Archive for hormones
Deep Vein Thrombosis-Know Your Risks
Posted by: | CommentsVenous thromboembolic disease is a serious and potentially life threatening condition. Both men and women are at risk for this, however hormone therapy often used in menopause increases this risk. Blood clots in the leg veins, known as Deep Venous Thrombosis or DVT, are the most common manifestation of thromboembolic disease.
Predisposing factors include:
Woman's Circulation
- A hypercoagulable state in which the normal clotting mechanisms and the inhibitors which prevent uncontrolled clotting are inhibited
- Venous stasis where this is decreased blood circulation
- Damage to the blood vessel wall which can include chemical, physical and immune related injuries
It is generally agreed that the above three conditions are required for a DVT to occur. These conditions can be present in several different forms. Coagulation is mediated by several proteins which are produced in response to damage to the wall of the blood vessel. The platelets which travel there to repair the injury also help to produce coagulation proteins. There are several inherited conditions which can alter the response of these proteins, resulting in impaired coagulation.
There are also inhibitory substances that are responsible for dissolving a clot after it is created. These inhibitors act to neutralize the coagulation pathway when appropriate. A deficiency in these proteins can allow the coagulation system to be hyperactive.
Elevated levels of estrogens as seen in pregnancy, as well as use of HRT and oral contraceptives can create a hypercoagulable state through increased production of some coagulation proteins.
When other precipitating events or conditions exist in the setting of increased estrogen, you are at risk for a DVT.
Venous stasis can be caused by:
- Prolonged bed rest such as a hospitalization
- Prolonged air travel of over 4 hours without opportunity to walk
- Heart failure
Damage to blood vessel wall can include:
- A medical procedure which involves placing a catheter in the groin blood vessel
- Cancer and cancer treatment drugs
- Fractures of legs or pelvis
- Recent surgery of hip, knee or female reproductive organs
- Cigarette smoking
Other factors which could place you at risk for a DVT include age over 60, obesity, and being of blood Type A.
Signs and symptoms of a DVT includes an acutely swollen and painful leg without prior cause or reason for this. Pain in the calf with movement or flexion of your foot upwards can also be a sign of a blood clot, especially when combined with the above precipitating factors.
It is important to seek medical care as soon as possible if you believe you have a blood clot as several dangerous events can occur with these blood clots. The most serious problem could be a piece of the clot breaking loose and travelling to your lungs. This causes inability for that section of lung to work correctly and can ultimately cause destruction of this segment of lung. This event, pulmonary embolus, can be life threatening.
It is important to realize that anyone with several of the risk factors and the situation of immobility can be at risk for dangerous blood clots, however being older an being on hormone therapy increases this risk. It is important to take measures to prevent these clots such as use of support hose if involved with prolonged immobility, drink plenty of water, and work on improving fitness.
Anne V. PAC
Have you had an experience with phlebitis? Do you have something to add or a feeling you want to express to me? If you do, then many others reading this will also. Please, tell me what is on your mind in the comments section. I look forward to having a conversation with you.
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BioIdentical Hormones – Are They better for you?
Posted by: | CommentsWhat are Bioidentical Hormones?
They would be hormone replacements that are used to supplement the hormones of humans who have a shortage in the production of their own hormones. A hormone is chemical substance, produced by an organ in your body, secreted directly into your blood and intended to have an effect on another organ or group of tissues. Examples would be Insulin, Human Growth Factor, Estrogen, Progesterone and Testosterone.
When I was trained in medicine (I think I might have met Hippocrates) there were only two forms of insulin – Regular and NPH. They were manufactured from the pancreas of either pigs or cows. It helped, but also caused big problems. Then came bioidentical Insulin – made by putting the human gene into bacteria. It is just like the insulin you produce in your pancreas – Human Insulin.
Bruce Bair
Now everyone – specialty medical clinics, celebrities and others are touting the benefits of bioidentical estrogen, progesterone and testosterone. Specialty Pharmacies – called compounding pharmacies – are creating creams and lotions of various strengths to be rubbed on the skin for absorption into the blood.
The selling point is that these are “bioidentical”. Progesterone, or the most common type of progesterone, has been made from the urine of pregnant horses for many years. This type was shown to accelerate heart disease in women. Thus the proliferation of compounding pharmacies and conflicting claims made by so many individuals.
We have an imperfect system
The system of drug regulation and enforcement is quite imperfect. It is influenced by politics, moneyed interests and the ineptitude of bureaucrats. The regulatory agency is understaffed and sometimes under trained. The underlying principles are good and basically the system works. It has flaws but generally it works. The pharmacies doing the compounding are regulated by the states. The system there is even more flawed and less staffed. Unless there are flagrant violations of state law, the over site is minimal. Thus you are dependent upon the integrity and training of the person or persons involved. Unfortunately, the practice of medicine involves more and more impersonal interactions. The less personal the interaction, the more room there is for abuse. The motive becomes strictly money.
What do the experts say?
I read a publication called The Medical Letter.
It is an independent nonprofit organization that provides health care professionals with unbiased drug prescribing recommendations.
In volume 52, Issue 1339 the authors review the Manufacturing Standards, Dosages, Adverse Effects and Drug Interactions of Bioidentical Hormones from compounding pharmacies. They conclude:
There is no acceptable evidence that “bioidentical” hormones are safe or effective. Patients should be discouraged from taking them.
I put a lot of stock into what they say. I think this is a good general statement. The idea in medicine is to care for people well and do them no harm. The organization doing this has to make money. In the tiny organization in which I work, we have to make several thousand dollars each day we open our doors just to pay expenses on the building, staff salaries, licenses, computer technologies, medical record software, phones, electric, water, etc,etc,etc…
What is the proof that what a Clinician does is effective and improves your health?
I believe the problem enters in when you purchase your product through the clinic. When the clinic is using tests that are not standard in medicine (saliva tests for hormone levels is still quite crude) and their mission is to keep you “young” and not to prevent disease or treat serious problems, you are likely to not get the highest level of care. What you do get at some hefty expense is a spa experience and medical treatment that is intended to make you feel good about how you look. Ultimately is is all about money. Those treatments and the clinics that do them are doing things that are legal but are for people with the money to afford them. People full of fear of getting old, not looking good and not feeling good.
Let the Buyer Beware. Know in your mind what claim they made that caused you to go there. What are you wanting? Why do you have to go there to get it? Why isn’t the largest medical organization in your state providing this same treatment?
What do you think? Is this just “sour grapes” to all the people in medicine not doing it? Are these clinics and pharmacies the “saviors” of our health? Leave a comment with your opinion. If you like this, use the tabs to make it for others on your favorite site like Twitter or Facebook.