Monthly Archives: February 2014

Breast Health
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   Proper diet and nutrition, exercise, assessment of risk factors and screening with mammograms and self-exams are all important for breast health. Research shows that a woman who is over 40, or whose mother or sister has had breast cancer, may be at greater risk, but this does not mean the woman will develop breast cancer. The purpose of knowing your risk factors is to help devise a breast health program suited to each woman’s individual needs.      A growing body of evidence suggests that breast cancer in many cases is preventable. For example, studies suggesting that eating a low-fat diet, and a high ratio of omega-3 fatty acids to omega 6 fatty acids in a diet may help reduce the risk of breast cancer. Many knowledgeable healthcare practitioners recommend supplements to support breast health.

 

Unequal Risks for Breast Cancer Associated with Different Forms of Hormone Therapies 

Many forms of hormone therapy are available for the treatment of menopausal symptoms and the proper selection of hormones is critical. To determine whether some hormones are more harmful than others regarding breast cancer risk, data was reviewed from a study of 80,377 postmenopausal women. The findings suggest that it could be preferable to use natural progesterone instead of a synthetic progestin as part of hormone therapy.     The Women’s Health Initiative (WHI) reported that women who take conjugated equine estrogens (“estrogen” from pregnant mares’ urine) and the synthetic progestin medroxyprogesterone acetate have an increased risk of breast cancer. Recently, an article in the Journal of the American Medical Association noted that when breast cancer does occur in women taking synthetic hormones (such as progestins which are NOT found in humans), the cancer is more likely to be node-positive and have a higher risk of mortality.

 

Protective Effect of Vitamin D Against Breast Cancer

Vitamin D deficiency has been associated with elevated risk of about 20 types of cancer, according to Dr. John Cannell, vitamin D expert and director of the Vitamin D Council. Dr. Cannell suggests adults need around 5000 IU per day of vitamin D3 to maintain healthy body functions and even higher doses may be needed to fight diseases.      Low levels of Vitamin D are associated with elevated breast cancer risk, and women who have an aggressive form of breast cancer are eight times more likely to be diagnosed with vitamin D deficiency. African-American women are at a higher risk because their skin color reduces the efficiency of the absorption of UV rays, which are needed for the body to produce vitamin D.      Not only does vitamin D inhibit breast cancer cells from growing, it makes those cells grow and die more like natural cells. Furthermore, vitamin D inhibits the formation of excessive blood vessel growth around the cancerous tumor, a process called anti-angiogenesis.      In 2004, a group at the University Hospital in Quebec confirmed that vitamin D, especially when taken with calcium, significantly reduced abnormal mammograms. In fact they found women with the highest vitamin D intake had only one fourth as many abnormal densities on their mammogram as did women with the lowest intake.      Researchers in Norway discovered that women who were diagnosed with breast cancer during the summer and fall, the season where vitamin D levels are the highest, had the best prognosis. The researchers concluded that high vitamin D levels during the course of cancer treatment may improve the prognosis of women with breast cancer, plus, both colon cancer and prostate cancer showed similar improvements.   Note:  Vitamin D is not a cure-all and should never be used as the main treatment for cancer. Oncologists prescribe treatments with proven efficacy that should be considered the mainstay of therapy. At the same time, evidence suggests that the proper amount of vitamin D may help in the fight against breast cancer.

We work together with patients and practitioners to individualize Bioidentical Hormone Therapy and other medications to meet specific needs. We welcome your questions and your medication problems.

References
JAMA. 2010;304:1684-1692. Breast Cancer Res Treat. 2008 Jan;107(1):103-11 Postgrad Med. 2009 Jan;121(1):73-85. http://www.vitamindcouncil.org/cancerBreast.shtml Braz J Med Biol Res. 2002 Jan;35(1):1–9 Cancer Epidemiol Biomarkers Prev. 2004 Sep;13(9):1466–72. Cancer Causes Control 2004 Mar; 15(2):149-58.

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The Power of Probiotics
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   Probiotics are live organisms that, when ingested in adequate amounts, provide a health benefit to the person who consumes them.  The most commonly used probiotics are lactobacilli, bifidobacteria and non-disease-causing yeasts such as Saccharomyces boulardii. Products labeled as “probiotics” are now widely available; however some may not contain sufficient live organisms to convey a health benefit due to formulation, storage conditions (consistent cool temperature is recommended) or failure to survive as they pass through the gastrointestinal tract.

Probiotics offer many health benefits:

  • reduction or elimination of potentially disease-causing micro-organisms, toxins, mutagens, and carcinogens
  • modulation of  innate and adaptive immune defense mechanisms
  • promotion of apoptosis (death of cancer cells)
  • release of numerous nutrients, antioxidants, and other factors necessary for recovery from illness

Probiotics are important in recolonizing the intestine during and after antibiotic use. Preparations containing one or more strains of beneficial bacteria can prevent or lower the risk of antibiotic-associated diarrhea and “traveler’s diarrhea”. Infection of the colon with Clostridium difficile, can occur following antibiotic therapy and lead to a serious complication known as pseudomembranous colitis. Probiotics may prevent the development and recurrence of C. difficile infection. Probiotics may also be used to treat inflammatory bowel disease, irritable bowel syndrome, and food allergy. Evidence is emerging for the effectiveness of probiotics in the prevention of postoperative infections. Potentially preventable conditions range from necrotizing enterocolitis to urogenital infections, skin diseases, respiratory diseases, and dental caries (cavities). Scientists are intrigued by the possibility that probiotics could lower cholesterol and reduce the risk of cancer and kidney stones. Future uses of probiotics may include the treatment of cystic fibrosis and rheumatoid arthritis.

Some experts believe that probiotics should be part of the daily diet, because our immunity is frequently compromised. Allergies, atopic skin diseases like eczema, asthma, autoimmune diseases, and other immune-related conditions are on the rise because:

  • Improved hygiene prevents spread of disease by decreasing exposure to harmful bacteria (“germs”), yet this advancement also means that our immune systems are not adequately stimulated, allowing immune-related conditions to develop.
  • Changes in our environment and diet, such as treatment of meat and poultry with antibiotics, result in consumption of fewer bacteria to challenge our immune systems.
  • Drugs, especially antibiotics, kill or cause mutations in microorganisms that normally live in our gastrointestinal (GI) tracts, decreasing the ability of this “normal flora”  to mount an immune response when we are exposed to substances that might compromise health.

Probiotics have been clearly shown to boost immunity, especially in subjects with less than adequate immune function such as the elderly. Twice daily supplementation with Bifidobacterium lactis was found in a double-blind trial to significantly enhance various aspects of immune function in a group of healthy elderly people after only six weeks of supplementation. A study published in 2010 suggests that probiotics may lower the risk of common childhood illnesses such as ear infections, strep throat, and colds.

Probiotics secrete enzymes that promote healthy digestion. For example, acidophilus is a source of lactase, the enzyme needed to digest milk sugar, which is lacking in lactose-intolerant people. Probiotics may be helpful in preventing malnutrition, improving calcium absorption, and in relieving constipation. Recent research also suggests that probiotics may decrease Helicobacter pylori infections which are responsible for gastric ulcers, and decrease the risk of certain cancers.

Probiotics may reduce the recurrence of urogenital infections in women. Most cases of bacterial or yeast vaginitis and urinary tract infection arise from contamination with bacteria from the woman’s gastrointestinal tract, as microbes travel the short distance from the anus to the vagina. The more common presence of these pathologic organisms has led to an increase in bacterial vaginitis which in turn has increased the rate of preterm labor and premature births. Regular oral consumption as well as vaginal use of probiotic bacteria may help to prevent bacterial vaginitis.

Yogurt is often promoted or even recommended as a source of probiotics. However, different brands of yogurt can vary greatly in bacterial strains and potency. Some (particularly frozen) yogurts do not contain any live bacteria. “…there’s no evidence that Lactobacillus acidophilus, which is used in many commercial yogurts, has any benefits for diarrhea,” according to Martin Floch, MD, a professor of gastroenterology at Yale University, co-author of Probiotics: A Clinical Guide, and a consultant for the Dannon Company.

Specific probiotic organisms appear to be useful for particular illnesses. Probiotic preparations should say the name of the specific bacteria they contain, as well as how many organisms a single dose provides. The amount of probiotics necessary to replenish the intestine varies according to the extent of microbial depletion and the presence of harmful bacteria. One to two billion colony forming units (CFUs) per day of acidophilus is considered to be the minimum amount for the healthy maintenance of intestinal microflora. Some S. boulardii research has used 500 mg taken four times per day. It seems that, at least for acute infectious diarrhea, higher doses of probiotics given for short courses are more effective than lower doses and are equally safe. Adequate doses of probiotics can be provided as standardized supplements in powder, liquid extract, capsule, or tablet form.

Research continues to report additional benefits of probiotics to prevent and treat illness.
Please contact our pharmacy for more information about currently recommended formulations and suggested doses.

References
Aliment Pharmacol Ther. 2012;35(12):1355-1369.
Clin Lipidology. 2012;7(5):501-507.
Pediatr Infect Dis J. 2012;31(8):859-862.
http://www.webmd.com/digestive-disorders/features/what-are-probiotics?

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Eczema and Psoriasis Help
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    One of the body’s initial responses to stress is the release of hormones such cortisol that initially help a person to react or adapt to a stressful situation. High levels of cortisol can also lead to exacerbation of skin conditions such as psoriasis and eczema. We are here to help!

Treatments for eczema (atopic dermatitis) aim to control inflammation, decrease itching, and manage infections that may occur as a result of repeated skin irritation. Common treatments can cause significant side effects; for example, topical corticosteroids used to decrease inflammation and control itching may cause skin thinning and prolong the healing time of damaged skin, and topical tacrolimus can cause a burning sensation or itching.

Topical vitamin B12 offers a new therapeutic approach for eczema. A study showed that topical application of vitamin B12 cream (0.07% cyanocobalamin) reduced the severity  and extent of eczema. Both physicians and study participants rated the vitamin B12 cream as significantly superior to the placebo cream, and the treatment was very well tolerated. Avocado oil has been added to improve the formulation so that vitamin B12 cream can be distributed more easily on the surface of the skin, or we can use a specialized base that is easily applied and cosmetically appealing.

For patients with localized psoriasis, and for many of those with moderate psoriasis as well, the mainstay of treatment is still topical therapy. Topical regimens, such as combination therapy with topical tacrolimus and salicylic acid, can be helpful.  Vitamin B12 cream also has considerable potential as a well-tolerated, long-term topical therapy of psoriasis. Oral vitamin B12 is rapidly eliminated by the body, and oral vitamin B12 does not appear to be beneficial for psoriasis.

Methotrexate has been used orally as a treatment for psoriasis by dermatologists for over 30 years, but oral methotrexate can cause serious side effects. Interestingly, researchers from the Department of Dermatology, University of California-San Francisco, and three other locations note that if methotrexate is properly compounded into a topical gel and dosed appropriately, it can provide better results without the bad side effects. Furthermore, published data have indicated that 70% of patients prefer topical therapy for psoriasis. A placebo-controlled double-blind study evaluated methotrexate 0.25% gel applied topically to treat patients with psoriasis vulgaris. After four weeks, 83.3% of patients improved compared to 6.7% of patients who received a placebo. The treatment was well-tolerated by all the patients, with no adverse drug-related symptoms and no dropouts.

A new study has reported that children who take probiotics – “good” bacteria that normally live in our guts – are less likely to develop eczema. Researchers have found that infants on probiotic supplements were 50% less likely to develop eczema, and taking probiotic supplements daily could reduce the risk of eczema in older children by 58%. Study results vary, and one of the reasons is because different types of probiotics are used in various studies and produce different results. The best evidence for improvement of eczema is associated with the probiotic Lactobacillus rhamnosus GG. Lactobacillus rhamnosus GG supplements are available in powdered or chewable forms.

 
Ask our pharmacist about customized medications to help relieve eczema and psoriasis and check out Suzy Cohen’s book “Eczema, Itchin – For A Cure”. We can also recommend the probiotic preparations that are best for each member of your family.

References
British Journal of Dermatology 2004; 150: 977–983.
Dermatology 2001;203:141–147
Arch Dermatol. 2005;141:43-46
J Cutan Med Surg 2001; 299-302
J Dermatol 2004 Oct;31(10):798-801
Int J Dermatol 2003 Feb;42(2):157-9

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