Author Archives: Sarenka Smith

The Basics of BHRT: Myths vs. Facts

June 13, 2017

While there is no magic bullet or cure to effectively reverse or stall the aging process, many experts believe that bioidentical hormone replacement therapy (BHRT) comes close. BHRT technically refers to the use of hormones that mimic the endogenous hormones produced by our bodies, with the ability to restore normal physiological pathways with optimal bodily responses. Because aging results in a myriad of declining health issues, BHRT has the potential to restore declining hormone levels, while slowing the aging process, preventing chronic disease, and restoring vigor and vitality.

Kenneth Orbeck, DO practices bioidentical hormone therapy at his integrative and functional medicine practice in South Carolina, citing that hormonal therapy is in large part effective because it requires doctors to have routine contact with patients. This, in turn, delivers optimal results, as patients are not simply receiving prescriptions, but rather being continuously monitored by physicians. “I have no rejections, no infections…it does take training, and you have to understand the therapy, but this ensures a very consistent, linear delivery.” Dr. Orbeck’s patients have been treated for a range of symptoms often associated with aging, including hot flashes, night sweats, decreased libido, fatigue, and irritability.

Jennifer Landa, MD, Chief Medical Officer of BodyLogicMD, has likewise dedicated her practice to bioidentical hormone therapy and preventive medicine, in order to assist men and women resolve menopausal and andropausal symptoms. Dr. Landa explains that results are often contingent upon the ways in which hormones are administered, in addition to the fact that not all hormones are created equally. “Only someone trained as an expert knows the good and bad, and really understands the studies. When we talk bioidentical, it is a way of saying the same exact chemical structure of what is in our body naturally. People do not realize that there are already plenty of prescriptions with bioidentical hormones.” Like Orbeck, Landa’s patients have continuously experienced positive health and wellness through hormonal balance and preventive medicine, in large part to customized BHRT therapy.

Landa clarifies that much of the hormone literature is inaccurate, because most of the studies are conducted with ‘bad’ hormones, like progestin. Landa further discusses a study at Yale, in which researchers and scientists stated that the women only taking estrogen should have stayed on it, and that many more women died of heart disease because they were taken off of their hormones. Landa states, “Timing is of the essence in hormone therapy. Unfortunately, many doctors are still not schooled properly in this area. Even the American College of OBGYN has agreed that we should not be taking older women off of hormones, as symptoms will likely recur.”

Sahar Swidan, PharmD, President & CEO of Pharmacy Solutions in Ann Arbor, Michigan—a uniquely personal, educational specialty pharmacy—and Clinical Associate Professor of Pharmacy at the College of Pharmacy at University of Michigan, explains that while we continue to lump bioidentical hormones with synthetic hormones, they are physiologically extremely different—“Yet you cannot pick up a medical article without clumping them together. Estrogens are not all the same.” Swidan describes the process of hormone therapy as highly individualized, and that physicians must understand their patients’ levels before prescribing hormones. “The earlier we start hormone therapy, the better people do. I tell people: I promise you, you don’t have a Prozac deficiency…you probably have a progesterone deficiency.”

Thierry Hertoghe, MD comes from a family that has worked with bioidentical hormone therapy for four successive generations. Like Swidan and Landa, he believes that BHRT represents the most powerful tools in order to stay healthy, and maintain physical appearance. He elucidates that BHRT has the capacity to treat causes, conditions, and not solely consequences; more importantly, Hertoghe firmly believes that BHRT is both safer and more efficient. “It is personalized, and I can vary the doses. In standardized pharmaceutical medicine, you have one or two doses—but you certainly do not have the possibility of 15-20 doses, depending on the patient. BHRT allows us to fine-tune treatment.” Hertoghe further illuminates the ability of hormone therapy to treat several types of disorders: both physical and psychological, that stem from hormonal imbalances.

A4M/MMI will be hosting a BHRT Symposium in Nashville, from September 27-30. During the three-day workshop, experts will analyze the medical evidence surrounding BHRT, while participants can learn from instructors actively practicing this specialty. Lecturers will discuss the ways in which to identify signs of hormonal deficiencies in patients, and how to subsequently treat imbalances. Sessions will ultimately allow attendees to gain the information needed to safely and effectively merge BHRT into practice. Register now.

The Study of Sleep

The Centers for Disease Control and Prevention have deemed insufficient sleep to be a public health epidemic, as millions of people suffer from lack of sleep and sleep disorders, with related health problems and cognitive impairment. Sleep disorders and sleep hygiene constitute primary reasons for patients seeking medical advice and intervention, as there are over 100 different types and forms of sleep disorders, which range from excessive sleepiness during the daytime to difficulty sleeping at night.

Sahar Swidan, PharmD and Kelly Olson, PhD, have worked in both sleep and pain management for decades, partially due to the huge overlap and comorbidity between sleep and pain, and because of the similar neurochemistry and neurobiology. Olson is Director of Clinical Research & Development at SleepImage, with a Master’s in Science and a PhD in Pharmacology and Therapeutics. Swidan currently serves as President & CEO of Pharmacy Solutions in Ann Arbor, Michigan: a uniquely personal, educational specialty pharmacy; she also acts as Clinical Associate Professor of Pharmacy at the College of Pharmacy of University of Michigan. While Swidan often receives questions regarding sleep hygiene from people who have tried a host of various sleep aids, she also has many patients with pain problems who simultaneously suffer from sleep disorders and are unable to get restful sleep.

Olson has spent the last decade practicing integrative medicine, with a specific focus on molecular neuro-pharmacology. As previous director of research and development for a medical device company that worked with Harvard on new innovations, she found that there was “so much physiology behind impaired sleep that it is almost like an iceberg—we can just see the tip.” Olson has found that sleep is a fairly uncharted territory, which requires more research in order to understand the neuro-circuitry. “It is very unique,” she says, “just like DNA fingerprints—specific to each person.”

A4M Sleep Workshop

Both Olson and Swidan aim to create teaching practices that are rooted in enjoyment, interaction, and practicality. Due to practicing pain management and neurology for over two decades, in addition to the majority of her publications and clinical teachings surrounding pain management, Swidan attempts to teach better ways of treatment—as her students touch ‘thousands of lives.’ Olson is committed to developing practices and protocols that students can immediately implement and integrate into practice: “I mix in the science with applicable clinical relevancy, while presenting case studies from my own experience. Clinicians need to know how to apply the science to their own patients.”

In conjunction with the American Academy of Anti-Aging Medicine (A4M), Swidan and Olson will be holding a Sleep Workshop on July 29th, in West Palm Beach, Florida, covering topics that include the physiology and neurobiology of sleep; the effects of hormones, adrenal, and HPA dysregulation on sleep disorders; techniques that can assist in healthy sleep hygiene; and tools that reset the circadian clock, regulate HPA, and the neuro-endocrine connection. Pamela Hughes, DO, ABFM, FAARM, an expert in functional medicine, will join Swidan and Olson in discussing elements of brain fitness, in addition to patient clinical case studies. Interested physicians or healthcare practitioners can apply here.

 “I am against money-based medicine,” says Swidan, who has committed years of research and investigation into both sleep disorders and pain management—particularly the recent global spread of the opioid epidemic, and the connections between sleep hygiene and pain management. “This is a national epidemic; we need to do something at our level and teach our students how to treat this.”

Looking to Improve Sleep? Solution: Exercise

June 5, 2017

Statistics indicate that almost one third of all Americans, approximately 108 million people, suffer from insomnia and poor sleep hygiene. While many turn to pharmaceuticals and sleeping pills, science offers a safer and more effective solution: exercise.

Rush University clinical psychologist Kelly Glazer Baron states that an increasing amount of research demonstrates that exercise can reduce insomnia; moreover, those who engage in physical activity have increased energy levels, and are less depressed. Further studies assessed people with clinically diagnosed insomnia disorder, as opposed to self-described ‘poor sleepers.’ The results likewise showed enhanced sleep quality.

While Arizona State University sleep researcher Shawn Youngstedt admits that while exercise is not quite as effective as sleeping pills, the considerable potential downsides of drugs and pharmaceuticals include increased infection, dementia, and other hazards.

18 million Americans also suffer from sleep apnea, a disorder in which breathing temporarily stops during the night. Exercise can also assist with this; one study showed a 25% reduction of sleep apnea symptoms over a 12-week period. Youngstedt also points to the efficacy of exercise in helping with restless-leg symptoms.

A large amount of literature shows that people who exercise inevitably have better sleep, reporting an increase in deep sleep and a decrease in the number of awakenings. Moreover, most people feel less depressed, and moods are enhanced.

Attend our upcoming Sleep Workshop in West Palm Beach on July 29th, and learn more about innovative options and various techniques that can assist in healthy sleep hygiene.