dr. phuli's blog

Menopause: Half a Lifetime

Tuesday, September 24th, 2013

Did you know that women are destined to spend one half of their lives in menopause? And guess what? Contrary to common lore, it’s a time that you can begin to feel your best. No longer are you at the mercy of monthly mood changes, weight gain and all the evils that can accompany rising and falling hormones.

Ancient Chinese sages were among the first experts in menopause. They wrote about a woman’s “tides” shifting, so that a woman was no longer giving out into the world, but rather gathering her inner strength. It is a time of introspection and enhanced intuition.

Menopause is a time to take stock of your life physically, emotionally and spiritually. What are you doing with your time and energy? Its time for you to come first and prepare for the second half of your life.

Its a great time to write the bucket list, prepare a vision board, interview a life coach, create a woman’s group, start a journal, and see an educated anti-aging doctor.

I repeat, see an anti-aging doctor. If you are proactive about your physical and emotional health, you will enjoy your second act much more. Tests can be done at most labs to provide you and your doctor with a comprehensive overview of your health risks and preventive needs going forward. I recommend the following tests:

For bone health: Measure your bone density. Your Vitamin D3 (25 OH) levels should be around 60, but not over 80.

For breast health: I recommend having an annual mammogram, and, because many women are deficient in Iodine (which can predispose to breast cancer), please request a random urine or blood iodine test. I give all of my patients a multivitamin with iodine. My favorite is Nutrient 950 (without iron at our age), by Pure Encapsulation.

For gastrointestinal health: Its important to be up to date with your screening Colonoscopy screenings. These should be done every 5 to 10 years depending on your history. Also if you haven’t had one, have a hepatitis B and C screen.

For heart health: Ask your doctor for a thyroid screen, including measurements for free T3, free T4, reverse T3, and TSH. Your TSH should be between 1.0-2.0. Other important tests to get are: Homocysteine, MTHFR (genetic marker), cardio-CRP, diabetic screen with HbA1c, and fasting lipids.

For overall vitality: Ask for these blood tests:
DHEA-S (see my prior blogs), CBC, red blood cell Magnesium, and IGF-1 (indirect measure of growth hormone).

Many of your questions about all of this are answered in my book, The Natural Hormone Makeover.

Take this blog to your doctor and make sure to follow through after the results are in. Take the time to meet with your doctor to review the results and make a plan. It takes a team and a commitment- after all, you would do a 65,000 mile tune-up for your car. You deserve nothing less.

To your health and a great second act!

1 Comment  |  Permalink  |  Posted in Bone Health, Breast Disease, Heart Disease, Hormones, Menopause, Uncategorized


Adrenal Burnout

Tuesday, August 20th, 2013

I always feel like the end of the summer is a good time to plan the upcoming year. Its a great time to think about gaining balance and health. So are you “burned out?” Are you overdoing? Are you consistently over-scheduled? Are you giving too much without rest and recharge? If you are thinking, “yes” to these questions you need to get a grip on your life and start understanding and appreciating your adrenal glands.

Your adrenal glands sit atop your kidneys and produce several hormones that regulate your body’s energy, metabolism, and immune function. Hormones like DHEA, cortisol, pregnenolone, epinephrine, and norepinephrine make your life run smoothly.

If you are chronically giving out more than you receive you can bet that, over time, your adrenal glands are going to tire, resulting in adrenal burnout. Signs of this are losing your temper easily, feeling irritable when stressed, trouble falling or staying asleep, and generally feeling anxious when things are actually going okay.

When your adrenals burn out you lose control over cortisol production. Its high when it should be low and low when you need it most. Some advertisements will have you believe that most of us have too much cortisol, but this is not the case. Most women over the age of 50 have too little cortisol early in the day, and too much late in the day, causing us to run out of energy mid-day and have trouble sleeping in the night.

Restoring your adrenals right starts with testing. You can take blood or saliva tests to measure adrenal hormone levels. Most women with burnout have low DHEA, low pregnenolone and variable cortisol. Chronic stress with high cortisol levels can confuse the brain overtime. The brain HPA (hypothalamic- pituitary-adrenal) response is lost. Little cortisol is made during the day and too much is made in the evening, when things should be winding down for the night.

As adrenal burnout continues, we become like shift workers- tired in the day but unable to sleep at night. This is not a healthy long-term plan. High night cortisol is linked with increased risk of heart disease, diabetes, hypertension, and depression, not to mention many unhappy moments in an otherwise good life.

What can you do about it? First, recognize it and consider how you got this way. Are you the one constantly volunteering and offering without considering your own needs? Patterns are hard to break, especially for us women raised to believe that we can, and should, do it all. But break patterns of over giving and overdoing, we must.
What can you do? First of all, know that you cannot, nor should you try to “do it all.” Learn to ask for help, know your limits, schedule rest into your day, and build respite/vacations into your life.

Also, discover adrenal adaptogens or herbs that help the body adapt to stress. They have been used for centuries by many cultures. Here are a few examples, taken from the adrenal chapter in my book, The Natural Hormone Makeover:

1. Siberian ginseng (Eleutherococcus): energizing and good for physical stress
2. Korean ginseng (Panax Ginseng): similar to Siberian in that it helps with physical fatigue but also considered to be a sexual tonic as well
3. Indian ginseng (Ashwaganda or Withania): calming, good for fatigue with insomnia
4. Rhodiola: good for mental stress- but beware, a low dose is energizing but high doses are calming
5. Gingko: improves blood flow to organs- especially helpful for the brain and adrenals to communicate better
6. Astragalus: supports immune function
7. Cordyceps and Rhemania: supports all adrenal hormone production

So be kind to your adrenals this summer. Recharge, refresh and look at your life. Summer is a great time to reassess your lifestyle and think about resetting your automatic responses.

Learn to delegate, set rest goals, plan the year’s vacations, and get your adrenal hormones checked out.

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Over 50 Sex Risks: Have Fun But Beware

Thursday, August 1st, 2013

Here’s the good news: women over 50 are reporting more satisfying sex than ever. Sadly, this news is coupled with the surprising fact that the over-50 age group has become the fastest growing population of HIV/AIDS in our nation, and women are becoming infected more commonly than men. Lets look at what you can do to stay infection free.

The hard facts:

1. In the last decade AIDS in women over 50 have tripled.
2. According to the CDC, 20 percent of the 1.1 million American men and women living with HIV/AIDS do not know they have the disease. Experts believe the percentage is higher among those over 50, due to a lack of education and testing in this population.
3. Vaginal wall thinning and dryness, which could cause small tears, create more opportunity for HIV infection to occur in women.
4. Age reduces the immune response in general which can predispose to infection.
5. Oil-based vaginal lubricants can cause latex condoms to break, increasing risk of transmission of HIV and other STDs.
6. With the advent of drugs for erectile dysfunction, men over the age of 50 are more likely to have multiple sex partners, including prostitutes.
7. Older adults with no suspicions that their partners could be infected fail to get tested for HIV when they have checkups.

How to protect yourself:

1. If you are sexually active, don’t underestimate your risk for HIV/AIDS. Use condoms and be sure to have an open conversation about HIV risk with your partner.
2. You and your partner should have HIV testing.
3. In most cases of infection, testing will become positive within 3 months of exposure.
4. When testing for HIV, test for other common STDs like chlamydia, gonorrhea, hepatitis B and C, herpes 1 & 2 and syphilis.
5. Talk to your pharmacist about which vaginal lubricants or estrogen supplements can be used with specific condoms. There are plenty of water based lubricants. Do not use Vaseline, or other oil-based lotions. Remember that most vaginal treatments for yeast will break latex.
6. Carry your own condoms. The best condoms for prevention are lubricated latex, (lambskin condoms do not block transmission!).
7. Make sure to check condom expiration dates.
8. Use a condom with oral sex too- transmission of HIV (and other STD’s) can occur orally.

Have fun but please be safe!

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Tuesday, June 18th, 2013

It’s a little known fact but we wear our hormones on our face!

You can get all of the face work and Botox in the world but hormonal health is how to keep your skin looking as young as possible.

Too little hormones will leave you looking (and feeling), tired. Estrogen, testosterone, thyroid, Growth Hormone, melatonin, and the adrenal hormone DHEA (the most abundant hormone in us), keep our skin bright, supple, moist and less wrinkled.

The small creases that crowned my upper lip convinced me to become an anti-aging medical physician. When I was a mere 43 years old I was plucked from the audience as an example of “premature aging.” To my surprise, the lines on my face told the story of what was happening inside…..my thyroid was underactive, my adrenal glands were too stressed to make enough DHEA, my ovaries were not making much estrogen and testosterone, and growth hormone and melatonin were no longer pulsing in me. I was literally drying up.

Here’s a brief list of what happens to your skin and hair when certain hormones are too low:

Low Estrogen: fine lines form around your mouth, your skin and eyes become dry, your hair thins, crow’s feet form, and forehead wrinkles multiply

Low Testosterone: causes facial wrinkles to increase at a faster rate

Low Thyroid: you’ll notice dry, scaly skin, thinning eyebrows- especially the outer brows, your hair becomes brittle and thin, and your face/eyelids can look puffy

DHEA: the plus side of low DHEA is less leg and underarm hair, but with that your skin and hair is depleted of its natural oils, losing sheen and healthy glow

Melatonin: in addition to poor sleep, low melatonin makes you look generally older than your age

Growth Hormone: lack of growth hormone causes your upper lip to thin and makes the jaw line look smaller. It also causes deeper skin wrinkles.

Hormones have been given bad press but it’s time to set the record straight. Did you know that the WHI study which damned hormones did NOT show any increase in breast cancer in women taking only estrogen? Only the women in the WHI study who used synthetic progesterone (Provera) had an increase in cancer.
Despite the safety of natural hormones, the media hype surrounding this 2001 study caused hormone backlash. Millions of women stopped all forms of hormones causing epidemics of bone loss, insomnia, depression, and sexual dysfunction, not to mention a lot of sad skin and bad hair days.

Ask you doctor to measure these hormones:

DHEA-S, for adrenal DHEA
TSH, free T3 and free T4 Thyroid hormones
IgF-1 for growth hormone

Sex hormones such as Estrogen and Testosterone are safe to use if you use bioidentical forms, in a balanced way, (always use progesterone with estrogen). Never eat estrogen, take it by the skin. Melatonin and DHEA are available over the counter in most pharmacies.

European studies have shown that using bioidentical estrogen by skin lotion, balanced with natural progesterone was safe. Educate yourselves and your doctors about safe uses of hormones so that you can look and feel even better after 50.

6 Comments  |  Permalink  |  Posted in Adrenal Hormones, Estrogen, Hormones, Menopause, Natural Hormones, Uncategorized


Women Vote!!!!

Monday, November 5th, 2012

We women are 60 percent of the vote. We women are now able to change our world……..be part of this and vote. http://vimeo.com/51940856

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Back to School/Back to Life

Tuesday, September 4th, 2012

School started again for our town and I, like most mom’s am sad and happy about it. Sad me can barely comprehend how quickly my daughter is traversing life, and I am slightly dreading the “busy-ness” that lies ahead…the carpools, homework, structure, and end of care-free summer days. The happy me is ecstatic to finally be feeling well enough to ponder my next phase. What should I do with my mid-fifty life? Where should I put my talents? What do I want my year to look like?

One thing I plan to do is to update this website. I hope to blog regularly and hopefully develop an arena for like-minded people to discuss hormones, aging, Lyme disease and add a few of my interests such as yoga, cooking, meditation and life balance. I’m going to try to do something new, maybe art or a dance lesson.

How are you guys coping with the end of summer?

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Hey! Its Great to Be Back

Monday, May 7th, 2012

Wow, time flies, especially when you’ve been sick from Lyme Disease. I am happy to report that I am well and on the road to full recovery, some 5 years after a baby girl tick took a bite from my life.

It’s been a hard road but I’ve learned a lot, so much so that I’m writing another book about my experiences recovering from a chronic illness, especially one as misunderstood and common as Lyme disease.

I am starting to blog again and even beginning to tweet, so please follow me on twitter @drphuli

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