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See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog 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 nonoral 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.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Even though all women eventually stop having periods and stop making estrogen, testosterone, and progesterone we all have symptoms of menopause, even if you don't recognize them as symptoms relating to loss of estrogen, testosterone, and progesterone after menopause. However, every woman experiences menopause differently. Some of us are devastated in every way by the multitude of symptoms that loss of our sex-hormones can create, on the other hand some women merely endure painful intercourse, hot flashes, headaches, and fatigue…or are told by their doctors that their symptoms are "getting older" and they have to live with it! Aren't your symptoms enough for you to demand treatment? What I See: Every day in the office and even in my private life I run into women who complain about their symptoms of hormone loss. When I offer a solution for their symptoms of menopause and low T, I am often shot down by my patient's "fear" of hormones. For example, I was at a 70th birthday party recently and a flood of women came up to me and told me how young and heathy I looked. When they asked me what I do to achieve that, and I explain that I have taken hormone pellets with T and E2 since I was 47 and they can get the same results, they immediately say, "I'm not doing that! I don't want breast cancer! Or "that will cause heart disease or gain weight! ". The media and their doctors who are not up to date in their reading of research have frightened them away from treatment for their symptoms! The doctors should read more and not depend on 40-year-old information (med school and residency). They just told me I was doing something right, but then the fear that society has instilled in them shuts the door on a chance to be healthy, mobile and at ideal weight forever. The opposition to us is strong and this is really brainwashing women away from taking care of themselves! The recent (last 10-15 years) research has revealed that medicine has been wrong about much of the advice that we give patients based on flawed research and the need for the media to scare women into dangerous action (not taking hormones). These groups are literally making women suffer, take too many medications, and literally to be ill during the second half of their lives! The power of the press causes women to comply. Here are the "facts" doctors were taught over the last 4 decades: that are lies! Genetics hold your future. The new study of Epigenetics has revealed that we can turn off our "bad" genes with a healthy lifestyle. Diet—the Food pyramid lied to the American people to make money for America. They advised us to eat grains and sugar, and now we know that that caused Americans to be obese and diabetic. Exercise—Jogging long distances is healthy. Lie! Exercise helps weight loss in a percentage of patients however most patients who exercise to extreme are less healthy than other people who are moderate in their exercise. Moderation prevents the need for knee and hip replacements, the stress on the heart and kidneys causes early circulatory and renal disease. "Hormones" –cause Breast Cancer. Estrogen doesn't cause breast cancer however it can increase growth in estrogen receptor positive women. Not a cause, in fact women on ERT (without provera) had fewer breast cancers and less aggressive ones than women who took nothing! Testosterone is a MALE hormone, and we can't have any! Lie! We make three times as much testosterone in our ovaries as we do estradiol when we are fertile! Do you see that we are manipulated into following false truths because our doctors are too busy to keep up and fear sells newspapers, magazines, and other news agencies. This is how we are discouraged from treatment by our gynecologists, our friends and society. Women are continually barraged with misleading information that makes us think that menopause is no big deal and we just have to live with it and get old gracefully, like our mothers did! However, our mothers did get estrogen and other treatments for menopause! Medicine has been completely revamped in the last 50 years, so we should be healthier, happier and have a better quality of life, yet we are prevented from achieving that through instilling fear in women. While we are dissuaded from treating the symptoms of menopause that take away our productivity and quality of life, we are put in an untenable position. We are discriminated against because we are menopausal. The most recent example of this mission to cripple women's success was on national TV when Former Governor Nikki Hayley, the 52 yr. old female Senator who is running for president, was described as inadequate because she was "past her Prime", by a male politician who is in a party that touts the ability of an 81 year old man in that position to act as president of the US. This is one example of millions of examples as to how we are denied treatment to give us powerful and productive li

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Often in medicine, doctors discover a new use for an old treatment or a treatment that is approved for one use and serendipitously doctors find a new use for a drug or medical device. I have used a specific type of IUD in menopausal women on estradiol to prevent postmenopausal bleeding. The Mirena or Kyla IUD produces progesterone into the uterus to suppress the effects of estrogen on the endometrium, preventing post-menopausal bleeding and growth of fibroids. In the May 2023 Journal of OBG Management the experts have discovered that these special IUDs can be used for more than just birth control. They don't contain any estrogen, but they deliver the progesterone (progestin) where it is needed to the lining of the uterus for 8 years! The cost of one IUD/8 years vs that of daily progesterone reveals a great cost savings by using a Mirena or Lyetta or Kyla (for uteruses that have not been pregnant) and a time savings for patients who are having difficulty with post-menopausal bleeding while on estradiol pellets, or any form of estrogen after menopause. The way these IUDs work is that the soft plastic material of the IUD has a packet of progestin attached to it that slowly dissolves over 8 years. In general, I don't advise the use of Progestins orally as it increases risk of breast cancer and heart disease ONLY when it is taken orally. The small dose that circulates locally in the uterus is only beneficial and is not circulated throughout the bloodstream. The Mirena (I will use "Mirena" to represent all IUDs of the same genre because it was the first one FDA approved) is placed in the uterus in the GYN office, and a short string is left to stick out of the cervix to be palpable by the patient or the doctor to show that the IUD has not exited the uterus (which is rare in women not having periods, menopause). Generally the patient is given a week of progesterone to cause her to evacuate the remaining lining of the uterus before the IUD is placed. This will decrease the spotting and bleeding after the procedure. If it is a difficult insertion of the IUD, the GYN will often do a post insertion Ultrasound of the uterus to make sure the IUD is in place. There are a few menopausal women who cannot have an IUD after menopause. Those patients who have had an ablation of the lining of the uterus usually has scarring of the uterine lining so that an IUD would not be inserted easily or at all. A patient with a uterine septum is not a cancidate for an IUD. Patients who have had a perforation of the uterus in the past are not a candidate for this treatment either. Patients with fibroids on the inside of the uterine cavity are not a candidate either, because the IUD may rub against the fibroid and cause it to bleed. However if you have a uterus and are on estradiol or oral estrogen and take progesterone or progestin with it to protect your uterus, and have trouble remembering the progestin or progesterone dose every night or you continue to bleed even on progesterone/progestin, then a Mirena would be a good solution for you! There is a novel treatment for those women who we have been unable to give estrogen to because of uterine bleeding, and the Mirena IUD or one of its sisters is the answer!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog My medical practice at BioBalance® Health brings me many interesting issues that my patients have had to struggle with, before they finally come to me for T Pellets. The latest complaint that men bring to me on their first visit is their reticence to try T pellets because they already tried T cream, or T gel or T patches and they did not get the results that they expected and needed, so they believe T Pellets won't help them either. Another problem the other forms of T can pose for men is that they try non-pellet forms of T and tell me that they felt a little bit better and they tell me that is all they thought they would get from any form of T replacement….they settle for feeling slightly better instead of feeling Completely Well! Compared to FDA approved Testosterone Creams, Gels, and Patches, Testosterone Pellets at BioBalance Health are superior in every way! When deciding on a treatment or even when buying an important item for your home you should do your homework! I am going to tell you today why men should switch to long-acting Bio-identical testosterone pellets instead of the other forms. Deciding between various forms of Testosterone #1 Effectiveness of each form of Testosterone When making a decision about which treatment to employ, you should look at whether the treatment will completely treat my symptoms, or just some of them/ and what are the side effects (what is the downside)? Below is a comparison from my book for men, "Got Testosterone?" that compares T pellets to other forms. Note that Creams/Gels/patches are all "Transdermal", or delivered through the skin: The reasons for why the quality of the treatment is different for trans-dermals and pellets is because the up to 80% of testosterone converts into estrogen as it is absorbed by the skin. Men don't need or tolerate estrogens like women do, in fact estrogen binds up testosterone so it can't be used by the body. So, gels, creams and patches give a man a small amount of T, but soon it inactivates the testosterone, and doctors think the dose is too low, so they raise the dose. The same thing happens over again and finally both doctor and patient give up and generalize the treatment failure and assume the man cannot take Testosterone (in any form). Pellet testosterone dissolves under the skin in a layer of fat and goes directly into the bloodstream where it goes to work and attached to Testosterone receptor sights. A small amount is converted into estrogen, but it is not enough to inactivate the testosterone from the pellet, so the effectiveness of Pellet Testosterone is quite different from transdermal forms of testosterone, and is greatly superior. #2 Side Effects/Risks The flipside of whether a medical treatment of any kind is right for you, is the risks of the treatment and the likelihood of side effects. Knowing the effectiveness of a treatment and the risks, helps you decide whether it will work for you. Knowing these two most important factors help a patient make a decision on which treatment he wants to try. There are risks that may not apply to you, however you should look to the side effects or risks that apply to you, to make your decision. In the table the highest risk is noted with three Xs, and the lowest risk is one X. The side effects of T in Pellets are much lower than other forms of Testosterone. You must review whether these are risks for you individually or not. For example, if you are still of childbearing age or you still want more children than the lowest risk of infertility is offered by T Pellets, however there is still a risk. For those men who don't have hemochromatosis then this risk is not a risk at all. This really means that risks must be individualized for each man just like dosage. #3 Ease of Complying with Dosage and #4 Cost Whether you can actually continue treatment for a long period of time is pivotal to determine whether you should take a type of Testosterone replacement. You should look at these factors: · Can I realistically follow the dosing schedule? · How many times a year do I have to go to the doctor's office for this treatment? · How much time will I waste a month waiting in a doctor's office to get the treatment? · Is it administered at home or at the doctor's office? The next part of this equation is the cost of treatment. Most testosterone medications are not paid for by insurance. If they are paid for, they have a high copay for most insurance. If you get your testosterone from a pharmacy, then to compute your fee you should multiply the copay by 11 months. If you have to go to the doctor to get the script, you should add the doctor's fee as well. I have compiled the cost of each kind of treatment based on the initial dose, which might not be adequate for people who use trans-dermal testosterone and need to increase the dose multiple times. As for dosing, If you can't remember your vitamins, your medicine or to brush

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Your Consultations with Dr. Sullivan or Dr. Maupin last one hour! No other medical practices schedule an hour for consultations with each patient. You will see a doctor and have time to discuss your issues!!! Drs Maupin and Sullivan spend hours preparing for your first appointment. They know what medical problems you have, your medications and allergies, and based on your medial history they determine your treatment plan. This plan includes your pellet dose, treatment of other conditions or diseases that are out of control, a diet and eating plan, exercise advice, individualized supplement advice, and prescriptions for medications. Your health will benefit from the expert advice given by Dr. Sullivan and Dr Maupin and their team of Nurse Practitioners and Registered Nurses. BioBalance® Testosterone Pellets are the most effective, lowest risk Testosterone Replacement: We exclusively use Testosterone and Estradiol Pellets made from Non-Micronized Bio-identical Testosterone powder, from two compounding pharmacies who have been our providers for two decades. BioBalance® Health has the most experience in providing Testosterone and Estradiol Pellets in the Midwest We have been practicing anti-aging medicine and treating patients with bioidentical testosterone pellets longer than any other practice in the Midwest, over 20 years! BioBalance® Health doctors and NPs provide such a unique and successful level of care that patients fly from all over the world to see them. We are innovators and we have learned how to trouble shoot side effects and treat them before they happen. We have such a unique treatment method that we have doctors who request training with us, and patients who spread the word of our success to their doctors and their friends. BioBalance® Health Has the Highest Success Rate of any other provider of T and E2 pellets. We not only offer quality and service to the practice of Anti-Aging Medicine/ Functional Medicine, we also have the highest success rate of any other BI hormone practice anywhere. We encounter the fewest side effects and complaints of any other hormone practice, and we are 95% effective at resolving the symptoms of hormone deficiency. We Treat Much More than Just Your Sex Hormone Deficiency! When replacing hormones and treating the symptoms of hormone deficiency is not enough, we treat our patients for other hormone deficiencies and diseases of aging: hypothyroidism, and Pre-diseases like pre-diabetes, obesity, fatty liver disease, and nutritional deficiencies. Our doctors and NPs often diagnose illnesses that your primary hasn't found yet! We apply cutting edge medical and nutritional treatments to keep you healthy as you age. Our goal for you is much more than giving you testosterone, it is lasting health. We combat the sickness and symptoms of aging with a foundation of bioidentical hormones (testosterone and estradiol pellets) plus nutrition, weight loss, exercise advice, esthetic procedures and genetic evaluations to determine your health risks and to diagnose cancer early. We add new novel and effective ways to help our patients live healthier, longer, and more productive lives like the Gallery test for 99 types of cancer that finds cancer before traditional tests can (this test is for those patients who chose to have it and it is an additional fee). You are Not Just a Number! We are not a practice built on volume. We learn your history and know who you are when you see us. We make sure we keep your health history in mind when we make decisions for your treatment! Our staff is family to the doctors and to each other. When you enter our office, you will feel special and cared for! Our results are remarkable! BioBalance Health receives most of our referrals from existing patients and doctors. Our Patients tell us that they have never had such a complete evaluation of their symptoms and that no other hormonal therapy has made them feel completely well as the treatment they receive in our office. We are excellent Doctors and Nurse Practitioners who are determined to bring our patients back to health with the latest treatments and the most natural testosterone for both women and men. We individualize your care because we know that one size medicine doesn't fit all! Before you come to our office, we study your medical history and your blood lab results, to create a treatment plan that we adjust during your initial visit based on your needs. We offer the best Education for Patients available anywhere from Any Anti-aging, Integrative Practice in the US, and possibly the world. Dr Maupin has written 2 books for patients over age 36 that have been distributed in 6 countries, The Secret Female Hormone is for aging women and Got Testosterone? is for aging men. The Secret Female Hormone is the first book about testosterone for women was the first book of its kind published anywhere! Her book for men received the Intern

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog BioBalance® Health uses other forms of measurement to determine body composition, and to diagnose healthy weight, versus overweight and obesity. BMI is a calculation of healthy weight, overweight, and obesity using just two parameters: Height and Weight. The US government endorses and uses this measurement in many ways to manage citizens, categorize them and even pay their salaries. The AMA has been using this as a measurement of body health for decades. As of July 2023, the AMA is rejecting this measurement of health and illness. Calculate your BMI Go to https://www.calculator.net/bmi-calculator.html and you can calculate your own BMI. Below is a chart that many types of companies and people use as a reliable measurement to use for many purposes. Below is the NIH explanation of BMI. You can find your BMI and corollate it with how lean your body is. The Body Mass Index (BMI) Calculator can be used to calculate BMI value and corresponding weight status while taking age into consideration. Use the "Metric Units" tab for the International System of Units or the "Other Units" tab to convert units into either US or metric units. Note that the calculator also computes the Ponderal Index in addition to BMI, both of which are discussed below in detail. BMI introduction BMI is a measurement of a person's leanness or corpulence based on their height and weight and is intended to quantify tissue mass. It is widely used as a general indicator of whether a person has a healthy body weight for their height. Specifically, the value obtained from the calculation of BMI is used to categorize whether a person is underweight, normal weight, overweight, or obese depending on what range the value falls between. These ranges of BMI vary based on factors such as region and age and are sometimes further divided into subcategories such as severely underweight or very severely obese. Being overweight or underweight can have significant health effects, so while BMI is an imperfect measure of healthy body weight, it is a useful indicator of whether any additional testing or action is required. Refer to the table below to see the different categories based on BMI that are used by the calculator. Nurses have understood the fallacy of using BMI to judge whether a patient is overweight or not for decades, but the AMA and medical specialty societies have defended its use for as long as I have been in medical practice. However, BMI is a crude way to evaluate patients for obesity and we use a more accurate measure, a true body composition from an InBody® machine to determine exactly how much fat, muscle, and water our patients are made of and if they need to lose fat for their health. This true measurement of body composition gives us an accurate measurement of your percent body fat, weight of your muscle and your visceral fat (belly fat) measurement. You may say, "so what?", but I'll give you a few examples of how BMI is an INACCURATE measurement to follow for healthcare and for insurance, and other agencies that require employees to be a certain weight for their height. In my practice I take care of two men whose height is exactly the same, 5-10 (70 inches), both weigh 200 lbs., and they both have a BMI of 28.69 which is considered overweight (normal is not at risk for hypertension, heart disease and diabetes. The BMI makes them the same, and therefore their doctors and employers consider them the same for insurance, treatment of their illnesses and categorization in medical studies that determine the qualities that put patients at risk for diseases. Therefore, BMI is a very bad measurement to judge whether a person is at risk for diseases of obesity. The medical industry is big and slow, and this measurement will not be replaced with something else in the near future, however this gives you a basis for challenging the measurement as a basis for promotion, or a reason to deny you insurance or charge you more for insurance. At Bio balance® Health we have used % body fat and abdominal visceral fat determined by a body composition machine (InBody) as our only measurements to determine future risk, and to determine whether someone requires weight loss treatment or not. BMI is very unfair to those people who are required to maintain a healthy weight for their jobs. Those men and women who are in the armed forces cannot be promoted in rank unless they have a BMI of 25 or less, however the training that is required and the strength and stamina to be in the active military means that they must work out and exercise to build muscle, which then disqualifies them from promotion because it causes them to gain weight, but healthy weight. Using the BMI as a measurement, can cause a person to be disqualified for promotion because they are well muscled! Not only the US military discriminates against people with high BMI due to high percentage of muscle mass, the life insurance and

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Every physician and every overweight patient have struggled with achieving effective weight loss that was effective for most people, until now! Almost simultaneously 6 weight loss drugs hit the market approved by the FDA for different uses. The only drug approved for just weight loss is called Wegovy, a once-a-week injection that causes loss of appetite as well as a feeling of fullness when only a fraction of volume of an American meal is eaten. It also works by limiting the hormone glucagon that dumps stored blood sugar into the blood when blood sugar levels get low, and it decreases the craving that many overweight patients complain of. The majority of overweight people have been eating a high carbohydrate diet filled with sugared soda, bread, pasta, cereals, candy, cake, cookies, chips, crackers etc. This is the average American diet, and it is killing us! Years of eating this diet has made us fat and insulin resistant, as well as malnourished. Humans need food for fuel, and we have made it into entertainment! We need a varied diet of proteins, fats, and carbs. Our genetics dictates how much of each group we need; however, the one size fits all mentality of the FDA and the US government has led citizens to believe that cereal and bread is the basis for diet because America grows grain and sells it to our citizens…it is a diet based on GNP not our metabolism. Simply said this has left most children and adults obese and fatigued because they are not getting the right nutrition from their food intake. Now we have to work backward, and the insurers of this country will not pay for the drugs we need to reverse the process. The drugs above are all variations of the generic name Semaglutide. The only drug that is different is Mounjaro or Tirzepide. It is more effective for treatment of diabetes and obesity, however Ozempic and the only oral version, Rybelsus, are also effective for both Diabetes and weight loss. We generally prescribe Wegovy for weight loss without diabetes, and we can try to get it approved by insurance for weight loss. However, this is generally not approved. The requirements for insurance to pay for these drugs for weight loss includes: BMI over 30 Two other illnesses that are associated with being overweight, eg hypertension, heart disease, prediabetes. Even with these requirements fulfilled they usually don't pay for it! The price is $ 1,500 for one month! Three months is around $4,500. This is prohibitive for everyone. To solve this access problem, Dr Sullivan has contacted several compounding pharmacies who will make the drug for weekly self-injection at a much lower price! The price is $540 for 3 months compared to $4,500. We have been recommending this avenue when we cannot get the drug paid for. The only difference is that patients must draw up the small amount of semaglutide in an insulin syringe and inject themselves with a needle instead of a "pen". This is the way we have been accessing this medication for our patients and we have seen unbelievable results! People who could never lose weight are losing and very obese patients who did not have the staying power to continue dieting to get appreciable weight loss are now approaching ideal weight. The only people who cannot take this medication are those with a history of a specific type of thyroid cancer or a disease of the endocrine system called MEN II. You know it if you have one of these rare problems. Others love to eat so much that limiting their intake is a problem for them. Special Cases: Those people who genetically are "never full", or "always hungry", this is the drug for them to make them feel full for the first time in their life….. Obesity from never feeling full or always hungry is genetic. Dr. Maupin: "I never understood those kids and adults who had to eat 24-seven or who could eat 2-3 plates of dinner. .I just had never walked in their shoes until I was pregnant…At that time in my life being 118 lbs and 5-3 when I got pregnant I never could catch up by eating enough calories to feed both of us. I felt full at the beginning of a meal but was always hungry, so I had to eat every 30 or 40 minutes. I was hungry all the time! It literally ruled my life, and it made me think about food all the time. I felt like I was in a prison of low blood sugar restricting my activities. NOW I understand how terrible a genetic albatross having the "never full" or "always hungry" is! Except for pregnancy, I know that inherited genetics make some people always hungry, and others never feel full, and my heart goes out to them. These GLP-1 drugs work well for people with these genes. PS. I was thrilled to deliver my daughter, and it was both the happiest day of my life to see our beautiful baby, but I was also so relieved not to be hungry anymore!" If you have this genetic issue, then this classification of drug is for you! You will be able to get to ideal weight a

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Most women believe that the only reason to start taking estradiol when menopause begins is to decrease hot flashes and night sweats. But Estradiol replacement is so much more effective and versatile than just stopping hot flashes! When it comes to the replacement of testosterone for women, most still believe that T is just for men! If a woman has been reading for the last ten years, she may have picked up the fact that T brings back a sex drive and energy to women over 40, but most of the important benefits of Estradiol and Testosterone replacement are hidden from the majority of women. Journalists just aren't interested in us after we are no longer young and fertile, unless of course we are involved with a scandal! The importance of replacing the hormones that are deficient after age 40, and the unpublished benefits that you can receive with E2, and T are the subject of this Blog. After the age of 40, after our childbearing years, we experience a multitude of symptoms and changes that when asked, OBGYN doctors shrug their shoulders and tell their patients that these terrible, quality of life "downers" are "just aging" and therefore the don't address them and won't treat them! It seems medicine discriminates against women in mid-life by ignoring their pleas for help dealing with many symptoms of aging. These common problems are listed below, and I will address each of them in regard to hormonal solutions for these problems. By the way, the replacement of the hormones estradiol and testosterone will treat all of these problems! Stress urinary incontinence—T increases the connective tissue that holds up your bladder, and estrogen supports the vaginal and bladder lining, assisting in working against gravity. Irritable Bladder—T and E2 send blood blow to the bladder and stimulate nerves that may be "short-circuited" causing the bladder to spasm and refer the feeling of needing to urinate all day and night. Recurrent Bladder infections-Testosterone and estradiol pellets thicken the lining of the bladder and the urethra, blocking an invasion of the bladder with bacteria which start a bladder infection. Interstitial Cystitis is a very difficult problem that comes from severe inflammation of the bladder and causes affected patients to feel like they have to pee every 5 minutes. These patients can think of little else—T and E2 pellets decrease the inflammation in the bladder and thicken the lining of the bladder to protect the bladder lining from irritants in the urine. Vulvodynia—a painful inflammation of the skin around the vaginal opening, the urethra and rectum. This condition has no effective treatment, however by taking systemic E2 and T pellets, women have gotten relief from this acutely painful problem by taking E & T hormone pellets. Anemia—Testosterone increases the ability of your stomach to absorb iron from your diet and increases you hemoglobin and oxygen carrying capacity. Painful intercourse from a dry vulva and vagina—E2 and T together thicken vaginal and vulvar skin, protecting the nerves in and around the vagina. The thickened skin and increased lubrication from these two hormones recreate the youthful stretchiness and moisture needed for painless intercourse. Osteo-Arthritis—Testosterone suppresses inflammation and T and E2 together increase synovial fluid that lubricates the joints, stopping pain. Hormonal Migraines —T and E2 in pellet form create a constant blood level of E2 and T which prevents hormonal migraines, which are stimulated by large fluctuations in E2 and T and from total lack of these hormones. As you can see many of the complaints that perimenopausal bring to their doctors can be treated with a single hormone complication! Instead, they are told that these terrible symptoms are just a normal part of aging and that they should just "suck it up"! I believe that if the American College of OBGYN and the FDA would listen to women over 40 more, and "bless" the use of hormone replacement therapy in all forms, but especially Testosterone and Estradiol Pellets we would create a generation of women who were still productive, happy and without multiple doctors' visits! How can the powers that are making the rules be so discriminatory against women! We are more than half of the public….we need help in this area of medicine.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog A month or so ago I had a woman come to me for hormone replacement and one of the symptoms that bothered her the most was Lichen sclerosis on her vulva, the area around her vagina. The symptoms are itching, burning, intolerance to putting creams and gels on the area, pain on intercourse, and the skin is fragile and breaks open and bleeds with intercourse. My patient did not come to me to treat this problem, because she had been told by many other doctors that it was not going to get better. Lichen sclerosis (LS) is an autoimmune disease that affects the vulva and vagina. I know from reading the research and my 20 years of experience that our treatment with T pellets has decreased the symptoms and sometimes reversed many different autoimmune diseases, however I had not had a patient with lichen sclerosis before so I told her that I was hopeful that her lichen sclerosis would resolve with Testosterone and estradiol pellets. After 3.5 months when she returned to the office she was grinning and said that she no longer had the LS…her gynecologist said it was a coincidence, because she had not been trained with the use of testosterone for treatment of post-menopausal symptoms, and autoimmune disease. I had another surprise when I treated a patient who had become agoraphobic when her doctor had told her she couldn't have any more post-menopausal hormones, even though she had had her ovaries removed 10 years before and before her hormones she had multiple severe symptoms of estradiol and testosterone deficiency. The ERT had resolved her problems but now they all came back more severely…she became depressed and anxious and afraid of leaving her house. Her son is an Internal Medicine doctor and he called to ask for my help with his mother. He had tried everything he knew of medically and nothing worked. Agoraphobia is thought to be a psychiatric condition, but in this patient's case it was merely a chemical reaction caused by a lack of estradiol and testosterone. After 4 months of E+T pellets she was planning a trip to New Zealand and her agoraphobia was just a memory! I had no idea that that condition could be due to menopause and lack of E2 and T. In the end it was clear that hormonal deprivation can cause agoraphobia and replacement can treat it! I have prescribed T and E2 pellets to treat a different group of diseases, autoimmune diseases, like Lupus, Rheumatoid arthritis, Sarcoidosis, and Grave's disease of the thyroid. The testosterone pellets are very effective at modulating the immune system and normalizing it, which decreases the severity and symptoms of these diseases. Even though I know that every person with an autoimmune disease that I have treated with T pellets, has gotten much better the specialists who take care of them won't admit that it was testosterone pellets that improved their patient's quality of life. There is plenty of research on the use of testosterone for autoimmune diseases, but it is not in the journals that Rheumatologists read. The research is in the Journal of Metabolism and Endocrinology. Worse yet, These doctors have learned that "hormones" worsen autoimmune diseases, however the information they are quoting really only refers to oral estrogen replacement and not non-oral testosterone. This scares their patients from even seeking help for their hormone symptoms, and prevents them from improving their autoimmune diseases with a safer treatment, T and E pellets. Here are some examples of my patients who have had autoimmune (AI) diseases and have come to me for E and T pellet replacement. Women with autoimmune diseases improve drastically with testosterone pellets! Not only do their symptoms of low testosterone and menopause resolve, but their symptoms of their autoimmune diseases improve! The old belief that hormones make AI diseases worse springs from the fact that oral estrogen (Premarin) that turns into estrone can decrease a woman's free T and make her autoimmune symptoms worsen. However. Educated hormone specialists like Dr. Sullivan and me, know how to prevent this and in fact make the symptoms of AI improve. Here is the key to AI success: We give our patients with AI diseases a lower dose of estradiol in their E2 pellet, and a higher than average dose of T in their testosterone pellets, and we watch our patients get better! The Rheumatologists can't stop patting themselves on the back for the improvement in their patients after I treat them and tell their patients that the hormones should be stopped! Patients are smart and they know why their symptoms disappeared! They chuckle at the arrogance of their rheumatologist. The Rheumatologists just look ridiculous when they claim a patient's progress as from their own treatment, when it was really the addition of Estradiol and Testosterone pellets that improved their symptoms. Some autoimmune diseases are progressive and very hard to treat in any way. I was

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog There was once a Saturday night live skit that featured one of their actors, Eddie Murphy, teaching how to spell and say Py-ro-man-ia..and every time I see the word sarcopenia, I think of that skit…mostly because it is a word only researchers and doctors use to describe a condition where a person has lost a lot of skeletal muscle, leaving her or him without enough muscle to move around normally. Sarcopenia is considered a side effect of aging….but it is really a condition of low testosterone level in the blood, that occurs with aging and results in disability. For people over 70, this is what happens, you lose your muscles if you don't take testosterone replacement, and don't exercise and eat enough protein. At any age your muscle is stimulated to grow by your resistance training, daily exercise, and it must be supplied with the building blocks of muscle which is protein from animal products in your diet. However, you can exercise daily and eat the right amount of animal protein and you will still become sarcopenic if you don't replace your testosterone to a level that is clinically needed as you age. Muscle is only made in people who have enough testosterone. I am hoping that the next generation of women and men who are 70-year-old now will not be bent over, using walkers, and wheelchairs, and unable to get out of a chair as they age. With long-acting testosterone pellets, in combination with daily exercise, active daily life and sufficient animal protein to make muscle I am working toward a world where humans aren't put on the shelf because they can't physically take care of themselves. But muscle mass does more for you as you age than just get you from here to there without assistance. Your muscle mass also is the primary organ in your body that burns 80% of your calories and turns them into energy. The muscle cell itself is like a generator. It takes in blood sugar and burns it to make energy for your cell. The trick here is to maintain enough muscle mass to make enough energy and burn your calories! This takes the three elements above: 1) Young healthy free testosterone blood levels, 2) a diet including a large amount of the proteins needed by your body to make muscle which are found in animal proteins, and 3) exercise! Every day, many times a day you must be active to keep your body healthy and muscled. What happens when free testosterone does not stimulate your muscles to make more muscle? Here is how it works when you are young and have sufficient testosterone and when you replace your deficient testosterone. Every time you move or exercise you use your muscles. Your muscles make heat and energy for you and for your cells. Testosterone sends blood flow to your muscles to stimulate your muscle cells to take in blood sugar and make energy and heat. Testosterone does something more; it directs the muscles to regenerate after they are broken down the 24 hours after exercise and are discarded. The day after exercise, your use your dietary protein to rebuild your muscles. Without the stimulation of Testosterone to rebuild your muscle mass, your muscles break down as usual, but are not built up again! This leads to a never-ending loss of muscle, leading you to lose muscle mass, bone mass, and your best burner of calories! The endpoint is a person who is 75, looks frail, can't walk fast, who has poor balance and falls and breaks bones. Older people who don't take testosterone also replace their muscle mass with fat, so their weight may go down (loss of muscle with fat replacement causes the waistline measurement to go up and clothing size to go up, but weight may in fact go down from the lack of testosterone stimulating muscle growth. All of this is well known to doctors yet it is hard to explain in a 15-minute office visit. Now let's talk about what is new to our knowledge of muscle tissue and the diseases of aging. In a research article from 2023, revealed the relationship between muscle mass and diabetes. Those people who had a high % of muscle for their weight had a lower chance of having insulin resistance and diabetes. Diabetes increases our risk for heart disease and death and requires many drugs and doctor's visits and increases the risk of an individual's early mortality. Think of it like this: Replacing T to a premenopausal level in women and to a young healthy youthful level in men increases muscle mass, which uses up blood sugar, which in turn decreases the risk of adult-onset diabetes, which decreases your risk of heart disease and early death! Another study revealed the relationship between muscle mass and early death and found that the more muscle you have the lower your risk of mortality. You and I know that you can't have great muscle mass as you age, without testosterone but that was not mentioned. They just measured muscle mass and correlated it with the chance of death, and they found that the more muscle mass yo

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog. At BioBalance Health we use the information from a vaginal probe ultrasound, combined with information from your medical history questionnaire, and an extensive fasting blood panel to determine whether an individual woman is a candidate for estradiol and testosterone bioidentical pellets. We also review the collated information to determine if we need more tests before we see a new patient. The ultrasound of the pelvis gives us a visual picture of the ovaries and uterus of a woman. It is necessary to know if a patient is menopausal yet to interpret a new patient's ultrasound. We obtain that information from your blood lab and medical history from the patient questionnaire. All three pieces of information are essential to our treatment plan. What can we discover from the vaginal ultrasound? We are ruling out (making sure a woman doesn't have these pelvic problems): Several of these conditions preclude the use of estradiol in any form, some require a visit to your gynecologist for treatment before we add estradiol to your hormones and some of these conditions increase the risk of side effects. 1. Endometrial Cancer 2. Endometrial hyperplasia 3. Endometrial polyps 4. Fibroids 5. Ovarian cancer 6. Ovarian cysts 7. PCO **We use the vaginal ultrasound to determine the risk of bleeding on HRT. ***For the first 3 uterine pathologies listed above we look at the measurement of the Endometrial Thickness (ET), or finding an endometrial polyp necessitates a visit to her GYN for evaluation, and most probably an endometrial biopsy or D&C. This pathologic test will rule in or out Endometrial cancer, endometrial hyperplasia. The other diagnoses are determined by looking at the uterine size, contour, whether there are uterine fibroids, and looking at the ovaries for cysts or masses and the presence or absence of fluid in the cul-de-sac (area behind the uterus). Why would we order a Vaginal Probe US for our hormone pellet patients after the first visit, while they are taking estradiol? 1. Uterine bleeding is nonresponsive to treatment 2. Uterine size is getting larger (patient complains of pain or pressure) 3. High risk patients with recurrent uterine bleeding 4. To follow the growth of fibroids 5. To check the ovaries in patients who have a Family History of ovarian cancer (generally we have the patient's GYN follow this). 6. To follow a benign looking cyst seen on the first US for growth.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog At Biobalance® Health we often find cysts or masses on the ovaries of women who are menopausal quite by accident. We order an ultrasound before we treat a menopausal woman with estradiol to see if there is a thickened lining that might cause bleeding under the influence of estrogen replacement, or to make sure there is no uterine cancer before we treat a new patient. We also incidentally find ovarian masses or cysts when we are investigating pelvic pain or postmenopausal bleeding on our patients who are already on estrogen replacement. In general, since BioBalance's female patients have their own GYN we don't do pelvic exams in the office, therefore we don't find a mass by palpating (feeling) the pelvic structures, however ovarian cysts and masses can be found by ultrasound as well as by physical exam. We generally find ours by vaginal ultrasound. Why do we get ovarian cysts? Before menopause we make an egg every month (if we are not on birth control) that grows within a fluid filled sack. This egg will grow to about 18 mm, or 1.8 cm before it ruptures and releases the egg. That is the miracle of ovulation. It is normal to see one or two of these small cysts on the ovaries of ovulating, fertile women. These small sacks are not cysts because of their size. Ovarian cysts are fluid filled sacks attached to the ovary that are over 2.5 cm. They often occur secondary to a trapped egg that won't ovulate for some reason, and the cyst will remain until the next period. If the cyst doesn't dissolve before the next cycle, it can grow larger with the surges of hormones and it can prevent future ovulation, or it can cause pain from the stretching of the outer covering of the ovary. If a cyst is less than 2.5 mg. we don't re-ultrasound in cycling women. If it is larger or continues to cause pain, we follow up an ultrasound in 6 weeks to see if it is growing. If it is growing but is still clear, depending on the size and the pain involved, we might do a laparoscopy to remove the cyst from the ovary. If it is growing and looks unusual in shape or density, we order 2 blood tumor markers for ovarian cancer. If those are negative, we follow up with another ultrasound in 3 more months. In some patients, multiple ovarian cysts are the norm. Those patients with polycystic ovaries create multiple cysts each month and rarely ovulate. It helps to use the drug Metformin ER to improve ovulation in PCO patients (and the rupture of cysts). Some patients require laparoscopy to punch holes in all the cysts especially if she is trying to get pregnant. What does a postmenopausal ovarian mass or cyst mean indicate? Now for postmenopausal patient's ovarian cysts and masses are much more worrisome but much rarer. Because the ovary is not metabolically active, and therefore not ovulating the menopausal ovary should look small without cystic structures, however there are some exceptions! The menopausal ovary that has a fluid filled cyst 2.5 cm or less can have been there since the patient stopped ovulating and it never deflated, or ovulated. This type of cyst doesn't grow and is not malignant. Ovarian cysts in postmenopausal women that are fluid filled and larger than 2.5 cm, or solid, or partially fluid filled and partially solid are suspicious for malignancy. In this case your doctor may order an MRI, a CT scan of the pelvis, and order cancer tumor markers. In most cases these masses are benign, or early in a malignancy and can be treated with surgery. Sometimes we find a suspicious mass that needs confirmatory ultrasound or MRI by a GYN Oncologist, tumor markers, and surgery would be scheduled to take the uterus tubes and ovaries and sometimes the omentum and lymph nodes. When will a patient know that her mass if not malignant and if she needs surgery? The surgeon may do a frozen section in the operating room to see if more than the ovary itself must be removed or your GYN may wait for the final pathology report to determine if it is malignant. That takes several days to a week. How common is ovarian cancer? Ovarian cancer is very rare and tends to run in families. If you have not had a relative with ovarian cancer, then you are not likely to have ovarian cancer if you have a suspicious mass. That does not mean you won't' need surgery, it just means the outcome has a high chance of being benign. What can be mistaken for an ovarian mass on ultrasound? There are several pelvic structures that might be confused with an ovarian cyst/mass. The most common is a pedunculated fibroid that hangs down from the uterus and looks like it is coming from the ovary. These muscle masses from the ovary are generally benign, but they can grow under the influence of estrogens. There are cysts called para-ovarian cysts that can originate from the fallopian tube. They are fluid filled and can actually grow, looking like an ovarian mass, but they are benign, and most are sedentary and don'

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog. I learned about electrolytes in medical school as the substances Sodium, Chloride, Potassium, Calcium, Magnesium, and Phosphate we check on a metabolic panel. However, electrolytes are much more than values on a blood test. These minerals are some of the most vital substances needed to keep us alive. Electrolytes can get out of balance in normal daily life and put us at risk of illness and death if we do not replenish them orally along with rehydration with water. Our kidneys and hormones manage electrolyte concentrations as our intake of these substances in our food and drinks replenish electrolytes that are lost in urine, sweat, and bowel movements. We are not conscious of the bodily mechanisms that manage our water balance, urination, keep our blood pressure normal and supply our brain with these vital nutrients to maintain consciousness, and we become symptomatic only when we are severely deprived of them. In my medical training, I also learned about how illnesses, and medications affect the amount of each electrolyte in our body however what I didn't learn was how important it is for healthy people who exercise in the heat to replace their electrolytes. You don't have to be an NFL football player or play in the NBA to require electrolytes when you exercise. With inadequate electrolytes you can become weak, and confused, lose muscle strength, faint or completely lose consciousness when you are working or playing games in the heat, even if you are drinking water! To make my point I'll relay a personal experience that you may have experienced as well, while playing a game outside in the heat. I don't play much golf, but I do play in charity golf tournaments. They are generally timed at the height of the summer heat, and they take almost twice as long as a usual round of golf. This scenario sets all the players up for dehydration and a deficiency of electrolytes. For several years in a row, I noticed that I was well hydrated for about 3 hours by drinking 3 or more bottles of water while I played the first 9 holes. By the 10th hole I was becoming physically weak and mentally slow. I felt I should be ok because I was drinking water and staying hydrated. However, I felt like I was playing golf in Jell-O. I continued to drink water because I thought I was dry, and that is what I thought was wrong with me. Not so…instead of feeling refreshed by drinking endless water, I got worse. Two years in a row I didn't finish the 18 holes. What had I done wrong? I started using my diagnostic brain to figure out what I was missing. Was I sick or was there something wrong with my metabolism? While I was watching a pre-season football, I noticed the Gatorade that the players were guzzling. I had never tried Gatorade because of the amount of sugar in that drink. I pulled up the contents of Gatorade and found that not only did it rehydrate the hot and sweaty players with water and sugar, but it contained all the electrolytes that players lose when they sweat and exercise in the heat! Bingo! I bet that was what I needed to finish the golf tournament….electrolytes! It turns out that I had been half right by continuing to drink water, however the more water you drink while you are exercising the more your electrolytes are diluted! It is not a reason to hold off drinking water, because dehydration can damage your kidneys and you can get heat stroke, however adding electrolytes is vital to surviving exercise in the heat. The following year I armed myself with many bottles of water and plenty of electrolytes in the form of NUUN. To every third bottle of water, I added NUUN electrolytes tablet…voila! I could play 18 holes in hot weather and sweat for 5 hours without fainting, or losing muscle strength, and quitting! So how do you know when you are getting dehydrated and low on electrolytes? You pay attention to your symptoms! Like everything else, the symptoms of electrolyte deficiency is somewhat individual. The possible symptoms of electrolyte imbalance, either high or low electrolytes are listed below: · Dry mouth and thirsty · Restlessness · Mental Confusion · Weakness-overall · Inability to stand up · Muscle weakness · muscle spasms · Fatigue · Heart palpitations · Constipation · Nausea or vomiting · Diarrhea · Slow or irregular heart rate · Low blood pressure · Headache · Difficulty breathing · Low or high blood pressure · Fainting (Syncope) Remember I'm talking about electrolyte imbalance that is associated with sweating, exercise, diarrhea, drinking a lot of water without electrolytes while exercising, but the same symptoms can come from food poisoning and the severe fluid losses that accompany diarrhea and vomiting. I am not talking about electrolyte imbalance that can be a specifically related to chronic medical illnesses, medical treatments and medications. These imbalances are specific to a particular electrolyte loss and are not treated with glo

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog. BioBalance Health® pellets are very safe and not painful to have inserted. They are also the easiest form of hormone replacement a woman can have because the dose is adapted every 4 months and our patients only have to think about their hormones three times a year. BioBalance Pellet therapy is associated with fewer side effects than any other hormone replacement, and we have a 95% success rate for resolving the symptoms of menopause and testosterone loss. Women's lives are drastically impaired at menopause. BioBalance, and T pellets improve their quality of life to the level of quality they had before they were 40. Dosage and pellet side effects are specific to the individual and it may take us a few pellet insertions and blood tests to get the ideal result. Finding your perfect fit is like having a custom suit made: hormone balance requires patience and several fittings, before we determine your maintenance dose, which will direct your dose of E/T for follow up pellet insertions. We give a handout to each patient when she checks out after her first pellet insertion. We ask patients to follow the instructions given to them verbally and in writing in our office. Risks of pellet insertion procedure, risk of taking estradiol and risk of taking testosterone are rare, but patients are given this handout, so they know what to expect. These same risks are on their consent that they read and sign before they even come to the office the first time. Here are the most important instructions for immediate care of the insertion site: · Take the pressure dressing off in 3 HOURS · Take the steri-strip off in 3 DAYS · Don't traumatize your incisional area · If you are allergic to tape please tell us · For three days don't submerge in water—hot tubs, bathtubs, the lake, a stream, or the ocean. · For three days don't exercise · Don't take oral or IV steroids if it is not life-threatening Please tell us if you are on steroids or take blood thinners so we can alter our treatment plan. The risks of the pellet insertion procedure include: · Infection · Bleeding, · Bruising · Allergic reactions · Swelling · Pain · Reaction to the lidocaine with epinephrine :shakiness and anxiety, lasts a short period of time, and is not permanent. Tell us if you have this side effect, and we will use lidocaine without epinephrine the next insertion. · Keloid scarring As is usual for medicine , individual patients have a higher risk based on their medical history. Patients who are at higher risk for complications secondary to the pellet insertion procedure in patients who are: · Diabetic · Have an autoimmune disease · Take steroids · Have a clotting/bleeding disorder · Keloid former · If you have many allergies · If you have orthopedic implants that require antibiotics at the dentist, then you should tell us so we can give you antibiotics. Risks of taking testosterone pellets with BioBalance Health® in the first few weeks or months and are transient. These side effects usually resolve on their own without treatment. The transient risks of testosterone treatment include: · Over the top sex drive=Hypersexuality · Vaginal itching from increased blood flow—it is not an infection · Facial hair and acne (Prevented with Spironolactone preventive treatment) · Weight gain from muscle mass and sometimes from conversion of testosterone into estrone which is a genetic risk. · Increased muscle mass that is confused with weight gain. · Lowered voice is only a problem when you are a singer. Generally, those who think they have a lowered voice really have reflux and it has nothing to do with testosterone pellets. · Clitoral enlargement—this is a reaction to a new testosterone exposure, and generally will go away in the following few months. · Thinning of hair at the temples and crown (Prevented with Spironolactone preventive treatment) Women can take testosterone without estrogen before menopause, and after menopause if requested, however the symptoms of menopause will not be completely resolved with testosterone only pellets. The risks of estradiol pellets are higher for patients with a uterus, than those women who have had a hysterectomy. Those women with a uterus have the following risks: • Uterine bleeding, growth of fibroids: Estradiol of any kind - pellets, pills, patches etc. - can stimulate the uterus to bleed. This can come from a thick lining, adenomyosis (spongy uterus), or fibroids. Prescribing progesterone, optimally sub-lingual progesterone or BLA progesterone from Belmar pharmacy, taken 1-2 times a day, counteracts this. Other treatments are surgical and offered by your Gyn. Your doctor will evaluate you for treatments: uterine wall ablation (80% effective), or a Mirena IUD. Sometimes bleeding will necessitate the choice between a hysterectomy and contin Risks of estradiol pellets for women with and without a uterus: · Vaginal discharge: Estradiol increases the moisture in

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The most common cause of hysterectomy in women are benign masses that grow within the uterine wall. They occur in 4 out of 5 women, and they can be small and asymptomatic, or they can grow large and cause pain, uterine bleeding, pelvic pressure, urinary incontinence and pregnancy complications. Uterine Fibroids are "the most common tumor in women world-wide". Although benign, uterine fibroids are associated with significant morbidity; they are the primary indication for hysterectomy, and a major source of gynecologic and reproductive dysfunction, ranging from menorrhagia and pelvic pain to infertility, recurrent miscarriage, and preterm labor. Fibroids are also referred to as "leiomyomas", "myomas", "fibroid tumors", and sometimes slangily referred to as "fireballs". They are in fact "ball-like" in shape and when we inspect them at hysterectomy, they are made up of swirling muscle cells that are laid down in concentric circles. Gynecologists find fibroids when we examine a patient at their yearly visit by feeling an enlarged irregular uterus. The fibroids are within the wall of the uterus and often cause heavy uterine bleeding. Where the fibroids are, within the wall of the uterus, determines whether they are more likely to cause bleeding or not. Placement up against the uterine cavity ("submucosal") increases risk of bleeding, and placement in the middle and surface of the uterine wall ("subserosal") decreases risk of severe bleeding. At BioBalance Health LLC we require every patient who comes to us who still has a uterus to have a formal abdominal and vaginal ultrasound to diagnose fibroids and other uterine abnormalities, before we will give them estradiol pellets. Testosterone doesn't have a negative effect on fibroids so we can still put a woman on testosterone with fibroids. Otherwise, we have the risk of fibroid growth in our consents, and we discuss this issue when a patient's ultrasound shows significant fibroids. What causes a woman to be more likely to have fibroids during her reproductive years? Triggers for Fibroid Development · Race · Genetics/ family history · Diet · Early Age at First Period · Toxins in the environment especially in early life · Obesity · Advancing age · Vitamin D deficiency · Hypertension · Pregnancy suppresses the growth of fibroids Race: Both Black and Hispanic women are the most likely to develop fibroids and experience enough symptoms to cause the need for a hysterectomy. Black women are 3X as likely as white women to have fibroids, and they are more likely to have very large fibroids. In some circumstances fibroids can prevent pregnancy and cause recurrent miscarriages and preterm labor. 60% of African American women aged 35-49 years reported uterine fibroids, whereas 80% of those aged ≥ 50 have uterine fi-broids. Genetics/Family History: If a woman has a mother or sister with fibroids, then that woman has twice the risk compared to a woman without a family history of fibroids. "Uterine fibroid-linked mutations in MED12" are the most common mutation we have found, however a mutation in the COMP pathway is also found to be associated with fibroids. Diet: A diet with high intake of meat, fat and alcohol increases a woman's risk of developing fibroids. A diet deficient in fresh fruit and vegetables also increases the risk of fibroid appearance and growth. Smoking is highly associated with fibroid growth. Early age of Menarche is a risk for developing fibroids, which increases the years a woman is exposed to estrogens. Toxins from the environment, and from alcohol increases the development of fibroids. Cleanses might help rid your body of toxins that might methylate your genes and stimulate fibroid growth. Obesity and Being overweight: Body fat increases the estrone estrogens in the circulation, which stimulates fibroids to grow. Advancing age until Menopause: When women enter their late 40s their ovaries decrease ovulation and the uterus is exposed to estrogen without progesterone, which causes fibroids to grow. After menopause, some fibroids shrink while others stay the same. When women take HRT their fibroids may be stimulated again, however because it is not cyclic, it is less likely to stimulate fibroid growth. Hormone Replacement Therapy can increase the size of fibroids: HRT is only one of the factors that causes growth of fibroids in menopausal women. If estrogen is balanced with progesterone (not progestins) growth is less likely. Testosterone has no effect on fibroids so replacing testosterone is not a factor for Fibroid growth. At BioBalance we have medicated pellets that combine Testosterone with Anastrazole which suppress the growth of fibroids. We use these on our patient who have known fibroids, if they are willing to undergo treatment with this Vitamin D deficiency The role of Vitamin D in development of fibroids is being researched at this time, however an adequate Vitamin D blood

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you are over 50 you have probably wished that you could have a face lift to bring you back to how you looked in your 20s or 30s. As an owner of a Medical Esthetic Spa named BioBalance Skin®, and because I am 68 myself, I have spent years looking for a facial treatment that would get the results of a surgical face lift, but without the pain, surgery and downtime. Because of the EmFace, I have finally found what I was looking for so I bought it! It is called EM-Face, kin is the first medical spa to offer this treatment that makes facelifts a thing of the past. The EM Face is not only unique because the results of the EmFace are amazing, but it is also unique because it isn't painful, it doesn't require many treatments (EMFace series is 4-6 treatments, one per week), and does not require anesthesia, there is no down time, no loss of time from work, and you are not at the mercy of a surgeon's skill to make you look like yourself at a younger age, instead of a young stranger (think Sharon Stone). The EmFace treatment is done in our Medical Spa, and each treatment takes 30 minutes. There is no operating room or anesthesia needed and it takes 4-6 sessions 30-minutes long , painless treatments that you don't even have to get undressed for! After your treatment you can go right out in the world without bruising or any sign that you had a face lifting procedure. How does the EmFace work? It uses electrical stimulation of the facial muscles to pull your facial skin up toward your temples, and it also tightens the facial skin so it literally makes your skin smooth and removes wrinkles! Skin tone and muscle tone are improved and wrinkles disappear. …A face lift doesn't improve your skin tone and it only smooths deep wrinkles. Leaves no evidence of having a lifting procedure except that over the following 3 months you look progressively younger. This is an advantage if you don't want your friends to know that you had anything done to make you look younger. A face lift is obvious and it is hard to hide the fact that you had a major procedure to regain a youthful looking face. How long does it last? A Face Lift lasts about 10 years depending on the thickness and tone of your skin, as well as your age when you have the surgery. EmFace generally requires one maintenance treatment a year to maintain the "lift" indefinitely. Cost comparison? EM-face 4 treatments costs around $2,800 and 6 treatments cost $3600 at BioBalance Skin®and that's it!. A facelift surgeon can charge t up to $100,000 for his or her services. Then you have to add the additional costs of the operating room + the cost of the surgical assistant + supplies and usually you have to pay for one night in the surgery center. For a facelift, plan on paying over $150,000 total (assuming you have no complications) vs a total charge of $2,800-$3,600 for an EMSCULPT facelift. Oh, I forgot to add the value of your time off from your job which can be 3 months after a facelift, before you want be seen in public. Why does a face lift prevent you from showing your face right away? Facelift Surgery on the face involves dissecting the skin away from the muscle and bones of the face, pulling the skin up toward your temples, trimming off extra skin and then closing the incisions with suture. This massive dissection causes a large amount of swelling and bruising, requiring drains placed in your face, for weeks. This damage lasts a long time and is PAINFUL! It generally causes patients to remain housebound until they completely recover, which can be months. EMFace causes none of these side effects and complications, so you can go out in public, or back to work right afterwards with a "glow", and no sign that you had anything more than a facial. What are the comparable risks? The risks of a facial surgery of any kind are dramatic…damage to the facial nerve may not be recoverable, making you unable to smile or show expression on one side of your face. Surgery risks are always numerous and most surgeries include the complications of anesthesia, even death, infection, bruising, non-healing, nerve damage scar formation and facial drooping. What should I do to prepare for either of these treatments for good results? Replace your testosterone (improves healing), and estradiol (improves texture and tone of your facial skin. Topical Skin Care, medical grade, (eg. Skinceuticals products) that stimulates the stem cells of your skin to grow and smooth the texture preparing for healing and tightening. Replace your estrogen and testosterone if you are over 45, 4- 6 months before the "lift". Eat a high protein diet (more than half your weight in grams of protein/day) Stay hydrated with water and sometimes electrolytes. Lose as much weight as possible before the procedure. Get monthly hydra-facials and or micro-needling to prep your skin Take daily collagen supplementation in your coffee or tea Take healing vitamins:

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog I spent the first half of my medical life as a gynecologist trying to figure out why my patients would come to my office asking what was wrong with them when they turned 40? They felt they could not talk to their friends about it, and they were even embarrassed to tell me that even though they used to enjoy sex with their husband/partner, they now were repelled by the thought of it! Remember this was in the 1980s through 2002, and the only way doctors knew anything about how to treat medical problems was because they learned it in medical school, residency or in their monthly specialty journal. At that time and throughout that time period the primary doctor for women, gynecologists, we never taught anything about sex and the problems that women had after 40 due to deficient hormones. I wasn't taught how to counsel women about sexual problems. This was and is a great oversight by the Specialty society that I belonged to, ACOG, American College of OBGYN. Then in 2002, when the internet grew to include medical articles and research, I could find journal articles about sexuality and dysfunctional sex after age 40…and with the help of Beverly Whipple NP who wrote the Science of Orgasm. I began to be able to put the pieces together so I could counsel my patients with real medical information about women's sexual problems. The loss of orgasms and libido (sex drive) actually comes down to one hormone that is deficient! Unfortunately, it is the one sex hormone that ACOG doesn't recognize for women, despite all the research that is currently available—Testosterone. Replacing testosterone has made all the difference for greater than 50,000 female patient visits. I have treated with it in pellet delivery systems. Replacing deficient testosterone is not complicated and it is amazing to me that the medical community shuns the simple replacement of testosterone for women and advocates many drugs to treat anorgasmia (lack of orgasms) that are risky, expensive and often have no effect on a patient's orgasms. I have a 95% success rate of bringing orgasms back to aging women and in fact have also been successful in helping my patients who have NEVER had one! Recently I read an article about orgasms and how to get them back, that never once mentioned testosterone, the most effective treatment that would bring sleeping orgasms back! A recent article in the journal called "Menopause", titled Oh no! Where did my "big O" go? Or could severe menopausal symptoms have stolen my orgasm? Written by Simon, James A. MD, CCD, NCMP, IF, FACOG. Here is what the author wrote to "educate" other gynecologists and family physicians. The author blames the lack of orgasms in aging women on the dry vagina caused by a lack of estrogen after menopause, however my 40+ years of experience has taught me that giving women estrogen either systemically or as a cream to the vagina, has not improved any woman's orgasms in the absence of testosterone. It is amazing to me that they still get it wrong! There are many scientific articles and studies that prove what I now have proven over the course of 20 years of giving women testosterone pellets and seeing them smile broadly when I ask them how their sexual life is going. They say that they have their orgasms back and sometimes are multi orgasmic! Their relationship with their partner is now excellent and they have a sex drive too! The treatment with testosterone pellets to women after age 40, is the only treatment my patients need to help their relationship and their sexuality. There is another misconception by the OBGYN world. They believe that women's sexuality gets better after age 60! After talking to so many women about their sex lives, I have evidence that this is a false statement, and one that will prevent women from getting treatment for their sexual dysfunction with testosterone pellets, while they wait for it to get better as they age. It is a lie that that occurs…the older a woman gets without estradiol and testosterone, the more dysfunction they have. After 150,000 patient visits since 2002, who come to me for hormone replacement and help with their sexual dysfunction, aging has only ruined sexuality for women, and never improved it. The dysfunction can start as early as 36 years of age and continues until they die. This recent article still gets it wrong! I can only imagine what the motivation of the authors are, or are they just repeating unsubstantiated beliefs from what they learned in medical school? Remember, 35% of studies are blatantly wrong for several reasons: 1.The statistics are manipulated to prove a point The wrong questions are asked of the patients The study age group is not the real group of women that is affected The title is a lie which scares doctors and patients alike. Medical methods and dose are wrong to produce the patient's resolution of symptoms. I'm sure there are more reasons a study could fals

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog In the history of medicine over the last 2 centuries there have been many changes in the recommendations given to patients by their doctors. In general, to change the way medicine is practiced improving the care of patients, a new treatment had to be opposed by one or two courageous doctors who were willing to put his/her livelihood and status in the society of medical doctors on the line. Any medical practice that was contrary to the dogma that had been taught to doctors in training was looked down upon by medical peers and often the doctors who were trying to improve the life of their patients were ousted from their practices and lost their livelihood. I have been one of those doctors trying to improve the practice of medicine in the face of criticism and "name calling" by other doctors who didn't want to change any of their practices. In all cases it took a decade or more to regain my status and acceptance by other doctors and in some cases the changes I have made for the sake of my patients are still not accepted, and most likely won't be for another decade. How and why medicine improves is a painful and complicated process that is always opposed at first. How Progress of Medical Practice Has Been Thwarted by Doctors' Dogma Example #1 Handwashing between examining patients, When Did That Become a Medical Requirement? Doctors now embrace the practice of washing our hands between examining patients, and the practice of wearing one-use disposable gloves to do a vaginal exam on pregnant patients. However, before 1847 doctors didn't believe in hand washing between examining patients. There were no sterile procedures or wash basins available in doctors' suites, and vaginal exams were done on many patients in a maternity ward, one after the other without handwashing. Bacteria had not been discovered in that century and therefore washing away bacteria was unknown, then bacteria were discovered and the presence of dangerous "bugs" that one couldn't see was questioned by the older doctors and the, but Ignaz Semmelweis proved that ha dogma of the day. With the discovery of bacteria by young doctors and scientists presented a change to the practice of medicine that the older physicians in charge didn't accept. Then Dr. Semmelweis showed up on the scene, touting the new knowledge, and insisting that he must wash his hands between Obstetric patients in the ward. This set off an explosion and pitted the old guard versus one young, new doctor. His insistence in washing his hands caused the doctors to throw Dr Semmelweis off staff of his hospital and peer pressure caused him to be shunned by all of the physicians on staff. He had a hard time finding a medical practice and ended his life destitute and without anyone recognizing that he was right the whole time. Medical handwashing became mandatory long after Hungarian physician Ignaz Semmelweis discovered its effectiveness (in 1846) in preventing disease in a hospital environment. He was before his time, and if he had been listened to, thousands of laboring women would have survived childbirth, instead of dying from childbed fever! In retrospect we can sympathize with him because we now know he was right, and his refusal to accept a dangerous practice and to help women live through childbirth, was a personally costly stand to make, but was the first step toward an advance in the practice of medicine. Example #2 Is Estrogen Replacement for Menopause: Dangerous or Healthy? Reference--Menopause: The Journal of The North American Menopause Society Vol. 26, No. 12, pp. 1366-1374 DOI: 10.1097/GME.0000000000001405 ß 2019 by The North American Menopause Society Estrogen for menopausal women has always been a hot potato for medicine. Many studies done in the 1950s and 1960s documented the benefit of giving women estrogen after menopause. Medicine embraced this belief, and the majority of women were put on Premarin, the most popular estrogen replacement. All went well until late in the 1960s and early in the 1970s doctors noticed that women with uteruses were getting uterine cancer at a very high number and the majority of women were taking Premarin. Research confirmed that estrogen replacement without progesterone/progestin could cause uterine cancer! This caused two things to happen: Research began within the drug companies to see if giving Provera®, a synthetic progesterone, would protect women from uterine cancer; The second thing that happened was that women immediately stopped their Premarin therapy and were suffering all over the US. "Premarin" and "Estrogen" became bad words in the doctor's offices, on the front page of papers. This emotional response to a drug name was hard to erase when several years later, when I learned about Premarin replacement through medical school. About that time Premarin + Provera, Prempro® was introduced to the public as the answer to getting uterine cancer in menopausa

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog There is an interesting conflict between the truth and the mainstream medical protocols surrounding statins, that we have noticed in our practice for a decade. Patients who are placed on statins soon develop weight gain and Type II diabetes, and those patients who already have AODM, become worse, gain weight and need more diabetic medications. I have questioned the brilliance of the FDA letting this side effect through their testing process for years. More importantly, why are statins always prescribed for people who have diabetes, even if their lipids are normal? Finally, here is a recent study that documents this side effect, decades after we noticed this phenomenon. The study is found in The Journal of Clinical Endocrinology & Metabolism, Volume 108, Issue 2, February 2023, Pages 385–396. The reason for the study: "Statins and possibly other lipid modifiers increase type 2 diabetes risk and body mass index (BMI). However, to what extent BMI mediates the diabetogenic effects of lipid modifiers remain unclear. " The findings: 'Genetically mimicked effects of statins and ezetimibe, but not PCSK9 inhibitors were associated with higher risk of type 2 diabetes (odds ratio [OR] 1.74 [95% CI, 1.49 to 2.03]; 1.92 [1.22 to 3.02]; 1.06 [0.87 to 1.29] per SD reduction in low-density lipoprotein (LDL)-cholesterol). Of these lipid modifiers, only genetic mimics of statins were associated with higher BMI (0.33 SD [0.29 to 0.38] per SD reduction in LDL- cholesterol), which explained 54% of the total effect of statins on type 2 diabetes risk. Statins were considered a miracle drug for people who had had heart disease in the past, which is what statins were made for. To prevent another heart attack or stroke in this particular group. For some reason, as they were distributed as samples to doctors by pharmaceutical representatives they were pitched as preventive drugs to prevent heart attacks and strokes in normal people with high cholesterol. Statins became the drug to choose to prevent heart disease in normal people and that is where they hit a snag. There are many side effects that statins cause as seen in the recent study, and they also have not been tested by the FDA in women, who are the group of people who have the worst side effects and the lowest rate of MI from atherosclerosis. In addition it was sold as a drug without risk, and I even heard internal medicine doctors telling patients it should be put in the drinking water….a joke but that is what they almost did…they gave it to many people who had no plaque in their vessels and who were not going to have a heart attack in the future. The risks then outweighed the benefits and doctors should stop giving it to women and low risk patients, especially diabetics and patients who are obese, which is 50% of the US adult population. Statins often have lasting side effects, such as statin dementia and severe sarcopenia (loss of muscle) as well as severe muscle-aches and pains that stop people from exercising. What should happen in medicine is that a doctor should weigh the risks verses the benefits. If they don't know if a patient has atherosclerosis that patient should have an x-ray called Cardiac Calcium Scan every 5-7 years and if they don't have plaque, then they should not get a statin. In addition, there is a genetic test to see if the severe effect of sarcopenia (muscle loss) will happen and if a person has that genetic snip, they should take something which is not a statin. If everyone was tested for these two things most people would not take a statin! The blood sugar increases and the increase in obesity are side effects of statins that were evident in our patients who we test for testosterone deficiency, and who were later put on a statin by their primary care. We found that their lab parameters for diabetes immediately worsened. For those who had visible side effects, we stopped the statins and found that the lab tests went to normal after stopping the statins, and the side effects went away in most of them. We have been waiting for this research study ever since, and now it is official. The research matches our clinical experience!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The Mediterranean diet was originally discovered from comparing different diet regimens around the world in the 1950s, and the researchers found that those people living around the Mediterranean had a lower risk of heart disease and related illness. The researchers then described the Mediterranean diet and advised Americans to follow this way of eating. It has been studied over and over again and it is still true that a Mediterranean diet is healthy for Americans. Doctors glibly tell patients you should eat a Mediterranean diet, but what really is the Mediterranean Diet? I know what we are taught to eat the Mediterranean diet, however what Mayo Clinic describes as the Mediterranean diet, is not what I experience when I go to Italy and Greece. Let me start with what the Mayo Clinic lists as components of the Mediterranean diet. They say that we should eat: · primarily vegetables, beans and whole grains · Eat fish twice a week · Use olive Oil instead of butter · Serve fresh fruit for dessert. However here is what I observe of the Mediterranean diet that is really what Mediterranean people eat: · Main courses generally include Fish, meat like lamb, beef, veal, and pork-they are NOT vegan! · Fresh vegetables are included but "beans" are not a primary source of protein, however milk products, fish and meat are! · Italians and Greeks do eat fish at least twice a week if they are on the coast, but not so in the countryside, or northern part of these countries. · Pasta is a healthy carb and is made of semolina flour is generally served at every meal—but in much smaller portions than we eat. · Homemade bread is served at every meal. · Olive oil and Balsamic vinegar is generally used on bread instead of butter or margarine, however they use a lot of both olive oil and butter in their sauces and cooking. · Desserts are usually sweet and made with creams or milk products and flour. They use honey and sugar to sweeten the desserts, and they do not just serve desserts consisting of fruit. The main difference between how we eat and how they eat would not be possible for most Americans because it takes so much time, and most of us do not live in an area of the country that is warm enough to grow vegetables and fruit during the majority of the year! The following differences in their diet that actually make a healthy difference are as follows: · Their portions are less than half the size of ours! · They shop every day, so they don't eat preservatives which are added to American food to increase shelf life. · They make their own bread and pasta fresh, also without additives. · They have a garden next to their house and because of the climate they are able to eat fresh vegetables and fruit throughout the year….most of Americans don't live in a warm climate all year round. · They walk everywhere! They get exercise just visiting their neighbors..everyone takes a walk after dinner. There are fewer cars used for getting places. They also live in smaller communities that are walking distance from everything they need. · Nuts (Almonds, pine nuts) are integral to their diets, as a good form of protein · One person in the family has the job of feeding everyone in the extended family. It is her job to shop and cook and grow vegetables for the whole family. · Families come home for lunch and eat their heaviest meal at lunch so they can walk it or exercise it off! · Exercise is key to the Mediterranean diet! · Every day they eat extra virgin olive oil…tablespoons of it, and it is known to lower the risk of heart disease. · Fast food, junk food, is available only in the cities and is not stocked except for Americans. · Candy is an extravagance and usually has nuts or honey or other sweeteners but not white sugar or artificial sweeteners. So….. like most great ideas, eating like a Mediterranean when you live in America is not practical for everyone and is not plant based…it is lean meat, fish, milk products, olive oil and cheese based. Not sure why they added beans…have never seen beans on the menu for either country I have traveled to, Italy and Greece several times each, so the Mayo Clinic's version of Mediterranean Diet is not what Mediterranean's really eat! I believe for a person to actually be able to follow this diet in the US you can change some of your habits, but it is nearly impossible to recreate their society and eating habits. Try this: Cook with olive oil instead of other vegetable oils, put olive oil on your salads or drink a tablespoon of extra virgin olive oil daily to get a portion of the M. Diet. We can eat the same types of food but unless we go back to baking our own bread and hand making our pasta, cultivating a garden next to each house and apartment, move in with our grandparents so they can cook for us, and give up our cars in favor of walking we cannot recreate that diet here in the US, but we can embrace some of the achievable goals of

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Recently I had a shoulder replacement that went according to plan, and I healed amazingly fast. Of course, my surgeon was excellent, and he gave me preoperative instructions that were integral to the speed of my recovery. I began to think about the reasons people heal and why they may not heal from either surgery or an injury. I started with the instructions given to me by my surgeon, and the reason he gave asked me to prepare my body for healing prior to the surgery. His instructions included diet, activity, and supplements to my diet. The first recommendation was to load my diet with protein to provide my body with the necessary building blocks to heal my muscles and connective tissue during the surgery and afterwards. His instructions told me to eat a diet including meat, milk products with yogurt and cheese, eggs, and protein shakes. The amount of protein a day required was grams of protein equal to my weight in lbs. For example: I weigh 125 lbs. and therefore I was instructed to eat 125 grams of protein/day. I ate the foods that he recommended, and I took daily whey protein shakes with 25 grams of protein each, plus 20 grams of collagen (another animal protein) every day in my coffee. That satisfied the need to eat the building blocks of what I would use to heal. The next recommendation was to eat a diet with fresh fruit and vegetables at every meal, avoid sugar, and junk food, and avoid all alcohol and sugared soda and diet drinks. This part of the instructions provided the enzymes and vitamins necessary for healing, as well as advised me to avoid toxins and junk food which can prevent healing. Elevated blood sugar that accompanies intake of carbohydrate food and drink, promote insulin resistance and poor healing. Alcohol is a toxin that blocks the liver from normal activity and blocks processing of nutrients. It is absolutely contraindicated while you are pre-op and healing. Next, there were supplement recommendations given to me to provide the necessary vitamins and minerals involved in healing, that are difficult to get in a normal diet. These included the Vitamins methyl B12, multi-methyl-B vitamins, Vitamin D, Vitamin A, Vitamin C, and the minerals Magnesium, Zinc, Selenium and copper. The additional supplements were herbs and other substances that help healing including Quercetin, NAC (or Glutamine), Bromelain and Probiotics. I was told to start all of these recommendations 6 weeks before surgery, and for 6 weeks after surgery. I believe that following these recommendations is key to a great recovery after surgery or an injury. The other factors that are key to success after surgery is to have a healthy level of testosterone, and I have taken T for 20 years and I realize that my health has been greatly improved after age 40 because of testosterone replacement. Testosterone is an anabolic steroid and is necessary for healthy healing. Most men and women have good levels of testosterone until they get older, and ovaries and testes stop producing enough T. When women become deficient at an average age of 45, and men at 55, our immune system decreases their production of healing white cells, our growth hormone decreases and stem cell activity decreases, all of which are deficient secondary to testosterone deficiency. This makes healing as we get older much more difficult unless we replace the key hormone of T. The success of surgery is dependent on our overall health so we can heal, the skill of our surgeon, our own health status at the time of surgery, our diseases, and our age/testosterone blood levels, our nutrient status and our diet providing the necessary building blocks to heal our tissues. Surgery is not something you can just show up for, it is something you should plan to prepare yourself for and to follow up with excellent self-care until you are discharged from surgery, or until you are healed. Other issues that can cause a surgery to fail or to be redone: · Surgery did not completely fix the problem (lack of surgical skill or complications secondary to your anatomy or physiology). · Your medical condition or medications can decrease your ability to heal (steroid treatment or treatment for autoimmune diseases). · Diabetes, heart disease, autoimmune diseases, cancer or other chronic illnesses · Old age, female over 45, male over 55. · Testicular or ovarian removal · Poor nutrition · Lack of exercise · Smoking and drinking alcohol · Lung disease that decreases your O2 levels · Obesity, Body fat % > 20 % in men and > 26% in women, or BMI > 25 · Medications that decrease your ability to heal: corticosteroids, cancer meds, autoimmune disease medications · Lab results that indicate your poor risk of healing: High CRP (inflammation), Anemia, Cortisol is high, Free T is low, Estrone is high in men > 30, High CO2 , high HBA1C, High fasting BS and fasting insulin > 10, Elevated liver enzymes, poor kidney functions, low whit

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog There is an increase in medical news and research articles that talk about what aging Americans can do to delay the symptoms and diseases of aging. Some of the articles note lifestyle changes and exercise and or supplements that can combat aging…..but these changes alone are NOT the answer! There is another group of news articles that state the problem that aging, and they leave the reader with the feeling that nothing can be done to prevent these symptoms and diseases. The call "aging" an untreatable part of life, therefore when these symptoms hit doctors tell their patients, "That's just aging! Learn to live with it!" They rarely note the hormonal changes that are KEY to preventing the changes and diseases of aging: replacing testosterone for both men and women in a bio-identical non-oral form and replacing estradiol for women! In reality all the lifestyle changes alone will not work to reverse aging….it is a multi-pronged approach that brings aging men and women back to health: Hormone replacement first, diet and exercise optimization and supplementation of necessary nutrients. After treating several thousands of aging men and women over the last 40 years I can state confidently that the one key factor in staying healthy, mobile, and able to think, is the replacement of testosterone with T pellets. The medical community shies away from stating that testosterone is key to both men and women at any age. Why is that? I think it is because young men who treat themselves with illegal adrenal androgens that are bought on the internet have mistakenly equated these androgen products with the pure testosterone men make in their testes and women make in their ovaries. They are not the same and should be discussed specifically so they are not confused! Medicine also has not accepted testosterone as a female sex hormone! That is just an extension of the male-managed medical care in the US. Lastly the US government see older Americans as dead-weight to the society and they don't want to make us live longer past when we are useful! Many decisions have been made by our representatives and senators in Washington who have no idea about medicine and aren't educated that Men and women would cost Medicare less money, not more because they would be healthier for a longer period of time. For example, Medicare warns patients not to take their thyroid medicine after they are 65! What happens when they stop taking thyroid medicine? Patients die! Many titles of current research articles talk the dangers of aging and then tell us we can't do anything about it! When a written or spoken article coming from the medical community states that the symptoms that women's experience after age 40 is called "perimenopause" they Miss-label the period of a woman's life between 40 and 50 with a word that means "around menopause", when in reality all of those symptoms occur because of testosterone deficiency, not estrogen deficiency! The word perimenopause makes doctors and patients alike think the problems of this era of life is estrogen when most of us have too much estrogen and testosterone deficiency. Just the word "perimenopause",implies that estrogen replacement will fix them, when more estrogen will make a woman's bleeding problems worse, not better. secret ingredient is! The secret label of our problem, "testosterone replacement", is hidden from us which steers research and treatments away from the real problem….It is no wonder that experimental drugs to fix the symptoms of a woman's decade after age 40 don't work! A word, or a label carries power with it, and when given the wrong name the disastrous outcomes are inevitable! Because women begin to experience aging after 40, the sequence of events is important to get right so that we can replace what our ovaries stop producing in order of the natural hormone changes. The ovary stops making testosterone first, followed by progesterone deficiency plus estrogen dominance, with the last stage being the final one of loss of estradiol. If this was considered by the research community, then there would be fewer worthless studies based on replacing E2 in women between age 40-50 that of course fail, and more successful studies of testosterone deficiency, that are treated with pure testosterone, and the medical health of middle-aged women would be so much less stressful, and diseases of aging would be suppressed. I hope that when you read news articles or medical research about middle aged women with the following symptoms you will think "testosterone deficiency" not perimenopause. Testosterone loss after age 40 causes fatigue, gain of belly fat, loss of muscle, loss of sex drive, increase in autoimmune diseases and loss of motivation and ability to think logically. The more women who know what is really wrong with them the better! In reality, "Testosterone" can be substituted for the word "aging". In most medical articles

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog I often see patients at the office who come back to get BBH Pellets after a hiatus of months to years, that they tell me waiting was the biggest mistake they ever made. They were feeling so good after their hormones were replaced that they forgot how bad they felt before their treatment. Stopping their hormones brought back their symptoms, and they realize how much their pellets are doing for them! This is human nature, and often happens because when we feel better, we forget quickly how we felt before treatment. The problem with starting and stopping pellet hormone replacement is that slowly all the symptoms come roaring back and then my patient wonders why they don't feel well. Until they remember that the pellets made such a difference and come back. Stopping Hormone Pellets for No Apparent Reason Hormone Treatment with Pellets Is different than other medications because when a person stops therapy, pellets continue to dissolve slowly, so they continue to make our patients feel good before the pellet hormones wear out which can be 6 months for women and 12 months for men. Because blood levels of testosterone and estradiol from pellets are slow to increase and slow to run out, patients don't notice an abrupt change. Generally, months after an insertion was supposed to be repeated, the symptoms of hormone deficiency are evident but patients may not put it together with not getting their pellets on time. Other medications make it easier to recognize the cause and effect, because if you don't take a medication such as a diuretic or an ADD medication, you get the symptoms you are taking the drug for back in 24 hours. Even oral, transdermal and suppository hormones have a half-life that is less than hours long, so if a patient is taking oral estrogen for hot flashes, then discontinuing treatment would bring an obvious return of hot flashes and dry vagina right away. That makes it easier to the return of symptoms with the stoppage of the oral hormones. Short acting hormones or drugs make it more obvious to a patient that they need to take their medication or get they will get their symptoms back. I have to ask my patients to consider their pellet treatment as a lifelong therapy like taking thyroid or blood pressure medicine. The result of stopping pellets is that a patient feels well for a while and then slowly goes back to their symptoms before pellets, and they don't put it together and look for other causes and other diseases without results, until they remember they didn't get their pellets inserted. This causes patients to delay feeling well and they don't get the benefits of symptom relief or prevention of the diseases of aging during the time without pellets. For those patients who put realize what is going on and comeback "late", it takes months to years to get their hormones replaced and balanced again. Stopping Supplements Has a Delayed Response Too Let's look at another treatment that patients often stop and then don't know why they don't feel well. That is treatment with supplements. Supplements slowly improve specific symptoms by either treating genetic deficiencies or deficiencies in your diet that take a month to 6 weeks to have an effect and that same amount of time to wear off. Let me tell you a story that is an example of this very thing. I was at dinner with one of my friends who is also my patient. He had a knee replacement a month before. His doctor asked him to hold the supplements that would cause bleeding at surgery 2 weeks before his surgery. My friend is a type A guy who believes that a little is good and a lot is better, so he stopped all of his supplements. Then 4 weeks after surgery and 6 weeks after stopping all of his supplements, he sat at dinner with us and looked "deflated"…he complained that he just didn't feel good, and this was occurring more and more since his surgery. He left dinner early because he just didn't feel well and that his symptoms had been getting worse over the last 2-3 weeks. I did my usual casual questioning with a purpose—asked about his knee, pain meds, how long since his pellets, etc. All his answers didn't give me a clue. I went home and looked at his last labs and meds and supplements. I then talked to him and asked if her had gone back on the supplements his surgeon told him not to take? He said, "I stopped taking everything two weeks before surgery! I never restarted them." This "aha" moment hit at the same time for both of us…he needed his supplements both to heal and to replace the nutrients he didn't get in his diet. Supplements for patients who have no genetic deficiencies, who eat a perfect diet, who exercise daily and who have no bad habits or take drugs that would use up their nutrients, don't need supplements. I haven't seen a person who qualifies as too healthy for supplements including me and my husband. If there were a perfectly healthy patient who eats a perfectly

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The best way to decrease you risk of developing illness and cancer, as well as a cancer recurrence, is to get your immune system as healthy as possible. Everyone's body makes cancer cells daily, but your amazing immune system protects you by killing them before they multiply. The key to preventing chronic illness, cancer, and a cancer recurrence, infections such as viruses or bacteria, and chronic fatigue is to turn the clock backwards to when you were young and your immune system's "power center", the thymus gland, was large and active. The thymus gland makes T Killer and T helper white blood cells that kill cancer and bacteria. The thymus gland is key to your immune system, and it shrinks with age. It is large and active when we are children and gets smaller and less active as we age. After age 60 you may notice that people get sicker and that is when they have the most frequent cancer diagnoses. The thymus gland can be stimulated again by "feeding" it and stimulating it into action again. The best way to improve your immune system's health and reverse the thymus's aging process is to make your thymus more active, like it was when you were younger. The best way to achieve this is to replace testosterone, stimulate growth hormone (if necessary), eat healthy food and avoid unhealthy food, add daily exercise to your lifestyle, achieve ideal weight, take supplements, and use immune-boosting peptides like Thymosin alpha-1 or Thymulin and or take medications like Metformin ER. The following lists are meant to be helpful for you to improve the status of your immune system. Medications/Hormone Prescriptions that improve Immunity: Testosterone pellets and injections Metformin ER 500 mg-2,000 mg Thymosin alpha-1 peptide (currently unavailable) Thymulin peptide Peptides that stimulate the Growth Hormone. Eg. Sermorelin, Ipamorelin, CJC.. Supplements that Support your Immune System & Recommended Daily Dosing: Vitamin C - 1,000 mg/day Vitamin D3 - 5,000 IU/day Zinc - 30-50 mg/day Methyl-B Complex from BioBalance Health - 1 /day Magnesium Glycinate or Magnesium Complex from BioBalance Health - 400-800/day N-Acetyl Cysteine (NAC) from BioBalance Health – 1800 mg/day Inositol 1-2 grams a day Choline 425-550 per day Glutathione (given im, IV optimally) 50-600 mg/day orally (20-40 mg/kg of body weight 3 x a day) Airborn® Diet: Lots of fresh fruits, vegetables, eggs, and animal protein (meat and milk products) Citrus fruit Limit caffeine to no more than 2 cups/day Avoid sugar, synthetic sugars (Saccharin, Equal®), alcohol, gluten, and processed foods Avoid preservatives, and food coloring/dyes (especially Red #40 & Yellow #5) Exercise: Doing 45min of cardio per day or more is optimal! Add weight training for the whole body. Red Light Therapy: 20 minutes a day stimulates the mitochondria to make more immune cells, and to activate them. Sunshine: 45-60min/day is optimal! No sunglasses or sunscreen. Medications to AVOID: Statins Steroids Drugs that treat autoimmune disease called biologics Medical Treatments to avoid if possible that Suppress the Immune System Immune suppressants Treatments for autoimmune diseases Cancer treatments such as radiation and chemotherapy Habits and substances to avoid that suppress the immune response (the thymus gland and the cells that it produces. Avoid the habits and environmental substances that follow: All types of tobacco products Smoking anything—tobacco, THC, etc. causes the lungs to be damaged and to carry carcinogens into the body. You can put an air purifier in your home and or office. Alcohol, yes including wine and beer (they are toxins) Drugs not prescribed by a doctor and some that are prescribed by a doctor. See "Medications to Avoid" above. Fast food Sugar, honey, simple carbohydrates that raise the blood sugar Inactivity Short lengths of sleeping. Humans need at least 7 hours of sleep. Night work/shift work Indoor light > outdoor sun light Tap water that contains chemicals and fluoride--only drink purified water Use of chemicals on your lawn and pesticides in and outside of your home because they are carcinogens No one can avoid all bad habits and substances that block your production of White Blood cells and protect you from cancer, autoimmune diseases and infections, however you can take steps to improve your immune system to decrease your chance of these diseases. The most important change you can make that protects you with just one change is to replace testosterone with bioidentical pellets, if you are over 40 years old. Testosterone in pellet form is the one hormonal replacement that will improve your immune status more than any other single treatment or supplement. So what is stopping you from preventing future illness and suffering?

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog You probably have never heard of the need for Iodine in your nutrition, but it is a trace element that is vital to human life, because iodine plays a role in all of your hormones, your immune system, your metabolic rate and yes, your breasts! Iodine is produced by seaweed, and is a natural mineral in the soil, sand and ocean of any area of the globe that has been under the ocean or near an ocean currently. Iodine is present in most of the US except the Midwest. Unfortunately, the glaciers of the last ice age, scraped off the topsoil, and the iodine, from the Midwest of the US and carried it to Canada. The Midwest, where I live and practice medicine, is ground zero for the diseases secondary to iodine deficiency. If you live by the ocean, you probably get enough iodine, however the farther away you are from the coast, or if you live in the US Midwest, the higher your chance of having iodine deficiency. Where do we find Iodine concentrated in our body? The thyroid gland takes 75% of the iodine, and the rest is distributed to the breasts, ovaries, muscles and blood. The breasts need iodine to be healthy and normal, and insufficient iodine causes women to develop fibro-glandular conditions that obscure masses on mammogram, and make the breasts feel "lumpy". There is a direct relationship between iodine deficiency and breast disease. Taking Iodine can reverse the fibrocystic condition of the breast and it can give your thyroid gland the iodine it needs to make T3 and T4, and keep your metabolism burning calories. Hypothyroidism and fibrocystic breast disease are primarily diseases affecting women, and both conditions occur most frequently at the times in a woman's life-cycle when breast growth is most active. Breasts are most actively growing during the following times: puberty, pregnancy, and pre-menopause. I noticed the occurrence of these diseases at these times in my GYN patients when I practiced OBGYN. I did a breast exam on every one of my patients and I noticed that breasts because more cystic in my patient's early teens, during pregnancy and between 35 and 50. However my practice is in the middle of the "goiter belt" of the Midwest and almost every woman had somewhat cystic breasts due to a lack of iodine. All the mammograms I saw were fibrocystic, which doesn't increase their chance of getting breast cancer, but does make reading a mammogram more difficult. Fibrocystic breasts make mammograms have a "static" like quality which decreases their accuracy. Here is how this works…when you are a child and have enough Iodine for your thyroid function, you were thin and active, then you are less likely to have hypothyroidism as a child. About 2 years before puberty, a girl's breasts start to form and they soak up the iodine from the blood, stealing it from the thyroid. This makes these young girls gain fat, they become fatigues and often have all the symptoms of hypothyroidism, like hair loss, thin eyebrows and lack of motivation. During those two years as their breasts grow, women who have plenty of iodine in their diet, don't' become hypothyroid and don't develop cystic breasts. The young women who effectively increase their iodine intake, or who have small breasts don't require very much Iodine, escape the puberty process with a normal thyroid. Other girls soak up more of their Iodine in their breasts and starve their thyroid. The thyroid shuts down, they gain fat, are fatigued, get all the symptoms of low thyroid, and get lumpy breasts. This leads to a group of women who get Hypothyroidism and FCBDX (fibrocystic breast disease) at puberty. The second time of life women get hypothyroidism is during or after pregnancy when their breasts are much larger than ever before, and are lactating, using up their iodine. Hypothyroidism can occur at this time is unlike other times of a woman's life that puts a woman at high risk of developing hypothyroidism, they can actually get over hypothyroidism within a year of developing it. Generally, once you have hypothyroidism, you never get over it and you must take thyroid replacement medication the rest of your life. How can you prevent the breast changes from low Iodine intake? You would think that the government would supplement foods with Iodine to prevent this, but in their usual manner of bad dietary advice, they took Iodine supplementation out of bread and other baked goods in the 1960s under the false assumption that iodine caused hypothyroidism, when it doesn't! They replaced it with Bromine, which cripples the thyroid gland and can cause hypothyroidism. In addition, they added fluoride to water and that effectively blocks the effectiveness of iodine. It basically kicks Iodine off the thyroid hormone molecule and replaces it with Fluoride which stops thyroid function. Why does the government not reverse its previous stand on Iodine? Because they would have to admit they made a mistake! That

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog One of the new tests available to doctors and patients without a prescription is a test that tells you if you currently have arterial plaque and gives you reassurance for 12 years that you will avoid a heart attack from blockage of the coronary arteries. The CACS looks for calcium buildup that shows white on the CT scan. Where there is calcium in the arteries there is plaque. To me this is a wonderful preventive medicine adjunct to the care I give my patients. I no longer have to look at high cholesterol numbers and worry that my patient is going to have a heart attack, because I have found that high cholesterol is not always associated with development of arterial plaque! Let me back up and explain to you what heart disease really is. Your heart is a muscle that never stops beating until you die. It is fed by arteries that cross over and around the heart and the arteries feed the heart with oxygen, nutrients, and proteins to feed and repair the heart. Heart Disease is really disease of the heart's arteries. It occurs when cholesterol sticks to the arteries of the heart, which narrow the pipeline that feeds the heart. As the plaque grows the arteries narrow more and more until the vessels clog and a part of the heart is deprived of oxygen and nutrition. That part of the heart muscle dies…that is a heart attack. Cholesterol in the blood does not mean the development of heart disease. Yes, there is cholesterol in the plaque, but it takes inflammation which is the glue that sticks cholesterol to the arteries. Some people have high cholesterol their whole lives and never have arterial plaque or a heart attack. Cholesterol is not a bad lipid, it is necessary to our whole body, and our brain is mostly cholesterol, every cell wall in our body has cholesterol as the main component, so lowering cholesterol too low can harm you! Statin dose that makes your cholesterol too low is damaging to your brain and all your cells. There is a new kind of dementia called Statin Dementia! This is why I think you should not take a statin unless you have arterial plaque, or your habits increase the inflammation and the formation of arterial plaque. My own experience is key to my belief in this test. In 2002 one of my friends who was a surgeon died at the age of 47 of a heart attack. He had no sign of this ahead of time and it came as a surprise to everyone who knew him. I always have had high cholesterol and my husband has had it too, he was even placed on a statin at age 40, so I set us up for the NEW TEST the CACS. At that time the test was brand new, and the research wasn't back however seeing is believing and we have used ultrasound for diagnostic purposes for years in OBGYN, so we both had the tests. Now the test is $99 at most radiology departments and at that time it was $1000/test! I didn't care because it was worth knowing whether we would have a heart attack in the near future. It turns out that we both had a score of zero (0) and there was no plaque! Yea, I felt better and stopped worrying about my cholesterol. I was 47 and my husband was 51. I never recommended this test to my patients because the stats weren't totally back yet, and it was very expensive, until years after I began my BioBalance hormone replacement and preventive medicine practice. I began to read about the test and that it was reliable and a good way to tell if someone needed a statin or not. I began to recommend the test to anyone including anyone at risk or on statins. Over the next 20 years I ordered tests on my at-risk patients (those who had family histories of heart disease but normal cholesterol and those who had high lipids that didn't come down with bioidentical hormones. I was surprised when over the 20 years, at least half of the patients who had high cholesterol had no arterial plaque (no risk for heart disease and MI) and about half the patients who had positive family history, but normal cholesterol had no plaque! So lipids and family history didn't mean anything! These are the 2 reasons that patients take statins! Patients are given statins blindly for positive family history and high cholesterol not knowing whether they are at risk or not, and one test for $99 can tell if you need statins or not! By the way, when I was 63 and John was 67 we had another CACS and I was still 0 and John who had been on statins for 27 years did have plaque! His score was 141! The statin didn't work to prevent narrowing of his cardiac arteries. His new cardiologist was on board and put him on a different kind of cholesterol lowering agent and I put him on Celebrex to prevent inflammation that stimulates plaque formation. Without this test he would have been on a drug that was not working— a statin! What is the test like? The test is a 2 picture CT scan. It takes 5 minutes and can tell your doctor a lot! It is recommended after 40 in men with a family history or who are on statins, and

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog My patients who are listing their symptoms of menopause and low testosterone invariably check the box next to INSOMNIA. In addition to insomnia, they tell me that it is the one problem that they have that affects all their other symptoms of menopause such as difficulty thinking and memory, depression, restless legs, muscle aches, irritability, and generally sabotages their quality of life. This subject has finally been studied in depth by the J or Endocrinology, and I want to share the information with you. Insomnia is one of the symptoms that plagued me after my hysterectomy and removal of my ovaries. When my sex hormones, estradiol, and testosterone were depleted, my sleep was significantly disrupted. We spend 1/3 of our life sleeping, recharging and healing our brain and body. Prior to my hysterectomy I had always been able to sleep. For an OBGYN who is always sleep deprived, I was able to lie down between deliveries or surgeries and sleep for 20 minutes and wake up refreshed. After my hysterectomy I couldn't even sleep when I had a chance to at night! I was literally the walking wounded, and medicine told me this was completely unrelated to hormones…..I had proof that it wasn't and no one would listen to me. I added estradiol to replace the only hormone that medicine accepted as a product of the ovary, but estrogen made me fatter (I gained 20 lbs after my hysterectomy) and didn't help my sleep, it just decreased my hot flashes, but didn't stop them. My life path led me to Dr Gino Tutera who knew that I needed testosterone as well and the loss of T was the source of all my symptoms. Voila! The first night after my pellets were inserted, I slept all night! I woke rested and all my symptoms went away from that day on! Medicine had failed me…and I began to question everything I learned. The medical articles blamed insomnia on everything else that is downstream from T and E2 loss…..hot flashes, anxiety, depression, worry, getting olde, or normal aging. The latest research from the Endocrine Society confirms the findings that I discovered 20 years ago…that the loss of ovarian and testicular hormones cause insomnia. There is emerging evidence that menopause-associated hormone loss contributes to this elevated risk, but age is also an important factor. The extent to which menopause-associated sleep disturbance persists into postmenopause above and beyond the effects of age remains unknown. Untreated sleep disturbances have important implications for cognitive health, as they are emerging as risk factors for dementia. Given that sleep loss impairs memory, an important knowledge gap concerns the role played by menopause-associated hormone loss in exacerbating sleep disturbance and, ultimately, cognitive function in aging women. In this review, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining the sleep–wake cycle in younger and middle-aged females, with evidence implicating 17β-estradiol in supporting the memory- promoting effects of sleep. They now admit that insomnia is independent of aging, it occurs when ever sex hormones fall below the genetic normal for a patient. We see this most acutely in patients who have their ovaries removed before menopause. So if sleep is vital to avoiding dementia and Alzheimer's disease, and necessary to your ability to think and problem solve, and to prevent depression and anxiety how does this work? The basic timing and duration of sleep is regulated by homeostasis (balance of the brain). A person has a necessary amount of sleep needed and everyone is unique. As you are sleep deprived something called "sleep pressure" increase until you go to sleep and relieve this pressure. The second factor in timing and duration of sleep is circadian rhythm, aligning your sleep and wake cycles to the light and dark cycles of your environment. Estradiol and Testosterone affect both of these natural regulators of sleep.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Medications are getting more expensive, and the % of the price of each medication goes up every year as insurance companies hold on to their profits. This one fact should make you listen read this blog, but there are more recent changes in medicine that has caused the average patient to take more total medications, and government with the FDA are making the personal cost of medications higher while they create legislation to prevent the use of cheaper and more medications for each medical condition that you have. So it comes down to the following agencies of "health" make more money at your expense: 1. Insurance companies, 2. Medical practices and doctors who are paid by insurance companies make your appointment times shorter and the number of issues they can take care of at one visit, one, 3. The governmental agency that your tax dollars pay for, the FDA block the basic medications from approval because they are not patentable and the FDA is REALLY just another arm of the pharmaceutical companies. None of these groups want you to be healthy, because they all make more money when you are sick and need more and more medications, that you pay more and more for every year. How do we deal with this and make ourselves healthier and at a lower cost? Efficiency! That means that you will have to do several things to protect yourself. The first and most important thing is to take fewer medications by treating the disease that causes the symptoms you take several drugs for, one for each symptom. I will give you an example that I deal with every day, the symptoms of menopause. Women who go through menopause not only have obvious symptoms of menopause, but they also have many other symptoms that medicine doesn't connect to the loss of estrogen and testosterone in women. For example, we all know that hot flashes, insomnia from night sweats and painful intercourse from vaginal dryness are all caused by loss of estrogen, however medicine teaches doctors to treat these symptoms separately, instead of replacing estradiol + progesterone if you have a uterus. Treating the cause, replacing estradiol as a patch, pill, vaginal tablet or pellet can treat these obvious symptoms of menopause, but current medical practice tells doctors to give that patient one drug to treat a dry vagina—vaginal estrogen, or vaginal DHEA, or a vaginal SERM, all of which are less effective and much more expensive than giving a woman one prescription of estrogen replacement to treat the whole body and all the symptoms plus many other symptoms that are secondary to low estradiol/testosterone, but are considered unrelated to menopause, so they need many more prescriptions (and more doctors)! Symptoms that are considered unrelated to menopause and hormone deficiency, are treated by other specialties with multiple other drugs. For instance, many types of arthritis begin with loss of testosterone and estradiol before and at menopause, however they are treated by a rheumatologist with multiple very expensive medications that have severe side effects. If menopause is treated with non-oral estradiol and testosterone, then there would be fewer patients with autoimmune arthritis and autoimmune diseases. Most of my patients who have developed these diseases after menopause before they see me are better after I treat them by replacing the hormones they are missing! One Rheumatologist told me he wasn't going to send me any more patients because after his rheumatology patients saw me they were better and didn't need his care anymore! They never went back to him. That says it all. My patients who have these diseases not only don't need the other expensive medications, but they also don't have pain or destruction of their joints anymore! Another symptom of menopause is insomnia. There are many over the counter drugs that are out of pocket and many drugs for sleep that help your inability to sleep that occurs after age 40. However, when my patients get their testosterone and estradiol replaced, they don't need sleep medicine anymore! They save much more money on their copays and over the counter drugs than they spend on their hormone pellets and feel more rested after they get their "sex hormones" back, without other drugs! Insomnia is not currently considered secondary to menopause by medicine and the FDA, but it is! My patients are proof! My patients don't have hot flashes, irritability, or painful intercourse either, so replacing hormones treats 3 symptoms of menopause and more than 2 other medical diseases, that are thought to be independent of hormone replacement. Lastly many women develop migraine headaches at the end of their 30s or the beginning of their40s and they need at least 3 drugs to treat their migraine headaches, and they still are left leaving work to go home and sleep in a dark room the rest of the day. I know how bad this and the other symptoms of testosterone loss and menop

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog Do you want more energy, improved your immunity, develop better skin and to look younger? These are just a few of the benefits of Red Light (LED therapy), and BioBalance Skin has a Red Light Sauna. Our Red Light sauna is a 20 minute treatment that you can have once a day every day if you want to. You just have to be willing to sweat….but you can sit and work on your phone or computer for 20 minutes while you just sit there. Red Light Saunas make you younger and healthier with an improved immune system just by sitting there—it is a cellular cleanse. Recommended treatments are 1- 3 x a week, for 20 minutes. It will dehydrate you and you should drink water before and after the therapy. Facts: Did you know that red light therapy also called LED Therapy and can activate your metabolism by exciting the mitochondria within your cells that are contained in your cells of your major organs and metabolic systems in your body. We recommend weekly Red Light therapy in our redlight spa at BioBalance Skin. A Red Light sauna treatment is 20 minutes long. Instructions: You should bring clothing you can sweat in, that expose at least your arms and legs, but more skin exposure the better. Your skin absorbs the red light, and it stimulates every part of your body. You will get hot and sweat but your phone and laptop will not, you can work in the sauna, but it is more effective if you are relaxing for 20 minutes. BioBalance Skin® : Please schedule your 20 minute appointment by calling BioBalance Skin® at (314) 648-5710. We provide towels to sit on and dry off with, and the redlight sauna with each treatment. The cost is $35 for each 20-minute treatment Monthly packages of 8 treatments are $245/use within a month – a year, 8 treatments per month or spread them out within a year from the first treatment. You will sweat so be hydrated when you come to BioBalance Skin®. You can drink water while you are in the sauna too.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ For decades OBGYNs and oncologists have been denying estrogen replacement to women who have had ER positive Breast Cancer because they believed that estrogen would increase the risk of breast cancer recurrence…As of July of 2022, The National Cancer Institute has reversed the previous position that estrogen in local form for bladder and vaginal atrophic symptoms, and for the systemic form of estrogen would increase the risk of recurrence and death. Now the findings of the most recent study are that the replacement of estradiol in any form to postmenopausal women who are symptomatic (vaginal dryness, bladder infections and bladder irritability and urinary incontinence), as well as ERT for hot flashes, and depression in postmenopausal ER + breast cancer patients reveal that the risk of death and breast cancer recurrence is no higher among women who take ERT compared to women who take nothing! In my OBGYNB residency and for my ACOG boards, I was taught that Estrogen replacement was dangerous for women who have had a positive family history of breast cancer, for women who have + ER, + Breast cancer in the past, and for women who are at high risk for breast cancer. The latest study repeals that belief! This study finally does an "about face" to the previous belief that Estrogen Replacement Causes recurrence or a shortened life span. The newest study proves what I have seen in my gyn practice: patients taking ERT after non-metastatic breast cancer were safe and had the same rate of recurrence as women who took no estrogen. In the latest study by the National Cancer Center found that estradiol benefitted women in general and was safe. The biggest difference between those women who did take estrogen after breast cancer and those who didn't take estradiol was that women on estrogen had a normal sex life and lived a healthy quality of life, and those without estradiol did not. This finding is the same conclusion I came to by watching my patients with and without Breast Cancer, who took estrogen because of severe menopausal symptoms after non-metastatic ER+ breast cancer. Recurrence of breast cancer in my 29 years of GYN practice and in the 20 years of BioBalance Health® medical practice was no more common in those who took E2 replacement than women who took no estrogens after cancer! Finally, research reveals, and I hope medical practice guidelines will soon include the OK to give estradiol of women at risk for Breast Cancer and those who have been successfully treated. The refusal of doctors to give women what they need after menopause and successful treatment for breast cancer has damaged many women's lives…Doctors need to realize that quality of life is important and fear of non-documented beliefs just hampers the health and quality of life of their patients.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ When the human body is exposed to radiation (even the sun), toxins, stress, unhealthy food, infection and extremes of temperature and physically stressful environments, it creates unstable free radicals, charged cells that travel through the body causing cellular damage. For example, oxidative stress causes oxygen, which is usually a beneficial element in the body, to divide into two oxygen molecules, each with a charge. The oxidative stress makes O2 into two oxygen free radicals. The two free oxygen free radicals are harmful to the body, and the damage is in the mitochondria, and the cell can't efficiently make energy out of Oxygen and sugar. Oxidative stress is somewhat like putting a pillow over the mitochondria so the cell can't breathe! How do we get exposed to free radicals? Sun, processed foods and toxins in the environment. Inadequate supply of antioxidants, fat, and protein, lack of fiber in the diet, inactivity, drugs, smoking, lack of sleep. Many common items in our diet increase free radicals: Processed flour, wheat, gluten, sugar, sweeteners, and trans-fats. Source Of Free Radicals and Oxidative Stress Air pollution. Cigarette smoke. Alcohol intake. High blood sugar levels Consuming large amounts of polyunsaturated fatty acids Radiation, including excessive sunbathing. Infections by bacteria, fungi or viruses. Excessive intake of iron, magnesium, copper, or zinc Too little oxygen in the body Too muchoxygen in the body. Intense and prolonged exercise, which causes tissue damage. Excessive intake of antioxidants, such as vitamins C and E Antioxidant deficiency Prolonged oxidative stress (exposure to free radicals) leads to increased risk of negative health outcomes, such as cardiovascular disease and certain types of cancer. It is also thought to contribute to degenerative diseases such as Alzheimer's Disease, Parkinson's Disease and Dementia as well as the aging process. The Treatment for Oxidative Stress, and Mitochondrial Damage Oxidative stress is treated with antioxidants, microniutrients, supplements, and refraining from bad habits such as smoking, drug use and alcohol. The antidote t o oxidative stress is found in Antioxidants which are found in fresh fruit and vegetables as well as meat, healthy fats and eggs. They are also made in the body of humans and animals, and can be given as supplements. Antioxidants work by combining with free radicals, which literally defuses them, so the free radicals cannot damage the cellular mitochondria. "Antioxidants are molecules that fight damage by free radicals, unstable molecules that can harm cellular structures. Antioxidants do this by giving electrons to the free radicals and neutralizing or defusing them." Fresh Foods That Contain Antioxidants Dark Chocolate. Goji Berries. ... Blueberries Coffee Cranberries Green tea Garlic Grape skins Popcorn Yogurt Broccoli Vitamins & Nutrients That Are Antioxidants, Found In Many Foods But Can Also Be Taken As A Supplement: Vitamin E, Vitamin D, Carotene, Vitamin A Vitamin C Omega 3 DHA Alpha-lipoic acid L-carnitine Coenzyme Q Selenium Reservatol (found in grape skins and wine) Sulfur containing amino acids Iodine Methylated Folate Glutamine (eat bone broth) NAC How do Antioxidants remove free radicals? Anti-oxidants actually sacrifice themselves to remove free radicals. The antioxidants bind with the body's free radicals, making the free radicals safe by taking the charge from them, and then they (the antioxidants) are recruited to protect the cells from oxidative damage. The outcome of unfettered Oxidative Stress is damage to cells, proteins and DNA. This causes aging, disease, degeneration of tissues, and finally cellular and whole-body death.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Mitochondria are discussed in antiaging advertising like they are understood by the common man. Even TV discussions and podcasts discuss mitochondria like we are all biology majors, but to most people mitochondria is a word but most people don't know really what they are. Most people think Mitochondria are "good", but what are they? Some examples of ads that use the word Mitochondria, reads "Take these Anti-oxidants every day and you will heal your mitochondria, and live longer…" "Your mitochondria are sick and need to be treated with BLANK to bring you back to health, just buy…." In reality, most students of biology and medical doctors are the only people who understand what they are and how they work, what can make them "sick", and how to make them operate normally within each cell of our body. Simply mitochondria are organelles that take BS and Oxygen and make energy. You can think of it as "breathing for the cell" , by taking blood sugar and O2 and creating energy, CO2 (carbon dioxide) and water H2O. Mitochondria are the tiny determiners of our ability to metabolize food and make the energy the cell needs to do its job effectively. I bet you never thought anything about the fact that when you breath oxygen it goes into your blood stream on your red blood cells, and delivered to your tissues by diffusion through capillaries and enters the cells within your tissues…but what does it do then to sustain us? That is where Mitochondria come in…as they work as I described in the previous paragraph. Another important piece of information about the mitochondria is that they are passed from mother to child, which means your metabolism is secondary to the genes only your mother gave you! We call this genetic communicator that tells cells how to function metabolically, mitochondrial DNA! To locate our mitochondria, we must take a microscope to the human body, and successively dissect her into smaller and smaller parts: A whole human body, divided into organ systems eg. Skin, Gastrointestinal system, then divided into smaller parts called tissues such as muscles and neuro-tissue. Smaller still are the specialized cells that make up the tissues, call cells. Smaller still are the mitochondria that are located within each cell in the body, providing energy to the cell, to make the whole-body work! Mitochondria are small, oval, sub-cellular " energy packs" located inside every cell in our bodies. These small oranelles within our cells turn sugar (glucose) from our food, into ATP (energy) and Carbon Dioxide (CO2). They act like miniature lungs, taking in sugar which is made of oxygen and carbon, and returning CO2 as a by-product. Scientists say that mitochondria's activity is "respiration"! The CO2 passes out of the cell and is excreted by the lungs. So why do we use Mitochondria as a catchword for a way to sway lay people to buy a product to keep them healthy? It is a way to explain complicated physiology to people who aren't trained in a particular science like medicine or biology, and a way to sell products. The word mitochondria is associated with sickness and how to get better and it becomes a catch word everyone knows and wants to "fix". However, if it is a fad or an advertising method to sell something, knowledge of what mitochondria need to make energy, is a valid pursuit. In short, your cells need plenty of oxygen, healthy foods, exercise and a clean environment to make energy effectively in your mitochondria. Because our food sources do not have adequate nutrition for us and our mitochondria, we must eat foods that are particularly packed with nutrients and or add supplements such as resveratrol, Alpha-Lipoic Acid, L-carnitine and omega 3 oils to heal our "sick mitochondria". All the while we are trying to "help our mitochondria" with nutritious food and supplements, many of us are inactivating our mitochondria just when we need them most! How you ask? Those of the many people who take statins are inactivating their mitochondria 24-7. That is how a statin works! Statins inactivate mitochondria to decrease the production of cholesterol in the cells. So why are we killing our ability to make energy and to be healthy, just to decrease our chance of getting heart disease later? Statins are only worth the risk if you have already had a heart attack or are about to have one and have narrowed atherosclerotic arteries. Statins don't treat anything, but your cholesterol lab values, and only prevent additional buildup of more plaque. Some of my patients think statins are cleaning up the arteries, but they do not do that! The risk for a heart attack includes blocked arteries, inflammation, smoking and a high Homocysteine level and Family history. To clean up blood vessels, Zetia is the atherosclerotic cleaner-upper without the risks of a statin! Zetia leaves your mitochondria alone! To know if you actually have atherosclerotic plaque, you should h

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ One of my patients asked me why I was putting her on Metformin if she wasn't really diabetic yet, another woman I was consulting on asked why I'd put her on a dangerous drug, and another patient with Fatty Liver refused to take Metformin because it is for Diabetes and not for Fatty Liver! These patients made it clear that I had to create a Healthcast and blog about the miracle drug, Metformin. Metformin has been around since 1994 while early in my private practice. Metformin quickly became the first line therapy for type 2 diabetics. was the first line of treatment for type 2 diabetics. In that 40 years using Metformin for diabetes has opened a whole range of other diseases and conditions that Metformin can be used for, such as: Reducing risk of Cancer recurrence, all cancers Weight loss Lowering triglycerides Treating insulin resistance Treating Prediabetes Mood Disorders, Psychiatric problems Decreases NAFL from becoming Liver cancer Polycystic ovarian Disease Infertility Aging and the symptoms of aging People on Metformin have a lower rate of mortality How does Metformin work? Metformin exerts its hypoglycemic effects by: decreasing glucose production from the liver increasing insulin receptors' sensitivity in various body tissues increasing secretion of growth differentiating factor, which reduces appetite and calorie intake. When I find a patient with signs of Diabetes, a high HBA1C, and or an elevated fasting Insulin level (above 10), or consistently elevated FBS I prescribe Metformin for patients who don't have AODM yet, but who will progress to it if they are not treated and learn to eat low glycemic foods, and to exercise. Generally, the patients that I label with Metabolic Syndrome, revert to normal and don't proceed to AODM. I also use this drug for weight loss because most weight gain in women after 40 is because they have become menopausal and have a loss of testosterone which causes them to gain weight and become insulin resistant. Metformin, Diet and Exercise all work together to reverse the process and decrease a woman's chance of getting AODM. What medical Diseases and Problems Do I use Metformin for? Other patients who may or may not have IR, but who have elevated liver enzymes from Non-Alcoholic Fatty Liver Disease (NAFL) are placed on Metformin to reverse this problem as well. I have seen many patients who thought they were doomed to having fatty liver and possibly developing Liver Cancer, become healthy, lose weight and normalize their previous Fatty Liver. High Triglycerides (TGs) are generally from too many simple carbs over time and increase as insulin resistance gets worse with aging and length of time eating the wrong diet. Diet and exercise are necessary to drive the TG down to normal, but patients rarely stick to these lifestyle measures unless they see a visible change in their body composition. Metformin can make that possible and be the factor that leads patients to a healthier lifestyle. "Cancer Loves Sugar" so I try to explain that the 2 largest factors in recurrence of a cancer or even getting any cancer are obesity and dysregulation of blood sugar with insulin resistance. Both can be transformed by diet exercise and metformin! You can literally decrease your cancer risk by losing weight and not eating simple carbohydrates. Elevated Prolactin levels that are not in the tumor range are lowered in both men and women with Metformin. The article in the latest Psychiatry Today shows a use for Metformin for mood disorders. Psychiatrists use metformin ER to decrease the weight gain often caused by anti-psychotics. They also find that metformin increases repair in the brain and activates the brain to increase Motivation, cognition, and dopamine. This is a benefit for patients who may be on antipsychotics for life and need help with the side effects. Countering Inflammation that causes osteoporosis, degenerative brain diseases, frailty and arthritis. Antiaging is stimulated by Metformin..how does it work? Improving nutrient sensing Enhancing autophagy Enhancing intracellular communications Protecting against macromolecular damage Delaying stem cell aging Modulating mitochondrial function Regulating gene transcription Lowering telomere attrition How Do I prescribe Metformin? There are two types of Metformin, the short acting form of metformin which is made to be taken with each meal to manage BS after eating for diabetics only, and the long-acting type of Metformin, which is called Metformin ER or XR, and this is the type I use for every other problem including IR, and Prediabetes. The long-acting form must be taken with a meal, or it simply will not work! Generally, the dose is started with on 500 XR tablet with the largest meal of the day, then increasing each week to the max of 4 x 500XR tablets per day if needed. I write smaller doses for less severe dysregulations, and larger for severe IR, Obesity, and

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ At BioBalance Health our primary goal for our aging patients is to reverse the process of aging and treat their symptoms and body composition changes that come with loss of Testosterone in women and men. We also have a secondary goal to make our patients healthy for a lifetime and prevent the many diseases of aging! The diseases of aging are also started when Testosterone is deficient, years before we actually are diagnosed with one of the diseases we associate with aging. I am listing the diseases of aging below so you can decide if you already have one of them or if your family history put you at risk for them. We treat preemptively for these diseases if we see any sign of them and often can prevent them, stop their progress or decrease the symptoms of these diseases. If you have one or more of the Diseases of Aging or they run in your family: Adult Onset Diabetes (Type 2 Diabetes) Vascular Disease High lipids Heart Disease Autoimmune disease after 40 Obesity Insulin Resistance Chronic fatigue Hypothyroidism High Cortisol Obesity Osteoporosis then BioBalance Health® can bring you back to health and prevent the diseases and symptoms of aging for you! Please go to our website to fill out our forms and we will call you to make an appointment! BioBalancehealth.com. If you have noticed that you look old in the mirror and have: Sagging facial jowls Large and deep eye circles Sagging lids Poor facial skin tone, and large pores Sagging body skin and loss of muscle mass and strength Crepey skin Loss of facial cheeks Deep parenthesis around your mouth Smokers lines above your upper lip Full face or body sagging Urine loss –stress or intermittent urine loss Loss of eyebrows, causing lack of facial definition Facial hair and acne Unwanted hair anywhere Brown spots Deep facial wrinkles And more…… Then make an appointment at BBH BBSkin® to have a consultation, develop a treatment plan just for you and take care of the visible signs of aging skin . Our weight Loss program can be combined with the BBH treatment and BBS beautifying skin treatments. We provide diet and exercise treatment plans, and then make them, more effective by adding Testosterone pellet therapy i(f indicated), and or medications like Ozempic, Rybelus, Appetite suppressants, Metformin and oteher cutting edge weight loss meds and individualize your treatment plan, while we follow your progress with our INBody Body composition scale. We also offer Lipo-plus and HydroxyB12 shots in our office for our pellet, weight loss and esthetic patients. Sometimes we incorporate peptide treatment and supplements to assist the rest of our diet program. Some people are more difficult than others to start weight loss…but as you heard from our patient who sent a letter to Dave and Trish. If this sounds like what you need and you are in the area of Kansas City or Saint louis where our offices are located, then go to our website and hit the button New Patients and change the course of the second half of your life!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ BioBalance Health LLC turns 20 this year! We have been changing the lives of our patients for two decades. Every day I get amazing positive feedback, that makes me KNOW that I have found a unique answer to aging and a health program to treat all the symptoms of aging and prevent the diseases of aging with replacement of one hormone, TESTOSTERONE! We offer Replacement of bio-identical pellet Testosterone for men and women, and estradiol pellets for women combined with treatment of all other hormone deficiencies, and preventive treatment and lifestyle changes. We also have a very effective Medical Weight loss program that is very effective using multiple methods of weight loss and the newest weight loss medications tailored to your individual challenges. We even follow your weight loss with an advanced body composition scale. Our third avenue to fight aging is our medical spa, BioBalance Skin®, that fights aging and makes our patients look as good as they feel. I created BioBalance Health LLC to be the ultimate medical practice to treat patients over 40, to treat the symptoms and diseases of aging. BBH practices medicine the way it was meant to be –individualized for your specific issues—with the goals of bringing women and men back to robust health, physically, sexually, mentally and esthetically. BBH is my dream medical practice both for our patients and our medical and esthetic staff. My patients are amazed at their progress and ecstatic about how they feel, in contrast to the debilitated feeling they had before coming to us. Bio-identical Testosterone pellet treatment is the foundation of our Anti-aging treatment plans. Our goal is to bring you back to quality of life, with a great sex drive and a younger body and mind. I get a lot of positive feedback in the office from our patients who tell me the following things: "You saved my life!" "You saved my marriage! We love each other again and have recovered the sex lives we had in our 30s" "I have Rheumatoid Arthritis and have been limited by pain to sitting in a chair all day long. After my first Testosterone and Estradiol pellets, I painted the whole inside of my house" "My insomnia was severe and affected every area of my life but with testosterone pellets I sleep through the night and wake up refreshed. My medical problems have all improved." "I had ED and was treated elsewhere with Viagra and Cialis which improved my physical problem, but it didn't help my lack of desire. With BioBalance I got testosterone pellets and treated my prediabetes, atherosclerosis and I am healthier, and I have a sex drive and no ED!" "I am 68 and I feel like I am 35 again! Everyone asks me what I have done to look so good, and I just say BioBalance!" BioBalance Health is known for offering their new and follow up patient's hour-long consultations with a doctor to review all of a patient's health history, lifestyle and lab results finishing with an individualized treatment plan. Recently I was forwarded a letter from Dave Glover and Trish Gazall our key advertising voices in the Midwest on AM 1120, FM 97.1 They both have been treated for the symptoms and diseases of aging and weight loss with much success and this letter was sent to them, about BioBalance Health®. The letter- author wants to remain anonymous. Shortened. Letter to Dave Glover Dear Dave and Trish, I want to give a shout-out to BioBalance Health. BioBalance has made such a difference in my health! I remember about 10-14 years ago when you (Dave) had Crane Durham on your show, and he essentially said people are fat because they are lazy. At the time, I had been exercising regularly, with little to show for it. I had polycystic ovarian syndrome and had both of my thyroids removed, due to thyroid cancer. It was really demoralizing to know that people would make assumptions about my character and work ethic based on how I looked, without knowing anything about my medical struggles. At any rate, I eventually resigned myself to the fact that my body was destined to be fat and there was nothing I could do about it. Exercise wasn't helping and diets worked only if they were extreme and only for so long, so I finally gave up trying to fight it. Over the years, I listened to your advertisements for BioBalance Health and didn't give it much thought. But for some reason, I decided to give BioBalance a try in the summer of 2020. I was amazed at how thorough their medical intake and blood testing was! They asked me about everything — even a foul ball hitting my head at a Cardinals game was of interest to Dr. Sullivan and I had never given the incident a second thought. Dr. Sullivan determined that medications I was being prescribed for my thyroid replacement by my Primary Care Doc was not adequate. She also diagnosed me with a metabolic syndrome. After struggling all those years, it was a relief to know that there really was a biological element behin

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Women always ask about my goal for their blood level of free Testosterone after insertion of testosterone pellets. That is a good question, and it is not easily answered. When I was trained by Dr Gino Tutera in 2002, and he taught me that the optimal range for Free T in women who take T pellets to be over 15 pg/ml. He taught me that each woman is an individual and the blood level that they need is specific to their metabolism and genetics. To determine the perfect level of T free for an individual we should follow the resolution of her symptoms after her T pellets are inserted. Today we will talk about the research done by Dr Rebecca Glaser, published in Maturitis 74(2013) that confirms my practice of adjusting the dose of pellets based primarily on the resolution of Low T symptoms. Prescribing pellet Testosterone for woman is not easy and her doctor must find her own ideal blood level. Testosterone replacement for women has been ignored as an essential hormone replacement for women, and until recently was not considered a major sex hormone in women. Premenopausal women have 15-20 times more testosterone than estradiol circulating in their blood streams. This makes testosterone the most prevalent sex hormone in premenopausal women, yet it is still mislabeled as a strictly male hormone! After late 30s to mid 40s women develop a deficiency in testosterone and develop a host of symptoms that doctors have sadly called the symptoms of "aging", when the symptoms are directly related to the lack of free T in a woman's circulation. Both pre- and post-menopausal women over 36 may experience the following symptoms of testosterone deficiency: Sexual dysfunction-lack of libido and loss of orgasmic function Anxiety, irritability, depression Physical fatigue Lack of the feeling of well-being Poor cognition Memory loss Insomnia Hot flashes New autoimmune diseases Arthritis Weight gain Muscle loss and physical weakness Pain Vaginal Dryness Irritable Bladder Migraine headaches Osteoporosis One of the reasons that the majority of doctors don't use T pellets is because it takes intense individual training after residency and time and attention to each patient, her symptoms, and time for multiple adjustments of dose before the maintenance dose is determined. This is something a doctor or nurse must do all the time to be good at it and the doctor must have a complete grasp of endocrinology, nutrition, and gynecology to become good at this type of T hormone treatment. Once the pellet dose is determined it is the most convenient dosing schedule (once q 4 months, only 3 doctor visits a year) with 100% compliance because the T Pellet dose is given in the office, very rare complications, and an amazingly complete resolution of symptoms, which has not been seen in any other T preparations, bio-identical or not, given with a different delivery system. With the right doctor or Nurse Practitioner, a knowledge of pharmacology, endocrinology, gynecology and nutrition, this form of T delivery to women brings them back to a more youthful body and mind as well as prevents diseases of old age such as Osteoporosis, Heart disease, Sexual Dysfunction, mood disorders and autoimmune diseases to name a few. In the research paper by Dr Rebecca Glaser: Testosterone implants in women: Maturitis 2013 Dr Glaser explains that there are many problems secondary to following blood levels to determine dosage, and explains why following symptom resolution is the preferred way to provide this type of Testosterone replacement: Specifically, Blood tests of free T are rarely repeatable and often wrong—it is not a good, repeatable blood test. The only thing less reliable is saliva testing which I don't recommend. No single blood test represents the true daily blood level of free T in pellet patients. How fast your body uses the available T up, varies by number of hours or sleep, stress level, estradiol and estrone levels and amount of exercise engaged in per day. Fat metabolic activity: T pellets are inserted into fat in the hip and as we are now discovering, the ability of fat to dissolve a steroid hormone placed in fat is individual and determines how quickly the pellet is dissolved and needs to be re-dosed. There is no test for this, so trial and error is needed using different dosage to determine ongoing maintenance dose. ARs (Androgen receptors) are distributed throughout the body and the number of Ars plus the "stickiness" of the receptors for free-Testosterone in the blood, is determined both by genetic makeup and age. ARs of people with dominant genetics from the northern latitudes, are relatively resistant to binding, and these receptors must have a higher blood level to respond at an optimal level. Women who have their dominant genetics closer to the equator, require less free T to achieve optimal symptom relief. The genes are not specifically discovered as of yet, it is impossi

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ At a get together of friends, I was pulled aside by a good friend who asked me how she could prevent dementia, because the mother she loves is in a memory care facility and she never wants that to be her future! My answer was brief, but I can now think of so many other things I could have recommended for her, and I thought I would share them with you, and I will give her a copy of the blog that goes along with these suggestions. I read research every day that tells doctors what causes dementia and increases risk of getting dementia at the middle or latter part of life. When I get to the basis of all the findings in the medical articles, it is detailed as I will discuss, But the basic qualities and problems to treat include INFLAMMATION, ATHEROSCLEROTIC VASCULAR DISEASE, OBESITY, HIGH SUGAR DIET, HIGH BP SMOKING AND ALCOHOL AND POOR DIET. Risk of Dementia Includes the following categories of Modifiable Risk factors: Low Testosterone and estradiol Chronic inflammation Obesity Diabetes High BP Depression Cigarette/cigar smoking Hearing loss Binge Drinking and excessive alcohol intake Sedentary lifestyle Lack of sunlight High carb diet—sodas, sugar Aging= low sex hormones, poor production of nitric oxide and poor absorption of oral vitamin Bs Chronic injuries and pain that cause chronic inflammation—get that knee or shoulder fixed! Chronic heart disease---arrythmia, atherosclerotic heart disease Foods to Eat Prevent Dementia Eggs in moderation Cumin Anything with protein Yogurt and other foods (Kambucho) with probiotics and lactobacciluus Clean fresh foods Meats and fish that are fresh or frozen, not preserved, or processed Steamed or fresh vegetables (not canned or processed) Seeds and nuts (raw and roasted without salt preferable) Foods to avoid to prevent dementia: Inflammatory foods and soy products Milk, especially cow's milk. (High carb content) especially skin milk! Soy All phytoestrogens Wheat Food with preservatives (all processed foods have preservatives) Modifiable risk factors Replace hormones that are missing with bio-identical hormones, non-oral delivery system Estradiol pellets, patches, gels, for women Progesterone for women who miss it or who have a uterus Testosterone pellets, creams, gels Thyroid replacement. Armour Thyroid for women and levothyroxine for men Neurotransmitters by taking probiotics Suppress LH and FSH –high levels increase risk of dementia and osteoporosis (new study) Take estradiol and testosterone for women—enough to suppress FSH and LH to pre-menopausal levels Replace Testosterone for men Keep Blood Sugar Normal Eat a low sugar and low carb diet— Treat prediabetes with meds Treat diabetes with meds Decease alcohol; intake to 1 4 oz glass of wine a day and Get to ideal weight Achieve Ideal Weight –Obesity and Overweight Increases Inflammation That Increases Dementia, so Decrease Inflammation Eat properly--Eat your base caloric intake or less daily Low carb diet Eat ½ X -1 X your body weight in protein daily Drink clear water equivalent to your weight in ounces (you weight 130—drink 130 oz of water a day) No Soda No alcohol until you achieve ideal weight No desserts or baked goods, rice, wheat products until achieve id3al weight Supplements—see below Exercise Daily Aerobic exercise--for > 40 minutes a day Weight training 3-4 times a week Red Light Therapy especially in the evenings—activate your mitochondria! Directed toward skin for 20 minutes a day Specific red-light therapy –to face or area of pain Natural light in AM Step outside at sunrise or early morning for 15-30 minutes—no sunglasses Sleep in a dark room with quiet at least 7 hours a night OK to take melatonin at bedtime to sleep Supplements -Take a multi vitamin every day like Thorne daily Nutrients 2/day + Antioxidants: Vitamins C, A, and E Vitamin D3 Vitamin Bs—Methyl B12, Methyl Folate oral or injections Anti-inflammatory supplements: Aspirin 81 mg/day Milk thistle Curcumin Omega 3 and 6 oils DHA NAC DIM Arteriorisol Minerals: Zinc 30-60/day Magnesium 300-600/day Electrolytes: especially in summer during exercise NUUN supplement\ Increase Nitric oxide and keep BP less than 140/90 Neo 40 RX Cialis daily 2.5- 5 mg/day Eat beets—lots of them Non-modifiable risk factors: Race (Am Indians and Blacks have a higher risk) Early age of menopause (without hormone replacement) Genetics: HLA-DR15 tissue type, APO-E ¾. And 4/4 Less than high school education Just a word about genetics. We now know that even if you carry genes for dementia, you can modify your genetics…there is hope! This new concept is called epigenetics, and it shows that the factors we employ above can put certain dementia genes "to sleep" and activate other genes that are going to make you healthier! We are no longer a puppet of our genes! Genetic Risk for late-onset Alzheimer's disease (LOAD), the most prevalent dementia, is partially driven by genetics. To identify LOAD risk loc

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ BioBalance Health® has always been on the cutting edge of the newest medical methodology available. In the fight against cancer, we are now using he newest genetic methodology to find cancers early, when they are treatable. Throughout my almost 40 years of practicing medicine, I have believed that medicine should embrace preventive care and be based on the belief that we should only react to a disease that is already established. Now we finally have one test that screens for 72% of the cancers that we can't screen for. It is hard to believe that out of the 55 types of cancer we can only screen for 5 Cancers! Medicine has only developed 5 screening tests that are currently in use to find cancers early. Galleri is one simple blood test that screens for 50 types of cancer, to find them at early treatable stages, before they create symptoms, metastasize, or produce any symptoms. Galleri was created for those patients who have a positive family history of cancer, or those patients who are fearful of getting cancer of any type, and for those patients who have been successfully treated for cancer who want to find out early, if they have a recurrence! Galleri It is the dream child of a company who has been testing and retesting it with the finest geneticists in the US. We are offering this test through our office as an option for those who need it to truly practice preventive medicine! With Galleri, you have a good chance of being cured of cancer through very early detection! Before Galleri® was invented patients only had 5 cancers that could be detected early by screening tests. The following list enumerates the 5 cancers we have screening tests for. Breast cancer: Mammography can find cancer after it has been growing for 11 years. Cervical Cancer: Pap and HPV Test only finds the virus and possibly the cells that might be cancer. Colorectal Cancer, Colon Cancer: Colonoscopy and stool tests Lung Cancer: Low Dose C-T Scan Prostate Cancer: PSA Test Routine screening tests are recommended because they have been proven to save lives by detecting some cancers earlier.3 The Galleri test does not preclude the use of the 5 screening tests that are currently in use, however there are more than 50 cancers that Galleri® can test for, and you receive your results in 10 working days. It is time to look at cancer more broadly, in addition to the 5 cancers that are routinely screened for today. The most important cancer is the one that you or your loved one may have — and curing cancer starts with knowing you have it! If cancer runs in your family, and you lose sleep worrying about it you should take the Galleri® Test. If your genetic relatives (father mother, aunt or uncle, sisters or brothers or children have had cancer then testing yourself for cancer with Galleri® will answer the question as to whether you have it or not. Our patients at BioBalance Health® are offered this test yearly for high-risk patients and as needed, often less often than yearly. The test is not covered by insurance as it is a new test…but can you wait until it is covered? Worrying about cancer can make you literally sick by stimulating your adrenal gland's production of cortisol. This worry impairs your immune system that protects you from cancer, putting you at higher risk! The only risk of Galleri® is the cost…$ 1,250 paid directly to the Galleri® company at the time of your blood draw. 50 Types of cancer detected by Galleri® The Galleri test is a multicancer early detection test that detects a common cancer signal across more than 50 types of cancer through a simple blood draw. A Adrenal Cortical Carcinoma Ampulla of Vater Anus Appendix, Carcinoma B Bile Ducts, Distal Bile Ducts, Intrahepatic Bile Ducts, Perihilar Bladder, Urinary Bone Breast C Cervix Colon and Rectum E Esophagus and Esophagogastric Junction G Gallbladder Gastrointestinal Stromal Tumor Gestational Trophoblastic Neoplasms K Kidney L Larynx Leukemia Liver Lung Lymphoma (Hodgkin and Non-Hodgkin) M Melanoma of the Skin Merkel Cell Carcinoma Mesothelioma, Malignant Pleural N Nasal Cavity and Paranasal Sinuses Nasopharynx Neuroendocrine Tumors of the Appendix Neuroendocrine Tumors of the Colon and Rectum Neuroendocrine Tumors of the Pancreas O Oral Cavity Oropharynx (HPV-Mediated, p16+) Oropharynx (p16-) and Hypopharynx Ovary, Fallopian Tube and Primary Peritoneum P Pancreas, exocrine Penis Plasma Cell Myeloma and Plasma Cell Disorders Prostate S Small Intestine Soft Tissue Sarcoma of the Abdomen and Thoracic Visceral Organs Soft Tissue Sarcoma of the Head and Neck Soft Tissue Sarcoma of the Retroperitoneum Soft Tissue Sarcoma of the Trunk and Extremities Soft Tissue Sarcoma Unusual Histologies and Sites Stomach T Testis U Ureter, Renal Pelvis Uterus, Carcinoma and Carcinosarcoma Uterus, Sarcoma V Vagina Vulva The Galleri test is intended to detect a cancer signal and predict cancer signal's origin to inform diagn

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Don't stop at the headline of a written article or blog about hormones or you who take hormones will unnecessarily feel anxiety all the time. Journalists and bloggers often get you to read an article by first scaring you with a scary title….then reassuring you in the article. This is the first and primary problem with making assumptions about hormone therapy from, including estradiol, testosterone and progesterone. Research Translated into Lay Language Generalize All Hormones into One Big Group When reading anything about "Hormone Therapy being dangerous or safe, the author is lumping hundreds of types of hormones into one category and by doing that, dooming hormones to look like a failure, when they are not. Not all hormones are alike, and the difference between how you take a hormone (oral, pellet, vaginal, etc.) changes the safety and effectiveness. The other factors that change the effectiveness of hormones like estradiol and testosterone include: Whether they are they are synthetic or bio-identical (made from vegetables to look just like your own hormones) What type of hormone is it? For example Estrogen has 3 human forms: Estradiol (young women's estrogen), Estrone (old women's estrogen from adrenal), and Estriol (pregnancy estrogen)…the type you take matters. Horses have over 17 types of estrogen and none of them are human, but we use pregnant horse urine to make Premarin for humans. The dose (the amount given). By lowering the dose of any hormone, you can make it ineffective! The number of times you take it ( 2-3 times a Day, daily, weekly, monthly) determines whether you can keep up with the dosing or not. This determines compliance. How you take it : oral,. Transdermal, pellet, or intramuscular determines the activity and the effectiveness as well as the side effects of a hormone All of these factors change the effectiveness of a hormone treatment in humans. Most of the time, the investigator of a medical study uses one type of hormone for his scientific tests, but generalizes the side effects or the effectiveness of that one specific type of hormone, to ALL hormones in that category, eg. Testing Oral Premarin and generalizing it to every type and kind of estrogen on the market. For instance, Premarin® a synthetic estrogen from Pregnant Horses, was the estrogen used in a study that determined that "estrogen" causes a woman to be at risk for blood clots. This is true of the oral hormone Premarin and many doctors took their patients off all estrogens based on that one study. Much later, years, other types of estrogen were tested for increasing the rate of blood clots and were found NOT to increase the rate of blood clots. After many studies of different delivery systems of estrogen, the final agreement is that all non-oral forms of Estrogen Do NOT cause blood clot formation in women taking them. That sounds like justice was served, but for the 10-20 years in between the Premarin study and the other studies and the time it takes to get a final agreement of doctors, women were denied all forms of estrogen from their doctors based on this inaccurate interpretation and generalization of one medical study! For example, if a scientific study stated that all ice cream flavors tasted the same, could I convince you that all ice cream, of all flavors, taste the same? Of course not, because you have experience eating different flavors of ice cream and you know that every flavor of ice cream and even different companies making the same flavor tastes different! That is the biggest clue to doctors reading a study. If the results don't match their experience, they question it and should follow their experience until more study is done. Some doctors follow blindly the results of studies or follow the ones they WANT to follow because it relieves them of work. That is one factor in causing doctors to stop prescribing estrogen based on the study that said all estrogens caused blood clots, was that of laziness! Hormone therapy requires hours of explanation, which means time in the office and doctors who are overworked found a way out for themselves to shorten their days! Not talking about hormones and stating, "I don't believe in hormone replacement therapy", was their mantra and the cause of so many women being untreated with postmenopausal estrogens! If your doctor says that, then flee! Find someone who can take care of you properly. The doctors aren't the only ones who create the atmosphere of false information. The medical research community is trying to do with the medications (hormones) called HRT (Hormone replacement therapy) and Testosterone. Researchers are trying to tell us that all hormone treatments are the same with the same side effects and the same qualities, no matter what they are made of (plants vs chemicals) or what hormone is contained in them (horse estrogen with 18 types of horse estrogen, none of which are similar to hum

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Many people don't get what they need from their doctor's office appointment in this modern age of 10-minute doctor visits. They complain about it but don't know how fix the problem. I would like to challenge you to prepare yourself for your doctor's visit before your doctor appointment, because it is the only way you can get the treatment you need. Doctors are smart and the most intensively trained professionals in our society, but they are often not the best communicators. Your success when trying to get the right treatment is half your responsibility and half your doctor's. Here are a few things you can do to start the office visit for a problem you are having, in a way that helps your doctor come to the right treatment for you. PATIENT'S ROLE: DO write down your Chief Complaint (the primary problem you are seeking a solution to) and bring it with you. Think about it before your go to the office, or while you're in the waiting room. Then write down your symptoms in a list. These symptoms that you have, when they started and how severe they are, become the clues for your doctor to solve the mystery of your medical problem. If your doctor gets distracted, you can hand him the list of symptoms you have written down. DON'T launch into a long story! Stories are often convoluted and unrelated to what the problem you are seeing him or her for and will confuse the issue for your doctor. The office visit is not long, and you will waste your time talking about what you had for lunch instead of what is bothering you. Years ago I would accompany my MIL to the doctor and she would tell him everything that occurred since her last visit..what she ate, when she went to bed, trouble with her heating and cooling system…and I could see the doctors eyes glaze over. She never got to the reason she was there, and he doesn't have ESP, so it took multiple office visits to get to the bottom of a simple problem, so that she could receive treatment. Remember, are there either for a health checkup or for a problem. Tell your doctor what you are there for, in a few sentences. DO give your doctor any lab or radiology reports from your referring doctor at the beginning of a problem visit with a list of your symptoms so she can read them while you talk and get the clinical facts from them as you tell her what is wrong. Add any related problems that started at the same time as your primary problem. Remember, some symptoms that occur at the same time as your primary problem may be related to your medical problem and some may not. It is the doctor's job to help you decide what is related. An example is that sometimes a patient in our office will notice hair loss when they are taking testosterone and immediately think it is the T pellets, however there are many other medical conditions that cause hair loss. The many medical problems that are likely to be the cause include low thyroid, lack of protein in the diet, adrenal oversupply of cortisol, stress, autoimmune diseases, and medications. Your Primary problem may not be for the reason you think it is, but these other medical issues need to be evaluated to find the cause. On the other hand some medical problems happen secondary to a treatment, or a procedure, and infection or a trauma. You should tell your doctor those things that have happened around the time of your problem starting. My husband had symptoms of a Pulmonary Embolism on January 6th. He got a J&J vaccine on January 3rd. Was that the cause or was the fact that he had a positive covid test the cause? We will probably never know but now doctors have found that the J&J vaccine can cause PEs (pulmonary embolisms) on the second shot, and that is what might have caused his. His cause is figured out in retrospect with new problems that doctors encounter in their practices. Luckily, they treated the problem, and not the cause and he got better over night! IT is always better to know the cause of illness, but it is not always essential to treatment. Sometimes doctors cannot give you a definite diagnosis until they put you through the necessary tests to gather more information (clues). It is necessary to go through the testing to prove or disprove a diagnosis, so please be compliant and get the necessary testing for your doctor to put all the pieces together! BTW if you have had a test to diagnose a problem, then get the test and wait for the follow up appointment to get the results, unless it is an emergency. However, if the doctor said she would follow up by phone or email and you haven't heard in 7-10 days then call the office to make sure the test reached her and that she will contact you. You can't believe how many medical records; radiology reports and lab tests don't reach the doctor in this age of fax and email reports. However, it is better than waiting for the mail to come in like we used to do! Sometimes, doctors don't know the answer, or need you to

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ The list of the factors that bind T so you can't use it and those that produce estrogens block free testosterone in both men and women of all ages. The list of lifestyle choices and is much longer than the list of factors you can use to stimulate testosterone. Soy in many foods: It is a fact that foods that are processed have many "fillers" that are invisible to the person eating them. These fillers are often the culprit decreasing naturally produced testosterone levels and available or active T called free T. The biggest problem at the present is the addition of soy to nearly every processed food, even ice cream. Soy is a phytoestrogen. Phyto Estrogens in food (not medical estrogen) act as a female hormone, limiting the effectiveness of testosterone and the production of T. To avoid soy in everything you eat, you must do two things: 1. Eat basic meals cooked by you or a family member from fresh foods that do not include canned or processed foods, and 2. you have to look at the label and only buy products without soy. Currently there are only 2 brands of ice cream that don't add soy. Soy gives men a "Beer Belly" and all other foods with soy will also increase the fat collection in the abdominal area of both sexes. Soy is the primary proteins of vegans and therefore it is consumed in large volume therefore has more of an effect on lowering free T and T levels. Eating out of and microwaving in plastic containers (even drinking water out of plastic) causes our bodies to absorb the plastic chemical's estrogen. This does us no good and is a contaminant and toxin that we store in our body fat. It is the biggest enemy of T. It is everywhere and is considered the leading cause of lowering the average T level of men aged 15-40. It is everywhere so stop cooking in it and drinking from it when you can! Don't eat out of plastic bags, or microwave plastic containers, or plastic bags with food in it. Diabetes should be treated, and blood levels of sugar should be kept in control as low as possible for type 2 diabetes. Omega 6 fatty acids shrink the testes while the Omega 3 FA increase the activity of the testes Dairy has inherent estrogen in it and animal feed often contains soy, and that makes the milk and meat higher in estrogen. Trans Fats—Are in most processed foods. Chips, any snack food that is not dried fruit or nuts Commercial baked goods, such as cakes, cookies, and pies. Microwave popcorn. Frozen pizza. Refrigerated dough, such as biscuits and rolls. Fried foods, including french fries, doughnuts, and fried chicken. Nondairy coffee creamer. Stick margarine. Alcohol is a toxin and slows fat loss, damages the liver, and increases estrogen production in the liver, which inactivates testosterone. Obesity is dangerous to us in so many ways. The mere fact of being obese increases our risk for multiple diseases, but fat also converts testosterone in to estrone and estradiol in both men and women. The fatter a person is the less free testosterone he or she has. Being a Couch Potatoe. being inactive, is deadly for testosterone production and free Testosterone. Inactivity increases fat production and estrogen production. Moderate exercise every day is the answer! Over activity causes an increase in SHBG which binds testosterone. Marathoners and professional athletes run the risk of binding their good total testosterone so that it is not free to bind to Testosterone receptors. Fasting can cause increase in free testosterone by increasing SHBG. Humans were built to eat small amounts often, and eating one meal a day increases SHBG, that inactivates free T. Licorice root (in black licorice), Ashwaghanda and all mint family herbs even basil decrease active Testosterone blood levels. Phytoestrogens are in many women's natural supplements that are touted to decrease hot flashes. They only provide minimal relief, but also increase fat gain and estrone levels that cause inactivity of testosterone. Medications can lower the testosterone levels in both men and women Oral contraceptives increase estrone so much that they inactivate testosterone and suppress FSH and LH that stimulated the production of T from the ovary. Oral menopausal ERT and HRT binds up T and causes decrease of all of the benefits of T from replacement and natural T production however minimal after menopause. Finasteride and Dutasteride given to prevent hair loss or prostate enlargement causes a decrease of DHT to a point where sex drive, erectile function and muscle mass are impaired. Arimidex can cause an increase in testicular production of T, but in a small production of men and women it can inactivate the receptors for DHT and T. As the research about testosterone progress, we will find more and more lifestyle issues that decrease T total and T free levels that can interfere with normal production of T and free T in both men and women. As these are studied researched, we will update

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ What are the factors that stimulate or inhibit your own Testosterone (T) production? There are foods, supplements and activities that stimulate testosterone production, Just as there are foods, supplements and activities that lower your internal T production. Today I would like to address the factors that increase the production of testosterone in both men and women. However, there are limitations on these nonmedical pathways to a higher testosterone level: 1. One is your age. If you are a woman and menopausal then there are no foods or lifestyle changes that will stimulate your ovary to come back to life and make testosterone. Women have a finite lifespan for their production of estradiol and testosterone, and it ends at menopause. Estrogens can be made in the fat and the adrenal but pure testosterone is only made in the ovary, and when the ovaries "die" that's the end of testosterone production. 2. Men make testosterone throughout their lives, but their testes become resistant to stimulation around age 55, but they can become resistant as early as age 40, and then nothing other than T replacement will increase testosterone levels. 3. A person's body has a genetically driven sensitivity to the hormone Testosterone. Your heritage or the origin of your ancestors determine how you will "feel" with a particular blood level of testosterone. This has been studied by looking at the genetics of the T receptor on all the cells of your body. Receptors are more sensitive the closer you get to the equator in the western hemisphere, and the receptors are less sensitive if your ancestors' origin was closer to the north and south poles than if they were from around the equator. A certain level of testosterone doesn't have the same effect testosterone on both groups. In other words, those genes from around the equator need less testosterone to get the same effect as those people from extreme high and low latitudes. We are all different and our genes have an effect on our treatment. If you are a menopausal woman or over 40 then the manipulations of diet and exercise will be less likely to increase your testosterone production. There are foods and activities that inherently stimulate your internal testosterone production if you are a woman under 40 or a man under 50. After that you generally must replace your T to improve your symptoms of low Testosterone. Eating fewer fast foods and more of a well-balanced Mediterranean diet with fresh foods can optimize your testosterone production. High protein diets with grass fed animal foods and plenty of fish will optimize your testosterone production. Cholesterol containing foods provide the necessary building blocks for Testosterone in the body. Getting to your ideal weight will increase the free Testosterone in your blood stream making you feel your testosterone more. Getting 7-8 hours of sleep a night will increase the production of T, because T production is stimulated at night when you sleep. Sleeping in a dark room stimulates the production of Testosterone, Growth hormone (muscle development) and Melatonin (deep sleep). Daily moderate Exercise (not necessarily running a marathon) will stimulate your production of Testosterone. Supplements can stimulate production of Testosterone. There are several supplements targeted to stimulate testosterone that contain carnitine, inositol, choline. Protein in the diet provides the building blocks of muscle and testosterone and allow the activities and foods that stimulate the production of T have something to build with. People with a low protein diet (no eggs, fish, beans, milk products or meat) have a more difficult time making T. Most combination supplements that are touted on TV to increase your T are herbs and supplements that decrease estrogens like DIM, or supplements that increase your T by providing the hormones that are precursors to T like Pregnenalone and DHEA. Herb Fenugreek 500 mg increases free T production Decrease in DHT with the herb Saw Palmetto can decrease the production of DHT and increase free Testosterone, however it is important not to decrease the DHT too much because it is important in sex drive and building muscle. Ashwagandha decreases cortisol, and cortisol binding protein that inactivates T, therefore it can increase free T. If you are taking T supplementation, then don't take this supplement because it can cause you to not feel your free T. Zinc piccolate and Arginine improves prostate function and health, therefore your volume of ejaculate increases, and free testosterone is improved as well Lastly supplements that increase your erectile function by increasing Nitric Oxide e.g. Neo 40.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Sexism and bigotry are still alive and well in medicine. I have experienced this often during my 40 years in medicine. Women are considered hysterical to the medical man (and some women) which has been what men think about us since time began. This has passed it's "sell-by" date, as has the bigotry against people of color, but it is present, and we must somehow get what we need and get around the attitudes of medical personnel. My best advice is to not act hysterical because the male brain then flips to the thought that we are imagining this medical symptom! But if you cannot help it then have someone with you who can talk like a man---"just the facts", don't embellish and don't give them a long story…they lose interest, and forget why you are there. Tell the ER Doctors and EMTs" That you think you or your loved one is having a heart attack The estimated time you started having these symptoms If you took an aspirin, then tell them Have your medical history written on your iPhone app: look up this icon on any iPhone Have a list on the iPhone app or on a list in your wallet. Give all this information to your healthcare provider right away. Answer questions succinctly and quickly…no stories! We are successful at treating heart attacks and preventing disability and death in older men, but women of all ages and people of color, both sexes, are not being treated optimally, certainly not as well as their older white male counterparts. "Despite a decline in the number of overall heart attacks, this number is rising among young adults," Dr. Banco adds. "And young women and young Black adults have poorer outcomes after a heart attack compared to men and white adults." Journal of the American Heart Association: symptoms of heart attack Chest pain, pressure, chest tightness, burning in the chest Shortness of breath Left arm pain, Jaw pain Upper back pain Heart burn Passing out As doctors, we have been taught that women have different symptoms than men when having a heart attack, AND we have been taught that men have many more heart attacks than women. Only half of that is true. Women have fewer heart attacks when they are compared to young men of the same age, BUT women reach the same rate of heart attacks as men after menopause and if they are not replaced with estrogen. Our female patients at Biobalance Health actually have fewer heart attacks than is normal for their age after menopause because they are replaced with estradiol pellets. Young adults 18 to 55 years old who come to the emergency room with chest pain may wait longer and get less thorough workups when they're female or Black, a new study suggests. But they have fewer heart attacks than men and women as they age. The studies show that the care women receive is biased and are not considered at risk for heart attacks. An expert Gulati say in Everyday health, "There is implicit bias in how we care for women," Gulati says. "Women are still not seen to be at risk for heart disease (https://www.everydayhealth.com/heart-disease/). It is still seen as a man's disease, despite the fact that cardiovascular disease remains the leading cause of death in both men and women." Delay in treatment should not be discounted. It can mean the difference between life and death and health and disability. "Time is heart muscle," Dr. Gulati says. "So, these noted delays and less aggressive care of women have the potential to translate into delays in care, less diagnostic testing, deaths at home for some discharged, and continued worse outcomes after a heart attack in young women — particularly young Black women." If you have the symptoms of a heart attack, you should take a baby aspirin (81 mg) and call 911. Time is obviously very important to the heart and lack of oxygen from a heart attack damages the heart muscle and therefore can leave you with a damaged heart that will limit your activity and lifestyle. No matter who you are, you should tell the EMT that you think you are having a heart attack, and they will go as fast as possible to the hospital and treat you on the way. If you cannot talk then make sure you partner with your partner and make sure you help each other communicate with the EMT and doctors. Remember you only need to tell them that you think it is a heart attack and that your symptoms are, (choose yours), chest pain or chest pressure, shortness of breath, left arm pain, jaw pain, and or upper back pain.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Most of you know that when I replace Testosterone hormones for my female patients who lose testosterone as they age. I only used Bioidentical Estradiol and Testosterone in the form of long-lasting subcutaneous pellets. I have limited my practice to only use this type of delivery system because pellets deliver a steady supply of Testosterone, without daily variation in blood levels, and have the fewest side effects of any type of testosterone replacement. However, nothing is perfect, and it is important to know what the side effects of any treatment are. There is no medical care that I know of that does not have associated side effects in a small percentage of patients. There are several problems that can occasionally occur after pellet insertions. We follow a strict sterile procedure protocol and provide a complete instruction sheet to our patients and verbal instructions on how to take care of the insertion site. Despite all precautions, a few patients have complications associated with their pellet insertion. I will dedicate the accompanying blog to the side effects of the pellet insertion procedure. The side effects can be caused by allergy, infection, as well as not following our instructions. The problems that are possible, but rare: Expulsion—the pellet comes back out Allergy Infection Seromas: Fluid around the inserted pellets Reaction to numbing medicines Remember that the procedure safety is only as good as the operator and choosing your doctor carefully for experience and attention to safety. The more experienced your doctor is in pellet hormones and the more she concentrates on pellet only therapy, the less risk you will have. For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the Healthcast for #603. This presentation will include the slides and audio explaining the procedure and side effects. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Most of you know that when I replace hormones for my female patients, I only use Bioidentical estradiol and Testosterone in the form of long-lasting subcutaneous pellets. I only use this type of delivery system because pellets deliver a steady supply of T and have the fewest side effects of any type of testosterone replacement. However, nothing is perfect, and it is important to know what the side effects of any treatment is. There is no medical treatment without any side effects. There is no medical care that I know of that does not create complaints by patients. There are several problems that occur during the first 4 months after the T pellets are inserted and usually present during the first 4-12 months of treatment. I will dedicate the accompanying Healthcast to later side effects of Testosterone pellets and what we recommend to lessen these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The later side effects include: Facial Hair and Acne Androgenic Hair Loss Voice Lowering Weight Gain For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #602. This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Most of you know that when I replace hormones for my female patients, I only use bioidentical estradiol and testosterone in the form of long lasting (3-6 months) subcutaneous pellets. I have limited my practice to this type of delivery system because pellets deliver the most stable dose with the fewest side effects, while supplying a steady supply of testosterone compared to other delivery forms of bioidentical testosterone. However, no medical treatment is perfect for everyone, and it is important to know what the side effects of any treatment is both as a doctor and a patient. There is no medical care that I know of that does not create complaints of some form by patients. Sometimes it is because they have not listened, or not read our literature given them at their appointment. We try to prepare patients for the temporary symptoms of their first Testosterone insertion There are several problems that occur during the first 4 months after the T pellets are inserted. These side effects are treatable and temporary. and usually present during the first 4 months after the first pellet insertion. I will dedicate the accompanying Healthcast to the early side effects of testosterone pellets and what we recommend lessening these effects. Of all the types of testosterone replacement for women, pellet replacement has fewer and less severe side effects than all other forms of testosterone for women. The immediate side effects of this type of testosterone Temporary issues in the first 4 months: Vaginal Itching-not an infection! Clitoral enlargement! Hyper-sexuality Weight Gain=muscle gain These four complaints compose the most common phone calls we get after treatment with Testosterone pellets, even though we give our patients handouts preparing them for the adaptation changes the female body goes through when readjusting to testosterone blood levels in their bodies. The changes caused by testosterone deficiency occur slowly, so slowly in fact that you may not realize the numbness of the vulva and vagina, the shrinkage of the clitoris and vaginal opening, and lack of libido and muscle mass that accompanies loss of T. It takes several months for reversal of those deficiency symptoms and the adaptation that takes place as everything goes back to the normal you were accustomed to when you were younger, before testosterone became deficient. It is the re-adaptation to testosterone that causes the symptoms during the first 4 months. For a full video describing these issues and the treatments, please go to my website biobalancehealth.com watch the videocast for #601. This presentation will include the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women #600-603.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ Most of you know that when I am replacing hormones for my female patients, I only used Bio-identical estradiol and Testosterone in the form of long-lasting subcutaneous pellets. I only use this type of delivery system because pellets deliver a steady supply of T and have the fewest side effects of any type of testosterone. However, nothing is perfect, and it is important to know what the side effects of any treatment is. There is no medical treatment without any side effects. There is no medical care that I know of that does not create complaints by patients. There are several problems that occur during the first month or two after T pellets are inserted, and others that occur after months or years. To be completely candid, I will spend the next Healthcast #601 describing the side effects that occur during the first insertion cycle from Testosterone pellets, and the measures and treatments we use to prevent and treat them. For a full introduction to this series of 4 lectures, please go to my website biobalancehealth.com and look for the videos which will have the slides and audio explaining them. You can also go to You Tube to view the short lectures and slides about the side effects of testosterone pellets in women.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ 50% of men who receive Testosterone replacement therapy (TRT) have elevated Red Blood cell counts, and high Hemoglobin and Hematocrits. The numbers that are considered normal are usually normal for men at sea level, and an elevated H/H doesn't necessarily mean that a man will have any negative effects If you have lung problems, or disease: For those men who have COPD, Chronic Bronchitis, or asthma, high counts are an adaptation that help you live with a compromised ability to oxygenate your blood. You should not get your blood dumped because the high counts are keeping you alive! If you live at high altitude or if you spend a large amount of time at high altitudes, then you don't necessarily need your blood phlebotomized because you need higher counts to live or vacation there. Men who live at high altitude have adapted to a lower oxygen level making more RBCs. If you are an extreme athlete, or you train excessively you may have high red blood counts to help you collect and distribute oxygen during your exercise. You won't have to remove blood unless this level remains a year after you stop excessive exercise. Why are doctors telling us to get phlebotomies (blood dumped) all the time? The problem with having a diagnosis of Erythrocytosis from TRT is that it is almost always confused with the disease called Polycythemia Vera (PCV). PCV does carry with it a high risk of blood clots, strokes and heart attacks. The two conditions are completely different, but ER doctors and surgeons only know that a high H/H is a sign of PCV, and PVC causes blood clotting…but they don't know that elevated H/H from TRT or adaptation to a disease doesn't cause the same medical problems as Polycythemia vera.. One of the ways we can separate the disease of PVC from the condition of Erythrocytosis: The CBC will show us the difference. PVC his elevated RBCs, H/H, Platelets and WBCs…all of them are elevated. Erythrocytosis only has an elevated RBC, and H/H. If your doctor gets excited about your elevated blood count, please tell him we have evaluated you for PVC and you don't have that, so you are not in danger for clotting or CVDx. Here are the differences between PCV and Erythrocytosis from TFT: Polycythemia Vera Erythrocytosis Blood test: high RBC, High H/H and High platelets, High WBC Blood test: only high H/H and RBC Abnormal Platelets, increase clotting Normal Platelets, no increase clotting Genetics: + Jak 2 mutation Genetics: no mutation Cause is genetic requires blood dumping to lower all counts or hydroxyurea meds Causes: High Altitude, TRT, COPD, Familial cause Treatment: requires blood dumping to lower all counts or hydroxyurea meds Treatment not necessary to keep it below HCT of 50. Some people do better with higher counts especially COPD, High Altitude Living, exercise at high altitude. A lot of Research that supports the theory that these patients are at risk for blood clots and coronary artery disease. No research paper that says high H/H from T causes CVDX, Stroke, or Blood clots. Abnormal platelet number and function cause the vascular diseases and clotting TFT is associated with normal platelet counts and functions. Jak 2 increases clotting factors and platelet production, and erythropoietin from the kidneys and increases clotting. Way it works: T directly stimulated the bone marrow to make more RBCs. No other blood products are elevated Remember: It is not T that causes high H/H to require blood dumping, it is the confused medical community that goes crazy when they see high H/H and cry malpractice! In many cases we are dumping blood to appease the primary care doctors. We ideally would like to keep a man's H/H below 20/55. Other reasons for elevated H/H: Do you have COPD, Asthma or chronic bronchitis? Don't get your blood dumped. The high counts are helping you. Do you have, or have you had elevated platelet count with your elevated red blood cell count? If you have, please tell your primary or your BioBalance Health Nurse Practitioner you will be evaluated for PCV with a genetic test. Do you live for part of the year at high elevation? If yes, then it is not necessary to phlebotomize you to get your counts down because you need those RBCs. Do you eat high iron foods (liver, braunsweiger, pate, bone marrow, Deep green leafy veggies) ? If so of if you are taking iron, you can stop because you shouldn't need it while taking T, because the bone marrow is stimulated to make more red cells with T. Do men in your family die of CVDX before age 50? Then you might have PCV! Get an iron panel + a Jak 2 genetic test. Blood Phlebotomies: Men over 70, should only have 250 cc removed at one time and told not to exercise for a few days. Blood pressure and blood volume take longer to equilibrate after the age of 70. Make sure these patients have a lot of water and that they drink it and eat something after the phlebotomy. Remember you just removed blood

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ A doctor must have an ideal, healthy range for any test which they are using to diagnose a patient. Diagnosticians cannot decide whether this ideal level or "reference range" is accurate without a great deal of scientific investigation, so he or she uses what is listed on the lab report which results in misdiagnoses. Blood panels are expensive and should have the information listed with the result that explains what circumstances make the test fall into the healthy and asymptomatic range. This is a problem with most large national labs, and it is leading to great numbers of misdiagnoses. Let me give you some examples of the problem with how labs are reported: Female Estradiol Published Lab Reference Range Postmenopausal: Estradiol is the female estrogen that disappears after menopause. Before menopause the average blood level of E2 is 60-250 pg/dl depending on the pre-or post-ovulation stage of the menstrual cycle. That range of estradiol is healthy for women. Lack of estradiol (which occurs at menopause and creates disabling symptoms) is unhealthy for women and the reference range should show that lack of E2 is "abnormal" and not within reference range. The lab considers that Estradiol levels are "normal" after the age of 40, if they are Female FSH Female LH Published Lab Reference Range Published Lab Reference Range Postmenopausal: 23.0 – 116.3 mIU/mL Postmenopausal: 10.0 – 54.7 mIU/mL FSH/LH are 2 pituitary hormones that do not cause symptoms when they are under 23 and 10 respectively. If a woman is premenopausal, or on sufficient estrogen replacement after menopause their FSH and LH are low, and they are asymptomatic. We test FSH and LH hormones to find out if is a patient is menopausal. If her FSH is over 23, and estradiol is under 60 then the patient is menopausal OR they are taking enough Estradiol to suppress their LH and FSH levels to normal (less than 23/10 respectively). Why do the labs consider very high FSH and LH levels to be "normal" or "in range" even though these elevated hormones cause many symptoms in menopausal women? High LH and FSH are not healthy or normal, but the lab says that anyone over 40 is normal with these extremely high FSH and LH. None of this is reported or mentioned on the lab sheet. The reference range for FSH and LH is listed under "Normal "if the FSH and LH are higher than 23/10, even if the FSH is extremely high and the patient is symptomatic! Recently studies have shown that High LH and High FSH levels themselves cause osteoporosis and dementia. It is now even more important to give a woman enough Estradiol to suppress these 2 hormones. Female Testosterone Free Published Lab Reference Range Postmenopausal: 0.2 – 5.0 pg/mL Free Testosterone levels for women: Finding a test that can correctly report testosterone levels when they are in the low range, such as female blood levels, is difficult. Testing for accurate female testosterone levels to compare with a reference range, has many problems. For instance, no one really claims to know what the "normal" level of free T is for is for young healthy women. Large scientific studies looking at free T levels in young healthy women are just now commencing. However even though the test for free T in women doesn't have a reliable, repeatable blood level based on pre-menopausal healthy women, I still use it for a marker to tell me if a patient's free testosterone level improved along with the resolution of her symptoms. I was trained to only test for the free T with the normal number for young premenopausal women is > 7 pg/ml. Male Testosterone Free Published Lab Reference Range: 35.0 – 155.0 pg/mL T and free T for men: The reference range for men is very low. The way the lab obtains these numbers for their reference range for testosterone is by using the blood levels of men who come to their lab to get their testosterone drawn. This results in the "reference range" not representing healthy young men, but representing "sick men" of all ages, usually old men, who are having their blood drawn at the lab for other reasons. Testosterone and free T decrease with illness and with age. The way the reference range of T and T-free is skewed to a much lower level than is optimal. With a low range misrepresenting the ideal, men who have low T and free T and are symptomatic and are not treated. The range I use is 400-1500 the average for healthy young men between 20-40 years old. No man feels good with a total T of 234-400, the low end of the range considered normal for men by Quest and Labcorp. This misrepresentation is preventing many men from treatment. The way they derive their blood range for total T and free T is not scientifically sound, and that affects whether a man is treated or not. Physicians who treat aging men know and should know that testosterone decreases as a man age (after age 40), and becomes symptomatic at age 55, on average. Most men are symptom