Anti-Aging Psychologist, Dr. Michael Brickey

Dr. Steven Joyal

Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Dr. Steven Joyal

Broadcast: 5-3-08 on webtalkradio.net

after 5-11-08 availabe at: Cardiovascular Disease

Lower you cholesterol is the mantra we hear from our doctors and the media. Not so fast says the Life Extension Foundation. They cite 14 factors that contribute to cardiovascular disease. Problems in several of these 14 areas are easily corrected with vitamins or other supplements. The Life Extension Foundation also suggests that statin medications are overemphasized and overused. I’m a big fan of the Life Extension Foundation. They think independently, their magazine, Life Extension, does an excellent job of describing their research and analyzing research, and their recommendations are often ten years ahead of mainstream medicine.

 

Our guest is Dr. Steven Joyal, Vice President of Scientific Affairs and Medical Development of the Life Extension Foundation. In the first part of the show, we will focus on what causes heart disease and arteriosclerosis and how cholesterol is just one piece of the puzzle. In the second part of the show, we will focus on practical things you can do to improve your cardiovascular health and blood tests you need to insist on getting.

 

Anti-Aging Psychologist, Dr. Michael BrickeyDr. Sharon Moalem

Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Dr. Sharon Moalem

Broadcast: 4-21-08 on webtalkradio.net

after 5-1-08 availabe at: What’s Good about Disease

Most of us view disease as bad. We get sick and protest how unfair it is or see the disease as an enemy we need to nuke with pills, lasers, or a surgical strike. Dr. Sharon Moalem views disease as history lesson in how our ancestors adapted to survive plagues and climate changes. He believes these history lessons can help us be healthier. Dr. Moalem has a doctorate in physiology and the emerging fields of neurogenetics and evolutionary medicine. He is also completing his medical school training at Mt. Siani hospital in New Work City. He is author of the New York Times Best Selling book: Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease. In the first part of the show we will focus on how diseases help us adapt. In the second part of the show we’ll focus on how these insights can help us stay healthier and live longer.

Anti-Aging Psychologist, Dr. Michael BrickeyDr. Christiane Northrup

  

  

  

  

  

  

  

Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Dr. Christiane Northrup

Broadcast: 3-1-08 on webtalkradio.net where the latest shows are broadcast and posted as podcasts

Dr. Christiane Northrup is one of America’s most trusted medical advisors. She sees menopause as a life affirming –if a woman listens to her body and the wisdom it offers. She is an OBGYN physician who takes a holistic, mind-body-spirit approach to menopause, PMS, and women’s health. Dr. Northrup founded the trailblazing Women to Women health care center. She is author of The Wisdom of Menopause and Women’s Bodies, Women’s Wisdom. She has appeared on Oprah, The View, Good Morning America, Rachel Ray, and hosted six PBS specials. Her website is http://www.drnorthrup.com/

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.

First a caveat: Men, if you think today’s show is only for women, think again. The more you understand about menopause and women’s health, the better your relationships will be with the women in your life. And women, you might want to encourage your husbands or boyfriends to listen to the program, as well, because our guest today, Dr. Christiane Northrup, is one of America’s most trusted medical advisors. She has a very unique take on menopause as life-affirming, that is, if a woman listens to her body and the wisdom it offers. She is an OB/GYN physician who takes a holistic, mind-body-spirit approach to menopause, PMS, and women’s health.

Dr. Northrup founded the trailblazing Women to Women Health Care Center. She is the author of two books, The Wisdom of Menopause and Women’s Bodies, Women’s Wisdom. She’s appeared on Oprah, The View, Good Morning America, Rachael Ray, and hosted six PBS specials. In the first part of the program I want to emphasize Dr. Northrup’s unique holistic approach to menopause, and then in the second we’ll look at more specific things about problems such as PMS symptoms and health problems. Dr. Northrup, when I started reading your book, The Wisdom of Menopause, I was expecting a rather dry tome or manual, and I was delighted and just got sucked into the gripping drama of “What happens to her next?” and “What happens to this patient?” Have you always been so tuned in to listening to your body and intuition, or was this a revelation in your life?

CN: No, I started out that way. My Dad was what we would call today a holistic dentist, and he used to say that the mouth was the center of the personality, and that’s why people didn’t want you messing around in there, and also why dentists had the second highest suicide rate, second to psychiatrists.

MB: Oh my goodness.

CN: So there was a bit of mind-body integration going on in my childhood. And then when I got to medical school, I was completely enthralled with everything that modern medicine could do. And it wasn’t really until I got finished with my residency and met my cousin at a macrobiotic restaurant and she told me she was healing her fibroid tumors with a macrobiotic diet. Now, I had just finished a four-year surgical residency and my approach was surgery, so-

MB: Two different worlds.

CN: I began to meet with Michio Kushi of the macrobiotic community – he brought that to the United States back in the ‘50s – and I sat with him as he went over the diet and also the lifestyle of patients who had been given up on by standard medicine. And sitting there for months, looking at the medical records of people and seeing that they’d already been through everything I was trained to offer was a revelation, as I found many of them get better. And after that, I realized there was also a limitation to diet. And ultimately, when people understood the unity of their mind, their body, their emotions, particularly the influence of the subconscious, what they don’t know that they know, then you’ve got the keys to the ignition, your own ignition, and you can get somewhere. Otherwise, you’re at the whim of the culture which really believes that people are meant to disintegrate at the age of 50, that it’s all downhill from there, that your sex life goes away – all kinds of things that are simply beliefs and not grounded in fact or science at all.

MB: So you see menopause as a wake-up call. Can you tell us what you mean by that?

CN: Yes. It’s as though everything in your life converges to get your attention so that you will do what it takes to get healthy in the second half of your life, or you know, maybe – a friend of mine the other day, Gay Hendricks, said, “Why don’t we call it the second third of your life? Because maybe we can live to 150.” But what happens in a woman’s brain – and I know that this is happening in a man’s brain, as well, to some extent, is that as your ovaries are changing and not producing an egg every single month, you actually get an excess of estrogen relative to progesterone. Now, progesterone is a very calming hormone. It also increases heat and it’s very high during pregnancy, so women feel, usually, very calm during their pregnancies and unflappable. But when you don’t have as much progesterone and you have estrogen, that begins to work on certain areas of your brain, the amygdala and the basal forebrain, which is where old memories from childhood and so on are stored, and unfinished business from the past comes up. It’s as though the hormonal change uncovers things that have always been there. So in my experience, women at perimenopause, which is a six to thirteen year process, remember – menopause just means the final menstrual period – so perimenopause is when all the drama and the action takes place. You haven’t actually stopped your periods; you’ve just started the brain and body changes. So during that time, a woman may remember childhood abuse. She may have no tolerance for the kind of injustice that she’s put up with at her job or perhaps in her family. It may be as simple as saying, “I’m sick of being the one who always starts dinner. I’m surrounded by a houseful of teenagers, all of whom can boil water. I’ve had it!” And what that is, is it’s labor pains of birthing your true self. And the thing that’s so wonderful about midlife is you’ve been out in the workforce usually, you know how to drive a car, you know how to run a bank account, you have enough ego strength, you have enough skills finally to have created a container where your true self can finally thrive. You’re not proving to the world that you can do it. It’s not like being in school – although many women go back to school at this time and enjoy it more than they ever did. So I call it break down to break through. There is no question that the incidence of chronic degenerative diseases increases in the second half of life. This is not inevitable. It has to do with lifestyle choices. And what I believe happens is that, at this turning point, the body will not let you get away with the stuff you’ve been doing for the past 50 years that wasn’t a good idea in the first place.

MB: Before we elaborate on that, it’s only in the last couple of years I’ve heard much about estrogen dominance. How did we end up with this impression that everything was just a lack of estrogen?

CN: No kidding! Yeah, how did we? Well, you know, we could do a brief romp through the history of Premarin. Premarin was the first oral estrogen that was available and made from the urine of pregnant horses, back in 1949, 1950. Before that, estrogen was available only as an injectible. Now, when you have your ovaries removed with a hysterectomy, then you have the rug pulled out from under you in terms of estrogen, progesterone, and testosterone. And so clearly, we have needed a supplement to replace a woman’s missing hormones. And so we thought of the menopause actually, culturally, as a deficiency disease, you see – doctors were thinking about it as you were lacking something. And the truth is that you’re not lacking anything when the body is healthy, when the adrenals are healthy and the ovaries are healthy. But remember, one in three women has a hysterectomy in this country, and so she’s changed the blood supply to her ovaries. And in those women, clearly estrogen, which is considered the most important hormone, but progesterone is left out in the cold and testosterone has gotten short shrift, as well. So it’s all such an interesting thing because science takes place within the context of a culture, and so we look for what we expect to find. If we’re looking at menopause as a deficiency disease and if we have managed to create a pill from the urine of pregnant horses, then if the only tool you have is a hammer, everything looks like a nail.

MB: And we got to pregnant horses so that we could have a patentable medicine that would profitable, as opposed to a generic that wouldn’t earn much money.

CN: Exactly. That’s the whole thing about the term “bioidentical” hormones. Bioidentical simply means hormones that match exactly what your body produces, and those can be made from wild Mexican yams or soybeans, and that gives you the basic hormonal moiety, and then you make changes in the lab, but you end up with a hormone that matches the molecular structure of your own hormones. And if you know the way hormones work in the body, it’s a lock and key, but it’s more than that, because the charges around the molecule of a hormone, the positive and negative charges, cause it to fold in a unique three-dimensional structure that your body recognizes because it has evolved over millions of years to recognize, for instance, 17-beta estradiol. It hasn’t evolved over millions of years to recognize the urine of a pregnant horse. But as you say-

MB: See, as you said, our bodies are smart.

CN: Yeah, and those things are not patentable. The delivery system, however, can be patentable, and that’s why we have some very good choices with the patches, the transdermal patches, Climara, Estraderm. Those are bioidentical hormones that match what is in your body. But it is the delivery system that the pharmaceutical company was able to patent, and therefore they can make money on them.

MB: You see menopause as a gift and a metaphor. What do you mean by that?

CN: The gift of menopause is that you are now your own person and you must source your life from your own spirit, your own higher power, who you really are uniquely. So I often say to women, “Remember what you liked at 11, when you were 11, before your hormones started in.” And the gift is you live from the inside out, instead of the outside in. What happens is women then, because they are operating from who they really are, not from who the world expects them to be, they often find themselves doing the best art they’ve ever done, having the best sex of their lives, being healthier than they’ve ever been, being happier than they’ve ever been. This is the big secret, that life gets better in your 50s and 60s. And this is a secret because our culture believes just the opposite. We are such a youth-focused culture that people who hit 30 suddenly begin to think something is wrong. Can you imagine anything that’s more death-affirming than that, that at 30 it’s all over? This is simply insane. And it creates a great deal of pain and suffering that is needless, because the truth is you’re really at your best starting at about 50. And I think that maybe 65 is when we hit our stride in a big way.

MB: And there’s wonderful research that shows as we get older, a higher and higher proportion of Americans say they’re very happy, and it goes from 28% in your 20s all the way up to 38% in your 70s.

CN: Isn’t that wonderful?

MB: You talk a lot about women being in a subservient role. Do you think there’s something about puberty that brings that on, at a hormonal level?

CN: I do. I absolutely do. I believe that what it is, is that females are the bodies in which new life is formed. And in order to nurture new life successfully, you need support. And therefore you will do whatever it takes to get that support. We are mammals, after all. And so I believe that the women’s movement had to happen, where women said, “Wait a minute. I’m not going to be subservient anymore. I can do this on my own.” So then what we’ve had, what the Baby Boomers have been the pioneers in, is women going out and having sperm donors, or just deciding to have a baby on their own. As you know, in the ‘50s, you would’ve been so ostracized. You couldn’t have done that and stayed healthy, given that we all need community and we need support and social support to stay healthy. So we’ve changed all the rules. The Baby Boom generation has changed all the rules. Now we’re at a point where we can have true partnerships with men, because when you understand your own strengths and you understand yourself as a woman, as the source of life itself, when you see how important that is to the planet and you begin to own your own gifts, you also understand – and this is really new information for me and my daughters in about the past three years, in a way that we live it – you understand that it is this life force that you know how to support, that you actually support men with. Men don’t do well without the support of either their inner feminine or a woman in their life. We know that from psychology studies. The men who are the happiest and healthiest are the ones who have women in their lives. And when you know this as a woman and you don’t see him as more than, you see yourself as equals, but you have specific gifts, and when you can uplift a man and reflect to him his heroic status, when it’s warranted, then you can improve all of life on earth. It has taken me so long to get it that men are much simpler than women. They don’t get complicated like women do. Haven’t you found this? I mean-

MB: Yes.

CN: Yeah.

MB: Very much so.

CN: You have no idea where women go in their minds. I mean, it is like some kind of a maze in there where we make things so complicated. We hold on to old baggage. A man will have forgotten that, whatever you’re bringing up – you know, the fact that he left you standing at the street corner and didn’t know you were going to be there. You’ll be hanging on to that ten years later and you’ll haul it out of your purse and land it on him when something like that happens again, and a guy is kind of defenseless because he doesn’t even remember. Men are in the moment, and when a woman understands that her mind is multi-modal and she can remember forward and backward in time, and she can remember the birthdays and the needs of her whole family, that’s a tremendous gift that we cannot expect men to share that gift with us. They have different gifts and talents. So the anger that comes up at midlife needs to be addressed, but then it needs to be released or you will have a very unhappy second half of your life if you continue with your anger at men in particular.

MB: As my wife says, “Well, it’s all connected!”

CN: Right. And you know, this is why, in medical school, on my boards and all the multiple choice tests, I could figure out a way in which every choice was correct at least once. That’s a woman’s brain. A guys says, “It’s obvious what the answer is.” To a woman, it is not obvious because it’s all connected.

MB: You describe women as wired for intuition. Are they more wired than men are?

CN: I believe that they are wired differently than men are. Men call it a hunch, and the way you see the intuition playing out in men – if I may be stereotypical – would be on the sports field, where they sort of intuitively know where the ball is going to be tossed. Or the great hockey player Wayne Gretzky was able to tell what someone was doing behind his back – and if that isn’t intuition, I don’t know what is, because the definition of intuition is knowing something with insufficient data. I believe that all of us are intuitive, but we are taught to shut that down as children. The energy medicine teacher, Donna Eden, points out that when you say to children – when you acknowledge an energy field around people and places and plants and so on and you acknowledge that it’s there, the child will not lose his or her ability to see energy around things. And in fact, she has many young people that she trained in Ashland, Oregon, who have always been able to see auras, for instance. And that’s part of intuition. Clearly when you walk into a room, your gut knows who’s safe and who isn’t, and we train that out of kids by saying things like, “Don’t talk to strangers.” That’s really a wrong thing to teach anybody, you know; “Just don’t talk to people who seem strange” would be better.

MB: You pointed out that women are more prone to depression until menopause, and then after menopause their rates of depression are equal to rates for men. Does menopause cause women to become more like men?

CN: You know, I think that it does, actually. There’s a role reversal that happens at midlife, sort of kicks in their vocational arousal, as it were. So they want to go out in the world and get it. Many want to start new businesses, and so on. And in fact, the inner part of the ovaries, the stroma, does get bigger, so many women produce more testosterone around the menopausal transition, physically. But metaphorically, there is this huge drive to go out and get something done. Many men have already been out there fighting in the workplace for years, and so many come to the home and want to get more into cooking or gardening. And what works beautifully in a relationship is when they can trade off a bit and start doing what the other has been doing. I believe that women develop their more masculine side and men develop their more feminine side. So for the first half of life, men lead with the low heart and women lead with the high heart – and the low heart, I mean the genitals and so on. But at midlife these things switch around because we really need to come to balance so that it isn’t one or the other. And depression is interesting because it’s often been called anger turned inward. And what happens with many midlife women – it certainly happened with me – is that the anger comes out and gets expressed and you find that it’s simply energy, it’s just jet fuel. Anger means that you have been shortchanged in some way or you feel that you have been, or things haven’t turned out the way you wanted them to. And so it’s your job to address how to change the circumstances of your life. And I’d much rather deal with a woman who is angry than a woman who is depressed, but there isn’t a question – the female brain is more prone to depression, and I think it’s related to the fact that we have the ability to remember every thing bad that ever happened to us.

MB: You talk a lot about accepting responsibility as opposed to being a victim. What do you mean by that?

CN: Yes, this is the most bracing message I have, and that is that you must be responsible for your life, which simply means the ability to respond. It doesn’t mean that you are to blame for what happened. It doesn’t mean that if you were raped as a child or beaten in a marriage or passed over in a job that that is right or just. It simply means you are responsible for your response. So I was recently at the Books For a Better Life Award, and a woman who wrote a book called The 51% Minority – she was a lawyer who was working in a law firm and had been there a long time, was a senior litigator, I believe. And she found that someone who was ten years her junior, who didn’t have half the workload, was earning more money than she was. So she took it to the authorities in the business, and I believe that her boss said, “I will match your salary with his, as long as you don’t tell anyone” – like, don’t let this get out. And she was so outraged by that, that she wrote a book simply to help women stand up for themselves in a way that is reasonable. I believe that there are ways in which you can use your energy that is life-affirming, and then there are ways that you can just run around screaming that, “It ain’t fair and ain’t it awful?” It doesn’t take any time at all to find injustices in the world when it comes to women. I like to say I have footnoted women’s pain; I understand it very, very well from the bone marrow on out. But we’re now at a time when, if anything is going to change, we need to step out of the victim role, because whenever you’re in the victim role – you know that classic triangle, I think it’s called the Rossberg triangle – there’s the victim and then there’s the rescuer and then there’s the persecutor. And usually what happens is the victim becomes the persecutor to someone else, and then someone else has to come in and rescue. And there’s no health in any of those roles, if you’re in those roles chronically. The only health is when you step above all of that and see that you have different choices. You can leave a workplace that is chronically wrong for you. That’s one of the beauties of midlife is you actually get to the point where physiologically you can’t put up with it anymore. You’ve compromised and you’ve compromised and you’ve changed yourself and you’ve done everything in your power to fit in, and it just isn’t working anymore. And finally you say, “Hey, maybe it’s time to do something else.”

MB: So it’s a question of doing something about the anger, doing something about the wrongs in your life. Are there other things involved in listening to your body?

CN: Yes, resting when you’re tired is kind of huge. The average woman is not getting even eight hours of sleep a night, and sleep is the best way to metabolize stress hormones that we know of. It will gobble up excess cortisol and epinephrine. And by the way, excess cortisol and epinephrine are the things that create cellular inflammation, and cellular inflammation is at the root cause of all chronic degenerative diseases – diabetes, high blood pressure, cancer, heart disease. So getting enough sleep is important, resting when you’re tired. The other thing you must do is you must tune in to know what you’re really, really feeling, and that means slowing down. And when I say slowing down, I mean in the moment you pay attention to your body. You make sure you’re breathing fully all the way down to the bottom of your lungs. You have to exercise. And all of these things – you begin to know that your body responds also to choices that are empowering, thoughts that are happy and uplifting, and so little by little you monitor your thoughts. You start your day, let’s say, with a meditation or simply with some breathing, and you see the difference it makes when you change a thought, and you see the difference it makes in your body. But I will say this about the body. If you have a condition that is bothering you, you must understand it did not leap out of the closet to torture you. It’s related to your life. And that’s one of the things I share throughout the book, The Wisdom of Menopause. My own story of a fibroid, a big fibroid in my uterus, creativity that hasn’t been birthed yet, or creative energy being shoved into a dead-end job or relationship. In my case, it was a marriage that wasn’t working. You won’t know what the message was, usually, until after the thing is over. But I would say to everybody, you could so benefit by understanding that everything that happens to your body is a metaphor for something that’s going on in your life. And then you will not feel like a victim of your body. If you want to use standard conventional medicine as an approach, go right ahead. But understand that simply cutting an organ out or taking a pill to squash symptoms is not going to get you to the promised land. Only taking full responsibility for what this might be and working consciously with your body, mind, and spirit – that’s what works.

MB: So we have dealing with the anger, we have taking care of yourself, and really just realigning with “What’s my sense of purpose?” and “What do I need to do with my life?” Let me take a break here. You’re listening to Ageless Lifestyles Radio on Webtalkradio.net. We’re talking with Dr. Christiane Northrup, author of two books, The Wisdom of Menopause, and Women’s Bodies, Women’s Wisdom. Her website, http://www.drnorthrup.com/ has information about women’s health, her books, her newsletter, and speaking engagements, many of which are open to the public. Information on anti-aging psychology and my free Defy Aging Newsletter is at DrBrickey.com. Dr. Northrup, I’d like to shift to some of the practical things that women can do. I hear a lot about eating more soy. Is that helpful or not helpful?

CN: It depends on the woman. Soy has sort of gone – the pendulum has swung, I think, too far with soy, so that women are eating only soy protein. I believe that soy is an important part of the diet, and particularly in those women who are not on hormone replacement or who are having problems with hot flashes, vaginal dryness, anything of that nature, then trying soy is very, very effective in many, and I’ve certainly had – I’ve had women come up to me in airports to say thank you so much, you know, for recommending certain soy products. But there are other women who find that they don’t do well on it. So what I would do is I would try some soy nuts, some soy milk. There’s a product called Revival Soy that is particularly potent for menopausal symptoms, and give it a try. I would also say it’s important to take enough Omega-3 fats. These are what’s found in fish oil. And in an analysis of 70 studies, it was found that fish oil decreases all cause mortality, and is more effective at keeping cholesterol and heart disease at bay than all of the statin drugs. So fish oil is very, very important. If you’re a vegetarian, then you can bet Omega-3 fat in flaxseed or also in algae. So there’s no excuse, is what I’m saying here. You also need to take enough Vitamin D. We find that those women who are most at risk for hip fracture or spinal fracture from osteoporosis are the ones who have the lowest serum levels of Vitamin D. This is the one blood test I believe that every woman should have – not only a lipid profile, you should find out what your total cholesterol is, what the good cholesterol is, the LDL, the so-called bad cholesterol, triglyceride level. Don’t let someone put you on statins simply because your cholesterol is above 200, if it’s in the 200-250, 230 range. If your HDL cholesterol is good and high, like 60 or so, then you do not need statin drugs. Statin drugs decrease coenzyme Q10 in the blood. This is an absolutely essential nutrient for energy production in the cell. And where you need energy production in the cell is in your heart, and the statins are being prescribed far too much. Vitamin D levels should be 50 or above. You can have your healthcare practitioner draw that level. And then you should be taking at least 1000 IUs of Vitamin D every day, or going to a tanning booth – I would recommend the stand-up booths with sunscreen on your face and your hands, and about six minutes will boost up Vitamin D very nicely. It also boosts your mood because it increases serotonin in the brain. Light is a nutrient. So those two things are important. Enough calcium and magnesium. We hear all about calcium; we never hear enough about magnesium. Magnesium and calcium have to balance each other. Women who are depressed often have low magnesium levels. Magnesium is what’s necessary for sparking the nerve – from nerve cell to nerve cell requires magnesium to make that connection, and it’s also very relaxing. A very good way to get magnesium is with an Epsom salt bath. One half to one cup of Epsom salt in the bath, soak in there for 30 minutes, read a good novel – that’s a good prescription for a good night’s sleep.

MB: Are these the same things that would help with hot flashes, or are there additional things that would help?

CN: Actually, those could help. Soy will definitely help with hot flashes in many women, not all. The gold standard for hot flashes is estrogen replacement – although if a woman has estrogen dominance, then progesterone is what will help with hot flashes. And you can use as little as one-quarter teaspoon of transdermal progesterone on your skin – and this is available over the counter at health food stores. One of the good brands is Progest or Emerita. And many women have been helped by that. Also, that can help with premenstrual migraines, because those are triggered by too much estrogen. Now, the other things you can do for hot flashes, you can change your diet and get rid of the white foods. So that would be white flour products, mashed potatoes, white sugar products; also wine and coffee can trigger hot flashes, but not in everybody. So what you do is you say, “Okay, let me give myself a one-week period of time where I stay away from these foods, particularly the wine, and see what happens.” And if you notice that your hot flashes are far less, then you know what triggers them. Then you can decide whether you’re going to have the wine and get a little hot or not. You know, it’s at your fingertips. The other thing that helps hot flashes, believe it or not, is meditation. And Herbert Benson at Harvard did studies showing a 90% reduction in hot flashes with two 20-minute periods of meditation per day, using what he called his relaxation response, which is where you simply sit and repeat a word in your mind like “peace” or “rose.” There are various mantras that you can do. And the reason that this works is that it decreases stress hormones. And stress hormones in the body actually change the way hormones are metabolized. So it all goes back to what we call stress. And my definition of stress is anything in your life that you don’t like the way it’s turning out, and so therefore you’re railing against it. That’s emotional stress. Of course, there’s physical stress of being too cold or too hot or too hungry, that sort of thing. But it goes back to a balanced lifestyle.

MB: One of women’s biggest concerns, and men’s biggest concerns, is about the effect on the sex life. What can a woman do to maintain a good sex life during menopause and after menopause?

CN: Well, this is about my favorite topic. I just written my fourth book on that and it’ll be out in October, called The Secret Pleasures of Menopause. It’s interesting that you can have pleasure or you can have anger, but you can’t have them at the same time. And I’ll tell you why this is so – it’s really key. Stress hormones like norepinephrine, adrenaline shut down not only blood supply, but they also shunt your nervous system in the direction of fight or flight, so you’re preparing for battle. Entirely different from what’s necessary to shunt the blood flow to the clitoris and to the genitals and to the breast and to the erogenous areas of the bodies. For that, you must be very relaxed and receptive to receiving pleasure. So what happens during the midlife transition is all of the stuff in a relationship that’s been shoved under the rug comes up and hits women between the eyes, and the first thing that goes is their sex life. Now, data from the OB/GYN literature shows that the number one predictor of a great sex life during the menopausal transition and beyond is a new partner.

MB: Uh-oh.

CN: Now, the reason I say that is not because I want women to dump their partners, I want them to become that new partner. This is really important. Many times men don’t know what’s going on, and it is the woman’s job to find out, maybe for the first time in her life, what pleases her, what does she really, really want? And I would say for your listeners, write down five to ten things that you really, really want, and then ask for them. Ask your mate to provide them. But you must do it in a way that is very fun and very flirtatious. Now, that’s what you do in a relationship. But many women, for a while there, for a year or two, feel the need to go into a cocoon and reinvent themselves. So I feel as though the sex juice, as it were, the libido, goes underground like the sap in a tree route in the winter. It doesn’t mean it’s gone. It will come back. It will rise again. But a woman sometimes needs a little time alone in a cave as a she reinvents herself. So that’s very important for a woman to know. Then let’s say that she has her time alone or she goes away to a spa or she somehow changes her job or does something. Then it is her job to learn what turns her on. And you actually can learn this and do it with self-pleasuring or what the Daoist masters call self-cultivation. Another word for that, which I don’t like, is masturbation. Women need to learn what their wiring diagram is, and this is work that you do with yourself, for yourself, because you cannot tell another person what you like if you don’t know yourself. And this is the other thing. At midlife, many women develop thyroid problems. Thyroid is in the fifth chakra. It’s about having your say. It’s saying what you need to say. And it’s time that you learned to ask for what you want. This is a huge risk for most women because they’re afraid of being rejected, and many of them are so surprised and delighted to find out that their mate has been waiting for instructions. See, this is what women think. Women are brought up to believe that if a man is a good guy, he will know – he should know what to do to please them. He will know what to get them for Valentine’s Day. He will know what to get them for their birthday. He should do this big romantic thing like you see in the movies. Well, men want to be romantic. They don’t know how to do it. It is a woman’s job to decide what she wants her mate to do for her, and then set the stage to help him meet her expectations. This goes back to women as the bodies that create life. She can help him do that for her. But if she simply clams up and is angry without saying what would please her, then it’s a stalemate. And if you’ve got 25 years of that going on in a relationship, it is little wonder that sex drive goes away.

MB: So the biggest key on sex life is really getting to know your body and your needs and effectively communicating that?

CN: That’s right. And also understanding that menopause per se does not decrease libido, ease of reaching orgasm, or desire for sex. It doesn’t. And I believe that that is a big cultural myth that many women are up against, because they believe this is the end, when in fact it’s just the beginning. You have the ability, through your attention and focus, and to rewire your body for more pleasure. But to do that, you need to work through your resistance to pleasure. And we all have a ceiling on our pleasure that we’ve usually learned in our families of origin. But I’m here to tell you that the way the body was designed, sex gets better. And that is in fact the latest research: The women having the best sex of their lives are in their 60s and 70s.

MB: And also contributing to that is you’re not worrying about the children knocking at the door or interrupting, or so exhausted from childrearing, and you have more time and less worry about pregnancy.

CN: That’s exactly right. Now, for many women, there is the lack of a partner. So I want to cover that for a moment. And for many – let’s say that they’ve gone through a divorce like myself, or are widowed, or simply don’t have a man, of if they’re a lesbian, a woman in their life. Your job, ladies, is to begin to become the person that you yourself would fall in love with. You can use this time to reinvent yourself and become the person that you yourself can fall in love with. I did that for seven years. I’m now with a wonderful man. But I had to go through all of the stuff that all women go through, thinking it’s over, they’re too old. All of that is simply cultural baggage. I also read a book that I would like to recommend to all of you called Mama Gena’s Owner’s and Operator’s Guide to Men. Let me repeat that: Mama Gena’s Owner’s and Operator’s Guide to Men. It’s by Regena Thomashauer. And she runs Mama Gena’s School of Womanly Arts in New York City. I read the book to see if she was crazy or not, and she turned out to be not crazy at all, and in fact helped hundreds of women reinvent themselves and also find far more happiness with themselves and with the men in their lives.

MB: Sounds like a fascinating book. One more question. You talk about how women, or probably men as well, attract the unhealed parts of ourselves, and that brings on a lot of chronic disease. Can you explain that?

CN: Well, I believe that in childhood we make certain decisions about ourselves – I’m too fat, I’m not good enough, I’m whatever. And then the parent that we had the most conflict with, we tend to marry or they become our boss or whatever. And I believe it’s because we’re trying to bring love to an area where we have not experienced love. And then we stay in that relationship until more love needs to be called in than that particular container will hold. And if you fail to leave that relationship or you can’t be in a state of love in that relationship, then you get sick. And-

MB: It’s that simple.

CN: It is that simple. I wish it were more complicated. And I’m not blaming anyone. But let’s look at heart disease. It’s the number one killer of women – and men, for that matter. And it outpaces breast cancer by, you know, about 40 to 1. I mean, it’s the one that – if you’re going to be worried about something, be worried about this, and then do something about it, because heart disease is reversible. But anything that your heart isn’t in will begin to take its toll on your heart. Any time you can’t have your say because whoever you’re with won’t hear it, your thyroid could be adversely affected. Any time you’re not nurturing yourself fully, your breasts will take a hit. It’s that simple.

MB: Dr. Northrup, it’s just so refreshing talking with you and getting this holistic view of menopause and women’s health. I really appreciate you being on the program.

CN: It’s been my pleasure.

MB: I like to wrap up shows with some baby steps to hopefully help you live longer, healthier, and happier. In one of my favorite jokes, a reporter asked a 104-year-old woman, “What’s the best thing about being 104?” And she said, “No peer pressure.” As we get older, this is one of the perks, that we become less and less concerned about peer pressure. And indeed, people in their 80s and 90s says, “I don’t have time for that nonsense!” I think Dr. Northrup was teaching us that if you have problems with peer pressure during menopause, you’ve got one big wakeup call saying it needs to be dealt with now, instead of when you’re 80 or 90. The second baby step principle I’d suggest is what I call the rule of thirds, that unless you’re extremely charismatic or a horrible, horrible curmudgeon, most people have a third of people liking them, a third of the people not liking them or not liking their style, and then a third of people not really caring one way or another. And the moral is to be the person that you really want to be, the person that you really are, so that the third of the people who like you, like you for the real you. You’re listening to Ageless Lifestyles Radio on Webtalkradio.net. We’re talking with Dr. Christiane Northrup, author of The Wisdom of Menopause, and Women’s Bodies, Women’s Wisdom. Her website, http://www.drnorthrup.com/ has information about women’s health, her books, her newsletter and speaking engagements. Information on anti-aging psychology and the Defy Aging Newsletter, which is free, is at DrBrickey.com. This is Dr. Michael Brickey with Ageless Lifestyles Radio on Webtalkradio.net. Thank you for listening on our quest to live longer, healthier, happier lives.
 

 

 

Anti-Aging Psychologist, Dr. Michael BrickeyDr. Nicole Flora

  

  

  

  

  

  

  

Host: Anti-Aging Psychologist Dr. Michael Brickey

Expert Guest: Dr. Nicole Flora, Anti-Aging Physician

Broadcast: 2-24-08 on webtalkradio.net where the latest shows are broadcast and posted as podcasts

Medicine has focused on treating diseases. What we call healthcare has mostly been disease care. Anti-aging medicine emerged in the last ten years or so to ask what can doctors do to be proactive in preventing aging and diseases. As a new discipline, it has attracted both very dedicated physicians and frankly a few hucksters. Today’s expert is clearly one of the best anti-aging physicians, Dr. Nicole Flora. Dr. Flora was Board Certified in family medicine, obtained a Master’s degree in Public Health, and later specialized in age management and anti-aging medicine. She has been active in research and is on several policy boards. In the first part of the program, we will focus on what anti-aging medicine is and what it has to offer. In the second part of the program, we look at the pros and cons of different anti-aging treatments. Her websites are www.CincinnatiAgeManagement.com and www.Cenegenics-DrFlora.com

TRANSCRIPT ©Michael Brickey–excerpts permitted with attribution

MB: This is Dr. Michael Brickey with Ageless Lifestyles Radio, cutting-edge thinking for being youthful at every age. On each program I interview experts on what it takes to live longer, healthier, and happier. Our program takes a holistic approach in addressing anti-aging psychology, medicine, alternative medicine, fitness, nutrition, and wellness. Our emphasis is on innovative thinking and practices that have solid data and results.
Medicine has focused on treating diseases. What we call healthcare has been mostly disease care. Anti-aging medicine has emerged in the last ten years or so to ask, what can doctors do to practice preventing aging and preventing diseases? As a new discipline, it’s attracted both dedicated physicians and, frankly, a few hucksters. Today’s expert is clearly one of the best anti-aging physicians, Dr. Nicole Flora. Dr. Flora was board-certified in family medicine, obtained a masters degree in public health, and later specialized in age management and weight management. She’s been active in research and on several policy boards. In the first part of the program, we’ll focus on what anti-aging medicine is and what it has to offer. In the second part of the program, we’ll look at the pros and cons of different anti-aging treatments. Dr. Flora, after years in medical school, what prompted you to get a masters degree in public health?NF: It was part of the career path that I had chosen. After I came out of medical school and residency, I joined a group that was providing indigent care in the southern part of the state, southern Ohio. And we really took care of about 57,000 patients that had no insurance and had no access to good healthcare. And so as part of that path, they pursued the public health arena and then took over a lot of the quality assurance and some of the government programs to help people that couldn’t get good care.MB: So working with indigent patients got you interested in chunking up to a higher level of, “How can we solve some of these problems on a policy level and get a better system?”

NF: Absolutely. We saw some of the epidemics of disease and some of the cultural ills that affected these people, and it really – while I wanted to certainly impact people’s lives on an individual basis, I felt like there needed to be a broader approach.

MB: And then what got you into age management and weight management?

NF: It was kind of an extension of that. You know, after seeing – unfortunately, in the poorer populations, obesity, diabetes, heart disease, poor nutrition and poor lifestyle choices are rampant. And that really was what I wanted to tackle. And in age management, that’s exactly what we approach are all of those things, and how do we prevent those things, and how do we get people to think proactively about their health and about their lives.

MB: So you were working with the other end of the extreme, people who are aging very fast?

NF: That’s right. I would have young people in their 30s – you know, the most extreme examples were the 10 or 11-year-olds that came in and they were already obese and had diabetes. I probably diagnosed 50 preteens with Type 2 diabetes because of poor lifestyle choices. And those kids were not going to live very long.

MB: Was there something specific that got you to go from public health to the age management, weight management?

NF: It had a little bit to do with the system. Unfortunately now, the way healthcare is structured, in order for it to be financially feasible, you have to see a huge number of patients. And I was averaging, on a lot of days, 40 patients a day. And it really became an ethical dilemma to me. I knew I could treat them well. I was treating them at the standard of care, but I knew they needed something better than that, and I wanted to be able to provide more than that. The system as it’s structured now just doesn’t allow for that. So it really kind of became an ethical dilemma – do I give them another pill and I expect to see them in about three months when they come in for the side effects from the pill I gave them last month. I just wanted to have greater contact with my patients and hopefully have a great impact long-term.

MB: So now are you working with kind of a cross-section of social classes and lifestyles?

NF: Well, unfortunately I’m not. Age management medicine, because it is relatively new and because insurances don’t cover it in most cases, right now my experience is relegated to those people that can afford to pay out of pocket, and that’s certainly fine for them but it does leave out a huge portion of the population right now.

MB: Personally, I don’t have any problem with that because it blazes the trail, and what’s the ideal standard of care now becomes the standard of care maybe ten years from now.

NF: Well, that’s absolutely right. And that’s certainly my hope, is that as we get better and better at this and as we hopefully do get rid of, as you said, some of the hucksters in the arena, that it will become standard of care and will be more acceptable to people. And that’s certainly my hope for the long term, and some of the things I do with the physician advisory board and things are to promote those type of things.

MB: And in the long run, it’s going to be cost effective by preventing a lot of health problems, and a lot of medications.

NF: Absolutely, certainly.

MB: If a 50, 60-year-old person comes into your practice, what do you do that’s different than if you were a mainstream family practitioner?

NF: First thing is that I get to know them. Instead of spending 15 minutes, and two or three of that is looking at their chart and seeing what the nurse wrote and having a brief conversation about what’s ailing them today, they’re in my office for their first visit usually between six and seven hours – between meeting with the nutritionist and meeting with any additional people in the office, and they’re usually face-to-face with me for two to three hours. And most people have never had that type of experience with a doctor. And you get to know what’s affecting them, what pressures they’re under, how they eat, how they exercise, what are their support systems, certainly what are their medical issues in the past, what really do we need to fix now and what are going to be hurdles in the future to keep them healthy. So it really is that close connection that is the biggest difference to start with. In the long run, it really is the fact that we work together so closely, maintain a very close relationship. I work with their other physicians, if they have specialists that they work with. It really is that quarterback mentality that I think primary care was originally supposed to tackle, and it ended up just being a paperwork job where you just do referrals for everybody. But it really is keeping the patients educated on everything that’s going on in their lives from a health standpoint.

MB: So right from the start it’s holistic and it’s about a relationship.

NF: Absolutely. And that’s what makes it most rewarding.

MB: I suspect some of your patients are shocked to have so much one-to-one time with the physician.

NF: Oh, that’s the first thing. They’re like, “Really? Are you serious? You need six hours of my time?”

MB: We’ve all spent six hours of our time going from one test to another, but to spend a couple of hours face-to-face with a physician is a real treat.

NF: That’s right. And instead of wasting your time, at least we’re getting educated and getting to know each other.

MB: So we’ve had this first session – then what?

NF: Well, certainly after that it varies, depending on the person and what their individual needs are, what their goals are, what we’re trying to fix and kind of what the short-term issues are, as well as long-term. But certainly, just a general overview is we want to get them eating better, we want to get them moving, we want to – if they need medications, and whatever they need. If they need specialists, if they need therapists, we’ll facilitate it.

MB: I gather that it’s not everybody needs to be at this level of hormones and this level of exercise and, you know, get with the program, but extremely individualized.

NF: Absolutely. And that’s one of the problems we’ve had with mainstream medicine is that we have over-generalized. And a lot of the things that you will see come down the pike as problems are because we took some research point that sounded good and tried to apply it across the entire population, and we abdicated the thought process, I think, in some cases. And so everybody’s very individualized. I do certainly have people on hormones. I certainly have people on blood pressure medicine. I have the whole gamut. But it really is very individualized to each person and their needs and their health and what’s the best combination for them.

MB: How many of your patients come to you and say, “Dr. Flora, can you get me some of that HGH? You know, is it legal? Is it going to make me a he-man?”

NF: Well, I have a small percentage that actually come and say that. I probably have a bigger percentage that think that in the back of their mind. Honestly, about 7 or 8% of my patients are on HGH, but a lot of people, that’s what they hear about and so that’s what they think it’s all about. And certainly HGH is a wonderful medication when used appropriately in appropriate patients with the right expectations. But unfortunately, there is a ton of misinformation regarding it. It is not the cure-all for everything. It won’t make you live forever. It won’t make you beautiful if you’re not beautiful to start with. But it has its place. And it’s a very safe medication and it is certainly appropriate in some people.

MB: So who are the 7% that benefit from it?

NF: The people I specifically prescribe it to are people who have developed a deficiency, so they have stopped producing it naturally – they have no levels. And those people are usually experiencing things like a lot of muscle loss, weakness, tiredness, and a lot of quality of life issues. Growth hormone really affects your ability to kind of appreciate life and mood. And those are the people that really end up benefiting from it the most, are the ones that have that combination. The other thing with human growth hormone is it rarely is a problem by itself. When I see human growth hormone has declined, it’s usually declined in combination with other hormones. And so a lot of times when we balance the other hormones, it will help you produce human growth hormone, and a lot of people will improve their human growth hormone that way, as well.

MB: So you rarely recommend using human growth hormone to enhance; you’re usually using it for people who have deficiencies?

NF: That’s right, yes. I do not.

MB: What about testosterone? I see all these charts about how men’s level of testosterone declines with age dramatically. Is that something that should be enhanced? Or again, are you just concerned about deficiencies relative to a person’s age?

NF: It does decline dramatically. And not only does it decline dramatically, if we look at population studies from as little as about 20 years ago, the average testosterone level of men in our society now is 17% less at any given age, and we’re not quite sure why that has occurred either.

MB: All these metro males, huh?

NF: Yeah, certainly I do recommend we replace it, and I do take men to an optimal level, not for their age.

MB: My understanding, one of the problems with replacing testosterone is that it often gets bound and can actually turn into estrogen and have the reverse effect. How do you control for that?

NF: That’s why if you’re going to deal with hormones, you need somebody that’s very well-educated on how to do it. I’ll see a lot of people come in and they’ve gotten testosterone from one source or another and it’s not being managed well. You have to – before you start that medication – you have to measure all of those things. It’ll give you a pretty good picture of how an individual man or woman will metabolize the hormone. It doesn’t always give you the whole picture, but it’ll give you a good starting point. And then you monitor those as your start therapy and continuously throughout. If men start putting out too much estrogen, then certainly we can sometimes change the route of administration of the testosterone, you can sometimes use prescription medications that block the conversion, and you can sometimes use herbal preparations to stop the conversion, as well.

MB: With women, they practically stop producing testosterone after menopause. Are you doing any testosterone supplements with them?

NF: I do. And honestly, my experience with women is I will see women drop their testosterone usually in their 30s. We always think that the hormone production stops at menopause, but truly, I will generally see women who drop their progesterone, drop their testosterone in the early 30s, up to 10 to 15 years before they actually stop producing enough estrogen to stop having cycles. I will even replace it in some women before menopause if we see that it has declined beyond a normal range.

MB: Top of your head – what percentage of women in our country would probably benefit from hormone replacement after age, say, 40?

NF: After 40? Well, if we say after menopause, I would certainly say a majority, but not – you know, it’s not 100%. There are still other risks to be considered. After 40, though, it really depends on where they’re at in the perimenopausal cycle. But I do see a lot of women in their 40s have a lot of PMS type symptoms, have a lot of weight gain around the middle, develop more fatigue, those type of things. And so – and those are the women that usually seek me out. So of the people coming through my door, it’s a huge percentage. It’s probably 90%. In the general population, I would probably guess at age 40 that it’s probably about half of the women.

MB: So is weight gain a red flag that something’s probably going wrong?

NF: Something is wrong when you start gaining weight. Unless you’re someone that walks through my door and tells me that, “I eat McDonald’s three times a day and I never exercise,” that’s generally not the case. Those people – certainly it’s a lifestyle issue, and everybody has lifestyle issues. But when we start seeing the kind of weight creep, I like to call it, where it’s just every year you’re adding a little bit and you’re adding a little bit, and then all the sudden you’ll see it, about 20 pounds in a year – that tells me that there is a metabolic issue going on. And the fact that we tell women, “You know, just eat less and exercise” – certainly that is good advice, but it is missing a whole component of the picture of what’s going on, and it really is a little patronizing to people that have had weight issues. I’ve dealt with weight issues, and until I personally fixed the metabolic issues, the hormonal issues, it was impossible. I craved food, my appetite was much higher than it is now, and I had no energy to exercise, and it became very mentally daunting when you went to the doctor and they said, “Well, just exercise.” And once all of those thing were fixed, weight for me in the last seven, eight, nine years really hasn’t been an issue.

MB: So for you personally, the weight management became a lot easier?

NF: Oh, absolutely. I wasn’t, you know, five pounds overweight. I lost about 65 pounds when we fixed the hormones. And you know, I still go out to – I ate at an Italian restaurant last night and I enjoy myself. So I’m not depriving myself, but it just became much, much easier.

MB: I keep seeing the term “estrogen dominance” in the press. Is that a useful term, and are you seeing a lot of it?

NF: I do see a lot of it, and I think it’s under-diagnosed, and especially in a 40-year-old that you asked about, estrogen dominance is a big thing. I’ll see it in men, as well, but in the younger women, in the 40-year-old women, what has happened is the ovaries have slowed down so that the progesterone and the testosterone are declining; the estrogen production is still relatively high. And therefore that’s where they end up with some of those more PMS type symptoms. They’re more moody, irritable, the weight creeps up, they tend to retain fluids – all of those type of things. With the men, they gain weight, they put weight on in the middle, they can’t maintain the muscle mass that they had. They get moody and irritable, as well.

MB: For women who are going through menopause, how many of them do you recommend some kind of hormone replacement?

NF: For the people that come to my office, it’s about 90%, because that’s kind of why they’re coming to see me. And they usually – the people that I’m seeing are well-educated, they’ve done their research in this arena, so most of the people that come to see me, I do recommend it. People that I specifically don’t recommend it for – and we can’t lump all of hormonal therapy in one bushel, either – there’s very few people that, given blood work results, that I would say, “You just aren’t somebody that I would give hormonal replacement to.” Certainly if all the blood work is normal, they don’t need hormonal replacement. Most women or men that come to see me will have one abnormality or another. Places that it is a very complicated decision for me are women with a history of breast cancer or endometrial cancer or certain ovarian cancer; women that have a very high risk, so they’ve got two people in their family that have had breast cancer; men with a history of prostate cancer or certain other melanomas and things like that are also big flags for me that, you know, we really need to proceed very, very cautiously. The breast cancer issue is the one that almost invariably comes up in women. They come to me and they say, “I’ve got all these symptoms, my quality of life has declined, but I’m afraid if I take hormones, I’m going to get breast cancer.” The fact of the matter is, at this point – there is a lot of research, and at this point it is not conclusive that hormonal therapy caused breast cancer. It actually is pretty evenly split that it’s very safe, it can lower your risk, versus it increases your risk. And the relative risk increase on the studies that have said that is extremely small. But that is related to estrogen. What women forget is they still have progesterone, they still have thyroid hormones, they still have testosterone, all of these other hormones. So we can’t lump them all in together. So if women are concerned, they’re worried about estrogen, sometimes we’ll use some of the other therapies first, see how we get them feeling – base it on their risk, base it on their blood work, and then maybe add that down the road, once we feel more comfortable and they feel more comfortable about it.

MB: For women who are having that creeping weight gain, how often is thyroid a factor in that?

NF: More often than what we’re led to believe. I’m the perfect example. I was tired, my weight was up. I went to my primary doctor, went to my OB/GYN, went to an endocrinologist – they all said, “Your thyroid is fine.” And that was all based on a screening test. Back in the 1970s, this new screening test came out. It’s called the TSH. The insurance companies pay for it; that’s the only thing that they recommend if you want to look at thyroid. And that’s what all of us doctors that went through medical school since the ‘70s had been trained on, and so that’s all we look at. But thyroid is a very complicated gland. There are multiple hormones involved. There are absorption issues that a lot of doctors just fail to look at. And we like to treat it as a disease, too, like to wait until it’s really bad before we treat it. So I don’t know. So in my case and in patients that I see, probably about 30 to 35% of women will have a thyroid issue that, when corrected, it helps them tremendously. Whereas if you look at the statistics nationally, they say between 2 and 4% of people with weight issues are thyroid-related. And we really have, again, given the whole clinical responsibility – and we like to look at that number on the paper and say, “Oh, the number on the paper is fine,” and we forget about physical examinations, our skin texture and fluid retention and basal body temperatures and examination of the thyroid. All of those things go into the diagnosis, as well.

MB: If a woman’s having weight gain and suspecting thyroid might be a problem, what kind of tests should she ask her physician to do, to make sure that he or she catches it?

NF: It’s a tough thing. Most physicians are going to order the TSH, again because that’s what the insurance companies – and they were told to do. There are multiple other tests that you can do. You can do what’s called a T3 or a T4. The thyroid gland that’s in your throat is controlled by a hormone that comes from your brain and tells it to make thyroid hormone, and that’s called TSH and that’s what the screening test is for. The thyroid gland then puts out a hormone called T4 which floats around in the bloodstream and eventually gets broken down into T3. The T3 is the active form of thyroid hormone and that’s what actually goes into the cells and makes your cells metabolize energy. There’s also, in your bloodstream, there can be antibodies, things that block that T3 or that T4 from working. So you need to look at all of those things. Additionally, you can have issues of absorption of the T3 through the cells, which we don’t really have a good test for. So the biggest thing I tell people, if they’re concerned about thyroid, is to find a doctor that knows what they’re doing with the thyroid. Honestly, most doctors don’t. There’s a couple of very good books on thyroid that I will oftentimes refer patients to, to get educated on it and allow them to help themselves a little better.

MB: And what are those books?

NF: There’s a Dr. David Brownstein who is wonderful – he’s in Michigan. And he has a book called Overcoming Thyroid. And it talks about things from a physical exam standpoint, things that you can do at home to see if thyroid is potentially an issue, see if iodine absorption, which is what makes thyroid hormone active, is an issue. And plus, it gives you symptoms to look at that might tell you if it’s an issue, as well as here’s the test that should be done. So it’s a good quick read that gets you well-educated. And in a lot of cases, my patients will read that and go to their primary doctor and they’ll know a lot more about it than their primary doctor. We can point them in the right direction if they need to.

MB: Other than anti-aging specialists, are there physicians who, because of their specialty, would be knowledgeable about thyroid?

NF: Endocrinologists are the hormonal experts in the medical field. And they are very well-educated and very well-meaning, but unfortunately they treat diseases. Their philosophy right now with thyroid and the way they’re educated and their policies that are put out by the Endocrinologic Society is for thyroid, if the screening test – the TSH test – is elevated to 10 – TSH is an inverse number, so the higher the number, the less thyroid function you have. So with over 10, you treat thyroid. But when you’re going to treat it, you’re going to treat it down to a 2. Where I see a lot of people falling into thyroid issues are between that 2 and that 10, which the Endocrine Society says, “You don’t treat those people. It’s obvious that they have a problem, but we’ll wait until the problem gets worse before we treat it.” And that’s where philosophically I differ from them. I think if you know you have a problem and you have symptoms – you’re gaining weight, you’re tired, all of those things – then we need to treat it more aggressively. If you come in to me and you have abnormal blood tests and it seems elevated but your weight’s perfect, your energy is good, you’re not losing hair, you don’t have any symptoms, then I agree, we should watch it. But our goal in age management is to be more proactive and not wait until you’re in a disease state to fix things.

MB: It sounds like medicine as a whole – and I hope anti-aging medicine takes the leadership in this – needs to define new standards of what’s healthy instead of just what’s unhealthy and disease.

NF: And that’s right. That’s where medicine has been focused for decades now is illness, and nobody knows what it means to be healthy.

MB: Are there boards that are working on that issue?

NF: Oh, absolutely. There are a lot of people that are approaching Congress, approaching like the AMA to try and push things into this direction.

MB: Good.

NF: Certainly there is resistance. Doctors are the slowest people to change their mindset on anything, of any group I’ve ever seen – which is good and bad. But so there is certainly resistance within the system to that. There are also some inherent problems with things like research. Research funding is usually focused on, you know, how do we cure a disease, or it’s coming from pharmaceutical companies which are trying to sell us patentable products. And so there are some problems with getting funding for good research from that standpoint, as well. As well as, you know, there are certain biases, especially in the nutrition field. There are certain – we’ve gone from “Fat will kill you,” to “Carbs will kill you,” and back and forth for decades. And you know, a lot of that is there have been a lot of political shenanigans that have gone into those positions, unfortunately. And it’s probably going to persist for some time, just because – and part of the reason for that is that there’s not one universal answer. We want an answer that says, “Here is what everybody in the world should eat and you will be healthy.” The fact of the matter is not that straightforward. Again, back to where we like to generalize everybody. We are individuals. We are genetically different. We are metabolically different. There is not going to be a right answer for everybody.

MB: Everything you’re talking about is talking about how it’s not easy and it’s very individualized.

NF: That’s right.

MB: Let me take a break here. You’re listening to Ageless Lifestyles Radio on Webtalkradio.net and we’re talking with anti-aging physician, Dr. Nicole Flora. She practices anti-aging medicine and age management, weight management in Cincinnati, Ohio, and she’s associated with Cenegenics Medical Institute in Las Vegas, with affiliated physicians around the country. Her website is http://www.cincinnatiagemanagement.com/, and the Cenegenics Institute site is http://www.cenegenics.com/. For information on anti-aging psychology and my books, Defy Aging and 52 Baby Steps to Grow Young and my free Defy Aging Newsletter is at http://www.drbrickey.com/  or you can just to http://www.notaging.com/  and it’ll take you to http://www.drbrickey.com/ . Dr. Flora, how much does it cost to get a good workup in anti-aging medicine?

NF: Certainly individual doctors charge different amounts. I don’t think there is a set fee. It really depends on what you’re dealing with.

MB: So for a typical person that says, “I’m feeling rundown and want you to work it up and put me on a program of nutrition and exercise and hormone replacement, if that’s needed,” are we talking a few thousand dollars, several thousand dollars?

NF: We’re talking in general, to start with, all-inclusive – between a good blood work panel, which unfortunately is the majority of the cost – probably a couple of thousand dollars. I mean, blood work – we do exercise testing, fitness testing, bone density, body fat, all of those things, plus consultations with a nutritionist – all of those types of things are included.

MB: I’m surprised that it’s not a lot more than that. Sounds like a bargain to me. I mean-

NF: Honestly, if you compare what you would go and pay if went to the hospital and got those things, you’re right. It absolutely is a good bargain.

MB: Considering what we spend on cars and stereos and plasma TVs – well, it’s the cost of a fancy television set – which is more important?

NF: Absolutely. It is an investment. It’s how much do you know about your body, which is – you know, a car is going to last you, on the outside nowadays, 10-12 years. You have to live with this body for a very long time.

MB: You’re engaged in some research. Can you tell us about that?

NF: Through the Cenegenics Foundations, we work with two medical schools, the University of Miami and the University of Nevada, and we do multiple research programs yearly. And the latest one involves weight and particularly hormone replace, specifically growth hormone and testosterone. And that came out through Cenegenics in November. It’s being submitted for publication in March.

MB: Are you allowed to share with us the gist of it, or is it under wraps?

NF: It’s been presented at the national meeting, so I’m assuming I can tell you a little bit. But that we did see, particularly in women, we saw a significant weight loss when hormones were balanced. With men, the weight loss was less significant, but the body fat content came down significantly. So they gained more muscle mass and lost more fat, where women kept their muscle mass consistent and lost fat. So their actual number on the scale, which we women like to focus on a lot unfortunately, changed more so with the women than with the men. But it was statistically significant weight loss.

MB: Well, speaking for men, we’d be happy to have it translated to muscle instead of fat. That’s okay.

NF: Exactly, exactly. So it made people happy on both fronts.

MB: Well, wonderful. I gather your approach to anti-aging medicine is fairly Western as opposed to someone who emphasizes Ayurvedic medicine, colonics and fasting and that kind of thing?

NF: That is true. You know, I am a traditional doctor. I went to traditional medical school and I trained to look at the scientific evidence. So I am more comfortable in that realm. I certainly am open to my patients using other approaches, but I won’t certainly present myself as an expert in those realms. I get, particularly with chiropractic and acupuncture, I get patients that have tremendous response. But certainly I will work with other practitioners if that’s their choice. But again, I just don’t present myself as an expert in those fields because that’s not where my training lies.

MB: It seems to me like there’s three schools: what you’re doing, which is very Western integrative; there’s the more Eastern approach; and there people who are just emphasizing the hormones and the shots and the cosmetics but not asking people to do the exercise, to take a look at their eating, and that kind of thing.

NF: I think you’re correct in that assumption. My personal opinion is that really to have the best outcomes you need a combination of all those things. People like to go to the doctor and be given pills and shots and creams or what have you because that’s what they’ve been taught to kind of expect. But it really – we cannot under-emphasize the other components. You know, the psychological components – and you’re the perfect expert to talk about that. There’s a huge impact on, you know, the diet and the nutrition. If you are going to put – if you want to know what the side effects to this pill that you’re putting into your body are, you certainly ought to think about the side effects of what the food you’re putting in your body are and how we change those. I mean, that – you eat three meals a day. You may take one pill a day. What is going to have the bigger impact on your life long-term? And people like to forget about that component. Eating is unconscious in a lot of cases. Our activity level is unconscious and it takes a lot more work. It’s easier to take a pill or a cream or a shot and not have to do that component. So my opinion is certainly it needs to be a comprehensive program. It has to address all of those things. It is hard as a practitioner to put all of that together, but that’s where the challenge lies.

MB: What do you think is going to happen in anti-aging medicine the next 10, 20, 30 years?

NF: I think we’re going to get better at it, and I think we’re going to get better at doing research at it, I think we’re going to get better politically getting people to support our position that we want to promote health and avoid disease, as opposed to just treating disease. I don’t know in the next ten years where the traditional medical community or the insurance communities are going to be on that front. In 20 years, I think they will be onboard, but it’s going to be a rocky road between now and then, unfortunately.

MB: Do you see huge changes from, say, genetic engineering and tissue engineering that’s going to get integrated into the anti-aging medicine at the practitioner level?

NF: Absolutely. Right now, genetics are – there are a lot of problems with the genetic component, from a decision-making point. But the genetics I think will be the next big mover. However, we have to remember that probably 45 to 50% of what happens to you, you are predisposed to, from your genes. The remainder is lifestyle. So we can’t expect genes to come in and cure everything. We still are responsible for our health and our environment and our psychological wellbeing. So it will never come in – and a lot of people are waiting for it – “Hey, if I get the genes right, I won’t get heart disease and I won’t get this, that, or the other.” But it’s never going to be that simple.

MB: “And I can go to the restaurant and eat everything.”

NF: Right! “And if I’ve got the right genes, my jeans get on fine.” And I actually had a gentleman that called yesterday and said, “Hey, I heard about this genetic testing. Can I get it done to find out, you know, do I need to do this?” And you know, my take to him was that right now, at least, it can sometimes give you a false sense of security. If you have a genetic test that tells you you’re at low risk for heart disease or you’re at low risk for diabetes, does that mean that you don’t need to know what is best to prevent those things? And my position is no, I’m going to treat everyone like they’re at high risk for heart disease and diabetes, because still, the vast majority of heart disease cases and probably 85% of new diabetes cases, Type 2 diabetes, occur in people with no genetic risks. So we can’t rely on a blood test to tell us we’re safe.

MB: One of my pet peeves is statins. I think they have so many nasty side effects; I hate to see so many people taking them. What kind of alternatives do you tend to get into with patients to see if they can get off the statins?

NF: I have a problem with the statins, as well. I feel the same way. Cholesterol – certainly diet is important, but diet – if we’re honest with ourselves and we look back at the medical literature for the last 30 years, diet – and I hate to say this because it will tell people they can go every fried food they see – diet has a very small impact on cholesterol levels, maybe 10% if you’re very good – which is important. Diet has other impacts, though. It affects inflammation, which the statins also decrease. So we can’t just look at the cholesterol number. But diet is important. Exercise is important. Looking at hormonal levels – I never, never treat someone’s cholesterol number unless their thyroid is optimal. Thyroids will impact your cholesterol readings, as will testosterone levels, as will estrogen levels. And so a lot of people, when we get the hormones balanced, we get them eating right, we get them exercising, they don’t need the statins. The statins, I think, are so over-prescribed. If you actually follow the American Heart Association’s recommendations now for cholesterol levels, in my personal practice, my primary care practice – if I followed that, 75% of the patients that I saw on a daily basis would be on a statin. And honestly, that is – in my mind was a big turning point. Common sense has to come into play. There’s either something wrong with our society, with our lifestyle, with how we’re eating – that didn’t come about – you know, that isn’t a genetic issue that all of the sudden 75% of people need a pharmaceutical. It’s either our position as doctors and as researchers is wrong, or there’s something going on culturally with our diet. Something has changed that has made that occur. And that’s why I think, as a doctor, you really, really have to step back and step outside of the box and not just read the recommendations, but go back and look at the individual research that has been done to date.

MB: I’m hearing that public health perspective there.

NF: Absolutely, sure.

MB: How does a person tell whether somebody is a well-qualified, competent anti-aging physician?

NF: It’s tricky. There are a lot of people out there that are dabbling, that are not well-educated on the subject, that have gone to classes that may not have been the best classes, that have gone to seminars or have been pitched products that are not well-supported by research. And so honestly, it is a tough position as a consumer. My biggest thing is that you need to find a physician that you can talk to, that you’re comfortable with on a personal level, that can give you supporting evidence to their opinion, and who is willing to have that conversation, and also who doesn’t treat you – not a cattle call at their office, and they’re not going to treat you – everybody that comes through the door gets this treatment or that treatment. That is, for me, the biggest thing. You want certainly someone who has some experience in the field. You probably need someone who has been doing it – and I hate to, you know, give time cut-offs, but multiple years, five years or more. And you need somebody that, in my opinion, does this as their primary focus. The guys that are doing it one day a week out of their office unfortunately can’t keep up with the amount of medical and other sources of information at this point. You can’t keep up with your regular practice, let alone a whole other field. You wouldn’t go to a gynecologist that did gynecology one day a week and had some other job on the side. You really need somebody that this is their primary focus.

MB: Are there any board certifications yet that would tell you that you had this kind of doctor you’re talking about? Or are we not there yet?

NF: Some doctors will promote a board certification and there is a program out there that they can go take classes and get a board certification. To date, though, that board certification has not been recognized by the AMA. So the AMA has looked at the protocols and they have not given their stamp of approval yet. They may in the future – I’m sure they are continuing to work on that. So right now, board certification is – while it does indicate that they have taken a significant amount of education, at this point we don’t know specifically what that entails.

MB: What’s the patient to do, other than interview the doctor and find out whether they’re full-time in the business?

NF: I wish I could answer that. You know, the other thing that I will tell patients to do that aren’t local to me, is I will tell them to go to a local compounding pharmacist – if they’re women. Men a lot of times will use FDA-approved medications that you get through a regular pharmacy. But honestly, the pharmacists in the area know the good doctors. They really do. If you are an age management doctor and you’re doing hormones, you have to be working closely with a good qualified compounding pharmacist, almost on a daily basis. And I have a lot of patients come to me from a local pharmacist because that’s where they’re asking questions, and I think they’re a good resource.

MB: Oh, I love that strategy. That’s cool. The Cenegenics Medical Institute that you’re associated with, are they certifying people who have comparable credentials to yourself?

NF: Well, we do – at Cenegenics they train physicians and they are actually AMA-accredited to do training. They don’t offer a board certification but they do offer a certification through Cenegenics. They train – they have to be MDs or DOs and they have to go through – they have to see patients with the doctors there and their clinical knowledge is assessed. Certainly they do testing, they do home studies, they do ongoing monthly educational seminars to maintain that certification.

MB: Do they teach the kind of individual time-intensive holistic approach that you do? Or is that more a personal choice?

NF: They do. And that’s where I got my original training. I’ve done training from multiple different sources. But absolutely, they advocate the approach that, you know, you have to spend – to get a good idea of what’s going on with a patient, you have to spend minimally two to three hours with them on the first visit, and then close follow-up is really the key to success.

MB: Is there anything else that you would like us to know about, or some hints or advice that you’d like to share with us?

NF: I think the biggest thing, for people in general, is to not stand by and expect health as a given. You do have to, in our culture today, with the dietary stresses, with the environmental stresses that our body is under, and with the epidemic of disease that is out there, you do have to be proactive and you need to take some responsibility to get well-educated on it. It will make a huge impact in your life and your family’s life and your kids’ life. You’ll be around longer and you will enjoy life more. The biggest thing that my patients want to avoid is living to be 90 and spending the last 20-25 years being sick. And we know, with good medical evidence – this is not new things that we have made up or that there’s some new product – we know, looking at good medical research, that we can prevent probably 65 to 70% of disability that you see in the elderly population, if we start early and if we’re proactive and if each individual takes responsibility for their health, for eating well, for exercising. They don’t need to end up in the nursing home like their parents did. They don’t need to end up living with their kids because they can’t live independently.

MB: My role model is the Energizer Bunny on alkaline batteries. You know, with regular batteries, they just kind of wear out gradually, but the alkalines, you get the steady energy level and then when they die, they just die.

NF: Right, they just fall over.

MB: So it just keeps going and going and going. There’s a gentleman in the news, Mr. Rabinowitz, who recently, at 104, broke his 100-yard dash record at about 30 seconds, which is pretty good for 104!

NF: Oh, my goodness.

MB: And then I noticed he had a stroke a couple of months later. To me, that’s a good role model.

NF: Absolutely. You know, we don’t need to cure a lot of these diseases. We just need to delay them coming on. If I get cancer when I’m 94 and die from it, great, you know. But if I’m healthy until that point – you’ve got to die of something. My thing is that I just don’t want to be sick and tired and accept this unfortunate situation that we see so many seniors in now. And I don’t want us as a population to think that’s how it has to be, because it doesn’t. But you do have to work hard and you can’t wait until you’re 80 to do it. When you’re 80, we can still have good impact, but you’re going to do much, much better if you start when you’re 30 or you’re 20 or you’re working on your kids to get them to eat right and to get them outside and get them moving, and ingrain that as part of their lifestyle. You’re going to have much better outcomes. They’re going to have a better life.

MB: Dr. Flora, I just wish we could clone you.

NF: Well, thank you.

MB: Thank you so much for being on the show. I really appreciate it and appreciate all the information you shared with us.

NF: Well, you are so welcome. It has been a pleasure.

MB: As you’ve probably gathered, I’m a big fan of anti-aging medicine. True, it is having its growing pains and there are people who are emphasizing profits as opposed to the kind of careful planning and individualization and holistic health that Dr. Flora talks about, but I think it is destined to become the family practice medicine of the future. And Dr. Flora is a wonderful example of what an anti-aging physician should be like and what an anti-aging physician can do. I like to wrap up programs with a baby step that hopefully will help you live longer, healthier, and happier. In the business world, we place a lot of emphasis on starting with the end in mind, being very clear about the outcome you want, and then figuring out what it takes to achieve that outcome. In our lives, it’s even more important because it’s our lives! And the outcome we want is to be Energizer Bunnies, at 100, 110, 120, maybe even 150, to still be going strong with a snap in our step and a sparkle in our eye – passion and enthusiasm and a zest for life. The alternative might even be a nursing home. So we need to picture in our mind’s eye vividly ourselves as that Energizer Bunny and just see it so vividly and want it so badly, we’re almost salivating, saying, “I’ve got to have that, whatever it takes. That’s what I want. What do I need to do?” What do you need to do? Well, fortunately I think we got a lot of ideas today from Dr. Flora. You’ve been listening to Ageless Lifestyles Radio on Webtalkradio.net. Our expert guest has been Dr. Nicole Flora, an anti-aging physician who practices in the Cincinnati area. Here Cincinnati office website is http://www.cincinnatiagemanagement.com/. Her Cenegenics Institute website is http://www.cenegenics-drflora.com/. Information on anti-aging psychology and my books Defy Aging and 52 Baby Steps to Grow Young, and my free Defy Aging Newsletter is at DrBrickey.com, or you can just go to http://www.notaging.com/  and it’ll take you to DrBrickey.com. This is Dr. Michael Brickey with Ageless Lifestyles Radio, wishing you a very long, healthy, happy life.