by Dr. G. Pepper | Jan 16, 2012 | diabetes, diet, diet and weight loss, Family Nutrition, Family Nutrition General, fitness, general health & nutrition, hormones, metabolism, Uncategorized, weight gain
Polycystic Ovarian Syndrome (PCOS) sounds like a rare disorder but it is surprisingly common. This is a disorder with onset in early adolescence effecting up to 10% of young women. Characteristic signs and symptoms include increasing facial and body hair, hair loss from the scalp, muscular or heavy build, acne, thickening and darkening of the skin known as acanthosis nigricans, blood sugar problems including type 2 diabetes, high cholesterol and irregular menstrual cycles and infertility. In older women with PCOS coronary artery disease is more common. In severe cases deepening of the voice and enlargement of the clitoris (clitoromegaly) can be seen. Before the underlying hormone disorders were clarified, the main method of diagnosing this disorder was by finding multiple cysts on the ovary. We now understand that the main problem is not the ovarian cysts but metabolic disorders including insulin resistance and elevated male hormone levels (testosterone) in the blood.
Another misconception about PCOS is that it only occurs in overweight women. Obesity is common in PCOS but thin women are also capable of developing PCOS. The underlying hormone problems are complex but are thought to be at least in part due to high insulin levels in the blood resulting from insulin resistance. With insulin resistance the body requires high levels of insulin due to insensitivity of the tissues to insulinâ€™s presence.
What treatments are available for PCOS? There are very few, if any, drugs specifically approved for the treatment of PCOS. This is probably because of the low profit potential for treating this disorder. Drug companies cannot afford to invest millions of dollars in research because almost all of the existing standard therapies are generic drugs. Some of the most useful medications for treating PCOS are drugs used to treat type 2 diabetes because of their effect to reduce insulin resistance. These drugs are metformin and Actos. Metformin is the most popular oral medication for diabetes treatment in the U.S. Actos has been available for about 10 years but due to recent negative publicity about an unproven risk of bladder cancer, its popularity is declining. Neither drug is approved by the FDA for treatment of PCOS but multiple studies confirm the clinical and hormonal benefits of using these medications in this disorder. In 2011 research was published in the Journal of Clinical Endocrinology and Metabolism suggesting that the generic cholesterol lowering drug, simvastatin may also show benefits similar to metformin for the treatment of PCOS.
In the late 1980â€™s, I along with Dr. Lester Gabrilove at Mt. Sinai Hospital in New York, published our research showing that an anti-fungal medication, ketoconazole, could reverse the hormonal, physical and metabolic problems associated with PCOS. Due to the potential toxicity of ketoconazole this therapy never gained wide spread acceptance. The manufacturer refused to fund additional studies to determine how to more effectively use this drug, due to the low profit potential and liability concerns.
This information is strictly for educational puroses. Due to high risk of toxicity of medical therapy in young women who can potentially become fertile under treatment for PCOS, no drug should be taken without the close supervision of a physician. The reader agrees to the Terms of Service of this website, metabolism.com
by Gary Pepper M.D. | Mar 21, 2007 | health, hormones, metabolism, misc, nutrition, stress
A published study confirms what has been suspected for some time, which is that men in the Boston area over the past two decades are showing declining levels of testosterone (male hormone), in their blood. Over twenty years the average testosterone level in these men dropped from 501 to 391. Many experts regard a testosterone lower than 300 to be abnormally low and possibly needing testosterone replacement treatment. One of the scientists on the study, Dr. Thomas Travison states that when comparing testosterone levels in Boston men from 1987 to 2005 a decline in the testosterone level in every adult age group was found over this time. The researcher stated that the speed with which the levels of male hormone declined over the twenty years and the uniformity of the decline in all age groups was cause for concern.
It is known that testosterone levels decline slowly as men age. Declining male hormone levels were found even in the 45 to 71 year age range, however. Other known causes of declining testosterone levels, the growing incidence of obesity and sedentary life style in Boston men, did not explain the findings, say the researchers.
Could other factors be at work here? Alcohol has a powerful effect on male hormone levels for many reasons. Some alcohol products like bourbon and beer may have estrogen (female hormone) like plant products in them. Liver disease from excess alcohol consumption can also reduce the level of male hormone. Other drugs may have a negative effect on male hormone production such as cannabis (marijuana, Mary Jane, pot, herb, weed, splif, ganja, the bomb, the shit etc.). Although not nearly as wide spread in its use are the opiate type drugs, heroine, methadone, opium, codeine, hydrocodone etc. which can severely depress male hormone levels.
Environmental pollutants are known to cause adverse hormonal effects in men. Pollutants such as PCBâ€™s and DDT act like female hormone and could reduce a manâ€™s testicular function (the testicle is the site of testosterone and sperm production in men). Even herbal products can have anti-male hormone effect such as soy, black cohosh, and white clover. Perhaps the Boston men are being exposed to these influences more now then in the past and the result is sinking male hormone levels.
Before concluding that Boston men are simply pot smoking, beer drinking, soy eating effeminate couch potatoes, the authors of the study call for additional research into the possible origins of this serious loss of virility hormone in the Boston area.
Gary Pepper M.D.