POPULARITY
Download Your Free Guide - 3 Things You Need to Know About Cancer: https://www.katiedeming.com/cancer-101/Do you know all the facts surrounding anti-estrogen therapy for breast cancer treatment? Many women feel scared of their own bodies after a breast cancer diagnosis, especially when told their cancer is "estrogen-driven." Dr. Deming explains why this fear is misplaced and helps you understand the natural role of hormones in your body.Dr. Katie Deming breaks down complex biology into simple terms, helping you understand what estrogen receptors really mean for your health and treatment decisions.Key Takeaways:- What estrogen-positive breast cancer really means- How hormone therapy works and its side effects- The truth about risk reduction in breast cancer treatment- Cytostatic vs. cytotoxic: why it matters- The role of lifestyle changes in healing- Questions to ask your oncologist before starting treatmentIf you're wrestling with decisions about anti-estrogen therapy or feeling pressured to start treatment immediately, Dr. Katie provides the clear, factual information you need to make confident choices. She explains how to interpret the statistics your doctor shares and what questions to ask to fully understand your options.Listen, learn, and equip yourself with knowledge to have more productive conversations with your healthcare team.Send us a text with your question (include your phone number)Watch & Listen to Born to Heal on Youtube: Click Here Transform your hydration with the system that delivers filtered, mineralized, and structured water all in one. Spring Aqua System: https://springaqua.info/drkatie Don't Face Cancer Alone"The 6 Pillars of Healing Cancer" workshop series provides you valuable insights and strategies to support your healing journey - Click Here to Enroll MORE FROM KATIE DEMING M.D. Free Guide - 3 Things You Need to Know About Cancer: https://www.katiedeming.com/cancer-101/6 Pillars of Healing Cancer Workshop Series - Click Here to EnrollWork with Dr. Katie: www.katiedeming.comFollow Dr. Katie Deming on Instagram: The.Conscious.Oncologist Take a Deeper Dive into Your Healing Journey: Dr. Katie Deming's Linkedin Here Please Support the Show Share this episode with a friend or family member Give a Review on Spotify Give a Review on Apple Podcast DISCLAIMER:The Born to Heal Podcast is intended for informational purposes only and is not a substitute for seeking professional medical advice, diagnosis, or treatment. Individual medical histories are unique; therefore, this episode should not be used to diagnose, treat, cure, or prevent any disease without consulting your healthcare provider.
In today's episode we're diving into a question I hear all the time: “Why do I need to take aromatase inhibitors if I'm post-menopausal? Isn't my body done making estrogen?” If you've wondered the same thing, you're not alone! We'll explore how your body still produces small amounts of estrogen even after menopause, and why this matters for breast cancer survivors. I'll explain where post-menopausal estrogen comes from—hint: it's not just your ovaries—and how lifestyle factors can support your body's hormone balance. You'll also hear why aromatase inhibitors play an important role in preventing recurrence, but we won't avoid discussing their risks, either. We're also diving into something that might surprise you—a genetic variation that can make one aromatase inhibitor less effective in some women. This genetic factor can impact how your body metabolizes the drug, which you want to hear about! I'm excited for you to tune in to this episode, whether you're currently on aromatase inhibitors, considering them, or just curious about how your body works post-menopause. I'll cover all of this and more to help you make the best choices for your health and healing after breast cancer. Don't miss it! Referred to in this episode: Work with Laura Follow me on Social Media: Facebook Instagram Pinterest YouTube
Watch Here : https://www.youtube.com/watch?v=JWloPcNmVKI Website: https://vigoroussteve.com/ Consultations: https://vigoroussteve.com/consultations/ eBooks: https://vigoroussteve.com/shop/ YouTube Channel: http://www.youtube.com/user/VigorousSteve/ Workout Clips Channel: https://www.youtube.com/channel/UCWi2zZJwmQ6Mqg92FW2JbiA Instagram: https://instagram.com/vigoroussteve/ TikTok: https://www.tiktok.com/@vigoroussteve Reddit: https://www.reddit.com/r/VigorousSteve/ PodBean: https://vigoroussteve.podbean.com/ Spotify: https://open.spotify.com/show/2wR0XWY00qLq9K7tlvJ000 Patreon: https://www.patreon.com/vigoroussteve
Sexual health after a cancer diagnosis is complex and it's not enough to purely address our physical symptoms. The brilliant medical oncologist Dr. Laila Agrawal from the US, joins us for this episode where we embark on understanding the complexity of emotional, physical and social changes that affect our sex lives.And of course, we talk about what your options are and why we need to create the book club we never knew we needed! We talk: Zero libidoBody confidenceHow to treat symptomsVaginal oestrogen after breast cancer - new guidanceSexy stories And so much more.You can find Dr. Agrawal here: https://providers.nortonhealthcare.com/provider/Laila+S+Agrawal/466429This is her informative Instagram: https://www.instagram.com/drlailaagrawal/For perhaps your first ever women's erotic story go here: https://meetrosy.com/eroticaA large group of high-quality studies show that vaginal oestrogen is safe for breast cancer survivors even those on Aromatase Inhibitors.Here is the Guidance:https://jamanetwork.com/journals/jamaoncology/article-abstract/2811413https://www.acog.org/news/news-releases/2016/02/acog-supports-the-use-of-estrogen-for-breast-cancer-survivorshttps://ascopubs.org/doi/10.1200/JCO.2017.75.8995https://journals.sagepub.com/doi/10.1177/20533691231208473Episode Highlights:00:00 Intro07:06 Low rate of women reporting sexual health issues.11:54 Breast cancer treatments may worsen vaginal symptoms.15:18 Recommended hyaluronic acid vaginal products.23:09 Guidelines support vaginal hormones for breast cancer.31:18 Vaginal dilator helps with pelvic muscle discomfort.36:17 Knowing your sexual goals is important for health.41:05 Chemotherapy and medications can affect libido desire.44:42 Planning builds anticipation, connection, and pleasure.48:23 Rediscovering pleasure, connecting with partner, sex therapy.51:28 Body image and cancer's impact on self-esteem.01:00:01 Explore sexy stories to spice up libido.About Dani:The Menopause and Cancer Podcast is hosted by Dani Binnington, menopause guide, patients advocate for people in menopause after a cancer diagnosis, and founder of the online platform Healthy Whole Me. There is lots of information out there about the menopause but hardly any if you have had a cancer diagnosis as well. Many people say to me they have no idea what their options are, who to ask for help, and that they feel really isolated in their experiences. I started this podcast because there was nothing out there when I was thrown into surgical menopause at the age of 39, which followed on from my cancer diagnosis aged 33.Through the episodes, I want to create more awareness, share information from our fabulous guest experts, doctors and other specialists in the cancer and menopause field. And of course, I will share stories from the people in our community.So that together we can...
Dr. Keith Nichols delves into the intricacies of testosterone optimization, shedding light on common misconceptions and outdated practices prevalent among physicians. Here are key takeaways from the discussion: Rethinking Normalcy: Dr. Nichols challenges the fixation on normal reference ranges for testosterone levels, emphasizing that these ranges do not necessarily equate to optimal health or the absence of symptoms. Symptom-Based Treatment: Rather than targeting a specific testosterone number, Dr. Nichols advocates for treatment based on individual symptoms and response, recognizing the importance of free testosterone levels in achieving desired outcomes. The Saturation Point: While higher testosterone levels may be beneficial up to a certain point, Dr. Nichols explains the concept of saturation, beyond which further increases yield no additional benefits. Environmental Factors: The low testosterone epidemic is not solely attributed to biological factors but is also influenced by environmental pollutants and endocrine disruptors. Clarifying Misconceptions: Dr. Nichols clarifies misunderstandings surrounding hematocrit levels and testosterone therapy, as well as the role of DHT in hair loss. Aromatase Inhibitors and Estrogen: While some clinics are using aromatase inhibitors to block estrogen, caution is warranted as they negate the benefits of testosterone. Delivery Methods: Both injections and transdermal creams can effectively deliver testosterone, with creams potentially offering better elevation of free testosterone levels. Concerns in the Field: Dr. Nichols expresses concerns about the proliferation of clinics in the hormone optimization space that do not adhere to evidence-based practices, underscoring the importance of seeking reputable providers. In summary, Dr. Nichols advocates for a nuanced approach to testosterone optimization, emphasizing the need for individualized treatment based on symptoms and response rather than a one-size-fits-all approach dictated by lab values. His insights serve as a valuable guide for both physicians and individuals navigating the complex landscape of hormone optimization. To visit Tier 1 Health & Wellness Click HERE Tier 1 Health & Wellness YouTube Tier 1 Health & Wellness Location: 2700 Oak Street Chattanooga, TN 37404 Victory Men's Health For questions email podcast@amystuttle.com Disclaimer: The Women Want Strong Men Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
DEARG: Delivering Endometriosis and Adenomyosis Resources and Guidance
Summary Dr. Caoimhe Hartley discusses perimenopause, menopause, and the symptoms women may experience during this time. She explains the impact of hormonal fluctuations on endometriosis and the importance of managing symptoms during perimenopause. Dr. Hartley also explores various treatment options for perimenopause and postmenopause, including hormone replacement therapy (HRT) and the use of testosterone. She emphasises the need for individualised care and risk assessment when considering HRT. Additionally, Dr. Hartley highlights the importance of lifestyle factors in managing menopausal symptoms and reducing overall health risks. This conversation covers various topics related to hormone replacement therapy (HRT) and the management of menopausal symptoms. It explores individualised approaches to HRT, the importance of long consultations and patient advocacy, options for managing menopausal bleeding, non-hormonal medications for heavy bleeding, different hormonal options for bleeding control, the use of Tibolone as an alternative hormone therapy, the safety of vaginal oestrogens in breast cancer patients, and the myth of hormone balancing. Takeaways Hormone replacement therapy (HRT) should be individualised based on a person's symptoms, risk factors, and preferences. It is not a one-size-fits-all approach. Long consultations and patient advocacy are crucial in providing comprehensive care for menopausal patients. Patients should be well-informed and actively involved in their treatment decisions. There are various options for managing pre and perimenopausal bleeding, including non-hormonal medications like tranexamic acid, as well as hormonal options. Tibolone is a synthetic steroid that can be used as an alternative hormone therapy. It has similar benefits to other forms of HRT and is considered safe for most women. It was studied as addback HRT for use with GnRHa like Zoladex. Aromatase inhibitors are commonly used in post-breast cancer treatments and infertility. They can be effective but may cause significant side effects. Some patients with endometriosis have used them for symptom control. Vaginal oestrogens are safe and effective for managing vaginal dryness and other genitourinary symptoms in women. They do not increase the risk of breast cancer. Resources Dr Caoimhe Hartley - Menopause Health https://www.menopausehealth.ie/ Chapters 00:00 Introduction and Background 03:32 Perimenopause and Menopause 06:50 Perimenopausal Symptoms and Endometriosis 15:06 Treatment Options for Perimenopause and Postmenopause 20:17 Managing Symptoms in Hysterectomy Patients 22:48 The Use of Testosterone in Menopause 27:44 Alternative Options for Women Not Taking HRT 34:51 Risks and Side Effects of HRT 40:23 Individualised Risk Assessment 41:13 Individualised Hormone Replacement Therapy (HRT) 42:02 Long Consultations and Patient Advocacy 43:14 Managing Menopausal Bleeding 44:19 Non-Hormonal Medications for Heavy Bleeding 44:49 Hormonal Options for Bleeding Control 45:46 Tibolone as an Alternative Hormone Therapy 48:36 Aromatase Inhibitors in Endometriosis Treatment 50:53 Vaginal Oestrogens and Breast Cancer 54:46 The Myth of Hormone Balancing
The Cancer Pod: A Resource for Cancer Patients, Survivors, Caregivers & Everyone In Between.
Joint pain is common, but that doesn't mean you have to suffer! There are so many natural remedies to control and relieve the discomfort. Whether you are preventing joint pain during treatment or you have ongoing arthritis-type pain, Tina & Leah talk about ways to find relief. We even tackle the tough-to-treat joint pain from aromatase inhibitors (yes, there are things you can do!). Sometimes, the answer is already in your kitchen!Links to prior episodes we mention:Turmeric Brain Fog Sammy Peterson, RD, CSO Rebecca Katz- nutrition, recipes, etc.- her website and her cookbooks. Aromatase Inhibitors and Vitamin D in your blood.Exercise to reduce the joint pain from aromatase inhibitors.Community acupuncture can keep your cost for acupuncture way down.Support the showShare this podcast with someone you think would like it!https://www.thecancerpod.com Have an idea or question? Email us: thecancerpod@gmail.comJoin our growing community, we are @TheCancerPod on: Instagram Twitter Facebook LinkedIn We appreciate your support! THANK YOU!
Watch Here : https://www.youtube.com/watch?v=_E9NaiRMKOw Website: https://vigoroussteve.com/ Consultations: https://vigoroussteve.com/consultations/ eBooks: https://vigoroussteve.com/shop/ YouTube Channel: http://www.youtube.com/user/VigorousSteve/ Workout Clips Channel: https://www.youtube.com/channel/UCWi2zZJwmQ6Mqg92FW2JbiA Instagram: https://instagram.com/vigoroussteve/ TikTok: https://www.tiktok.com/@vigoroussteve Reddit: https://www.reddit.com/r/VigorousSteve/ PodBean: https://vigoroussteve.podbean.com/ Spotify: https://open.spotify.com/show/2wR0XWY00qLq9K7tlvJ000 Patreon: https://www.patreon.com/vigoroussteve
Many women say that being on a long-term anti-hormone treatment such as tamoxifen and aromatase inhibitors is much harder than chemotherapy, radiotherapy, and surgery altogether.So I've invited breast speciality oncologist Dr. Claire Macaulay from Glasgow onto the podcast to answer your questions. We're also joined by a group of our community to join us for this recording so that they get to ask their questions whilst being on the live show!Both tamoxifen and aromatase inhibitors (AIs) are hormonal therapies used in the treatment of oestrogen-positive (ER-positive) breast cancers to stop tumour growth and recurrence and to treat cancer that has come back after initial treatment or that has spread to other parts of the body.These treatments come with the benefits of reducing the risks of cancer recurrence and they also come with a host of unwanted side effects. Sometimes, these can very much reduce a woman's quality of life. Dr. Claire Macaulay recognises the challenges these treatments come with and talks us through our options. Dr. Macaulay is also a certified sex coach supporting people in the menopause to have improved sex lives. You can find her here https://www.pleasurepossibility.comAnd join her private Facebook group here About Dani:The Menopause and Cancer Podcast is hosted by Dani Binnington, menopause guide, patients advocate for people in menopause after a cancer diagnosis, and founder of the online platform Healthy Whole Me. There is lots of information out there about the menopause but hardly any if you have had a cancer diagnosis as well. Many people say to me they have no idea what their options are, who to ask for help, and that they feel really isolated in their experiences. I started this podcast because there was nothing out there when I was thrown into surgical menopause at the age of 39, which followed on from my cancer diagnosis aged 33.Through the episodes, I want to create more awareness, share information from our fabulous guest experts, doctors and other specialists in the cancer and menopause field. And of course, I will share stories from the people in our community.So that together we can work towards a better menopause experience. For all of us.More educated, better informed and less alone.Connect with Dani:Instagram @healthywholeme Facebook: @healthywholeme Website: menopauseandcancer.org Join Dani's private Facebook group: https://www.facebook.com/groups/menopauseandcancerchathubFor oodles of inspiration, healthy recipes, yoga classes and all round positivity go to her website: https://www.healthywholeme.com/
The Cochrane Gynaecology and Fertility Group has prepared more than 220 reviews and, in September 2022, a team from Germany, The Netherlands and New Zealand updated one of these, looking at the use of a drug called letrozole for subfertile women with anovulatory polycystic ovary syndrome. Lead author, Sebastian Franik from the University of Münster in Germany describes the latest findings in this podcast.
The Cochrane Gynaecology and Fertility Group has prepared more than 220 reviews and, in September 2022, a team from Germany, The Netherlands and New Zealand updated one of these, looking at the use of a drug called letrozole for subfertile women with anovulatory polycystic ovary syndrome. Lead author, Sebastian Franik from the University of Münster in Germany describes the latest findings in this podcast.
Zenith All Natural Fat Burning Supplement Buy Zenith here Awakendnation.com/integrativematt Extra Zenith information: https://www.youtube.com/watch?v=igEyMcaCZDw https://www.youtube.com/watch?v=FSSZ-USzz3k https://www.youtube.com/watch?v=y9mkWri8TAw Magnesium Breakthrough Use Code : integrativethoughts10 for 10% OFF https://bioptimizers.com/shop/products/magnesium-breakthrough Integrative Thoughts Instagram: @integrativematt Website: Integrativethoughts.com Guest: Jay Campbell Jay Campbell is a 4x international best selling author, men's physique champion, and founder of the Jay Campbell Brand and Podcast. Recognized as one of the world's leading experts on hormonal optimization and therapeutic peptides, Jay has dedicated his life to teaching Men and Women how to #FullyOptimize their health while also instilling the importance of Raising their Consciousness. Raise Your Vibration To Optimize Your Love Creation!
Both tamoxifen and aromatase inhibitors (AIs) are hormonal therapies used in the treatment of oestrogen-positive (ER-positive) breast cancers to stop tumour growth and recurrence and to treat cancer that has come back after initial treatment or that has spread to other parts of the body.These treatments come with the benefits of reducing the risks of cancer recurrence and they also come with a host of unwanted side effects. Many women say that being on a long-term anti-hormone treatment is much harder to navigate than chemotherapy, radiotherapy, and surgery altogether.In today's episode, I am inviting Dr Alison Macbeth into the conversation. She is a Breast Speciality Doctor in an NHS Breast Surgery in Glasgow and sees NHS patients from all over the west coast of Scotland.She is passionate about meeting the often-overlooked needs of women in all stages of treatment or recovery from breast cancer. She gained experience as an NHS GP with a special interest in Women's Health, Menopause and Genito-urinary prolapse.Alison has an incredible understanding of what women go through and brings a compassionate approach to helping them have a good quality of life after their cancer diagnosis. You can find Dr Alison Macbeth here https://thebms.org.uk/clinic/stobhill-hospital-breast-unit/About Dani:The Menopause and Cancer Podcast is hosted by Dani Binnington, menopause guide, patients advocate for people in menopause after a cancer diagnosis, and founder of the online platform Healthy Whole Me. There is lots of information out there about the menopause but hardly any if you have had a cancer diagnosis as well. Many people say to me they have no idea what their options are, who to ask for help, and that they feel really isolated in their experiences. I started this podcast because there was nothing out there when I was thrown into surgical menopause at the age of 39, which followed on from my cancer diagnosis aged 33.Through the episodes, I want to create more awareness, share information from our fabulous guest experts, doctors and other specialists in the cancer and menopause field. And of course, I will share stories from the people in our community.So that together we can work towards a better menopause experience. For all of us.More educated, better informed and less alone.Connect with Dani:Instagram @healthywholeme Facebook: @healthywholeme Join Dani's private Facebook group: https://www.facebook.com/groups/menopauseandcancerchathubFor oodles of inspiration, healthy recipes, yoga classes and all round positivity go to her website: https://www.healthywholeme.com/
Dr. Becky Lynn is back! Previous on Episode #44 and #43 where we talked about vaginismus and endometriosis and sex after breast cancer (44) and hormones (43). So check them out! She is the founder of Evora Women's Health in Missouri Dr. Lynn recently authored the paper: Low Sexual Desire in Breast Cancer Survivors and Patients: A Review - Sexual dysfunction is 30-100% of women with breast cancer. And low desire is 5-87% - What happens when we do surgery on the breasts o Does it matter if we had radical mastectomy versus lumpectomy, with or without reconstruction? - Role of Chemotherapy on sexual function - Role of anti-estrogen meds on sexual function - Role of couples therapy - Data on vaginal moisturizers on sexual function - Role and safety of vaginal estrogen after breast cancer treatment – ACOG statement paper - Trial of Bupropion – open study shows improvement – randomized controlled trial versus placebo pending - Role of vaginal testosterone cream in pts on Aromatase Inhibitors – lowers estrogen in the body - There is a study looking at intravaginal DHEA on sexual function in breast cancer - Abstract at ISSWSH on Addyi (filbanserin) in breast cancer population - Role of hormones after breast cancer Dr. Lynn is a proponent of medical marijuana for better sex 34% OF WOMEN WHO REPORTED USING MARIJUANA BEFORE SEXUAL ACTIVITY SAID IT INCREASED THEIR SEX DRIVE, IMPROVED ORGASM, AND DECREASED PAIN. Luo F, Link M, Grabenhorst C, Lynn B. Low Sexual Desire in Breast Cancer Survivors and Patients: A Review. Sex Med Rev. 2022 Jul;10(3):367-375. website: https://evorawomen.com/ FB/IG @evorawomenshealth TikTok: @dr.beckylynn FB/IG Becky Kaufman Lynn, MD YouTube: search Dr. Becky Lynn YouTube: search Evora Women's Health Twitter: @Becky Lynn Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership Our podcast sponsor is Bonafide Bonafide products help women embrace the natural changes that occur throughout all phases of life. Discount code for 20% off:NOTBROKEN Sales link: https://hellobonafide.com/notbroken
In this episode, we review the high-yield topic of Aromatase Inhibitors from the Gynecology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Drs Lidia Schapira and Norah Lynn Henry discuss adjuvant endocrine therapy. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969538). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals. Resources Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update https://ascopubs.org/doi/10.1200/JCO.18.01160 Evidence-Based Approaches for the Management of Side-Effects of Adjuvant Endocrine Therapy in Patients With Breast Cancer https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30666-5/fulltext Acupuncture for Arthralgia-Induced by Aromatase Inhibitors in Patients With Breast Cancer: A Systematic Review and Meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883140/ Long-Term Results From a Randomized Blinded Sham- and Waitlist-Controlled Trial of Acupuncture for Joint Symptoms Related to Aromatase Inhibitors in Early Stage Breast Cancer (S1200) https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.12018 Adverse Events and Perception of Benefit From Duloxetine for Treating Aromatase Inhibitor-Associated Arthralgias https://academic.oup.com/jncics/article/5/2/pkab018/6130825 Predictors of Aromatase Inhibitor Discontinuation as a Result of Treatment-Emergent Symptoms in Early-Stage Breast Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341106/ Active Symptom Monitoring and Endocrine Therapy Persistence in Young Women With Breast Cancer https://maps.cancer.gov/overview/DCCPSGrants/abstract.jsp?applId=10337861&term=CA266012 Patient-Reported Outcomes and Early Discontinuation in Aromatase Inhibitor-Treated Postmenopausal Women With Early Stage Breast Cancer https://academic.oup.com/oncolo/article/21/5/539/6401566?login=false Effect of a Switch of Aromatase Inhibitors on Musculoskeletal Symptoms in Postmenopausal Women With Hormone-Receptor-Positive Breast Cancer: The ATOLL (Articular Tolerance of Letrozole) Study https://pubmed.ncbi.nlm.nih.gov/20035381/ Benefits of Digital Symptom Monitoring With Patient-Reported Outcomes During Adjuvant Cancer Treatment https://ascopubs.org/doi/full/10.1200/JCO.20.03375 Cohort Study of Adherence to Adjuvant Endocrine Therapy, Breast Cancer Recurrence and Mortality https://www.nature.com/articles/bjc2013116 Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493485/ Caution: Vaginal Estradiol Appears to Be Contraindicated in Postmenopausal Women on Adjuvant Aromatase Inhibitors https://www.annalsofoncology.org/article/S0923-7534(19)57558-5/fulltext Management of Genitourinary Syndrome of Menopause in Breast Cancer Survivors: An Update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894268/
Huberman Lab Podcast Notes Key Takeaways Six pillars of hormone health: (1) diet (specifically caloric restriction); (2) exercise (specifically resistance training); (3) stress & stress optimization; (4) sleep optimization; (5) sunlight; (6) spirit – dial in the body, mind, and soul connectionThink of yourself as a Venn diagram: you have a body, mind, and soul – you can't completely be well if you're missing the health of one areaTip to get your doctor to order more bloodwork than the basic panel: tell your doctor your (fill in the blank) – energy, sleep, endurance, etc. – is not as good as it used to beHigh alcohol intake and smoking marijuana will ultimately decrease testosteroneCaffeine has a negligible effect on hormonesVegans: you are possibly at risk of not getting enough of certain types of fats and nutrients to maintain a proper ratio of testosterone to estrogen – supplement with algae or other healthy fatsTo naturally increase growth hormone output: don't eat within 2 hours of sleep, get good deep sleep, resistance exercise early in the day, manage stress A word of caution about peptides: work with a physician! There are so many bad quality peptides with detrimental side effects Read the full notes @ podcastnotes.orgMy guest is Dr. Kyle Gillett, MD, a dual board-certified physician in family medicine and obesity medicine and an expert in optimizing hormone levels to improve overall health and well-being in both men and women. We discuss how to improve hormones using behavioral, nutritional, and exercise-based tools and safely and rationally approach supplementation and hormone therapies. We discuss testosterone and estrogen and how those hormones relate to fertility, mood, aging, relationships, disease pathologies, thyroid hormone, growth hormone, prolactin, dopamine and peptides that impact physical and mental health and vitality across the lifespan. The episode is rich with scientific mechanisms and tools for people to consider. Thank you to our sponsors Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman ROKA: https://roka.com - use code "huberman" See Andrew Huberman Live: The Brain Body Contract Tuesday, May 17th: Seattle, WA Wednesday, May 18th: Portland, OR https://hubermanlab.com/tour Our Patreon page https://www.patreon.com/andrewhuberman Supplements from Thorne https://www.thorne.com/u/huberman For the full show notes, visit hubermanlab.com. Timestamps (00:00:00) Dr. Kyle Gillett, MD, Hormone Optimization (00:03:10) The Brain-Body Contract (00:04:10) Thesis, InsideTracker, ROKA (00:08:24) Preventative Medicine & Hormone Health (00:14:17) The Six Pillars of Hormone Health Optimization (00:17:14) Diet for Hormone Health, Blood Testing (00:20:21) Exercise for Hormone Health (00:21:06) Caloric Restriction, Obesity & Testosterone (00:23:55) Intermittent Fasting, Growth Hormone (GH), IGF-1 (00:29:08) Sleep Quality & Hormones (00:35:03) Testosterone in Women (00:38:55) Dihydrotestosterone (DHT), Hair Loss (00:43:46) DHT in Men and Women, Turmeric/Curcumin, Creatine (00:50:10) 5-Alpha Reductase, Finasteride, Saw Palmetto (00:52:30) Hair loss, DHT, Creatine Monohydrate (00:55:07) Hair Regrowth, Male Pattern Baldness (00:58:12) Polycystic Ovary Syndrome (PCOS), Inositol, DIM (01:04:00) Oral Contraception, Perceived Attractiveness, Fertility (01:10:31) Testosterone & Marijuana or Alcohol (01:14:27) Sleep Supplement Frequency (01:15:34) Testosterone Supplementation & Prostate Cancer (01:20:24) Prostate Health, Dietary Fiber, Saw Palmetto, C-Reactive Protein (01:24:05) Prostate Health & Pelvic Floor, Viagra, Tadalafil (01:30:54) Testosterone Replacement Therapy (TRT) (01:35:17) Estrogen & Aromatase Inhibitors, Calcium D-Glucarate, DIM (01:39:28) Lifestyle Factors to Increase Testosterone/Estrogen Levels, Dietary Fats (01:45:34) Aromatase Supplements: Ecdysterone, Turkesterone (01:47:04) Tongkat Ali (Long Jack), Estrogen/Testosterone levels (01:52:25) Fadogia Agrestis, Luteinizing Hormone (LH), Frequency (01:56:44) Boron, Sex Hormone Binding Globulin (SHBG) (01:58:13) Human Chorionic Gonadotropin (hCG), Fertility (02:04:18) Prolactin & Dopamine, Pituitary Damage (02:08:34) Augmenting Dopamine Levels: Casein, Gluten, Vitamin E, Vitamin B6 (P5P) (02:12:30) L-Carnitine & Fertility, TMAO & Allicin (Garlic) (02:18:19) Blood Test Frequency (02:19:41) Long-Term Relationships & Effects on Hormones (02:25:33) Nesting Instincts: Prolactin, Childbirth & Relationships (02:29:05) Cold & Hot Exposure, Hormones & Fertility (02:32:34) Peptide Hormones: Insulin, Tesamorelin, Ghrelin (02:37:24) Growth Hormone-Releasing Peptides (GHRPs) (02:39:38) BPC-157 & Injury, Dosing Frequency (02:45:23) Uses for Melanotan (02:48:21) Spiritual Health Impact on Mental & Physical Health (02:54:18) Caffeine & Hormones (02:56:19) Neural Network Newsletter, Zero-Cost Support, YouTube Feedback, Spotify Review, Apple Reviews, Sponsors, Patreon, Thorne, Instagram, Twitter, Brain-Body Contract Title Card Photo Credit: Mike Blabac Disclaimer
My guest is Dr. Kyle Gillett, MD, a dual board-certified physician in family medicine and obesity medicine and an expert in optimizing hormone levels to improve overall health and well-being in both men and women. We discuss how to improve hormones using behavioral, nutritional, and exercise-based tools and safely and rationally approach supplementation and hormone therapies. We discuss testosterone and estrogen and how those hormones relate to fertility, mood, aging, relationships, disease pathologies, thyroid hormone, growth hormone, prolactin, dopamine and peptides that impact physical and mental health and vitality across the lifespan. The episode is rich with scientific mechanisms and tools for people to consider. Thank you to our sponsors Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman ROKA: https://roka.com - use code "huberman" See Andrew Huberman Live: The Brain Body Contract Tuesday, May 17th: Seattle, WA Wednesday, May 18th: Portland, OR https://hubermanlab.com/tour Our Patreon page https://www.patreon.com/andrewhuberman Supplements from Thorne https://www.thorne.com/u/huberman For the full show notes, visit hubermanlab.com. Timestamps (00:00:00) Dr. Kyle Gillett, MD, Hormone Optimization (00:03:10) The Brain-Body Contract (00:04:10) Thesis, InsideTracker, ROKA (00:08:24) Preventative Medicine & Hormone Health (00:14:17) The Six Pillars of Hormone Health Optimization (00:17:14) Diet for Hormone Health, Blood Testing (00:20:21) Exercise for Hormone Health (00:21:06) Caloric Restriction, Obesity & Testosterone (00:23:55) Intermittent Fasting, Growth Hormone (GH), IGF-1 (00:29:08) Sleep Quality & Hormones (00:35:03) Testosterone in Women (00:38:55) Dihydrotestosterone (DHT), Hair Loss (00:43:46) DHT in Men and Women, Turmeric/Curcumin, Creatine (00:50:10) 5-Alpha Reductase, Finasteride, Saw Palmetto (00:52:30) Hair loss, DHT, Creatine Monohydrate (00:55:07) Hair Regrowth, Male Pattern Baldness (00:58:12) Polycystic Ovary Syndrome (PCOS), Inositol, DIM (01:04:00) Oral Contraception, Perceived Attractiveness, Fertility (01:10:31) Testosterone & Marijuana or Alcohol (01:14:27) Sleep Supplement Frequency (01:15:34) Testosterone Supplementation & Prostate Cancer (01:20:24) Prostate Health, Dietary Fiber, Saw Palmetto, C-Reactive Protein (01:24:05) Prostate Health & Pelvic Floor, Viagra, Tadalafil (01:30:54) Testosterone Replacement Therapy (TRT) (01:35:17) Estrogen & Aromatase Inhibitors, Calcium D-Glucarate, DIM (01:39:28) Lifestyle Factors to Increase Testosterone/Estrogen Levels, Dietary Fats (01:45:34) Aromatase Supplements: Ecdysterone, Turkesterone (01:47:04) Tongkat Ali (Long Jack), Estrogen/Testosterone levels (01:52:25) Fadogia Agrestis, Luteinizing Hormone (LH), Frequency (01:56:44) Boron, Sex Hormone Binding Globulin (SHBG) (01:58:13) Human Chorionic Gonadotropin (hCG), Fertility (02:04:18) Prolactin & Dopamine, Pituitary Damage (02:08:34) Augmenting Dopamine Levels: Casein, Gluten, Vitamin E, Vitamin B6 (P5P) (02:12:30) L-Carnitine & Fertility, TMAO & Allicin (Garlic) (02:18:19) Blood Test Frequency (02:19:41) Long-Term Relationships & Effects on Hormones (02:25:33) Nesting Instincts: Prolactin, Childbirth & Relationships (02:29:05) Cold & Hot Exposure, Hormones & Fertility (02:32:34) Peptide Hormones: Insulin, Tesamorelin, Ghrelin (02:37:24) Growth Hormone-Releasing Peptides (GHRPs) (02:39:38) BPC-157 & Injury, Dosing Frequency (02:45:23) Uses for Melanotan (02:48:21) Spiritual Health Impact on Mental & Physical Health (02:54:18) Caffeine & Hormones (02:56:19) Neural Network Newsletter, Zero-Cost Support, YouTube Feedback, Spotify Review, Apple Reviews, Sponsors, Patreon, Thorne, Instagram, Twitter, Brain-Body Contract Title Card Photo Credit: Mike Blabac Disclaimer
It's FRIDAY and Mr. Worldwide is in the house. We're diving into updates and answering your questions live! Discussed in the episode: Sleepi Gummies: https://glnk.io/z2pl/jendelvaux15 To be the first to know when my book launches AND access my document on some of the changes Ive made you can get it here -> https://mailchi.mp/b609cecd4c0f/cancer Connect with me on Instagram: https://www.instagram.com/jendelvaux/ Email me coachjennyd@gmail.com GROUPS TO JOIN: * STRONGER TOGETHER - Cancer group for women you can request to join: https://www.facebook.com/groups/womeninpink * FIT TO FIGHT - Cancer group for those that want morivations for getting back on track with fitness and health: https://www.facebook.com/groups/nottodaycancerfittofight MY FAVORITES: MY favorite Luxury, organic, completely clean skincare line: http://www.kpsessentials.com/discount/Jen10 * Pique Tea: Favorite Tea-> https://www.piquetea.com/?rfsn=5818415.d1d969a&utm_source=affiliate * ORGANIFI CODE TO GET DISCOUNT: https://www.organifishop.com -> Use JEND at check out to save 15% off. * Mid-Day Sqaures!! 15% off here -> https://www.middaysquares.com/?sca_ref=858254.CbxPK42ccG * MENOPAUSE MIRACLE: https://pinklotus.com/elements/?r=401 * My FAVORITE journal where I write what Im grateful for!!! https://pushjournal.com/?rfsn=4086660.6edc3&utm_source=refersion&utm_medium=affiliate&utm_campaign=4086660.6edc3 * To access my document on some of the changes Ive made you can get it here -> https://mailchi.mp/b609cecd4c0f/cancer
Do aromatase inhibitors crush gains when using steroids?
Dr. Jeremy Braybrooke is a consultant medical oncologist and clinical lead for oncology at University Hospitals Bristol, as well as a senior clinical research fellow at the University of Oxford. Rosie Bradley is a medical statistician in the Clinical Trial Service Unit at the University of Oxford. At the 2021 San Antonio Breast Cancer Symposium, Rosie presented the results of their meta-analysis of four studies looking at effectiveness of aromatase inhibitors compared to tamoxifen in pre-menopausal women diagnosed with early-stage, hormone receptor-positive disease. Listen to the episode to hear them explain: the results of the study, showing that an aromatase inhibitor and ovarian suppression reduced recurrence risk more than tamoxifen, but didn't lead to better overall survival the side effects of aromatase inhibitors and tamoxifen how Dr. Braybrooke is advising his pre-menopausal patients diagnosed with early-stage, hormone receptor-positive disease
This is the last block of the hormone therapy drugs. We go through the Aromatase inhibitors, Gonadotropin releasing agonists, and Gonadotropin releasing hormone antagonists.
In this episode, I am talking to Karen Marszalec who was in the throes of moving from Michigan to Florida in America when we spoke. I am so grateful to her for taking time out of her hugely busy relocation schedule to share her story with me. Karen was diagnosed with Low Grade Serous Ovarian Cancer in 2015 following an abnormal PAP smear, which is very unusual to say the least. The cancer was found in her fallopian tube which is probably why the PAP smear picked up abnormal cells that had migrated. Karen tells me about her initial surgery and disease management including Hyperthermic intraperitoneal chemotherapy (HIPEC) when she experienced recurrent disease in 2020. Karen's healing process didn't exactly go to plan following her initial surgery and she tells how she had post-op complications which resulted in readmission to hospital. We chat about the side effects of the Aromatase Inhibitors because Karen now takes Arimidex as a maintenance treatment. Karen tells me how she coped and how she feels following the diagnosis and subsequent management. After all that she has been through, Karen and her Husband have seized the opportunity to move across country to warmer climes to help alleviate the constant joint pains from her medication. It was a pleasure to chat to Karen today and I wish her all the best for the move to Florida. Karen has asked me to share her email address for anyone who would like to be in touch about anything she has discussed in this episode because she would like to be a support to others. She can be contacted via marszak244@gmail.com During our conversation we mentioned Jane Ludeman, who set up Cure Our Ovarian Cancer. This is a charitable trust that fundraises globally for research to improve the survival of low-grade serous ovarian cancer. Jane is very knowledgeable about this rare sub-type of Ovarian Cancer and her website can be reached here: https://cureourovariancancer.org We mentioned STAAR (survive, thrive, advocate, advance research) which exists to raise critical funds for life-saving research for those with low-grade ovarian cancer. STAAR was co-founded in 2020 by three low-grade ovarian cancer thrivers Alex Feldt, Bailey Wolfe and Jess BeCraft. You can reach STAAR here: https://www.staaroc.org We also mentioned an international support group for people with Low Grade Serous Ovarian Cancer, which has been invaluable for Karen. I am one of the Administrators of the group. If you apply to join you need to confirm that you have Low Grade Serous Ovarian Cancer or have a loved one with this disease. You can find the group here: https://www.facebook.com/groups/1007723705963894 Thank you so much for listening to ‘Living with Ovarian Cancer'. If you want to get in touch with me or you would like to tell your own story on this Podcast about living with Ovarian Cancer, please email diane.evanswood@gmail.com You can find more information about me on my website by following this link: https://dianeevanswood.wordpress.com Disclaimer: Each story in this Podcast is unique to the woman who is telling it. The content of each episode and the views expressed are not meant to be a substitute for medical advice or intervention. You will hear stories of women who sought alternative therapies, integrated oncology services or even choosing to decline treatment options. If you have a diagnosis of Ovarian Cancer, please make sure that you discuss anything that is going to affect your treatment or wellbeing with your own Medical team.
In this episode we cover a broad range of topics including Nutrition, Gut Health, Diverse Diet Benefits, Aromatase Inhibitors for TRT, Alpha Male Mentality, Low and High Testosterone Levels, Participation Trophies, Meditation, Bad Genetics and the Wimhoff Meditation Technique! Check out Clips on our Youtube Channel! Social Media and Affiliate Links below!Test Your Levels Linkshttps://linktr.ee/testyourlevelsYoutube InstagramTikTok Sam Stolt's Linkshttp://bit.ly/sam-stolt-linksYoutubeInstagramTikTokTwitterDavid DeMesquita Linkshttps://taplink.cc/dynamite_dYoutubeInstagram
In this episode we're diving into Aromatase Inhibitors and Tamoxfin and how to combat the lovely side effects! As mentioned in the episode this is who has helped me with tapping. Her Instagram account is: https://www.instagram.com/designthoughtsstudio/?utm_medium=copy_link For those interested in becoming an integrative health practioner-> https://www.integrativehealthpractitioner.org/?x=JenD Let me know if you do decide to go for it. You can send an email to coachjennyd@gmail.com :) To join my breast cancer group: https://www.facebook.com/groups/womeninpink Connect with me on Instagram: https://www.instagram.com/jendelvaux/ If you need help starting your health/fitness journey reach out! You can email me at coachjennyd@gmail.com HEALTH FAVORITES: 1. Organifi - www.organifishop.com -> Use JEND at check out to save 15% off. 2. Shakeology (My favorite flavor is Plant based Chocolate) - https://www.teambeachbody.com/shop/b/shakeology?referringRepID=756017 3. My favorite bar out there! MidDay squares
Myths and Facts on Aromatase Inhibitors
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.15.340745v1?rss=1 Authors: Souza, S. A., Held, A., Lu, W., Drouhard, B., Avila, B., Leyva-Montes, R., Hu, M. G., Miller, B. R., Ng, H. L. Abstract: Aromatase (Cyp19) catalyzes the last biosynthetic step of estrogens in mammals and is a primary therapeutic target for postmenopausal women with hormone-related breast cancer. However, treatment with aromatase inhibitors is often associated with adverse effects and drug resistance. In this study, we used virtual screening to target a potential cytochrome P450 reductase binding site to discover four novel non-steroidal aromatase inhibitors. The inhibitors have potencies comparable to the noncompetitive tamoxifen metabolite, endoxifen. Our two most potent inhibitors, AR11 and AR13, exhibit mixed-type and competitive-type inhibition. The cytochrome P450 reductase binding site likely acts as a transient binding site. Modeling shows that our inhibitors actually bind better at various sites near the catalytic site. These structures may serve as chemical scaffolds to inhibit aromatase with different adverse effects profiles than clinically used aromatase inhibitors. Copy rights belong to original authors. Visit the link for more info
In this episode, we speak with Holly about Superior Gluteal Artery Perforator Flap surgery (aka, SGAP reconstruction). Often times we head into surgery and no always know what to expect. Holly reminds us to not only do our own research, but also ask your surgeons what the protocols are for complications. Additionally, Holly shares with us, her experience on Aromatase Inhibitors, her side effects, and managing osteopenia. The conversations shared in this episode dive deep into the quality of life we manage while also navigating and advocating for our health. Say Hi on Social:YouTube: https://www.youtube.com/SURVIVINGBREASTCANCERFacebook:https://www.facebook.com/SurvivingbreastcancerorgPinterest: https://www.pinterest.com/BreastCancerConversations/Twitter: https://twitter.com/SBC_org Instagram: https://www.instagram.com/survivingbreastcancerorg/_________________________Subscribe to our newsletter https://www.survivingbreastcancer.org/subscribe-1Donate to our cause https://tinyurl.com/yc9cgt4eAttend an event https://www.survivingbreastcancer.org/events
This week’s episode includes author Jeffrey Testani and Associate Editor Justin Grodin as they discuss empagliflozin heart failure, including diuretic and cardio-renal effects. TRANSCRIPT: Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Centre and Duke National University of Singapore. Dr Greg Hundley: And I'm Greg. I'm the director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr Carolyn Lam: Greg, the SGLT-2 inhibitors have really revolutionized heart failure treatment, but we still need to understand a bit better how they work. And today's feature paper is so important, talking about diuretic and cardio-renal effects of Empagliflozin. That's all I'm going to tell you though, because I want to talk about another paper in the issue very related. And it's from John McMurray from the University of Glasgow with insights from DAPA-HF. But maybe a question for you first. Have you ever wondered what to do about loop diuretics doses in patients with heart failure and whom you're thinking of initiating an SGLT-2 inhibitor, Greg? Dr Greg Hundley: Absolutely, Carolyn. That comes up all the time and how do you make that transition. Dr Carolyn Lam: Exactly. And so this paper is just so important, and Dr McMurray and his colleagues showed that in the DAPA-HF trial, the SGLT-2 inhibitor, dapagliflozin, first, just as a reminder, reduce the risk of worsening heart failure and death in patients with heart failure and reduced ejection fraction. And in the current paper, they examined the efficacy and tolerability that dapagliflozin falls in relation to background diuretic treatment and change in diuretic therapy, following randomization to dapagliflozin or placebo. They found that 84% of patients randomized were treated with a conventional diuretic, such as the loop or thiazides diuretic. The majority of patients did not change their diuretic dose throughout follow-up. And the mean diuretic dose did not differ between the dapagliflozin and placebo group after randomization. Although a decrease in diuretic dose was more frequent with dapagliflozin than with placebo, the between-group differences were small. So treatment with dapagliflozin is safe and effective regardless of diuretic dose or diuretic use. Dr Greg Hundley: Very nice, Carolyn. That's such a nice practical article. I really enjoyed your presentation of that. My next article comes from Professor Karlheinz Peter, and it's investigating the reduction of shear stress and how that might impact monocyte activation in patients that undergo TAVI. So this group hypothesized that the large shear forces exerted on circulating cells, particularly in the largest circulating cells, monocytes, while passing through stenotic aortic valves results in pro-inflammatory effects that could be resolved with TAVI. So to address this, the investigative team implemented functional essays, calcium imaging, RNA gene silencing and pharmacologic agonist and antagonist to identify the key mechanical- receptor mediating the shear stress sensitivity of the monocytes. In addition, they stained for monocytes in explanted, stenotic, aortic human valves. Dr Carolyn Lam: Lots of work done in a very translational study. So what did they find Greg? Dr Greg Hundley: They found monocyte accumulation at the aortic side of the leaflets in the explanted aortic valves. That was the human subject study. In addition, they demonstrated that high shear stress activates multiple monocyte functions and identify PZ1 as the main responsible mechanoreceptors representing, therefore, a potentially druggable target. So reducing the shear stress from a stenotic valve promotes an anti-inflammatory effect and, therefore, could serve as a novel therapeutic benefit of those undergoing TAVI procedures. Dr Carolyn Lam: Really nice, Greg. Thanks. We're going to switch tracks a bit, Greg. What do you remember about Noonan's syndrome? Dr Greg Hundley: Oh boy. Impactful, congenital disease for both the probands, as well as the family. Dr Carolyn Lam: That's truly beautifully put and you're right. Noonan syndrome is a multisystemic developmental disorder characterized by common clinically variable symptoms, such as typical facial dysmorphism, short stature, developmental delay, intellectual disability, as well as cardiac hypertrophy. Now the underlying mechanism is a gain of function of the RAs MAPK signaling pathway, kinase signaling pathway. However, our understanding of the pathophysiological alterations and mechanisms, especially of the associated cardiomyopathy, really remains limited. So today's paper contributes significantly to our understanding and is also notable for the methods that these authors use to uncover this novel potential therapeutic approaches. The paper is from Dr Cyganek and Wollnik as co-corresponding authors from the University Medical Center Göttingen in Germany. And they presented a family with two siblings, displaying an autosomal recessive form of Noonan syndrome with massive hypertrophic cardiomyopathy. As the clinically most prevalent symptom caused by allelic mutations within the leucine zipper like transcription regulator 1. They generated induced pluripotent STEM cell derived cardiomyocytes of the effected siblings and investigated the patient-specific cardiomyocytes on the molecular and functional level. Dr Greg Hundley: Carolyn, is such a thorough investigative initiative. So what did they find? Dr Carolyn Lam: They found that the patients induced, pluripotent STEM cell cardiomyocytes recapitulated the hypertrophic phenotype and uncovered, a so far not described, causal link between this leucine zipper like transcription regulator 1 dysfunction and ras map, kinase signaling hyperactivity, as well as, the hypertrophic gene response and cellular hypertrophy. Calcium channel blockade and MEK inhibition could prevent some of the disease characteristics providing a molecular underpinning for the clinical use of these drugs in patients with Noonan syndrome. In a proof of concept approach, they further explored a clinically translatable intronic CRISPR repair and demonstrated a rescue of the hypertrophic phenotype. Massive amount of work in a beautiful paper. Dr Greg Hundley: You bet, Carolyn, and boy giving hope to address some of that adverse phenotype in the heart. What an outstanding job. Dr Carolyn Lam: You're right, Greg. But now switching tracks a yet again. What do you know about ischemic preconditioning? Ischemic preconditioning refers to the process in which non-lethal ischemic stress of the heart prevents subsequent lethal ischemia reperfusion injury and provides important intrinsic protection against ischemia reperfusion injury of the heart, as well as other organs. So in this paper co-corresponding authors, Doctors, Zhang, Xiao and Cao from Peking University and colleagues provided multiple lines of evidence that a multifunctional TRIM family protein, the Mitsugumin-53 or MG53 is secreted from the heart in rodents in response to ischemic, preconditioning or oxidative stress. Now this secreted MG53 protected the heart against ischemia reperfusion injury. In the human heart, MG53 was expressed at a level about 1/10th of its skeletal muscle counterpart. And MG53 secretion was triggered by oxidative stress and human embryonic STEM cell derived cardiomyocytes, while deficiency exacerbated oxidative injury in these cells. Dr Greg Hundley: Very nice, Caroline. Tell me the take home message. How do I incorporate this information, maybe even clinically? Dr Carolyn Lam: Well, these results really defines secreted MG53 as an essential factor, conveying ischemic preconditioning induced cardioprotection. Now, since systemic delivery of MG53 protein restored ischemic preconditioning mediated cardioprotection in deficient mice, recombinant human MG53 protein could perhaps, or potentially be developed, into a novel treatment for various diseases of the human heart in which indigenous MG53 may be low. Dr Greg Hundley: All right, Carolyn. I'm going to tell you about a couple of letters in the mailbag. First, there's a research letter from Richard Vander Heide regarding unexpected feathers in cardiac pathology in COVID-19. And then, there's a large exchange of letters between Dr Yuji MIura, Chuanli Ren and Laurent Azoulay regarding a prior publication, entitled "Aromatase Inhibitors and the Risk of Cardiovascular Outcomes in Women With Breast Cancer, A Population-Based Cohort Study." And then finally, Carolyn, there's another research letter from professor, Nilesh Samani, entitled "Genetic Associations with Plasma ACE2 Concentration: Potential Relevance to COVID-19 Risk." Dr Carolyn Lam: Wow, interesting. There's also an "On My Mind" paper by Dr Kimura on "contextual imaging, a requisite concept for the emergence of point-of-care ultrasound." There's an ECG challenge, by Dr Dewland, with a case of an intermittent -wide QRS complexes. There's a cardiovascular case series presentation by Dr Nijjar on "a solitary left ventricular septal mass and amaurosis fugax." Dr Greg Hundley: That's great, Carolyn. How about we move on to the feature discussion. Dr Carolyn Lam: Let's do that. Dr Greg Hundley: Well listeners, we are here to discuss again, another important paper related to SGLT-2 inhibition. And we have with us, Dr Jeff Testani from Yale New Haven and our own associate editor, Dr Justin Grodin from University of Texas Southwestern Medical Center. Welcome gentlemen. Jeff let's start with you. Can you describe for us some of the background behind this study, and then also the hypothesis that you wanted to address? Dr Jeffrey Testani: Our lab is very interested in understanding volume overload and heart failure, why does the kidney retain sodium and why it stops responding to loop diuretics. Several years ago, when the SGLT-2 first came out, we saw them as a diuretic with the side effect of glucosuria. Back when they were still being thought of as primarily diabetes medications. But as the story unfolded and we saw that the SGLT-2 seemed to be doing something much more than just control blood glucose in diabetics and was demonstrating, particularly, a pronounced effect on heart failure outcomes, we got very interested in, better understanding this. We know that loop diuretics, they're really a double-edged sword. Loop diuretics are our mainstay of therapy to relieve congestion and heart failure patients, but they do so at the expense of quite a bit of toxicity. And we know that the loop diuretics directly cause neuronal activation, elaboration of rennin, norepinephrine, etc. through their effects directly on the kidney. In addition to causing normal moral activation through the volume depletion they cause. And as we all know, blocking the neurohormonal activation is one of the primary therapies we use in heart failure. So even though it helps our patients keep the fluid off, it does that at an expense of potentially some very negative effects. The interesting thing with the SGLT-2 inhibitors is, we've seen that in the diabetic populations, that they seem to actually improve volume status in diabetics, more so than one would really expect by the week diuretics that they are. And by and large, they were doing that without a pronounced activation of the neurohormonal system. So this led us to the conclusion that we really need to rigorously study this in heart theory and see what exactly are these effects of diuretics volume status and how much negative impact will any of those effects bring towards normal activation, kidney dysfunction, etc. Dr Greg Hundley: Very clever, Jeff. How did you go about addressing this question? What was your study design and what was your study population? Who did you enroll? Dr Jeffrey Testani: We wanted to have a pretty clean mechanistic study here. We weren't looking at ethnicity. We were really trying to understand a mechanism here and what are these agents doing to sodium handling in the kidney, etc. We enrolled diabetic patients that were stable. Per their advanced heart failure position, they were at added at a stable volume status. They hadn't had recent changes in medications diuretics, and we use the crossover design where we brought the patient in for about an eight-hour rigorous GCRT type study where we administered empagliflozin in 10 milligrams and then did some pretty rigorous characterization of them. As far as body fluids spaces, renal function, normal activation, your sodium excretion. Then they would continue that therapy for two weeks, come in for a terminal visit, that was a very similar protocol. Then we'd wash them out for two weeks and cross them over to the alternative therapy. And they were randomized whether they had placebo or epilobium first in order. Dr Greg Hundley: Very good. So a crossover design. And what were your study results, Jeff? Dr Jeffrey Testani: We were quite interested in the overall effects and it was actually quite surprising. We know the loop diuretic resistance is common and when physicians and patients are not responding well enough, oftentimes we add thiazides. And thiazides waste potassium. They waste magnesium. They increase uric acid. They usually cause renal dysfunction and significant normal activation. That was the default hypothesis that we would see that. And to the contrary, we pretty much saw the opposite of what a thiazide did. We saw a modest, but clinically significant natriuresis. So as a monotherapy, these drugs are quite weak. Although we saw a doubling of a baseline level of sodium excretion, that's sort of a clinically irrelevant amount as an acute diarrheic. However, when we added the eplerenone to a loop diuretic, we got a 30, 40% increase in sodium excretion. And just to benchmark that, if you look at the dose trial where they compared low dose to high dose Lasix, which were one X versus two and a half X, their home loop diuretic, they got a similar increase in sodium excretion. So even though 30, 40% increase in sodium excretion doesn't sound like a lot, it's all of our normal interventions. It's actually a pretty significant increase. We found that happened acutely. And to our surprise, that natriuretic effect had not completely gone away by two weeks. So the patient was still in a negative sodium balance at the two-week time point. And they actually had a reduction in their blood volume, in their total body water, in their weight, as a result of that kind of slow persistent, natriuresis that had happened over those two weeks. We were unable to detect any signs of normal MAL activation with this. There was actually a statistically significant better change in norepinephrine during the dapagliflozin period versus placebo. And there's some evidence that, that might be an actual finding of saccharolytic effect of these drugs. As in many of the other trials we've seen no, despite a reduction of blood pressure and probably volume status, heart rate stays the same or even goes down. And we saw an improvement in uric acid. We saw no additional potassium wasting. We saw an improvement in serum magnesium levels. So really kind of like I started this way is the opposite, in many ways of what we see, side effect wise, with the diuretic is what we saw with addition of an SGLT-2 inhibitor. Dr Greg Hundley: Listeners, we're going to turn now to Dr Justin Grodin, who's one of our associate editors and is also an editorialist for this paper. And Justin, we've heard some really exciting results here. The addition of a dapagliflozin to a loop diuretic enhancing the neurohormonal access and receiving some unexpected benefits on the electrolyte portfolio. Can you tell us a little bit about how you put this work in the context of everything else that we have been reading about this exciting new class of drug therapy? Dr Justin Grodin: This certainly is exciting because with the release of the DAPA-HF clinical trial, just about a year ago, we've really come to recognize that there really are substantial, long-term beneficial effects with SGLT-2 inhibition in patients with heart failure, and as Jeff alluded to, a lot of these effects, we saw that they were beneficial in individuals that are high risk or who already had heart disease and diabetes. And we weren't sure if that was going to translate to individuals with heart failure. We really saw beneficial effects in both, individuals with heart failure, with or without diabetes. So this is an interesting paradigm because, although we saw dramatic effects in long-term survival quality of life, the mechanism was actually somewhat murky. And a lot of this was transitive based on prior works. We obviously had a strong hypothesis that they would work through reducing incident heart failure and diabetics, but then we were left questioning what is the mechanism? And I think Jeff highlighted it quite well. There was the early thought that this was perhaps just a weak diuretic and that it was additive, and these patients were just getting long-term natiurer recess. And then others thought that there might've been, perhaps, some positive influence by some very low level, blood pressure reduction with these therapies. So in that sense, I think Jeff's paper really is put in context and when we reviewed it, we thought it was quite fascinating because I think as Jeff showed in his paper quite elegantly and actually in a very, very careful study, which the reviewers and your editorial staff appreciated, we really saw that there was a probably more robust response to natriuresis than we had anticipated. And importantly, this was independent of glycosuria, which is a very important observation. And if I might take a 10,000-foot view of at least this therapy and how we might think about it as an incremental therapy in heart failure, it's really doing something else. So we thought that with SGLT-2 inhibition, you get a little sodium and a little natriuresis, maybe perhaps a little bit extra, as it complexes with glucose. I think if you look at what the potential physiology would be with this therapy is that it's doing far more than that. And I think Jeff's study at least supports some of the speculation. And again, I'm going to perhaps look beyond SGLP-2 inhibitor, and then more so focus on the physiology of the proximal convoluted tubule. And given the location of the blockade, this is really priming the kidney, or at least Jeff's manuscript, and Jeff's analysis, supports the hypothesis that SGLT-2 inhibitors influence the proximal tubule environment, such that the kidney is ready to reset in natriuresis. And I think Jeff's data it at. least supports that because if we look at the proximal tubule physiology, there's really a lot more going on, then SGLT-2 inhibition. There are other receptors that it can influence that might also promote natriuresis. It can also promote increased distal sodium delivery to other areas of the nephron. And in essence, this almost, and in Jeff has put it this way before, which I totally agree. This gives the opportunity for the kidney to taste the salt, as opposed to the more common state that we have in somebody with heart failure and congestion, where, and I talk about this on rounds all the time, the kidney's response to a failing heart is to retain salt and water. So this kidney is in this perpetual state of dehydration. And I think the idea that Jeff's analysis is at least supporting, is that somehow, we were influencing the physiology in the proximal convoluted tubule, we are actually priming the kidney and readying it. We're almost hitting reset, where the kidneys may lose this physiology, thinking that the body is dehydrated and in essence, really readying it to assist with decongestion. Dr Greg Hundley: I love the way you explained that. It's almost as if I'm on ward rounds with you that just knocks home a lot of the message here, and the importance of Jeff's work. Understanding the physiology of the proximal tubule and then readying the kidney, instead of moving into a mode of retaining salt and water, actually allowing that to flow and facilitating a diaresis. I'll start with you, Jeff, and then come back to Justin. You might have unlocked a really special key here. What do you see as the next steps in research in this particular field? Dr Jeffrey Testani: I think Justin really, really captured the essence of what excites us so much about this is, most diuretics are a brute force sort of approach to getting salt out of the body. They are a stick, not a carrot and SGLT-2 inhibitors, when you look at them as how they would work as a brute force diarrheic, they are really wimpy and there is every opportunity for the kidney to defeat the of a SGLT-2 inhibitor, if it wanted to buy where they work and what they block. But the reality is, is that they really seem to be the carrot almost. if you think of resetting the sodium set point of the kidney, kind of quenching some of that salt first or sodium humidity that Justin was referring to. And the thing that's really interesting is when we look at trials like DAPA-HF. So despite the fact that they do seem to have this natural effect in blood pressure lowering effect and these different effects, they don't tend to cause hypertension, over diaresis, it's a much more of a natural, where the kidneys regulatory mechanisms are still operative. we have this duality of not causing over diaresis but causing diaresis. So it's really when the body needs to get rid of salt, it helps it do that. And so I think the next steps, at least for our research program is, we want to understand taking these drugs out of the context of stable, relatively euvolemic chronic heart failure patients. And when we put them into the acute setting of actual volume overload, do we see more robust diathesis and that natriuresis in that setting. The second thing is we want to dig into what is the internal mechanisms that are allowing the kidney to do these things. How is it that it's able to dump out salt when it's beneficial, but not leaked over to uresis. Since we're digging into those mechanisms, I think will give us some additional insight into this class. Dr Greg Hundley: Justin. Dr Justin Grodin: I think Jeff really encapsulated, or at least certainly highlighted some very important points, that are largely in parallel with where I foresee this. Because really, if you look at just study, a lot of these patients were quite stable. So the questions that come along are whether or not that this synergistic effect number one, is sustained long-term. Because there are some data, at least in diabetic individuals, that this might not be the case. So Jeff's paper elegantly highlights the influence of these therapies in two weeks. Now, whether that's sustained is certainly unclear. I think the logical next step is, "Okay. We show that we have a therapy that might prime the kidney for increased natriuresis" what are its effects and individuals that might need the natriuresis even more. So as Jeff highlighted individuals with more decompensated heart failure, that are more congested and more hypervolemic. And then obviously individuals that might be quite diarrheic resistant. This is something that I think Jeff and I have given talks on. And Jeff is clearly one of the world's experts in this space, but it's obviously a very attractive possibility that this might influence individuals whose kidneys are teased or trained into just holding onto sodium, no matter what. Or really no matter what therapies we give the kidney. I don't know if Jeff mentioned this, but at least in his analysis, they also showed through indicator dilution methods that there was a reduction in plasma volume in these individuals. And I think that's really important because we at least hypothesize that in many heart failure phenotypes, plasma volume is certainly a component of decompensation. So whether these kidneys have a more pleiotropic effect on the fluid balance from your status between the interstitium and the vascular space, long-term is really unknown. Dr Greg Hundley: I want to thank both Jeff and Justin. What an incredible, exciting discussion. And this paper, Jeff, were so thrilled to have the opportunity to publish it in circulation. And the clarity, helping us understand some of the mechanism of the efficacy of SGLT-2 inhibition. And then this unique combination of SGLT-2 with loop diuretics, potentiating, dieresis natriuresis without some of the harmful effects on serum electrolytes. And then I really appreciate both of you giving us an insight into the future where more work is needed to understand, is this a sustainable beyond two-week effect? And then, can these therapies, this combination, be helpful in those with decompensated heart failure. On behalf of Carolyn and myself, we wish you a great week and we look forward to catching you next week on the Run. This program is copyright, the American Heart Association 2020.
Conversion of Testosterone to Estradiol is a genetically regulated physiological function that is important to your wellbeing. Mess with is and all sorts of body organ symptoms are affected. Listen To This Podcast It May save your life. Scott Howell, Ph.D., is the research director and principal investigator of Tier 1 Center for Clinical Research https://tier1hw.com/ . He is a professor, epidemiologist, and exercise physiologist with research interests in the long-term safety of therapeutic androgen use, endocrine disrupting chemicals exposure, and preventative medicine. His primary expertise includes androgen metabolism, anabolic steroid abuse, pharmacogenetics, interpretation of clinical research, statistical analysis, and research methods. Dr. Howell is an author with expertise spanning many fields. His authorships include a recent sport science text, Integrated Periodization in Sports Training and Athletic Development, coauthored with Dr. Tudor Bompa, University of Toronto, and Dr. James Hoffmann, East Tennessee State University. He has also served as a subject matter expert coauthoring the Encyclopedia of Sports Speed for The National Association of Speed and Explosion. Dr. Howell has frequently published in notable peer-review journals including the American Journal of Physiology-Endocrinology and Metabolism, Karger Cardiology, Journal of Ethnopharmacology, Pharmacological Research, and the Yale Journal of Biology and Medicine. Dr. Howell has received numerous acknowledgments for his contributions to academic scholarship and clinical research. He received the American Military University Academic Scholar Award in 2016 and has taken part in two major National Institutes of Health (NIH) and Department of Defense (DoD) funded studies at Wake Forest University: Strength Training for Arthritis Trial (START) and The Runners and Injury Longitudinal Study (TRAILS). Dr. Howell holds a Ph.D. in Health Science-Epidemiology from Trident University, a Medical Degree from BMU School of Medicine, a Master of Science in Sport and Health Science from American Military University, a Bachelor of Science in Sport and Health Science from American Military University, and a Mechanical Engineering degree from Forsyth Technical College. Dr. Howell is a former Ph.D. faculty member of the Trident University Health Sciences program where he taught the most rigorous courses of the Ph.D. program. He served as a Dissertation
In Sept 2019, the USPTF revised and updated its 2013 recommendations on medications for risk reduction of primary breast cancer. Who qualifies for medical strategies? Which meds are recommended? In this session we will highlight the new USPSTF Guidelines, review the use of Prediction Models, and compare Tamoxifen, Raloxifene, and Aromatase Inhibitors.
Luke and Calum welcome fellow nerd and physique coach, Joe Jeffery, onto the podcast to cover all things related to aromatase inhibitor use in the world of physique enhancement. Joe is a wealth of knowledge on this front, and gives the research-backed lowdown on how this thoroughly misunderstood drug ought to be utilised with respect to harm prevention and physique optimisation. All the information in this podcast is intended for educational and entertainment purposes only and ought not be implemented under any circumstances without proper and legal medical supervision. Please make sure to consult your health care practitioner before implementing any of the areas discussed in this episode. The information presented here is not intended to diagnose, treat, cure or prevent any illnesses or diseases.
SHR # 2328 :: RLRx: Lab Test Explored plus Alternatives to Pharmaceutical Aromatase Inhibitors :: Adam Lamb - What tests should your physician be running for HRT? What about estrogen testing in men? Are there any ways to control aromatase naturally? And much more. ::
SHR # 2328 :: RLRx: Lab Test Explored plus Alternatives to Pharmaceutical Aromatase Inhibitors :: Adam Lamb - What tests should your physician be running for HRT? What about estrogen testing in men? Are there any ways to control aromatase naturally? And much more. ::
SHR # 2306 :: RLRx :: New Guidelines on Male Hypogonadism Put Men At Greater Risk plus There's No Place for Zealotry in Prescribing HRT :: Adam Lamb - A paper published in February 2019 suggests that men not be treated for late onset hypogonadism until their total testosterone levels is 250ng/dL . This is very worrisome. Many physicians don't even want to prescribe testosterone due to its unfair demonization attracting more scrutiny from various licensure boards. PLUS There is no place in medicine for zealotry. Estradiol and Aromatase Inhibitors are not inherently good or bad. If you see people drawing a line in the sand claiming Aromatase Inhibitors are only good or only bad, run. ::
SHR # 2306 :: RLRx :: New Guidelines on Male Hypogonadism Put Men At Greater Risk plus There's No Place for Zealotry in Prescribing HRT :: Adam Lamb - A paper published in February 2019 suggests that men not be treated for late onset hypogonadism until their total testosterone levels is 250ng/dL . This is very worrisome. Many physicians don't even want to prescribe testosterone due to its unfair demonization attracting more scrutiny from various licensure boards. PLUS There is no place in medicine for zealotry. Estradiol and Aromatase Inhibitors are not inherently good or bad. If you see people drawing a line in the sand claiming Aromatase Inhibitors are only good or only bad, run. ::
The Cochrane Gynaecology and Fertility Group has prepared more than 200 reviews and in May 2018, a team from Germany, The Netherlands and New Zealand updated one of these reviews, looking at the use of letrozole for subfertile women with anovulatory polycystic ovary syndrome. Lead author, Sebastian Franik from the University of Münster in Germany describes the latest findings in this podcast.
The Cochrane Gynaecology and Fertility Group has prepared more than 200 reviews and in May 2018, a team from Germany, The Netherlands and New Zealand updated one of these reviews, looking at the use of letrozole for subfertile women with anovulatory polycystic ovary syndrome. Lead author, Sebastian Franik from the University of Münster in Germany describes the latest findings in this podcast.
The Cochrane Gynaecology and Fertility Group has prepared more than 200 reviews and in May 2018, a team from Germany, The Netherlands and New Zealand updated one of these reviews, looking at the use of letrozole for subfertile women with anovulatory polycystic ovary syndrome. Lead author, Sebastian Franik from the University of Münster in Germany describes the latest findings in this podcast.
We spend very little time on male reproductive health, and a lot of men are in dire need of it. What are some of the factors that physicians should be tracking? How are the side effects of short term memory loss and anxiety on testosterone mitigated? What is the first thing that needs to be done in the case of a patient suffering from a metabolic emergency? On this episode, we are joined by author and physician, Dr. Rob Kominiarek to discuss insights in testosterone and health. You have to use Aromatase Inhibitors very strategically to solve issues. -Dr. Rob Kominiarek Takeaways Complications from fractures of the spine kill more people than heart attacks, strokes, and cancers combined. The doctors that put you on an Aromatase Inhibitor straight out of the gate don’t know what they’re doing. Insulin and growth hormone compete for the same receptors and insulin. At the start of the show we talked about why there’s no one-size fits all approach to optimization, and how to deal with patients who experience anxiety and panic attacks. Next, we talked about what so many doctors get wrong when it comes to Aromatase Inhibitors and why men need estrogen. We also discussed: How to get insulin levels in check with testosterone The importance of doing Dexa Scans Why almost every diabetic medication is a peptide There is no single recipe for testosterone optimization. An individualized approach has to be taken. That’s why it’s critical for a patient to get labs to determine what they need. Some physicians put patients on Aromatase Inhibitors right away, and this is a mistake. A lot of the side effects and problems we see on testosterone can be solved by adjusting dosage, not bringing AIs into the mix. Guest Bio- Dr. Rob is a bestselling author and physician with an expertise in Interventional Age Management Medicine and BioIdentical Hormone Optimization. Interventional Medicine focuses on optimizing your health and enhancing your quality of life while simultaneously reducing the risk of heart disease, stroke, diabetes, cancer, bone fractures, dementia, and other disorders of aging. Go to renewhealth.com or find him on LinkedIn https://www.linkedin.com/in/robertkominiarek/.
Cancer Care Podcast | Memorial Sloan Kettering Cancer Center
Runtime 07:30 Memorial Sloan Kettering experts discuss the importance of talking about sexual side effects from cancer treatment. read more
Prof Barrett-Lee talks to ecancertv to give some of his highlights from the 2013 San Antonio Breast Cancer Symposium (SABCS) on studies looking at oestrogen receptors, arthralgia caused (or not) by aromatase inhibitors, compliance, drug cost, exercise and mutational signatures in breast cancer.
In this podcast, we discuss some of the research on aromatase inhibitors, bisphosphonates, and HER2 targeted therapies for breast cancer presented at ASCO’s 2012 Annual Meeting. Cancer Research News
At the 8th European Breast Cancer Conference, Dr Neven talks about the challenges of treating patients who experience severe side effects from treatment. Patients may not adhere to the strict course of treatment because they believe that the side effects are doing damage; however, Dr Neven explains that the patient must be told specifically what each drug will do and that the side effects are temporary.
Discussion of the TEAM trial; tamoxifen and exemestane for early breast cancer.
Presented by Dr. Beverly Moy, MD, MPH