Women's Testosterone Patch May Not Work

(HealthDay News) -- A new testosterone patch designed to boost a woman's sex drive may be ineffective, and questions remain about its long-term safety, according to the journal Drugs and Therapeutics Bulletin.

The drug Intrinsa was recently approved in the United Kingdom for treatment of women who've gone through menopause as the result of ovary and womb removal and who are receiving estrogen replacement therapy. There is some evidence that low levels of circulating testosterone may be linked to a decline in sex drive after menopause.



The patch, which is placed on the lower abdomen and delivers a daily dose of testosterone, is worn constantly and replaced twice weekly.

The journal noted, in finding that the patch may not work, that key clinical trials on testosterone patches involved highly selective groups of women. For example, the studies excluded those with various mental or physical conditions that could affect sex drive. In some trials, a hypoactive sexual desire disorder (HSDD) diagnosis was based on short, unvalidated questionnaires filled out by participants, the journal reported.

There were other problems with the studies:

• There was a large placebo response. Significant numbers of women not treated with the patch reported improved sex drive, which suggests that low testosterone levels may not have been the problem.
• Improvements in sex drive were small.
• Many women were already having sex two or three times a month before they entered the trials, which raises questions about whether they really had poor sex drive in the first place.
• The trials for Intrinsa lasted a maximum of six months, which means they didn't demonstrate the long-term safety of the patch.
• Rates of side effects in the two key trials were around 75 percent. These included skin reactions at sites where the patches were applied, acne, excess hair, hair loss, breast pain, weight gain, insomnia , voice deepening, and migraine.

"The published evidence so far is based on highly selected women and only shows small improvements in sexual parameters and large placebo responses," according to the journal."Also, the long-term safety of the treatment is unknown. Unwanted side effects are common and not always reversible. For all these reasons, we cannot recommend Intrinsa for use in women with sexual dysfunction."

More information
The National Women's Health Information Center has more about sexual health.

Testosterone And Body Fat Are Controlled By The Same Genes

ScienceDaily (Aug. 6, 2008) — Genes that control percentage of body fat are also responsible for circulating levels of testosterone in men, research published in a recent edition of Clinical Endocrinology shows.

The research shows a 23% overlap between the genes that control testosterone and those that regulate body fat composition, suggesting that these two variables are partly controlled by the same set of genes.

The study led by Dr Jean-Marc Kaufman at Ghent University Hospital, Belgium was carried out on healthy male sibling pairs and estimated the extent to which sex hormones and body fat are controlled by the same genes. The research involved a cohort of 674 men from 274 independent families, as part of a larger study investigating the origins of body composition, sex steroid status and peak bone mass in healthy men.

Each participant had their weight, total body fat and BMI measured and a blood sample was taken to measure their levels of testosterone and SHBG (a protein that binds to sex hormones). The team then used two computer programs (SAGE and SOLAR 2.0) to carry out complex statistical modelling to calculate the ‘heritability estimate’ of each trait, that is, the extent to which each characteristic is influenced by genes (as opposed to environmental factors). The correlation between two different variables (e.g. testosterone and body fat) was then calculated, based on their individual heritability estimates. Continue Reading >>

Gene Variations Help Regulate Response to Stress

(HealthDay News) -- Certain variations in a gene that helps regulate stress response offer protection against depression in adults who suffered abuse when they were children, a new study says.

Adults who were abused as children and didn't have the protective variations of the CRHR1 gene had twice the symptoms of moderate to severe depression, compared to those with the variations.

The researchers interviewed more than 400 adults and tested their DNA. About one-third of them had the protective variations in the gene that produces CRHR1, a receptor for the stress hormone corticotropin-releasing hormone (CRH).

Extreme stress in childhood, brought on by factors such as abuse, can hyper-activate the hormone system that regulates stress response, leading to an increased risk of depression in adulthood, the researchers said.

"Our results suggest that genetic differences in CRH-mediated neurotransmission may change the developmental effects that childhood abuse can have on the stress hormone system -- developmental effects that can raise the risk of depression in adults," Dr. Kerry J. Ressler, of Emory University, said in a prepared statement.

"We know that childhood abuse and early life stress are among the strongest contributors to adult depression, and this study brings to light the importance of preventing them," Ressler said. "But when these tragic events do occur, studies like this one ultimately can help us learn how we might be able to better intervene against the pathology that often follows."

The study, funded by the U.S. National Institute of Mental Health (NIMH), is published in the current issue of the journal Archives of General Psychiatry.

NIMH Director Dr. Thomas R. Insel said in a prepared statement: "People's biological variations set the stage for how they respond to different environmental factors, like stress, that can lead to depression. Knowing what those variations are eventually could help clinicians individualize care for their patients by predicting who may be at risk or suggesting more precise avenues for treatment."

More information
Mental Health America has more about depression.

Born to Be Obese?

(HealthDay News) -- The brain circuitry that controls appetite might be wired differently in some people, and that could predispose them to obesity, California researchers suggest.

The study was conducted in rats, not humans, and yet it could ultimately lead to novel obesity treatments, said Philip Smith, director of the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases.

"It is not just about drugs that modify short-term appetite," he said, "there may be drugs that stimulate development of the appropriate neural pathways. So, it is an exciting, but very early, time in this field."

The study was published in the February issue of Cell Metabolism.

Sebastien Bouret, an assistant professor of neuroscience at the University of Southern California, and his colleagues examined neural circuits emanating from the appetite, hunger and body-weight control center of the brain -- the so-called arcuate nucleus of the hypothalamus (ARH) -- in a series of rats bred to be either prone to, or resistant to, obesity.

The team found fewer neural connections projecting from the ARH in obesity-prone animals than in their leaner counterparts. Surprisingly, Bouret said, this deficiency developed very early in life, before the animals became obese, and appeared to extend into adulthood.

"Somehow, these animals are programmed to become obese," Bouret said. "The obesity is hard-wired into the brain."

When the researchers then looked at why the brains of obese rats differed from their normal-weight counterparts, they found that the neurons from obesity-prone animals were less responsive to leptin, a hormone that controls the development of these circuits, and which also signals the body's energy status and controls metabolic rate.

"This paper presumes to say, these animals must be leptin-resistant, and that is why the pathways are not developing," said Smith.

But that doesn't mean they are doomed to a life of severe obesity, said Dr. Barbara Kahn, chief of the Division of Endocrinology, Diabetes and Metabolism at Beth Israel Deaconess Medical Center, in Boston. How they live their lives also matters.

"It is important not to 'blame' the obese person or imply that he/she is responsible for being obese," Kahn noted. "Having said that, reasonable, healthy caloric restriction and a safe and sustainable program of physical activity can help limit weight gain and often bring about some degree of weight loss. In addition, healthy eating and regular exercise can reduce the complications of obesity such as type 2 diabetes and cardiovascular disease."

At the same time, she added, not everyone can wear a size 4.

"There is a certain aspect of genetics that sets somebody in a certain range of possible body weights, and then how that person lives his or her life will determine whether they are at the bottom or top of the range," she explained.

Human obesity has both genetic and environmental roots. The rats used in this study, like most humans, developed obesity when fed a high-energy diet. On a normal diet, they were heavier than normal rats, but not yet obese.

"This is quite an exciting paper," said Smith, "because it links more closely to human behavior than most rodent models we have seen."

The findings also suggest a possible therapeutic approach to combating human obesity. If drugs could be designed to influence the formation of neural circuits during development and targeted to at-risk pregnancies, Smith said, "there is a good likelihood we could have successful interventions that improve the health of the mother, and which have a major impact on disease risk for the infant, during pregnancy."

A related study from Boston University researchers in the same journal found that bulking up muscle mass can lead to a general metabolic improvement in obese individuals. "Interventions designed to increase skeletal muscle mass in at-risk human populations may prove to be critical weapons in the fight against obesity and obesity-related comorbidities, including diabetes, heart disease, stroke, hypertension and cancer," an accompanying editorial stated.

More information
For more on obesity, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

Health Tip: Female Infertility

(HealthDay News) - About 7.3 million females in the United States aged 15 to 44 had difficulty becoming pregnant or carrying a baby to term in 2002, according to the U.S. Centers for Disease Control and Prevention.




The U.S. Department of Health and Human Services lists these factors that may contribute to female infertility:

• Age.
• Stress.
• Unhealthy diet.
• Being overweight or obese, or significantly underweight.
• Strenuous exercise.
• Smoking or drinking alcohol.
• Sexually transmitted disease.
• Health conditions that affect hormone production.

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Cell Insights May Predict Breast Cancer's Spread

(HealthDay News) -- U.S. researchers believe they're on the way to solving a major question about breast cancer: Which women have a type of lesion in their breast duct that will progress to invasive disease?

"It's an exciting step forward -- people have been trying to get traction on this big clinical problem for about 40 years, and this is a big crack in the door," said lead researcher Thea Tlsty, a professor of pathology at the University of California, San Francisco.

Ductal carcinoma in situ (DCIS), as this type of lesion is officially known, is diagnosed in about 47,000 American women every year, according to the U.S. National Cancer Institute. To prevent its recurrence as invasive breast cancer, DCIS generally is treated by lumpectomy alone (approximately 25 percent of cases) or lumpectomy with adjunctive treatments such as radiation, chemotherapy, and/or hormones (approximately 40 percent).

In about 25 percent of cases, complete mastectomies are performed. Less than an estimated 5 percent of women choose "watchful waiting" in lieu of a surgical intervention, Tlsty said.

But doctors are still confronted with a guessing game when it comes to predicting those patients at highest risk for recurrence, Tlsty said. "Only about 12 to 15 percent of women diagnosed with DCIS are going to have a future invasive cancer, and all the others won't. Up until now, the problem was that we couldn't distinguish the 12 to 15 percent from those who were not [at risk]," explained Tlsty.

Consequently, some women unknowingly are overtreated by having a mastectomy, and others are undertreated if they chose a course of watchful waiting rather than surgical intervention, Tlsty added.

In their pilot study, published in the November issue of Cancer Cell, the UCSF team looked at how a collection of biomarkers, including molecules called p16 and ki67, interact to predict invasive tumors, she explained.

Because this initial study was done on tissue samples from 70 women, a larger retrospective study is under way at UCSF to validate the initial results, Tlsty said.

Further research, including a large prospective trial, is also needed before the findings can be ready for clinical use, she added. If that work upholds the results of the pilot study, the biomarkers could be ready for clinical use within four to five years, Tlsty said.

Dr. Joseph Geradts, a professor of pathology at Duke University in Durham, N.C., said that finding biomarkers that predict the conversion of DCIS into invasive cancer is "the holy grail of breast cancer research." He said there have been a number of previous studies that have been published, but, so far, they've been "mostly a fruitless effort."

According to Geradts, the UCSF study "is valuable," because "the authors propose two new biomarkers that in the past have not been looked at." The UCSF team's findings "are intriguing preliminary data" that "merit confirmation and subsequent studies," he added.

Geradts said his own lab currently is researching whether changes in DNA may identify a tumor's capacity to metastasize or become invasive. Other researchers are looking at other DCIS biomarkers, he said.

"DCIS itself is a non-life threatening condition" with rare exceptions, noted Dr. Eric Winer, director of breast oncology at the Dana-Farber Cancer Institute in Boston, and women are usually treated to help prevent invasive cancer. If the findings of the initial UCSF study are confirmed, then with "careful investigation, we may get to the point where we don't have to treat all women with DCIS, and we may be able to tailor it so some women get less, and some women get more" depending upon their risk for invasive breast cancer, Winer said.

"It's a very complex and interesting study" added Dr. Richard Bleicher, a surgical oncologist at Fox Chase Cancer Center in Philadelphia. "We need to be cautiously optimistic."

Bleicher added that while the findings have "significant potential," women at this point shouldn't "pin all your hopes on it," because the p16 assay is not something they can ask their doctors for at this point in time.

More information
For more on breast cancer, visit the U.S. National Cancer Institute.
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Health Tip: Risk Factors for Type 2 Diabetes

(HealthDay News) - Type 2 diabetes is a disease in which the body doesn't properly process the hormone insulin, which regulates blood sugar. This form of diabetes is controlled with medication, proper diet and exercise, and maintaining a healthy body weight, and normal blood pressure and cholesterol levels.

The National Diabetes Information Clearinghouse lists common risk factors for type 2 diabetes:

• Being overweight.
• Being over age 45.
• Having a family history of type 2 diabetes.
• Giving birth to a large baby (more than 9 pounds).
• Having high blood pressure or high cholesterol.
• Having a history of heart disease.
• Maintaining a sedentary lifestyle and getting little or no exercise.

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Health Tip: Choosing a Contraceptive

(HealthDay News) -- Among couples who wish to prevent unwanted pregnancy, there are many contraceptive options available.

Here are some of them, courtesy of the American Academy of Family Physicians:

• Condoms, which also protect against sexually transmitted disease.
• A diaphragm or cervical cap, which must be fitted by a doctor.
• Birth control pills, which must be taken each day.
• The prescription birth control patch.
• The vaginal contraceptive ring, which is worn all the time in three-week increments.
• Hormone shots, which can prevent pregnancy for about one to three months.
• An intrauterine device (IUD), which is implanted in the uterus.

1 in 4 Men Over 30 Has Low Testosterone

(HealthDay News) -- New research suggests that one out of four men over 30 have low testosterone levels, but only one out of every 20 men have clinical symptoms linked to such a deficiency.

As men age, they are more likely to experience symptoms such as lack of sex drive and erectile dysfunction as a result of low levels of testosterone, the researchers explain.

Low testosterone is defined as 300ng/dL (nanograms per deciliter) of total testosterone and less than 5 ng/dL of free testosterone. Free testosterone is the amount of hormone not bound to other proteins.

Low testosterone can indicate androgen deficiency if it is accompanied by low sex drive, erectile dysfunction, osteoporosis or fracture, and two or more of the following: sleep disturbance, depressed mood, lethargy or diminished physical performance.

"Low levels of testosterone impact many aspects of male physiology," lead author Andre B. Araujo, a research scientist at the New England Research Institutes in Watertown, Mass., said in a prepared statement. "This is particularly significant because the ongoing aging of the U.S. male population is likely to cause the number of men suffering from androgen deficiency to increase appreciably."

New England Research Institute scientists analyzed data from almost 1,500 men enrolled in the Boston Area Community Health Survey. The survey tracks people aged 30 to 79 years and compiles data on factors such as testosterone, symptoms of hormone deficiency, and medications that may impact sex hormone levels.

Approximately 24 percent of the men surveyed had low total testosterone and 11 percent had low levels of free testosterone. Many of the men had no symptoms related to their low testosterone.

About 5.6 percent of the men in this study suffered from symptomatic androgen deficiency. Older men were especially prone: over 18 percent of men over age 70 met the criteria for this deficiency.

Based on these results, the researchers predict that by 2025 there may be as many as 6.5 million American men between 30 and 79 years of age with symptomatic androgen deficiency, an increase of 38 percent from the year 2000 population estimates.

"This study did not assess whether men with symptomatic androgen deficiency are good candidates for testosterone therapy," said Araujo. "Well-designed, randomized, placebo-controlled trials would be needed to address the risks and benefits of testosterone therapy."

The study is available online and will appear in the November issue of the Journal of Clinical Endocrinology & Metabolism.

More information
To learn about androgen deficiency in men, visit The Men's Health Network.

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Hormone Therapy Extends Lives of Ovarian Cancer Patients

(HealthDay News) -- Hormone therapy that has proved successful against breast cancer may also extend and improve the lives of women with estrogen-sensitive ovarian cancer, a British study suggests.

Letrozole hormone therapy may also be an alternative to chemotherapy for some women with the disease, according the report in the June 15 issue of Clinical Cancer Research.

"This study demonstrates that some ovarian cancers are responsive to anti-estrogen hormonal therapy, and these cancers, and therefore the patients who would benefit, can be identified," said lead researcher Simon Langdon, a Cancer Research UK scientist and a senior lecturer in cancer research at the University of Edinburgh.

Langdon noted that his team's research has shown that growth of certain ovarian cancers is stimulated by the female hormone estrogen. "These cancers could be identified as those possessing high levels of the estrogen receptor," he said.

For the study, which included 44 women, the researchers used letrozole, which works by limiting production of estrogen in the body. "This treatment then effectively starves the ovarian cancer of estrogen and inhibits growth," Langdon said.

During six months of treatment, 25 percent of the women had no tumor growth, and 33 percent of the women with the greatest estrogen values had a positive response that delayed the use of chemotherapy. "Within the trial, we were able to show that tumors with the highest levels of estrogen receptor were the most likely to respond to treatment," Langdon said.

"This approach provides an addition to chemotherapy for this disease," he added. "It is unlikely to replace chemotherapy but could be used to delay the need for chemotherapy."

The patients most likely to benefit from the therapy can be identified before treatment starts. So, this kind of approach means women can be better targeted and the drug not given to those unlikely to benefit who should receive some other type of treatment, Langdon said.

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The American Cancer Society reports that ovarian cancer is the eighth most common cancer in women, not including skin cancer. There will be about 22,430 new cases of ovarian cancer in the United States this year, and an estimated 15,280 women will die from the disease.

A large majority -- about two-thirds -- of women with ovarian cancer are 55 or older. A woman's risk of getting ovarian cancer is about one in 67, according to the cancer society.

Dr. Len Lichtenfeld, the deputy chief medical officer at the American Cancer Society, said, "Letrozole is already approved for treating ovarian cancer in women who have failed other treatment. This study refines these researchers' previous work by identifying those women with estrogen-receptor-sensitive ovarian cancer who are the most likely to respond to this drug.

"Whether the drug should be started earlier in the course of ovarian cancer and whether we should be evaluating whether or not a woman has estrogen-receptor-sensitive ovarian cancer are questions that need to be answered," he said.

More information
For more information on ovarian cancer, visit the American Cancer Society.

New Study Stresses Mammogram's Importance in Breast Cancer Decline

(HealthDay News) -- The decline in U.S. breast cancer cases is caused not only by fewer women using hormone replacement therapy but also by the use of mammography screening, new research suggests.

"Two distinct patterns are observed in breast cancer trends," wrote Dr. Ahmedin Jemal, strategic director for cancer surveillance for the American Cancer Society, in a report published in the May 3 online edition of the journal Breast Cancer Research.

After colleagues presented an abstract at a breast cancer symposium that attributed the 7 percent decline in U.S. breast cancer cases in the years 2002 to 2003 to the reduced use of hormone replacement therapy, Jemal's team decided to look at an older data base.

The researchers who linked the decline to reduced hormone use looked at a large data base from 2002 and 2003 called SEER (Surveillance, Epidemiology, and End Results). In 2002, a large federally funded trial -- part of the Women's Health Initiative -- was halted when evidence emerged of an increased risk of heart disease and breast cancer due to hormone therapy.

After that, women in large numbers went off their hormone replacement regimens.

But Jemal's team looked at older SEER data bases, from 1975 to 2003. The researchers looked at breast cancer incidence rates by tumor size, tumor stage, and whether the tumor was estrogen-receptor positive or negative among women who were age 40 or older in the years studied.

They found that the decline in breast cancer cases also dropped prior to the 2002-2003 SEER data, although the decrease was less dramatic -- about 5 percent between 1999 and 2000 there was a 5 percent drop, according to Jemal.

"The point is breast cancer started to decrease before 2002," Jemal said. And screening mammograms were the reason, he added.

The decline in breast cancer rates directly attributed to mammography, he said, has now leveled off.

"The message for women over 40 is still, they should get a mammogram every year so the tumor [if there is one] can be detected," Jemal said.

The new study is "a more nuanced analysis," said Roshan Bastani, professor and associate dean for research at the University of California, Los Angeles, and associate director for cancer prevention and control at the university's Jonsson Comprehensive Cancer Center. "It shows there were declines in breast cancer that started before the recent declines."

While from a public health perspective a plateau may have been reached when it comes to the benefits of screening mammography, Bastani added, it's still crucial for women over age 40 to keep their mammogram appointments. "About 75 percent of [U.S.] women are getting screened. That has not changed since 1999," she said.

More information
To learn more about breast cancer, visit the American Cancer Society.

HEALTH EFFECTS OF XENOBIOTICS

We Are All Toxic!

There is not a person on this earth that does not have some hazardous chemicals in their tissues; exposure to them has been linked to several cancers and to a broad range of reproductive problems, including birth defects.

The increasing incidence of some of these conditions, and our continued exposure to a cocktail of these chemicals, is alarming. On of the patterns being observed in developed countries is the increase in chronic diseases associated with environmental factors: indeed, a quarter of all diseases have been attributed to environmental causes, and there can be little doubt that exposure to hazardous chemicals is one of them.

Hormone (or endocrine) disrupting chemicals inparticular pose a high risk to human welfare and are likely to be causing widespread harm. For example, some man-made chemicals have been linked with:

• a range of effects on the reproductive system including sperm quality and the incidence of male genital abnormalities;


• spontaneous abortion, premature deliveries and low birth weight;


• alterations in the ratio of male to female offspring; and
  delays in development of, and deficits in, the mental ability of children.


• In addition, some chemicals may play a role in certain diseases such as breast and testicular cancer.

It’s a Big Problem!

Global chemical production has escalated from around one million tonnes a year in 1930 to some 400 million tonnes in 2000. By the end of the 1990s, some 100,000 chemicals had been registered in the EU, of which 30,000 have annual production volumes above one tonne.

Synthetic chemicals can affect human biology in numerous ways. Many are carcinogens, others can cause birth defects, and still others can disrupt the hormone system. These chemicals, on the market today, can be found in everything from pesticides, paints and industrial detergents to cosmetics, furniture and hair dyes. Many of these xenobiotics were present in the September 9-11 calamity, as well as some of the other wars in the Middle East - polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, polychlorinated dibenzodioxins, polychlorinated dibenzofurans, pesticides, phthalate esters, brominated diphenyl ethers, and other hydrocarbons.

Some accumulate over time and contaminate our water, soil and food, and some are transported long distances on air and ocean currents, so that they contaminate people living in remote areas as far away as the Arctic. Regulations have not kept up with the scale of chemical production. Most chemicals on the market and in everyday use have never been adequately assessed for their human and environmental safety. Of particular concern to World Wildelife Fund (WWF) are chemicals that are very persistent and bioaccumulative, and those that are capable of disrupting the normal functioning of the hormone (or endocrine) system.

Bioaccumulation of XenobioticsOur bodies build up over time very persistent and bioaccumulative xenobiotics – most of these will last many years and probably be one of the main causes of our mortality. This is really quite a new science as most of the toxic reference ranges set by most authorities are based on a one-dose toxic level, not on a bioaccumulative process - scientists must now put on their thinking caps and begin thinking laterally! It is probably a good idea to begin phasing these chemicals out NOW before they kill our grandchildren and great grandchildren!

Endocrine Disrupting Chemicals, Reproductive Problems & Obesity

Previous studies have found that exposure to phthalates—found in cosmetics, shampoos, soaps, lotions, lubricants, paint, pesticides, plastics and in the coating of some timed-release medicines - may be associated with reproductive problems. More than 75 percent of the United States population is thought to have measurable levels of several phthalates in their urine. Researchers have theorized that this class of chemicals, as well as other environmental pollutants, may be lowering testosterone levels in men and may be responsible for the substantial declines in testosterone levels and sperm quality that have occurred in the United States and other countries over the last several decades.

Animal studies have demonstrated that phthalates lower testosterone levels and recent human data has found that phthalates are associated with poor semen quality in men and subtle changes in the reproductive organs in male children. Researchers of the current study decided to investigate the effect of this class of chemicals on obesity after noting that low testosterone appears to cause increased abdominal fat and pre-diabetes in men.

Consequently, if phthalates cause a decrease in testosterone, they theorized, then it could also play a role in weight gain and insulin resistance. The scientists analyzed urine, blood samples and other data from subjects participating in the National Health and Nutrition Examination Survey, a large, multi-ethnic, cross-sectional sampling of the U.S. population conducted routinely by the Centers for Disease Control and Prevention.

After adjusting for confounding factors, the researchers discovered that there was a definite link between levels of several phthalate metabolites and abdominal obesity. Men who had the highest phthalate levels in their urine had more belly fat and a greater prevalence of insulin resistance compared to subjects with lower levels.

This is why it is important to detoxify on a regular basis, clean our liver and gallbladder as well as help to remove these phthalates and other xenobiotics or foreign chemicals – taking HMD can help this process -

Health Effects in Children

Children are exposed to more toxic chemicals in food, air and water than adults because relative to their size, they breathe twice as much air, eat three to four times more food, and drink as much as seven times more water. There is increasing scientific evidence that children face much higher cancer risks from exposure to environmental contaminants than adults.

Only last year, a US study showed that neonate cord blood contained an average of 287 chemicals, of which 180 of these were carcinogens. A similar study in neonates in the Inuit Eskimos living in the North Pole also showed arsenic, lead, mercury and organochlorine pesticides such as DDT which has been banned in the Western world for more than 20 years. This is why the statement “we are all toxic” can no longer be refuted.

Given this level of toxicity from the womb, it should be no surprise that there is a rise in childhood cancers, such as brain cancer, as well as in cancers such as non-Hodgkin’s lymphoma and multiple myeloma among adults. The risk of non-Hodgkin’s lymphoma has been linked to industrial chemicals used in dark hair dyes and the incidence of this disease was seven times greater in children whose parents frequently used home pesticides.

Neurological and Behavioural EffectsThere is evidence that children’s exposure to some man-made chemicals, especially PCBs, can affect their neurological development and mental ability. Xenobiotics commonly present in women, which are passed on to the developing foetus, can affect the behaviour and mental development of their children, particularly in early childhood. However, these effects may persist to such an extent that impaired reading ability and reduced IQs have still been found in American children aged 11. Man-made chemicals are also suspected of contributing to learning disabilities, including attention deficithyperactivity disorder (ADHD) and autism.

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Natural Medicine Practitioner & Researcher

Women Benefit Less From Clot-Busting Stroke Drug

(HealthDay News) -- Women who suffer strokes are much less likely than men to benefit from treatment with the powerful clot-dissolving drug known as tissue plasminogen activator (tPA), new research suggests.

The biggest such study yet conducted found that while more women survived their stroke after receiving tPA, male patients were more than three times as likely to retain good physical function as measured by a test three months after tPA treatment.

"The most intriguing possibility is that there might be an intrinsic biological difference in the way in which women respond to tPA vs. how men respond to tPA," said Dr. Gary Abrams, an associate professor of neurology at the University of California, San Francisco, and a spokesman for the American Academy of Neurology.

Abrams was not involved in the study, which is published in the March 13 issue of Neurology.
Federal rules mandate that tPA can be used only if treatment starts in the first three hours after a stroke. The drug helps limit brain damage by dissolving clots that block blood flow through arteries.

The trial included almost 1,400 stroke patients, 333 of whom (24 percent) were treated with tPA within three hours.

The study found that 47.5 percent of men getting tPA had good function three months later on a standard measure called the Barthel Index, compared to 30.3 percent of women. On another measure, the Rankin Score, 32.2 percent of men and 23.4 percent of women did well.

"In general, women have worse outcomes than men after a stroke," noted lead researcher Dr. Mitchell S. V. Elkind, an associate professor of neurology at Columbia University, in New York City. "There are potential biological reasons why women may not respond as well as men to tPA. Hormonal factors such as the effects of hormones on blood clots may be the reason."

But Elkind added that, "at this point in time, it is premature to treat women differently [than men] after a stroke. We recommend that women as well as men get to a hospital as quickly as possible and be treated as aggressively, including tPA."

There have been indications that postmenopausal women have higher levels than men of a substance that inhibits tPA activity, Abrams said. "A lot more work would have to be done to prove it, but it is an intriguing thought. But there is conflicting evidence and reasons to believe there are caveats in taking this too far."

The results should also be interpreted cautiously, noted Dr. Edgar J. Kenton III, chair of the American Academy of Neurology's practice committee. "This is the only large trial of the response to tPA in women," he said. "We need more trials proving the point one way or another."

"I don't want this study interpreted to say that women should not get tPA," Kenton stressed. "There are small studies suggesting that with ultra-early treatment -- within one hour -- they do better than men. We need more women in more trials to look at these factors."

Kenton also noted the unusually high percentage of patients in the study who received tPA therapy within the three-hour post-stroke limit recommended by experts.

"Twenty-four percent got tPA within three hours," Kenton noted. "The national average is 5 or 6 percent." The measures used in this trial to get tPA delivered to patients early can and should be applied to everyday practice, he said.

More information
Find out more about tPA at the American Heart Association.

FDA Panel Backs Celebrex for Kids With Arthritis

(HealthDay News) -- A U.S. Food and Drug Administration advisory panel recommended Wednesday that use of the painkiller Celebrex be expanded to treat children with juvenile rheumatoid arthritis.

The panel, a committee of doctors and other specialists, voted 15-1 that the benefits of the drug for children with juvenile rheumatoid arthritis (JRA) outweigh the shortage of proof on its safety.

However, the panel also voted 8-7, with one abstention, that available data doesn't demonstrate that Celebrex is safe in treating JRA and that a registry should be established to track these young patients for 10 to 20 years.

"The feeling was short-term efficacy looked good and short-term safety was not an issue. Long-term safety is totally unknown and needs to be known," Dr. Joan Bathon, a Johns Hopkins University rheumatologist and panel member, told the Associated Press.

"That's not unreasonable. But the important part, when they considered both safety and benefit, is the benefits outweighed the risks," Dr. Steven Romano, a vice president in Pfizer's worldwide medical division, told the AP.

"This decision means that one additional therapeutic choice is available for patients and doctors," Dr. Jeffrey Greenberg, director of the Arthritis Translational Research Registry at New York University Hospital for Joint Diseases, told HealthDay.

"Any unknown, long-term cardiovascular risk associated with the use of Celebrex will need to be factored into the decision," he added.

The FDA is not required to follow the recommendations of its advisory committees, but it usually does.

It's estimated that as many as 60,000 children in the United States have JRA, which causes painful joint swelling and can affect growth and development.

Currently, Celebrex is approved to treat adults with osteoarthritis and rheumatoid arthritis. In its application to expand that approval to include treatment of JRA, drug maker Pfizer Inc. included a six-month study that concluded that Celebrex (celecoxib) works as well as naproxen in treating young JRA patients.

Bathon said that the panel recognized the importance of expanding the pool of treatment options for JRA. Vioxx, until it was withdrawn in 2004, had been the only FDA-approved drug of its class for the disease.

Celebrex is a member of the controversial group of painkillers called cox-2 inhibitors, which have been linked to an increased risk of heart attack and stroke.

Two other cox-2s, Vioxx and Bextra, have been withdrawn from the market because of heart risk concerns. Celebrex remains available to consumers, but in 2005, the FDA required that the drug carry a "black box" warning on the possible risk of heart attack or stroke.

During public testimony before the advisory committee Wednesday morning, a New Jersey father said Celebrex had worked wonders for his son, who suffers from juvenile rheumatoid arthritis.

Vincent Del Gaizo, of Whitehouse Station, told the panel members that his son Christopher, now 6, had been in such pain from the disease and was taking so many drugs, he could only sleep three hours a day. Each morning, the boy sat in a high chair with his arms raised for hours because it hurt too much to lower them, the Boston Globe reported.

"It's an image that will be burned in my mind forever," said Del Gaizo, 38. The boy's doctor had "the courage" to try Celebrex "off-label," and now Christopher is able to play soccer and T-ball, his father said.

Also Wednesday, British researchers said they've discovered why Vioxx and other cox-2 inhibitors can cause heart attacks and strokes, BBC News reported.

The reason: These drugs -- designed to block the cox-2 enzyme and halt production of hormones that swell joints and cause pain in people with arthritis -- also stop an enzyme called cox-1 from producing blood-thinning agents. This results in a greater risk of blood clots, the news service reported.

The researchers said their findings are significant because they may lead to the development of cox-2 inhibitors that do not increase the risk of heart attack and stroke.

The findings were published in the Federation of American Societies for Experimental Biology Journal.

More information
For more on with juvenile rheumatoid arthritis, visit the U.S. National Library of Medicine.

Post-Surgery Radiation Boosts Prostate Cancer Results

(HealthDay News) -- A series of studies in this week's Journal of the American Medical Association offers good news to men battling prostate cancer or concerned about healthy prostate function.

One trial found that the use of radiation therapy after prostate removal improves results for men at high risk for prostate cancer recurrence.

"The benefit of adjuvant radiation is now confirmed in prostate cancer, like it is in many other cancers. Finally, we have the data to show that these patients can be helped further after their surgery," said Dr. Gregory Swanson, associate professor of radiation oncology at the University of Texas Health Science Center, San Antonio.

A second study, focused on the biology of prostate tissue in older men, found that links between testosterone replacement therapy (TRT) and prostate cancer "may not be as great as once feared," according to the trial's lead author, Dr. Leonard Marks, medical director of the Urological Sciences Research Foundation in Culver City, Calif. His team found no changes in the prostate tissue of older men after six months of TRT.

Both researchers presented their findings Tuesday at an American Medical Association news briefing in New York City that was timed to the release of the Nov. 15 issue of JAMA, which is focused on men's health.

Despite advances in early detection and treatment, prostate cancer remains a leading killer of American men. Most fatal cases of the disease occur when it is allowed to migrate beyond the gland, sparking disease recurrence.

According to Swanson, about one-third of the 230,000 new prostate cases diagnosed in the United States each year are treated with radical prostatectomy -- surgical removal of the organ. In up to half of those cases -- 30,000 men -- post-surgical tests reveal traces of lingering cancer cells that boost the risk of a recurrence.

Post-surgical ("adjuvant") radiation has a long record of "mopping up" these stray cells and improving the survival of patients with other types of cancer. However, the jury has been out as to whether the same might be true for prostate cancer.

In its study, the largest and longest of its kind to date, Swanson's team compared 10-year outcomes in a group of 425 older prostate cancer patients who had undergone radical prostatectomy but who still showed suspicious cells in the surrounding margins. His group randomly assigned half of the men to adjuvant radiation therapy, while the other half did not receive the treatment.

Ten years later, 35.5 percent of men who received radiation had developed fatal or nonfatal metastatic disease, compared to 43 percent of those who didn't get irradiated. Overall survival rates were similar between the two groups -- 71 of 214 men who received radiation died vs. 83 of 211 men who did not get the treatment.

Both of these results came very close to -- but did not meet -- so-called statistical significance, meaning that definite proof of treatment benefit is still lacking. However, Swanson believes "there is a compelling, although not conclusive" trend toward better survival in the irradiated group.

He also noted that about one-third of patients in the group who originally did not receive radiation eventually did receive it once they encountered a recurrence.

"People recognized that there was a benefit to radiation and said, 'Let's treat those patients,' " Swanson said. This probably caused more patients in the control group to survive than normally would have, confounding the results, he said.

Swanson said changes in other prostate cancer "markers" -- such as elevated blood levels of prostate specific antigen (PSA), a harbinger of cancer -- did meet statistical significance and were much more prevalent in men who did not undergo radiation, compared with those who did. Men who did not have radiotherapy were also 38 percent more likely to suffer disease recurrence that those who had had the adjuvant therapy, the study found.

The bottom line, according to Swanson: "The message to the urological community is that, yes, your patients will do better [with radiation] than with just surgery alone."

Prostate cancer risk was the focus for Marks' group of researchers, as well. He said recent media hype on the power of testosterone to boost aging males' libido and muscle tone have pushed annual U.S. sales of testosterone replacement therapy (TRT) to more than $700 million.

However, doctors have long known that testosterone can also raise a man's risk for prostate malignancy. So, Marks' team decided to look at the biological effect of six months of standard TRT, given in injections every two weeks, on the prostate tissue of 44 men ranging from 44 to 78 years of age.

All of the men had relatively low levels of circulating testosterone upon entering the study, with no sign of prostate malignancy. Forty of the men agreed to provide the researchers with prostate tissue biopsies at the beginning and end of the six-month trial.

The researchers said they found no detectable change in prostate tissue after six months of TRT, despite the fact that the therapy caused blood levels of circulating testosterone to rise to mid-normal levels. Concentrations of male hormones in prostate tissues differed only slightly after therapy, and the team saw no changes in cells -- for example, alterations in gene expression or cell proliferation -- that might point to an increased risk for cancer.

While this is good news for men who are taking or might take TRT, Marks stressed that the study only examined the prostate tissue biology of a select group of men with no prior signs of cancer.

"These data do not assure prostate safety for populations of older men harboring highly prevalent subclinical disease," said Marks, who is also clinical professor of surgery/urology at the University of California, Los Angeles. "We know that if you do thorough studies of the prostate glands of aging men, microscopic [traces] of cancer are present in many of them."

So, while this tissue sampling of 44 men found testosterone therapy to have no cancer-promoting effects, those results might not be borne out in larger epidemiological studies, he said. Until such studies are done, Marks said, "My concern is that some physicians may misinterpret these data and start using testosterone willy-nilly. My hope is that it won't be used that way."

A third study in the same issue of JAMA offered some guidance to millions of men bothered by urinary incontinence triggered -- at least in part -- by an enlarged prostate.

The study of more than 700 men found that a combination of two widely used medications, tolterodine (Detrol LA) and tamsulosin (Flomax), worked better in combination at reducing urinary trouble than either drug alone.

"In those men who don't respond to a single therapy -- and that's a host of men -- we're able to now, with this combination, provide a real improvement in their quality of life," said lead researcher Dr. Stephen Kaplan, professor of urology at Weill Medical College of Cornell University, in New York City.

More information
Find out more about prostate health at the U.S. Food and Drug Administration.

Do You Need These Tests?

Q: Do You Need These Tests?
Can you tell me what tests we all should have as we get older? Which ones do you recommend?

A: As we get older, a variety of medical tests can warn of impending problems, with hearts, bones and other chronic disorders. As long as you're in good health and have no unusual symptoms, I don't necessarily recommend an annual physical exam. But here's a list of the tests I do think everyone should have periodically as they age:

Cholesterol: This simple blood test can give you an idea of your heart disease risk. Have your cholesterol tested every five years beginning at age 20 and have your HDL ("good") cholesterol and LDL ("bad" cholesterol) checked if your total cholesterol is over 200. You should also request measurement of serum homocysteine and C-reactive protein, other indicators of heart disease risk.

Bone density: Any woman at high risk of osteoporosis (because her mother had it or because she is light boned and fair-skinned) should have this DEXA scan to determine her bone mineral density and keep track of how it is declining over time.

All women age 65 and older should have at least one DEXA scan to gauge the condition of their bones. We have good drugs to halt and reverse osteoporosis and reduce risk of hip fractures in old age. You should know, however, that DEXA tests also identify bone weakness (osteopenia) that is nowhere near the range of osteoporosis.

As a result of these findings, women may be put on the same strong drugs used to treat osteoporosis - not a wise move, in my judgment.

PSA: This test for prostate specific antigen, a protein produced by prostate cells, can warn men of prostate cancer.

However, false positives are common, and even when the test does detect cancer, it provides no information about how aggressive it is or how likely it is to spread. Until we have a reliable follow-up test to show whether or not a tumor is aggressive, I doubt the wisdom of using PSA as a screening tool, except for men at high risk of prostate cancer on the basis of family history or lifestyle. A newer test, the pro-PSA, may do better.

Discuss prostate screening with your physician.

Mammogram: Every one to two years for all women over 40 to detect early (and curable) breast cancer. Women with a positive family history of breast cancer may want to start screening earlier.

Colonoscopy: A test for early signs of colon cancer; every 10 years starting at age 50, earlier if there is a positive family history.

Blood pressure: Every two years after the age of 18 as long as your blood pressure is normal.
Eye exams: Every two to four years between ages 40 and 65; every one to two years after age 65. If you wear glasses or contacts, you should have your eyes checked annually, regardless of age.

Dental exams: Everyone, regardless of age, should have a dental check-up once or twice a year.
Full body skin exams: Check yourself monthly for moles; an annual skin exam by a physician regardless of age; follow your doctor's recommendations for more frequent exams if you've had any type of skin cancer.

Thyroid tests: All adults, particularly women, should be screened for thyroid disorders at the age of 35 and every five years thereafter.

Pap smears: Women need Pap smears to detect abnormalities that may precede cervical cancer every one to three years.

Diabetes screening: Fasting blood sugar and insulin levels should be checked if you are overweight or have a positive family history.


Weil, M.D.

Chronic Fatigue Syndrome Campaign Launched

(HealthDay News) -- U.S. health officials on Friday launched a major campaign to increase awareness of chronic fatigue syndrome, an illness that has labored under an intense level of controversy.

"This disease has been shrouded in a lot of mystery. Sometimes people question if it's real or not real," Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, said at a news conference. "We hope to help patients know they have an illness that requires medical attention and help physicians be able to diagnose the illness, and be able to validate and understand the incredible suffering that many people and their families experience in this context."

The campaign will consist of public service announcements, brochures, a "tool kit" for health-care professionals and a photo exhibit called "The Faces of Chronic Fatigue Syndrome," which will travel to cities across the country throughout 2007.

"We hope this will be a turning point in the public's awareness of the disease as well as in health-care professionals' ability to diagnose and treat it," Kim McCleary, president and CEO of the CFIDS Association of America, said at the news conference.

"This launch is so important to increasing understanding of this illness," added Dr. Nancy Klimas, of the University of Miami Miller School of Medicine. "Historically, lack of credibility of this illness has been a major stumbling block."

According to Dr. William Reeves, of the CDC's National Center for Infectious Diseases, the level of impairment experienced by people with chronic fatigue syndrome is comparable to that of multiple sclerosis, AIDS, end-stage renal failure and chronic obstructive pulmonary disease.

One CFS patient, Adrianne Ryan, said that sometimes taking a walk or a shower was too much, and resulted in her collapsing for weeks afterwards. Ryan is a former marathoner.

Doctors still don't know what causes CFS or how to treat it successfully, but more than 4,000 studies over the past two decades show definite underlying biological abnormalities, said Dr. Anthony Komaroff, of Harvard Medical School.

"This is not an illness that people can imagine they have. It's not a psychological illness," he said. "That debate, which has raged for 20 years, should now be over."

Among other things, Komaroff pointed out, the brain hormone systems of people with CFS are different than those without the disease. Brain functioning is also impaired and cells' energy metabolism seems to be compromised.

Analyses of the activity levels of 20,000 genes in people with CFS have found abnormalities in genes related to the part of brain activity mediating the stress response, Reeves said.
Some 1 million Americans suffer from the disease. Women are affected at about four times the rate as men and non-white women are affected more than white women. The disease can affect any age and demographic but is most likely to strike when a person is 40 to 59 years of age.

According to a large study conducted in Wichita, Kans., only half of people with CFS have consulted a physician and only 16 percent have been diagnosed and treated, although studies have shown that those who get appropriate care early in the illness have better long-term results. A quarter of people with the disease were unemployed or receiving disability, with the average affected family foregoing $20,000 annually in income. That amounts to $9.1 billion in lost income and wages for the U.S. economy as a whole, the study found.

While there's reason to be happy with advances in the basic scientific knowledge of the disease, Klimas said she was less happy with advances in care. Over the past 20 years, she said, she has treated more than 2,000 people with CFS who were "angry and defiant, frustrated, trying to convince physicians, friends and families that this was a real illness."

"We need much more work to understand the biological underpinnings and translate this into clinical practice," she said. "At the same time, there are effective strategies we can use right now, treatments that do help and help significantly."

More information
Visit the U.S. Centers for Disease Control and Prevention for more on chronic fatigue syndrome.

Looking for Low-Cost Massages?

Q: Looking for Low-Cost Massages?
Part of my New Year's resolution was to keep my stress level down, and massage works great for me. The problem is I can't afford massage on a regular basis. Are there any secret bargains in bodywork?

A: Massage is wonderfully relaxing and a great way to counter stress. It is also therapeutic. Research has shown that massage can improve breathing in asthmatic children, lower levels of stress hormones in AIDS patients and help relieve tension headaches caused by contracting head, neck or facial muscles.

But you're right: massage can be costly. My medical partner, Dr. Brian Becker, originally trained as a massage therapist. He tells me there?s a longstanding joke that the stress of working to pay for a massage keeps many people from relaxing on the table. To enjoy the benefits of massage on a budget, he suggests the following.

Weekend courses/workshops: This is the short version of sending your spouse or significant other to massage school. Weekend workshops are often set up for couples, and the basics of massage can be learned in a few sessions. The better courses are taught at formal schools of massage, but there are many excellent instructors out there.

One of the best ways to learn to give a massage is to receive them, and then practice the techniques on yourself or a friend. You can visit the website of the American Massage Therapy Association (www.amtamassage.org ) to find an accredited school near you. Also check this site for weekend classes or instructor referral.

Massage clinics: These can be a real bargain if you live near a school where massage therapists are trained. Prices for a massage at a clinic depend on whether you request a professional, a graduate or a student therapist. A licensed therapist will probably cost you about $60 an hour, but you may be able to pay about half of that if you're willing to let a student practice on you.

Along with working in the clinic, many formal schools of massage therapy also require therapists to log independent massages as part of their training.

These students are out there looking for bodies to practice on, and often cannot charge a fee as they are not yet licensed. Some student practitioners are outstanding, and supporting a student through school with a tip for the practice time may earn you a discounted rate after he or she graduates.

Self-massage: Massaging your own muscles costs you nothing, and with good technique can be quite effective.

Massage therapists frequently use a tennis ball for those hard to reach places on their own backs and shoulder blades. Along the same line is the Healthy Body Ball (www.healthybodyball.com).

This is a self-massage tool you can use to access trigger points just about anywhere. Designed by a massage therapist, it looks like a ball with protruding circular nodules that resemble fat, round, blunt spikes. You put the ball between your body and the floor or a chair back and move against it to get your "massage."

Bargaining or Bartering: The cost of massage therapy isn't necessarily carved in stone, particularly if your therapist is a solo practitioner. You could always ask for a quantity "discount" if you're willing to commit to a series of massages. Or, you may be able to barter - trade your services, expertise, or discounts on products you sell for massages or for a break in the price.

Explore Other Ways to Unwind: Even people who can afford it usually don't have time for regular massages. Try breathing exercises, progressive relaxation, visualization, meditation or exercise as inexpensive alternatives to relieve stress.

Andrew Weil, M.D.

Could Personality Influence Cancer Risk?

HealthDay News) -- A new study in rats suggests a link between personality and cancer susceptibility.
Researchers at the University of Chicago say timid rats were more likely to develop cancer and to die sooner than more "adventuresome" rats. The findings suggest the need to examine the links between behavior traits and cancer in humans, the team said.
For this study, the Chicago group used a breed of rats prone to breast and pituitary tumors. Female rats that appeared apprehensive of new experiences as infants remained that way as they grew older. They also died earlier of breast and pituitary tumors than their braver sisters.
The more timid rats were also more likely to have irregular reproductive cycles than the tougher rats -- 52 percent vs. 22 percent. This disruption may account for hormonal differences associated with the development of cancer at an earlier age, the researchers speculated.
By the time they were 390 days old (middle age for rats), 80 percent of the timid rats had developed mammary cancer, compared with 38 percent of the bolder rats. The timid rats had an average life span of 573 days, compared to 850 for the more adventuresome rodents.
There was no difference between the two groups in the length of time between the onset of cancer and death.
The study was published in the current issue of Hormones and Behavior.
The findings suggest that more research is needed into temperament and cancer risk in humans, the study authors said. Most current research into cancer and personality focuses on survival once a person has already been diagnosed with cancer.
"Human studies may need to consider more basic behavior traits than those already considered," researcher Martha McClintock, a professor of psychology, said in a prepared statement.
More information
The U.S. National Cancer Institute has more about cancer.

Health Tip: Varicose Veins May Not Need Treatment

(HealthDay News) -- Varicose veins, also known as spider veins, look dark blue or purple under the skin. They may also appear as twisted clumps of veins that may cause the skin above them to harden and swell.
Although many people with varicose veins don't have any other symptoms, the Cleveland Clinic says that some people may have swelling or pain in the legs, itching, soreness or aching. Some skin discoloration may also occur.
Varicose veins occur most often among women, and may be influenced by a number of factors. Being older, overweight, and having a job that requires standing all day may contribute to varicose veins. Other factors may be heredity, crossing the legs often, using birth control pills, or use of post-menopausal hormone therapies.
Treatment may not be necessary, according to the clinic, unless you are experiencing pain. Support hose may help reduce symptoms in some people, and lifestyle changes like losing weight, exercise, and getting off your feet may also help.