference range 33-100 ng/mL). Should EB increase her dose of Vitamin D3? Should she continue her multi-vitamin?
There are so many myths surrounding Vitamin D. First and foremost, is the myth that Vitamin D is
a Vitamin. Vitamin D is not a Vitamin, it is actually a steroid hormone. Vitamin D is produced in one part of the body (the skin), and then travels to a remote site, where it exerts an endocrine effect. Thus, it fulfills the definition of a hormone. Another Vitamin D myth is that its only function is calcium regulation. That idea has been well and truly debunked in recent years. Then there is the idea that 1000 IUs a day is more than enough, which is simply not true. Also many believe that taking over 2000 units a day might cause toxicities. I hear this from numerous health professionals and even from pharmacists who should know better. The literature is very clear…..evidence from clinical trials shows that a prolonged intake of 10,000 units of Vitamin D per day poses no risk of adverse effects for adults 1 ……therefore one can take 10,000 units a day and have no risk for toxicity.
Other myths of interest include:
1) Most people living in the US get adequate amounts of Vitamin D – not true (see below).
2) Extreme care must be taken to avoid toxicity – not true! There have been numerous
studies on Vitamin D toxicity and no toxicity has been seen in doses lower than 30,000
IU/day (200 ng/mL). An excess of Vitamin D causes hypercalcemia, however all known
cases of Vitamin D toxicity with hypercalcemia have involved intakes of 40,000 IU or more
per day.2
3) Spending 15 minutes in the sun each day enables the body to produce ample amounts of
Vitamin D – that may be true if you are sitting on a beach in Hawaii at noon wearing
nothing but a bikini, but for the vast majority of us that is a myth. Unfortunately, once sunscreen is applied the Vitamin D production drops to nothing. If you live above 35 degrees latitude, the body is unable to produce adequate amounts of Vitamin D from the winter sun. In fact the only adequate amount of sunshine in Boston occurs, between May and Sept, otherwise there is inadequate sunlight for Vitamin D metabolism.
4) Eating a balanced diet will provide adequate amounts of Vitamin D – not true! Vitamin D is present, in small amounts, in only a handful of foods – oily fish, eggs, and fortified
foods. Vitamin D fortified Milk and Orange Juice only contain 50 Units of Vitamin D2, not Vitamin D3. Thus it is very unlikely that adequate amounts could be obtained from the diet.
• Vitamin D does not prevent cancer – it does , in fact one study showed the reduction in all cancers by 77 % over a four year period in a well designed study.(see below).
• Vitamin D does not prevent autoimmune disease – it does , reducing Systemic Lupus ,Rheumatoid Arthritis and Childhood onset diabetes(see below).
• Vitamin D does not prevent acute MI and heart disease – it does (see below).
As mentioned above, the notion that most people living in the US get adequate amounts of
Vitamin D is far from true. Research has shown that Vitamin D deficiency is present among all age groups of US citizens from children to the elderly, and especially in African-Americans.3 Studies have shown that the prevalence of low 25-(OH) D levels (<20 ng/mL) is approximately 36% in young adults aged 18-294 ,42% of African-American women aged 15-495 ,41% of outpatients aged 49-83,6 and 57% of inpatients.7
In Europe, it is believed that between 28 and 100% of healthy adults and 70-100% of hospitalized adults have low 25-(OH) D levels (<20 ng/mL).8,9,10
A study we completed examining women age 35-65 in Tampa, Florida in December, demonstrated that 92 % of the women had 25-(OH) D levels less than the low normal range of 32. Can you imagine what the Vitamin D levels are in the same group of women in Minneapolis, Minnesota in December?
Research has shown that the incidence of many diseases could be dramatically reduced by
increasing serum 25-(OH) D levels, and by looking at the list below, it is easy to see why Vitamin D has become a very hot topic in recent years:
1) Increasing serum 25-(OH) D levels to 35 ng/mL could prevent 30% of MI in men11 and
reduce the risk of fracture in elderly people by 50%.12
2) Increasing serum 25-(OH) D levels to approximately 40 ng/mL could reduce the risk of
cancer in postmenopausal women by 35%13 and reduce the risk of falls in elderly people
by 50%. 14
3) Increasing serum 25-(OH) D levels to 50 ng/mL could reduce the incidence of breast
cancer by as much as 80%,15 multiple sclerosis by as much as 60%,16 and type I
diabetes by up to 50%.17
Why is Vitamin D so beneficial? There is no clear answer at present. However, anything that has
such wide-ranging benefits has to possess the ability to modulate inflammation. Indeed, studies have shown that Vitamin D inhibits nuclear factor-κβ (NF-κβ) 18 – a protein that plays a key role in the inflammatory response and in the proliferation of cancer cells. It has also been shown to lower levels of the inflammatory marker CRP.19 Thus, it is vital that we ensure our patients are getting plenty of Vitamin D.
What about Patient EB, does she need to increase her daily dose of Vitamin D3? Yes. The
reference range for 25-(OH) D is 32-100 ng/mL Given the evidence published in the medical literature over the last few years, it is advisable to try and keep patients at the top end of the reference range – so, we should be aiming for 75-100 ng/mL The optimal dose for an average person is 5000-15,000 IU/day; however this should be lowered for people who get a lot of sun exposure. Ideally check Vitamin D leveIs and regularly check serum calcium in patients who take supplementary Vitamin D, just to ensure there is no risk of hypercalcemia.
So what about her multi-Vitamin choice? Some multi-Vitamins may be doing more harm than good. I recommend avoiding excessive amount of pre-formed Vitamin A in the retinol form, as opposed to the beta-carotene form that converts to Vitamin A in your body. The presence of excessive pre-formed actually will neutralize all the amazing benefits of Vitamin D3.20 Unfortunately, multi-vitamins often continue a lot of Vitamin A(average 4400 units) as retinol and very low levels of D3( average 400). Vitamin A and Vitamin D receptors are very close to each other and excess Vitamin A will block the beneficial effects of Vitamin D. Women who took the highest intake of pre-formed Vitamin A actually had twice as many hip fractures. 21 So keep the non- beta carotene Vitamin A supplements to less than 1000 units, and this will allow all the amazing benefits of Vitamin D3.
CONCLUDING REMARKS
There are many myths surrounding hormone replacement therapies, however from the evidence
presented above, we can see that not one of them is true. Hormone optimization provides us with an extremely powerful anti-aging tool to maximize quality of life.
REFERENCES
1. Vieth R. Vitamin D and Cancer Mini-Symposium: the risk of additional Vitamin D. Ann Epidemiol. 2009; 19(7):441-5.
2. Vieth R. Vitamin D supplementation, 25-hydroxyVitamin D concentration, and safety. Am J Clin Nutr. 1999;69:842-56.
3. Holick MF. High prevalence of Vitamin D inadequacy and implications for health. Mayo Clin Proc.
2006;81:353-373.
4. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young
adults. Am J Med. 2002;112:659-662.
5. Nesby-O'Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, Allen C, Doughertly C,
Gunter EW, Bowman BA. HypoVitaminosis D prevalence and determinants among African American and
336 white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. Am
J Clin Nutr. 2002;76:187-192.
6. Malabanan A, Veronikis IE, Holick MF. Redefining Vitamin D insufficiency [letter]. Lancet. 1998;351:805-
806.
7. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM,
Prince RL, Finkelstein JS. HypoVitaminosis D in medical inpatients. N Engl J Med. 1998;338:777-783.
8 . McKenna MJ. Differences in Vitamin D status between countries in young adults and the elderly. Am J
Med. 1992;93:69-77.
9. Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D, Adami S. Prevalence of hypoVitaminosis D in
elderly women in Italy: clinical consequences and risk factors. Osteoporos Int. 2003;14:577-582.
10. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M,
Franceschi C. Low Vitamin D status, high bone turnover, and bone fractures in centenarians. J Clin
Endocrinol Metab. 2003;88:5109-5115.
11. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyVitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174-80.
12. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture
prevention with Vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA.
2005;293:2257-2264.
13. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium
supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586-1591.
14. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of Vitamin d
reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc.
2007;55:234-239.
15. Garland CF, Gorham ED, Mohr SB, Grant WB, Garland FC. Breast cancer risk according to serum s5-
hydroxyVitamin D: Meta-analysis of dose-response. Presented at: American Association for Cancer
Research Annual Meeting; April 12-16, 2008; San Diego, California.
16. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyVitamin D levels and risk of
multiple sclerosis. JAMA. 2006;296:2832-2838.
17. Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of Vitamin D and risk of type 1
diabetes: a birth-cohort study. Lancet. 2001;358:1500-1503.
18. Szeto FL, Sun J, Kong J, Duan Y, Liao A, Madara JL, Li YC. Involvement of the Vitamin D receptor in the
regulation of NF-kappaB activity in fibroblasts. J Steroid Biochem Mol Biol. 2007;103:563-566.
19. Boxer RS, Dauser DA, Walsh SJ, Hager WD, Kenny AM. The association between Vitamin D and
inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc.
2008;56:454-461.
20. Melhus H, Michaëlsson K, Kindmark A, Bergström R,. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Annals of Internal Medicine, 1998;129(10):770-8.
21. Johansson S, Melhus H. Vitamin A antagonizes calcium response to vitamin D in man. J Bone Mineral Res. 2001;16(10):1899-905.
Robert G Carlson, MD, FACS
Tuesday, November 18, 2008
What is HGH (Human Growth Hormone)
Human Growth Hormone is made up of 191 amino acids. It is a normally occurring hormone that reaches levels often exceeding 800 mcg during your teenage years and early twenties. After this peak, these levels will generally decrease continuously as we age. I believe the the cause of the physical signs of aging is this decrease in hormone levels, contrary to the idea that these levels fall because of aging.
Can we extend life by continuing to keep hormone levels at a youthful level? Claiming that Human Growth Hormone is the “fountain of youth” is not a fair statement; however, the lack of HGH results in the deterioration of numerous bodily functions resulting in the many of the physical signs of aging.
Human Growth Hormone is produced in the anterior part of the Pituitary. The pituitary is located behind the nose, inside of the brain. It is the command center for numerous hormonally controlled critical functions. When patients are born with poor HGH output, they are referred to as pituitary dwarves. Unfortunately, for these patients, their stature is not the only function affected by this lack of HGH. These patients do not live a normal life, aging more quickly, having a higher incidence of cardiovascular disease, recurrent illnesses, healing problems, and deteriorating bone structure. Other patients develop loss of HGH production after surgery or pituitary irradiation, developing significant changes in body composition, metabolism, lipid abnormalities, increased cardiovascular disease, and bone density abnormalities. Patients develop rapidly diminishing levels of growth hormone associated with aging, and though this may be construed as “normal”, the progressive development of life-shortening conditions including cardiovascular disease, obesity, Metabolic Syndrome, the decline in memory and thought processes, and the deterioration of physical activity should be addressed as they are real health issues.
Human Growth is produced usually around 1:00 to 2:00 in the morning, and having a very short half-life of approximately 12 minutes, disappears within one hour. Its production is associated with something called the Arcadian rhythm, or a sleep rhythm. Do you wonder why you wake up at 1:00 in the morning? Growth hormone is produced then and helps one maintain the critical REM sleep. If it is not adequately produced, REM sleep is not obtained and one sleeps too lightly - awakening very easily. The appropriate timing of replacement of HGH will help the patient reach and maintain the restful quality REM sleep.
Growth Hormone is then metabolized in the liver into IGF-1, or insulin-like growth factor. This is the active form of growth hormone, benefiting sleep, cognition, body composition, heart function, heightened immune system, and improved skin quality, only to mention a few systems positively impacted by Human Growth Hormone. Aging correlates closely with the progressive decrease in IGF-1 production. Growth Hormone deficiency is characterized by progressive weight gain (primarily central), decreased lean body mass, and increased body fat. Studies have identified patients with growth hormone deficiency have at least a 7% increase in body fat, mostly central which results in an increased waist-hip ratio, which has been associated with a higher incidence of cardiovascular disease, and shortened life-span. A classic study performed at the Medical College of Wisconsin, and published in the New England Journal of Medicine by Dr. Daniel Rudman in the 90’s identified the benefit of Human Growth Hormone supplementation in patients who were HGH deficient. Two groups identified as Growth Hormone deficient, and were told not to change their eating pattern or exercise regimen. One group was given salt water, a placebo, and the other group a low dose Human Growth Hormone. The two groups were re-examined after 6 months of therapy, and the group who had received Human Growth Hormone demonstrated a 9% increase in lean body mass, and a 16% decrease in total body fat. Without exercising, or eating properly! Imagine what could happen if proper diet, and exercise were incorporated into that therapy.
Other benefits of Growth Hormone therapy include the impact on memory and cognition. The level of IGF-1 in the brain declines rapidly in the aging brain. This decline results in impairment in memory, the ability to learn, spatial memory, and delayed processing with response. IGF-1 has also been identified as important in neuronal and dendritic repair. The falls in IGF-1 and HGH have also been associated with neurodegenerative changes such as Alzheimer’s, Parkinson’s disease, and multiple sclerosis.
Patients who are Growth Hormone deficient appear to have memory issues and associated problems with concentration. Psychological well-being is also affected resulting in increased depression, loss of self-confidence and lack of motivation. Associated with this, patients with low growth hormone deficiency have higher rates of divorce, depression and higher rates of unemployment.
Numerous studies have identified the benefit of Growth Hormone replacement therapy and profound, impressive changes in body composition, with increased lean body mass, and decreased body fat. The improvement in lean body mass has been associated with increased protein synthesis, increased body mass, and exercise tolerance. The decrease in body fat is most significant as visceral fat, or the fat that is within your belly, and is very highly associated with cardiovascular disease. The loss of body fat truncally is most impressive, and often does not affect fat loss in the arms and legs. Then, the classic picture of a Growth Hormone deficient patient, especially males, is one with the large belly and the thin arms and legs. This pattern is probably genetic, but then the associated drop in HGH is also undoubtedly genetic!
There have been numerous studies that identify the cardiovascular benefits of Human Growth Hormone. A meta-analysis was performed in 2004, this approach uses a way of looking at numerous studies all together and determining benefit of the growth hormone, not on one individual study, but on the results of numerous well designed studies that were randomized to patient selection, blinded to the researchers on what the patients were receiving, and compared to placebo or basically receiving an injection of salt water instead of growth hormone. This approach is the absolute best way to determine the benefit of a therapy, and the best statistically. Dr. Maison published this article in The Journal of Clinical Endocrinology in 2004(vol 89 pp 2192-2199). He found that the use of low dose human growth hormone will increase lean body, decrease percent body fat, decrease the total cholesterol and the “bad” LDL cholesterol, as well as decrease diastolic blood pressure. Another important study by Juul(Circulation 106(2002) 939-944) demonstrated that when comparing patients in the lower 25% of the reference range of IGF-1(growth hormone metabolite) to patients in the upper 25% of the reference range that there was a two fold higher risk of ischemic heart disease in the lower group. Prospective studies have repeatedly identified a higher risk of ischemic heart disease and congestive heart failure in the growth hormone deficient patients in the lower 50th percentile of normal.
The classic profile for a Growth Hormone deficient patient may include increased central obesity, increased body fat, decreased lean mass, decreased energy, and exercise performance, altered lipid profile with low HDL’s (good type), high LDL’s (bad type) high total cholesterol. In addition, these patients often show early diabetes with evidence of Insulin Resistance. Patients with compromised lung function also demonstrated improvement with therapy. These patients almost universally have higher risks of cardiovascular morbidity/mortality, poor quality of life with more depression / neurodegenerative diseases, and metabolic deterioration. Medicine is very aggressive to manage already existing diseases. If we know ahead of time that we can dramatically reduce these disease processes than I firmly believe that physicians should intervene with the progressive depletion of human growth hormone. It is not about being a taller person, but it is about being a healthier individual, and doing everything we can do to proactively protect ourselves, and thus improve the quality of our lives.
Can we extend life by continuing to keep hormone levels at a youthful level? Claiming that Human Growth Hormone is the “fountain of youth” is not a fair statement; however, the lack of HGH results in the deterioration of numerous bodily functions resulting in the many of the physical signs of aging.
Human Growth Hormone is produced in the anterior part of the Pituitary. The pituitary is located behind the nose, inside of the brain. It is the command center for numerous hormonally controlled critical functions. When patients are born with poor HGH output, they are referred to as pituitary dwarves. Unfortunately, for these patients, their stature is not the only function affected by this lack of HGH. These patients do not live a normal life, aging more quickly, having a higher incidence of cardiovascular disease, recurrent illnesses, healing problems, and deteriorating bone structure. Other patients develop loss of HGH production after surgery or pituitary irradiation, developing significant changes in body composition, metabolism, lipid abnormalities, increased cardiovascular disease, and bone density abnormalities. Patients develop rapidly diminishing levels of growth hormone associated with aging, and though this may be construed as “normal”, the progressive development of life-shortening conditions including cardiovascular disease, obesity, Metabolic Syndrome, the decline in memory and thought processes, and the deterioration of physical activity should be addressed as they are real health issues.
Human Growth is produced usually around 1:00 to 2:00 in the morning, and having a very short half-life of approximately 12 minutes, disappears within one hour. Its production is associated with something called the Arcadian rhythm, or a sleep rhythm. Do you wonder why you wake up at 1:00 in the morning? Growth hormone is produced then and helps one maintain the critical REM sleep. If it is not adequately produced, REM sleep is not obtained and one sleeps too lightly - awakening very easily. The appropriate timing of replacement of HGH will help the patient reach and maintain the restful quality REM sleep.
Growth Hormone is then metabolized in the liver into IGF-1, or insulin-like growth factor. This is the active form of growth hormone, benefiting sleep, cognition, body composition, heart function, heightened immune system, and improved skin quality, only to mention a few systems positively impacted by Human Growth Hormone. Aging correlates closely with the progressive decrease in IGF-1 production. Growth Hormone deficiency is characterized by progressive weight gain (primarily central), decreased lean body mass, and increased body fat. Studies have identified patients with growth hormone deficiency have at least a 7% increase in body fat, mostly central which results in an increased waist-hip ratio, which has been associated with a higher incidence of cardiovascular disease, and shortened life-span. A classic study performed at the Medical College of Wisconsin, and published in the New England Journal of Medicine by Dr. Daniel Rudman in the 90’s identified the benefit of Human Growth Hormone supplementation in patients who were HGH deficient. Two groups identified as Growth Hormone deficient, and were told not to change their eating pattern or exercise regimen. One group was given salt water, a placebo, and the other group a low dose Human Growth Hormone. The two groups were re-examined after 6 months of therapy, and the group who had received Human Growth Hormone demonstrated a 9% increase in lean body mass, and a 16% decrease in total body fat. Without exercising, or eating properly! Imagine what could happen if proper diet, and exercise were incorporated into that therapy.
Other benefits of Growth Hormone therapy include the impact on memory and cognition. The level of IGF-1 in the brain declines rapidly in the aging brain. This decline results in impairment in memory, the ability to learn, spatial memory, and delayed processing with response. IGF-1 has also been identified as important in neuronal and dendritic repair. The falls in IGF-1 and HGH have also been associated with neurodegenerative changes such as Alzheimer’s, Parkinson’s disease, and multiple sclerosis.
Patients who are Growth Hormone deficient appear to have memory issues and associated problems with concentration. Psychological well-being is also affected resulting in increased depression, loss of self-confidence and lack of motivation. Associated with this, patients with low growth hormone deficiency have higher rates of divorce, depression and higher rates of unemployment.
Numerous studies have identified the benefit of Growth Hormone replacement therapy and profound, impressive changes in body composition, with increased lean body mass, and decreased body fat. The improvement in lean body mass has been associated with increased protein synthesis, increased body mass, and exercise tolerance. The decrease in body fat is most significant as visceral fat, or the fat that is within your belly, and is very highly associated with cardiovascular disease. The loss of body fat truncally is most impressive, and often does not affect fat loss in the arms and legs. Then, the classic picture of a Growth Hormone deficient patient, especially males, is one with the large belly and the thin arms and legs. This pattern is probably genetic, but then the associated drop in HGH is also undoubtedly genetic!
There have been numerous studies that identify the cardiovascular benefits of Human Growth Hormone. A meta-analysis was performed in 2004, this approach uses a way of looking at numerous studies all together and determining benefit of the growth hormone, not on one individual study, but on the results of numerous well designed studies that were randomized to patient selection, blinded to the researchers on what the patients were receiving, and compared to placebo or basically receiving an injection of salt water instead of growth hormone. This approach is the absolute best way to determine the benefit of a therapy, and the best statistically. Dr. Maison published this article in The Journal of Clinical Endocrinology in 2004(vol 89 pp 2192-2199). He found that the use of low dose human growth hormone will increase lean body, decrease percent body fat, decrease the total cholesterol and the “bad” LDL cholesterol, as well as decrease diastolic blood pressure. Another important study by Juul(Circulation 106(2002) 939-944) demonstrated that when comparing patients in the lower 25% of the reference range of IGF-1(growth hormone metabolite) to patients in the upper 25% of the reference range that there was a two fold higher risk of ischemic heart disease in the lower group. Prospective studies have repeatedly identified a higher risk of ischemic heart disease and congestive heart failure in the growth hormone deficient patients in the lower 50th percentile of normal.
The classic profile for a Growth Hormone deficient patient may include increased central obesity, increased body fat, decreased lean mass, decreased energy, and exercise performance, altered lipid profile with low HDL’s (good type), high LDL’s (bad type) high total cholesterol. In addition, these patients often show early diabetes with evidence of Insulin Resistance. Patients with compromised lung function also demonstrated improvement with therapy. These patients almost universally have higher risks of cardiovascular morbidity/mortality, poor quality of life with more depression / neurodegenerative diseases, and metabolic deterioration. Medicine is very aggressive to manage already existing diseases. If we know ahead of time that we can dramatically reduce these disease processes than I firmly believe that physicians should intervene with the progressive depletion of human growth hormone. It is not about being a taller person, but it is about being a healthier individual, and doing everything we can do to proactively protect ourselves, and thus improve the quality of our lives.
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