The Hemp Connection [Search results for drug] 

We focus almost entirely on the women's side of infertility on this blog. Now here's information important to the other half of the equation. The beauty of this is…the very advice we're giving to you women…can help men with depression, too. This article comes from Natural News, links are at the bottom.

SSRI Antidepressants Linked To Male Infertility
by S. L. Baker, features writer

(NaturalNews) The Food and Drug Administration (FDA) issued a warning a few years ago that pregnant women taking the selective serotonin reuptake inhibitor (SSRI) antidepressant paroxetine risk giving birth to infants with major birth defects, including heart abnormalities ( http://www.naturaln ews.com/021225_ P…). Now comes word that the same drug (sold as Paxil, Paxil CR, Seroxat, Pexeva, and generic paroxetine hydrochloride) carries another danger that could keep babies from being born in the first place. A new study just published in the online edition of the journal Fertility and Sterility concludes as many as fifty percent of all men taking the antidepressant could have damaged sperm and compromised fertility.

New York Presbyterian Hospital and Weill Cornell Medical Center researchers followed 35 healthy male volunteers who took paroxetine for five weeks. Then sperm samples from the men were studied using an assay called terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) to evaluate whether there were missing pieces of genetic code in the sperm DNA. This condition, know as DNA fragmentation, is associated with reproductive problems.

The results? The percentage of men with abnormal DNA fragmentation soared from less than 10 percent to 50 percent while taking the antidepressant. This is a crucial finding because DNA fragmentation has long been known to correlate with an increased risk of birth defects, poor fertility and unsuccessful pregnancy outcomes — even when high tech, extraordinarily expensive fertility enhancing techniques such as in vitro fertilization and intracytoplasmic sperm injection are used.

The study, one of the first scientific investigations into the effect of SSRIs on sperm quality, also confirmed that paroxetine impairs sexual function. More than a third of the research subjects reported significant changes in erectile function and about half had difficulty ejaculating.

"It's fairly well known that SSRI antidepressants negatively impact erectile function and ejaculation. This study goes one step further, demonstrating that they can cause a major increase in genetic damage to sperm," Dr. Peter Schlegel, the study's senior author and chairman of the Department of Urology and professor of reproductive medicine at Weill Cornell Medical College, explained in a statement to the media."Although this study doesn't look directly at fertility, we can infer that as many as half of men taking SSRIs have a reduced ability to conceive. These men should talk with their physician about their treatment options, including non-SSRI depression medications."

The scientists could not identify the exact way the SSRI caused the DNA fragmentation, but the evidence strongly suggests the drug slows sperm as it moves through the male reproductive tract from the testis to the ejaculatory ducts. When this happens, the sluggish sperm grows old and its DNA becomes damaged.

"This is a new concept for how drugs can affect fertility and sperm. In most cases, it was previously assumed that a drug damaged sperm production, so the concept that sperm transport could be affected is novel," Dr. Schlegel stated.

The study contains some good news for men currently on Paxil and related drugs who may be concerned about their fertility. All the changes the researchers found appeared to be totally reversible. Specifically, normal levels of sexual function and DNA fragmentation both returned to normal one month after discontinuation of the drug.

For more information:
http://news. med.cornell. edu/wcmc/ wc…
http://www.fda. gov/Drugs/ DrugSafety …
http://www.naturaln ews.com/026483_ SSRI_fertility_ DNA.html

Last night evening news reporters shared that a new anti-obesity drug is headed toward approval. I Googled this drug,"Contrave", to learn more.

On the the manufacturer's website, there was some technical information about this drug (see below). What caught MY eye, however, was a deviation from facts to the following commentary:

We believe that bupropion helps initiate weight loss while naltrexone may sustain weight loss by preventing the body’s natural tendency to counteract efforts to lose weight.

Really? It has been scientifically proven that the body has a natural tendency to resist weight loss?Well, if you believe that you're helpless and without any solution other than a medication, you're more likely to help this company's profit margin. That's what they need you to believe in order to satisfy their investors!

The buzz on the news was that the drug has been shown to induce a weight loss of 5%. That means if you're 250 lbs, you can expect to lose about 12 1/2 of them. We've been taught as health professionals, to tell the public that a small weight loss of 10% of body weight can have important health effects, and not to focus on large, drastic changes. But taking a pill to achieve only half of that? Not impressive at all.

I'm insulted for this blog's readers. Can't you do better than that? Can't you just tell the truth about the drug and trust that it has potential in certain cases? Which I'm sure it does? I like to think most people who I have ever come in contact with, deserve much more credit than that. They can make intelligent decisions and do not need to be manipulated in this fashion.

Here are the facts about the medication.

1. It is a combination of two medications that have been used for a variety of clinical purposes, naltrexone and bupropion (Wellbutrin).

2. Naltrexone is an opiate antagonist. According to NIH, it is"used along with counseling and social support to help people who have stopped drinking alcohol and using street drugs continue to avoid drinking or using drugs." The link above provides a pretty long list of contraindications and side effects, and they include pregnant and trying to become pregnant…not likely a great option for many of our readers.

3. Bupropion is an antidepressant that has been found to help facilitate weight loss. It's been used for this off-label purpose for a long time. Not that it can't help, especially if there is depression accompanying your weight gain (not ABOUT the weight gain but as a co-existing condition). But I believe there are many things about most of our audience that can be done to alleviate depression and normalize weight which should be tried BEFORE resorting to medication.

If anyone from Orexigen can produce peer-reviewed research supporting the claim that the body resists weight loss, they're welcome to comment on this blog.

Until that happens, I maintain that any time someone tries to tell you that you can't do something, and your believing them holds potential to transfer money from one bank account to another, you should consider the tactic a challenge to prove them dead wrong.

In addition to PCOS, I specialize in the nutritional aspects of medications affecting the brain and nervous system. That includes psych meds, Parkinson's meds…pretty much any medication that has the potential to affect how the brain and nervous system function.

A few years ago, while compiling a series of fact sheets about the nutritional implications of these medications, I started reading about the anti-obesity medication called Meridia (generic name sibutramine). This drug appeared on the market after the famous phen-fen combination was deemed dangerous. It was supposed to be a kindler, gentler alternative. And it supposedly can reduce the severity of symptoms associated with PCOS.

I was floored by what was showing up, unedited, in the peer-reviewed literature about this medication. But not at all surprised with the announcement yesterday that this drug is potentially dangerous for people with heart conditions.

Repeatedly and consistently, researchers were reporting reactions. Some of the most common problems this medication seemed to incite, were anxiety, hypertension, and elevated heart rate.

If Meridia was a drug intended to treat cancer, or glaucoma, or hangnail, and it caused this battery of symptoms, I don't think the FDA would have tolerated consistent reports that it had the ability to send the cardiovascular system into a tailspin.

Yet, in the obese research subject, in the face of these observations, researchers continued to report some of the following conclusions:

**In a 21 patient study, 40% experienced sleep disturbances and 30% complained of irritability, unusual impatience, or"excitation".
RESEARCH CONCLUSION: Sibutramine, 5 and 20 mg, added to a multimodal program assisted participants in losing weight.
Weintraub M, Rubio A, Golik A, Byrne L, Scheinbaum ML. Sibutramine in weight control: a dose-ranging, efficacy study. Clin Pharmacol Ther. 1991 Sep;50(3):330-7.

**In a review study, the author reported,"In controlled studies, 84% of sibutramine-treated patients reported adverse events, compared with 71% of patients receiving placebo. The most frequently reported adverse events are related to pharmacological actions of sibutramine, and include dry mouth, decreased appetite, constipation and insomnia. Despite the high incidence of"side effects" in the control population, the author of this article attributed the problems in the tested population to"pharmacological actions of sibutramine".
Lean ME. Sibutramine--a review of clinical efficacy. Int J Obes Relat Metab Disord. 1997 Mar;21 Suppl 1:S30-6; discussion 37-9.

**In a study of 226 people comparing sibutramine to dexfenfluramine, researchers reported,"174 patients (77%) experienced adverse events; 17 patients withdrew due to adverse events. Pulse rate increased significantly in sibutramine-treated patients." Then they concluded,"Sibutramine (10 mg once daily) is at least as effective as dexfenfluramine (15 mg twice daily) in achieving weight loss in patients with obesity."
Hanotin C, Thomas F, Jones SP, Leutenegger E, Drouin P. A comparison of sibutramine and dexfenfluramine in the treatment of obesity. Obes Res. 1998 Jul;6(4):285-91.

**In a study of 235 people, the following was reported,"a significant increase in heart rate (about 4 beats/min) was noted for patients who received 10 mg or 15 mg sibutramine, compared with the placebo." Then it was concluded,"Doses of 10 mg and 15 mg once daily were shown to be similarly effective, well tolerated and significantly more effective than the placebo."
Hanotin C, Thomas F, Jones SP, Leutenegger E, Drouin P. Efficacy and tolerability of sibutramine in obese patients: a dose-ranging study. Int J Obes Relat Metab Disord. 1998 Jan;22(1):32-8.

**In a study of 11 men, it was observed that"the sibutramine-induced increase in energy expenditure was accompanied by an increase in plasma epinephrine, heart rate, blood pressure, and plasma glucose. The conclusion:"Sibutramine caused a significant increase in both energy expenditure and satiety, which may both contribute to its weight-reducing properties.
Hansen DL, Toubro S, Stock MJ, Macdonald IA, Astrup A. Thermogenic effects of sibutramine in humans. Am J Clin Nutr. 1998 Dec;68(6):1180-6.

As of 2006, I had found 14 studies reporting an elevated heart rate with use. You can easily find them yourself in http://www.ncbi.nlm.nih.gov/pubmed/; I encourage you to see for yourself. I've supported myself here with enough references and my Saturday has other obligations prohibiting me from using it to repeat work I've already done. I hope I've encouraged you to see for yourself what I've been talking about with colleagues for several years.

I like to call this the Biggest Loser Mentality. It doesn't matter if we make these people vomit, pull a muscle, or give them a bloody heart attack. This market of obese people is just too lucrative to ignore.

If you have PCOS and you are obese, you deserve better. You're not where you are because you have a deficiency of ANY kind of medication in your body. Don't let anyone convince you otherwise.

In a study I did with over 1,000 women with PCOS who visited my website, over 85% described symptoms of anxiety and/or depression, conditions commonly treated with antidepressants. Therefore, any information I find regarding these medications and their effect on pregnancy is crucial to share.

In the study referenced in this post, over a period of almost 10 years, a total of 1,780 women who experienced 1,835 pregnancies over this time while also receiving either paroxetine (Paxil) or a combination of Paxil and at least one other antidepressants, during the first trimester of pregnancy. These women were compared to 9,008 women experiencing 9,134 pregnancies while on other antidepressants and antidepressant combinations that did not include paroxetine, in the first trimester of pregnancy, over the same period of time. The researchers report that there is a modest increased risk of congenital malformation (birth defects) in women who use paroxetine alone or in combination therapy during the first trimester of pregnancy.

Bottom line? Since often times you don't even know you're pregnant during that first trimester, if you are trying to conceive, or even having sex, and you are being treated for depression, it would be prudent to discuss an alternative to paroxetine with your caregiver.

Better safe than sorry!

Cole JA, Ephross SA, Cosmatos IS, Walker AM. Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf. 2007 Oct;16(10):1075-85. Comment in: Pharmacoepidemiol Drug Saf. 2007 Nov;16(11):1181-3.

Here is a sample page from my new drug booklet. You can order one for yourself at this link:

First of all…it's great to be back! I was traveling, and while it's kind of fun to say I saw both the Atlantic and Pacific oceans in the period of a week, I do like my base camp and I really missed reading research. I'm looking forward to getting back into my daily groove.

Last week, I read an article in the New York Times about insurance companies, and how they are starting to ask consumers to absorb the cost of medications by asking that these medications be paid for not by flat copayment, but proportionate to the cost of the medication.

Nice. First we're convinced that we absolutely need all these drugs, and that we can get them for cheap, then once we're dependent on them…we're thrown under the financial bus.

Right now, the medications that are being sold under this new proportionate plan are not any of the medications that I focus on with this blog. However…since several of the medications you readers are on, are some of the most popular medications out there, I suspect it won't be long before these insurance companies start to see dollar signs in terms of the quantity of people they can expect to help finance this venture. Categories of medications like antidepressants…and insulin sensitizers and statins, which are commonly prescribed when the antidepressants start to mess with hormone balance.

That's the bad news.

The GOOD news is, I finally felt vindicated for having sat through this scenario for the last 25 years, wishing people would see what I have always seen…that when you take responsibility for your own health, and don't depend on people who make money off of you to help you, you have a good chance of getting better results. Think about it. Why would a drug company spend millions and millions of dollars to develop a product that you eventually wouldn't need once you started using it?

My goal, ever since I started what I do, is to put myself out of business. I started learning to play golf last year and it has been very frustrating to have to put it aside to attend to the demands of my growing business. I have a children's story I'd like to publish. And there are a couple of screenplays roaming around in my head that I'd love to get into theaters.

But the drug and insurance industries don't have that goal. Their goal, as is the goal of most corporations, is to increase market share and return on investment. Which means you can (1) increase the dosages of medications you sell to already existing customers, (2) find new customers for your medications by either creating new diagnoses or finding off-label uses for your already developed products, and/or (3) increase the price you charge for the product. Hmmmmm…nowhere in there do I see"helping the patient feel better".

Of course, I'm not naive. I know some medications are entirely necessary and even life-saving. But I also see so many conditions that could drastically improve with a few judicious lifestyle choices.

Last week I listened to the husband of a friend tell me what it was like to go through an in-vitro fertilization (IVF) procedure with his wife. He was near tears as he spoke about the trauma, the callousness of the providers, the emotional stress…the expense, and the feeling of failure as a human being when the entire investment of time, emotions and money did not produce the desired result.

He drove me to the bus stop, and I headed to the airport. As I was standing in line to board my plane, a colleague phoned me. She'd gone through my professional training and had been using my protocol on women with infertility. And she told me, that with just a few nutritional tweaks, these women were getting pregnant! Not only that, their depression was responding with equal profundity. Even the women who'd failed with the same IVF procedure as my other friend and who had given up on ever having children, were seeing results.

There's something very wrong with a system that promotes a $20,000 emotional and financial (mis)adventure over a $12 bottle of Coscto fish oil…but we as consumers need to shift our expectations for help from those who stand to make money off of our misfortunes and invest in choices, behaviors, and financial purchases that are empowering and affirming. You'll never get a company making money off of you to change how they do things if it means less money. But we can certainly get their attention if, collectively, we start to say"no" to some of their answers to our problems and"yes" to options that make more sense.

You bet the power of where you pull out your wallet is tremendous. And when groups of thousands of wallets get together…well, that's the vision I have that will finally get these screenplays out of my head!

Eating well. Physical activity. Adequate sleep. Less stress. It's that simple. It's incredible what prioritizing these four areas can do to your overall health. Not to mention your budget.

http://www.nytimes.com/2008/04/15/opinion/15tues1.html?hp

Metformin, for many women, has been a miracle drug. It is the aspect of treatment that allowed them to finally conceive. Metformin is so popular it is almost expected as part of fertility treatment. So popular, in fact, that one client I referred to a reproductive practice here in Phoenix, before even being seen by her physician, was told by his receptionist…that she would be receiving a prescription for metformin on her visit.

That is not to say metformin is perfect, or that it is for everyone. A new article by a prominent PCOS researcher suggests that a"not so fast" approach to metformin use might be more appropriate. Dr. Dunaif at Northwestern University in Chicago writes that in her analysis of the data, metformin is no more effective than clomid in increasing pregnancy rates. She also writes that there is no evidence to support the use of metformin to prevent miscarriage or gestational diabetes.

She doesn't stop there. Mentioning the recent findings about increased cardiovascular risk with Avandia (rosiglitazone) and Actos (piaglitazone), she suggests that their use may not provide long-term health benefits.

Of course, I'm biased, being a dietitian and seeing our program work as well as it has, and I believe just a few simple dietary tweaks and diligent, consistent use of them…is incredibly important in the PCOS big picture. Whether or not you are pursuing conception.

If you're a woman considering or just beginning treatment for PCOS for infertility…or just PCOS in general, it might behoove you to bring this reference to your physician for review. These medications may still be appropriate in your individual case, but it is important to understand that no treatment is perfect or without risk. An informed decision based on input from both you and your physician will be sure that the best possible course of action was the one you decided on.

Dunaif A; Medscape. Drug insight: insulin-sensitizing drugs in the treatment of polycystic ovary syndrome--a reappraisal. Nat Clin Pract Endocrinol Metab. 2008 May;4(5):272-83.

Source: amazon.com via Jason on Pinterest

One of the most frequently asked questions we get at inCYST, is whether or not a specific food raises blood glucose. It is understandable, given the fact that women with PCOS are insulin resistant and highly likely to develop diabetes, that this would be a concern.

And in response to that concern, it is understandable that nutrition and wellness experts often quote a list of foods to avoid in order to maintain a low-glycemic diet.

Did you know, this"low glycemic" list is highly variable? That even though there are trends, certain foods may affect one person more than another? and that a food that has a tendency to be"high glycemic" on its own…may be perfectly fine when eaten with a mixed meal?

Those high glycemic lists floating around the Internet tend to report the response of your body to a food when it is eaten by itself. So all of those people telling you not to eat carrots or bananas are not telling you the entire story. We rarely eat that way. If you dip carrots in hummus, or eat a banana in a smoothie with Greek yogurt, for example, your body will respond completely differently to that nutrient mix than it would eating either of those foods by themselves.

So when you ask us if a food raises blood sugar and whether or not you should eat it, unless someone has measured YOUR blood sugar two hours after you have eaten it, any advice they give you is pure surmising and not based on relevant factual information.

You can do these tests yourself, you know. All you have to do, is buy a glucose meter at your nearest drug store and test your blood sugar a couple of hours after eating a meal. And before you conclude whether or not a food doesn't work for you, you need to try it alone, in a mixed meal, and at different times of day in order to determine how your body interacts with it.

My point here is, a nutrition, fitness, or wellness expert who is merely parroting information he or she has read on another website and is not customizing that advice to YOU is doing you a disservice. You may be cutting out perfectly healthy foods that you could eat in the right situation. You may be dealing with a food sensitivity that is not going to respond to a low glycemic diet.

Why waste time on information anyone can Google when you can tailor information to your own personal situation?

We love to do this kind of detective work at inCYST, and our network members have taken a lot of time to learn how to interpret that kind of data and make specific recommendations based on how YOUR body works.

Listen to someone who doesn't know you and who may be misguiding you, for free…or get evidence-based, customized information with personal relevance. It may cost you in the short term but save you a lot of trouble in the end.

Last week I had the opportunity to hear James May, the founder of Wisdom Natural Brands, based here in Phoenix, tell his story of how he became involved with developing the stevia industry. Below is a white paper he shared with us that is referenced and provides a lot of very interesting information. This is a business paper, not a scientific publication, but it does contain references that can get you started if you're looking for more information.

It's not just a sweetener, apparently it has some endocrine and appetite effects as well (may decrease your appetite for sugar), and a new study suggests it may help to improve memory.

Also, I'm providing a link to a brand new website, Stevia University, which is a resource for all things stevia. Be sure to bookmark it!

Stevia Rebaudiana Bertoni Prepared by James A. May and provided as an educational service by Wisdom Natural Brands
Stevia has been correctly framed as the promised sweetener that can help resolve many of the world's sweetener, obesity, and diabetes concerns. Stevia can also solve much of the poverty of the farmers in third world countries by giving them a cash crop to grow, even improving the productivity of their soil and the quality of their other crops.
Stevia can be the next generation of the world's most preferred steetener. Consumers are becoming even more excited as they learn that stevia extract was not originally a chemical invention targeted for a totally different purpose, such as a drug or insecticide, which, after it was tasted, became an artificial sweetener (1).
Stevia, in its various forms has always been a natural sweetener that also offers numerous health benefits. In its natural forms it has been in use in parts of South America for more than 1500 years and, as a high intensity sweetener, in Japan and Asia for over 35 years. (2) Millions of people have ingested stevia daily and there has never been a documented adverse reaction reported (3).
Modern consumers have joyful anticipation for increased use of this sweetener that does not cause fat storage, does not adversely affect blood sugar or blood pressure, reduces caries and gum disease, does no harm, is good for the human body and — can taste great — depending on the extraction methods utilized.
The Joint Expert Committee on Food Additives (JECFA) of the World Health Organization has studied and approved 9 of the numerous naturally occurring glycosides residing in stevia leaves to be safe for human consumption in high intensity sweeteners. They are: stevioside, rebaudioside A, rebaudioside B, rebaudioside C, rebaudioside D, rebaudioside F, dulcoside A, rubusoside, and steviolbioside. Any combination of these glycosides totaling a minimum of 95%, the balance being other components of the stevia leaf, meets the standard set.
HECFA refers to steviol glycosides rather than stevia glycosides in determining acceptable daily intake (ADI) amounts of 4 mg per kilogram of body weight. This provides a 100-fold safety factor, meaning the human body can handle 100 times this amount and still be within the safety limits. However, steviol is one of three metabolites (i.e. the breakdown aglycones being steviol, isosteviol, and a unit of glucose) of the stevia glycosides, therefore, this related to 12 mg of the naturally occurring stevia glycosides per kilogram of body weight. Stevia glycosides are broken down into the three metabolites by bacterial action in the intestinal tract. It is well documented that steviol and the other metabolites are entirely excreted from the body.
In a presentation of the recent science regarding stevia at the 2009 annual meeting of the Calorie Control Council, Claire C. Kruger, PhD, DABT, CEO of Spherix Incorporated, a biopharmaceutical company, reported that"Stevia glycosides have very low toxicity in animals and there is no evidence of risk in humans, including repeat dose systemic toxicity, carcinogenicity, developmental, or reproductive effects. The weight of evidence indicates that steviol glycosides are not genotoxic." She also reported that"Stevia extracts and steviol glycosides show no DNA damage in a broad array of in vitro and in vivo assay," and that the"safety of ingestion of steviol glycosides in hmans has been corroborated in clinical trials; measures of tolerance, body weight, clinical chemistry, hematology and urinalyis did not show any evidence of untoward effects." She reported that critical newly published studies (5) resolve questions about any untoward effects after long term repeated exposure to steviol glycosides.
The Proceedings of the 3rd Stevia Sumposium 2009, held in Belgium reported recent scientific studies that found that,"Stevioside (i.e. the combination of Stevia glyucosides- lowered glucose, insulin and cholesterol. It had no effect on triglycerides or glucose tolerance," and that it"inhibited atherosclerosis by reducing macrophage, oxidized LDL and lipids. Furthermore, stevioside treatment increased the smooth muscle area of the plaque. This increase, together with the reduction of macrophages resulted in an increase of the smooth muscle cell-to-macrophage ratio". The scientists concluded by stating that"this is the first report showing an association between stevioside treatment and increased adiponectin and insulin sensitivity, improved antioxidant defense and reduced atherosclerosis. The decrease of oxidized LDL by stevioside is particularly important in view of our recent observation that LDL is associated with metabolic syndrome components." (6) No allergic reactions to stevia have been reported (7).
A patent application submitted to the US Patent Office, dated February 17, 2011, makes several significant claims, as a result of their scientific research, pertaining to stevia and brain function."Thus to summarize, stevia extract enabled improved learning and memory performance, to a similar, or better, extent as a natural reference substance, ginkgo biloba, and a pharmaceutical positive control compound, rolipram. These data showed that stevia-treated mice not only learned better than other groups but also retained their memory for a longer time period." When the product was given to human subjects they reported that,"Cognitive function, alertness and the ability to focus on work are seen to improve." The product they used was make by cooking leaves in water and is basically the same product sold by SweetLeaf (R), as stevia concentrate, since 1982.
SweetLeaf Stevia Sweetener is the only commercially available stevia extract that is made with a revolutionary new technology that uses only cool purified water and a series of filters. All other brands, currently in the market, utilize old technology that incorporates various chemicals, solvents and alcohols, including ethanol and methanol. Because stevia extracts can be between 200 and 300 times sweeter than sugar, they must be blended with other ingredients utilized as a carrier to make them palatable as a table-top sweetener. While all other brands use a sugar product, SweetLeaf(R) uses inulin, extracted from chicory root, which is a natural soluble fiber and prebiotic, thus creating a sweetener that improve health and vitality. SweetLeaf (R) wass the first stevia brand in the United States to acienve the FDA GRAS (Generally Recognied As Safe) designation.
REFERENCES
1. Aspartame was developed in 1965 by GD Searle, a pharmaceutical company, to be a prescription only drug for peptic ulcers. After it was tasted the company began the process to obtain FDA acceptance as a sweetener,which was achieved in 1981. According to Discover Magazine, 20 Things You Don't Know About Sugar, Sucralose (Splenda) was originally developed to be an insecticide (Oct. 2009, 121).
2. May, James A, The Miracle of Stevia, Kensington Publishing Corp. New York City, NY, 2003, 7, 32-42.
3. Geuns, Jan MC. Review: The Safety of Stevioside Used as a Sweetener, Proceeding of the first symposium: The Safety of Steviiside, KULeuven, 2004, 112.
4. http://www.steviauniversity.com/. Health and Healing Benefits of Stevia.
5. Ferri et all 2006; Jeppesen et al 2006; Barriocanal et al 2008; Maki et al 2008.
6. Gerraert, Benjamine et a, Natural Sweetener Stevioside Inhibits Atherosclerosis by Increasing the Antioxidant Defense in Obese, Insulin Resistant Mice, Atherosclerosis and Metabolism Unit, Deptarmtne of Cardiovascular diseases and Leuven Food Science and Nutrition Research Center Laboratory of Functional Biology, Katholieke University, Leuven, Belgium.
7. Geuns, op cit p. 85.

Source: Uploaded by user via Monika on Pinterest

Last week I was at the farmer's market, admiring a beautiful box of greens. I noticed a woman looking longingly at the same box. So I asked her if she liked kale.

"Oh, I do!" she answered."But I had to give it up when my husband went on Coumadin."

Coumadin is a blood-thinning agent that is being prescribed more frequently than it used to be, as blood that clots too easily is one consequence of inflammation. Since leafy greens are high in vitamin K, a nutrient that promotes blood clotting, patients prescribed Coumadin are advised to limit their intake to a level they can consistently commit to eating. That commitment factor intimidates many people out of eating them at all.

What is ironic about the Coumadin dilemma, is that leafy greens are packed with omega-3 fatty acids and antioxidants, both of which hold potential to fight the very inflammatory process that is likely creating the need for Coumadin in the first place.

So how does one back themselves out of this corner once their previous lifestyle has backed them into it?

Here are a few things to try. Note, Coumadin is NOT a drug to mess with, so if you choose to make these suggested changes, it is essential that you communicate with the physician in charge of managing your blood clotting issues. If your condition is improving, medications will have to be adjusted to maintain clotting balance. It is best to make these shifts one at a time and wait 6 to 8 weeks to see how your body responds, rather than make too many changes at once, which can make it challenging for your physician to keep up with what is happening.

1. Shift your fat consumption, as much as possible, away from omega-6 fatty acid-dominant fats. They are easy to remember, they primarily begin with the letters"s" and"c"--soybean, safflower, sunflower, sesame, corn, and cottonseed. (Canola is the exception to this rule). They are primarily found in processed foods and in restaurant cooking, places where the price, not the quality, of the oil, is determining recipe makeup.

Check in with your physician to see how you are doing.

2. Add more vegetarian, non-leafy omega-3 foods into your diet. Flax is one of my favorites. You can add ground flaxseed into your smoothies, oatmeal, homemade vinaigrettes…and you may want to try a relatively new product on the market, flax milk, as a substitute for coffee creamer. If you are adventurous, try some chia seeds on your salad!

Check in with your physician to see how you are doing.

3. Try a protein-containing snack at night. It can help to stabilize blood sugar and cravings for sweets throughout the day, which keep you from being tempted by baked goods containing those oils.

Check in with your physician to see how you are doing.

4. Work on getting your seafood omega-3's. Note: ALL seafood, not just salmon, contain omega-3 fatty acids. If salmon is too fishy for your taste, spend some time at a knowledgeable seller such as Santa Monica Seafood, and try some of the recommendations they have. One of my favorites, which is available at Santa Monica Seafood, as well as Safeway, is barramundi, a sustainably farmed, mild-flavored whitefish that has a lot of versatility with regards to cooking technique.

Check in with your physician to see how you are doing.

5. If you are not a fish eater, consider a fish oil supplement. Despite what the supplement companies tell you, fish is fish; I've seen great changes in clients using Costco's Kirkland brand. The most important thing about using fish oil when you are taking Coumadin, is that you take it consistently. If remembering it is a challenge, program your smart phone to send you a daily reminder.

Check in with your physician to see how you are doing. If your clotting times have improved enough to get the greens-eating go ahead, good for you!

Later this week I will share some ideas for getting greens in your diet consistently without burning out on them.

I've been researching agave nectar over the past few weeks. I'm learning is that even though it is not a miracle food, and cannot be eaten in endless quantities without consequences, it's a viable option for a sweetener.

In order to get to that conclusion, I had to swim through quite a few websites, tweets, and Facebook posts. Many of them sounded formidable. However, what I discovered in the proccess, was that a few posts and tweets that were getting the most circulation, could be traced back to a few sources.

One of those sources was a very official looking website. At first glance, it appears that this organization is accredited and connected to several credible organizations, including the American Diabetes Association, the American Dietetic Association, the US Department of Agriculture, and the US Food and Drug Administration. Their logos all appear on the home page.

However, when I decided to fact check, both ADA's responded to my inquiry by denying any official type of affiliation. I'm pasting excerpts from the USDA's response below.

The website apparently has patents on its name, the lead researcher's name, among others, so I will oblige them and not mention them here. Suffice it to say you'll find it pretty easily if you're researching agave nectar and/or glycemic index.

It's easy to find yourself swimming in all kinds of information from"experts" and organizations. But because it takes a little bit of time to fact check, many people don't bother.

What I ask all of you to do in your own Internet activity, is to resist the impulse to tweet or hit the send button unless you are confident that what you're reading can be supported with facts. All four of the organizations I contacted were more than expedient with their responses and willing to help me understand what was true and what was not. I encourage you to use them in your own fact checking ventures.

********************************************************************************

Here is what the FDA said:

For your information, the linked articles that are…attributed to USDA, while apparently legitimate, may not have been properly cited as to the original source, and in one case, gives the appearance of being a USDA publication in error. The articles …were originally published on the USDA/ARS’ Web site in 2005 and 2007.

The first article listed under the USDA logo, is not actually a “publication” …posted on the USDA site (nor is this a USDA publication, as it may appear), but rather a comment made during the formation of the 2005 Dietary Guidelines for Americans and submitted to USDA and the Department of Health and Human Services. You can view the original comment in the comment database here (which is accessible to the public): http://www.health.gov/dietaryguidelines/dga2005/comments/ViewTopics.asp?TopicID=5&SubTopicID=22&submit1=Submit

I'm passing this along since the coexistence of depression and pregnancy is so very high amongst the readers of this blog. Findings like these are a huge reason I am so adamant about finding ways that nutrition and nonpharmacological treatments can keep both mother and baby healthy all the way through conception and pregnancy.

To see this story with its related links on the guardian.co. uk site, click here

Antidepressants linked to premature birth risk

Tuesday October 6 2009
BMJ Group

Mothers-to-be risk having a premature birth if they take commonly used antidepressants during pregnancy, a new study has found. Antidepressants called SSRIs (the group of drugs that includes Prozac) were also linked to a higher risk of babies needing treatment in intensive care soon after birth.What do we know already?

More than 1 in 10 women become depressed during pregnancy. In cases where doctors recommend drug treatment, the first choice is often a selective serotonin reuptake inhibitor (SSRI).

Doctors are advised that pregnant women should take SSRIs"only if potential benefit outweighs risk". Unfortunately, there's little research on how safe these drugs are during pregnancy. We do know that SSRIs get into the unborn baby's bloodstream, and that some babies get withdrawal symptoms soon after birth. Some research also suggests that babies may be more at risk of heart defects if their mother takes an SSRI called paroxetine in the first three months of pregnancy, although this problem is not common.

A new study has looked at 329 women who were taking SSRIs while pregnant. The health of their babies was compared with the health of babies born to women not taking antidepressants. Some of the women in this latter group had mental health problems, while others did not.What does the new study say?

Women taking an SSRI had twice the risk of a premature birth. On average, women gave birth four or five days sooner if they took an SSRI while pregnant. But the results don't tell us the actual numbers of women in each group who gave birth prematurely, so we can't say what the actual risk is.

About 16 in 100 babies needed treatment in an intensive care unit if their mother had taken an SSRI, compared with 7 in 100 babies whose mothers were healthy, and 9 in 100 babies whose mothers had a mental health problem but who weren't taking an SSRI.

Babies also appeared less healthy overall if their mother had taken an SSRI. This was measured looking at their skin colour, how much they moved about, their pulse rate and breathing, and how much they responded to stimulation.

SSRIs didn't increase the risk of having an underweight baby. The study only looked at what happened around birth, so we don't know whether or not SSRIs have longer-term consequences. How reliable are the findings?

This is a fairly good study. Since it also included a group of women who had mental health problems but who were not taking an SSRI, we can partly rule out the possibility that mental health issues affected the baby's health rather than antidepressants. However, it could still be that women taking SSRIs were more seriously depressed than the women they were compared with, or that they had worse overall health. This factor might have affected the health of the babies, and it makes the study less reliable.Where does the study come from?

The women who took part in the research all had antenatal care at a hospital in Aarhus, Denmark. The study appeared in a journal called Archives of Pediatrics & Adolescent Medicine, published by the American Medical Association. Some of the funding came from the Danish Medical Research Council.What does this mean for me?

The study suggests that, in the short term at least, there could be some negative consequences to taking SSRIs while pregnant. What the research doesn't tell us is how the risks of SSRIs in pregnancy compare with the dangers of untreated depression.

Depression itself can affect how babies grow. It can also cause unpleasant symptoms for the mother. There's a high chance of becoming depressed again when women stop taking antidepressants when they're pregnant. So, we can't simply say that pregnant women should completely avoid SSRIs.What should I do now?

If you're pregnant and taking an antidepressant, don't stop treatment suddenly. You could put yourself at risk of unpleasant withdrawal symptoms, and your depression could come back. Your doctor can help you weigh up the risks and benefits of treatment. If you and your doctor decide it's the right thing to do, you'll need to come off your medicine gradually. You could also ask about other types of treatment, such as talking therapy.

If you're taking antidepressants and you want to get pregnant, talk to your doctor. Depending on how severe your depression is, your doctor might suggest slowly coming off your medicine, or continuing to take it.From:

Lund N, Pedersen LH, Henriksen TB. Selective serotonin reuptake inhibitor exposure in utero and pregnancy outcomes. Archives of Pediatrics & Adolescent Medicine. 2009; 163: 949-954.
BMJ Publishing Group Limited ("BMJ Group") 2009

Two days ago a story made its way around the Internet, promoting the idea that 8 year old girls experiencing early puberty might benefit from metformin administration to delay the progression of PCOS. The argument was that these girls needed their fertility"protected". What the article neglected to acknowledge was that while metformin does appear to improve the rate of conception, it does not reduce the rate of miscarriage. I've written about this in a previous post.

I wrote an article with more detail about my feelings about this issue for my writing assignment as the Beverly Hills Women's Health writer for the Los Angeles Examiner. If you didn't know I also write over there, you can find all of my posts through the link I provided above.

With all due respect to the researchers so very excited to report this finding, I'm not impressed. Our little girls need to be treated as if they are more than just another profitable target market for a drug that has lost its patent and is looking for a new clinical indication/patent opportunity/way to keep sales going.

I mean, you'd think after spending 5 1/2 hours on this blog in the past year the researchers at Bristol Myers Squibb would've come up with something far more creative and helpful. So, BMS researchers, I would have told you this if you'd flat out asked, but since I don't have the money to build a research lab with anywhere near the capability of yours and just want someone to pursue the idea on behalf of helping 1 out of 10 women achieve better quality of life…I'll tell you what I would have told you had you been willing to admit you were even reading my stuff when I contacted you about it. Here is what I would do to get the patent and keep the revenue coming in so your reproductive scientists can keep their jobs.

Since the American public has now been conditioned to believe if it's not a prescription medication it can't possibly work, I propose you figure out a way to manufacture a metformin/fish oil combo pill. That way you get your money and the women who need the fish oil…actually take it.

There. You heard it here first. If you actually do something with this idea, sure would be nice to get some credit for it.

Oh and BMS, thanks for all the time on the blog. You've really helped our advertising rates, which helps us to research and advocate for non-medicinal answers to hormone problems. We'll never put you out of business…but we just might be able to give you a little bit of a run for your money.: )

I've told many a client they're sick and they've been playing catch up since before they were even born. Others feel the same way, too…this was recently published in USA Today:

By Liz Szabo, USA TODAY
Keishawn Williams is already talking to her baby, although her child isn't due until November.

"What are you doing?" asks Williams, 22."Are you awake? Are you asleep? Why are you sitting on my bladder?"

Although Williams may not realize it, her body and baby are also conducting a separate, even more important conversation that may influence her child's health for the rest of its life. Although neither mother nor child is aware of this crucial dialogue, Williams' body already is telling her baby about what to expect from the world outside, says Mark Hanson, a professor at the University of Southampton in England.

And thanks to those biological signals, the choices that Williams makes today — by getting good prenatal care, eating nutrient-packed vegetables and avoiding alcohol, tobacco and caffeine — may help her baby long after birth, Hanson says. Research into the"developmental origins of adult disease" suggests that Williams' healthy living may help her child avoid problems such as cancer, heart disease, depression and diabetes not just in childhood, but 50 years from now.

Though adults still need to eat right and exercise, a growing number of studies now suggest the best time to fight the diseases of aging may be before babies are even born, says Peter Gluckman of the University of Auckland in New Zealand.

Williams' baby is still too young to kick, let alone ponder its future. But its body is already adapting and preparing for its specific environment, Gluckman says, by reading cues sent through Williams' blood and amniotic fluid.

"Every baby in fetal life is adjusting its pattern of development according to the world it predicts it will live in," he says.

Reading cues while in utero

During the crucial"window of opportunity" before birth and during infancy, environmental cues help"program" a person's DNA, says Alexander Jones of Great Ormond Street Hospital in London and the University College of London Institute for Child Health. This happens through a delicate interplay of genes and the environment called epigenetics, which can determine how a baby reacts for the rest of its life, Jones says.

Through epigenetics, chemical groups attach to DNA. Although they don't change the order of the genes, the chemical groups can switch those genes on or off, Jones says.

Many things, such as chemical contaminants, can cause epigenetic changes. So babies exposed in the womb to synthetic hormones may begin responding abnormally to the natural hormones later made by their own bodies, says Hugh Taylor of Yale University School of Medicine.

That's why, doctors believe, many babies exposed before birth to a drug called DES, or diethylstilbestrol, later developed rare cancers or fertility problems, Taylor says.

Doctors stopped prescribing DES, which had been used for decades to prevent miscarriages, in 1971. But Taylor and other scientists are concerned that"hormone-disrupting" chemicals, such as those used in pesticides and even common plastics, could cause similar problems.

Babies and children also can develop abnormal reactions to stress, says Jack Shonkoff of Harvard University, co-author of a June paper on early influences in health in The Journal of the American Medical Association.

In the short term, reacting to typical, everyday difficulties can help people develop a healthy response to stress.

But persistent,"toxic" stress — such as neglect or extreme poverty — may program a child's nervous system to be on perpetual high alert. Over time, this can damage the immune response and lead to chronic ailments, such as heart disease and depression, the study says.

Diet as a predictor

A pregnant woman's diet tells a fetus a lot about its future environment, including how much food will be available after birth, Jones says.

A baby conceived during a famine, for example, might learn to be"thrifty," hoarding every calorie and packing on fat rather than muscle, even at the expense of developing vital organs, such as the kidneys, liver and brain. Because of a lack of calories, the baby also may be born small.

In a famine, those early adjustments and predictions about the future could mean the difference between survival and starvation, Jones says.

But babies may run into trouble if the world doesn't match their predictions, Jones says.

A baby who has learned to hoard calories, for example, may grow up to be fat or diabetic once he or she finally gets enough to eat, Jones says. Doctors believe this occurs not just with babies whose mothers are starving, but with those who are malnourished because of a mother's medical problems, poor nutrition or exposure to tobacco smoke, which damages the placenta.

It's well known, Taylor says, that women who smoke are more likely to have low-birth-weight babies, who are in some ways"starved" for nutrients in the womb. Babies born too small are at risk for many immediate problems, such as underdeveloped lungs and bleeding in the brain.

If they survive, these youngsters also face long-term risks.

Studies show that small babies who gain weight rapidly in infancy or childhood — a sign that bodies are already making the most of every calorie — also have higher rates of adult heart disease and diabetes, Jones says.

Specialized X-rays have shown babies of young mothers with poor diets in India, for example, are born with extra belly fat, even though they seem to be a normal weight. Once these babies start getting an adequate diet, they are likely to put on weight, Gluckman says.

"Even by the time of birth, they're on a different pattern of development," Gluckman says.

Teaching future mothers

Adversity in early life can increase a child's risk of disease, but it doesn't seal his or her fate, Shonkoff says.

Although emotional abuse in childhood increases the risk of adult depression, for example, supportive relationships with adults can help children cope and recover, Shonkoff says.

Communities also can help, Gluckman says. By helping women such as Williams get good prenatal care and nutrition, for example, communities can reduce the number of fetuses who are malnourished and born small, Gluckman says. Babies who are born at normal weight are more likely to maintain that healthy weight.

Because half of pregnancies are unplanned, women need to learn about nutrition — and maintain healthy diets — long before they conceive, Gluckman says.

"We have got to give far greater focus to mothers, the women who are likely to become mothers and to the care of newborn children than we have in the past," Gluckman says.

Williams, who also has a 1-year-old son and 5-year-old daughter, says she's trying hard to give her children a bright future. She breast-fed both and now works as a breast-feeding peer counselor at the Family Health and Birth Center in Washington, D.C., where many patients are low-income or minority mothers.

The birth center also aims to help babies by getting their moms good prenatal care.

About 6% of black mothers who delivered at the birth center had low-birth-weight babies, compared with the citywide average of 14.2% for black mothers, says the center's Ruth Watson Lubic.

"Twentieth-century medicine dealt with child health and adult health separately," Shonkoff says."What 21st-century medicine is telling us is that if we want to change adult health, we have to look in babies, even before they're born."

It keeps happening. I keep getting inquiries that are pretty clearly indicative of how little attention is focused on a huge issue, PCOS, and how much ground inCYST has gained in the progress of trying to change that.

--Several months ago, a noted researcher with an interest in PCOS wrote and told me he was interested in being considered to join my"board". I had to tell him I didn't have one!

--A reporter recently asked me for a photo of our"institute". I had to tell her that right now we're just virtual.

--Twice in the last week, I've been asked where someone might donate money to support PCOS research.

The second inquiry, yesterday, was my inspirational moment. It came through one of our network members, who had inspired one of her support group members enough to start exercising. This woman decided she wanted to run her first 5K race to celebrate her commitment to wellness. And she wanted to use her race running as a means to raise money to donate to PCOS research.

Only everywhere she turned and tried to give money…she was turned away. Someone actually told her the cause wasn't"sexy enough" to be worth raising money for.

I was appalled. I've spent years at this point listening to women with PCOS share their stories, their frustration, their heartache, their desire to just know what they need to do. I've seen, time after time, the benefits of simple lifestyle changes. And I've also personally witnessed the battle these women have to fight to be taken seriously. They deserve better than to be told their illness is not sexy enough for researchers to care about.

My emotional response was probably fueled by the story WVEC reporter Lucy Bustamante recently put together, in which a physician treating PCOS admitted that women don't often get the right diagnosis because the tests it would take to do so"are just too expensive."

Over the summer, someone in the reproductive medicine department of Bristol Myers Squibb spent about 7 hours of time reading 378 pages of inCYST content. I remembered that during my conversation yesterday, and thought two things.
--Apparently these women are sexy enough to keep making medications for and taking their money for.
Even though these women are too expensive to thoughtfully treat, given the fact that they comprise 10%
of the female population, they are a great revenue source to target in research projects.
--If we got that much attention from the people doing the"real" research, it seems to me that on our own
inCYST has what it takes to be a rockin' research institute.: )

I decided, the moment I heard the words"not sexy enough", that it was time to stop turning all these inquiries away and start pulling together all of those resources to do something different.

So, thanks to the small but profound and genuine gesture of the exact kind of person inCYST was created for, a woman who simply wants answers, I'm going to start the procedure for pulling together a not-for-profit arm of inCYST, devoted to research. Only our research will be different in nature. We want to encourage the kind of research that has a hard time getting funded, because it does not involve drug research. We want to balance the message that is out there and add credibility to the message we want you all to hear. And we want to be sure the supplements you all spend money on…are actually worth spending money on.

I have a lot of work to do, but I'm willing to do it if you're willing to help make it happen. My first step is the paperwork, and because that involves an attorney's work, it will cost money. I do not have an avenue for collecting donations right now, but I am posting this announcement so that anyone who might be interested in making a donation in the future might be able to write me and let me know where to find them when we're ready to take the plunge. It's not really all that much to get started, about $1000, so I think it's entirely doable.

If you are interested, please send me an email at marika@google.com.

Remember, it was a small gesture that prompted me to act. A lot of small gestures, pooled together, can make a huge difference.

Let's get this research party started!

Last week on the PCOS Challenge Radio Show, I was asked about the relationship between CoQ10 and fertility. I promised Sasha I would investigate the issue, since I did not have an informed answer on the tip of my tongue. Here is that answer!

My gold standard for information is peer-reviewed literature in the National Library of Medicine database. When I used the keywords,"CoQ10" and"PCOS", there were no studies listed. When I used the keywords,"CoQ10" and"fertility", 16 different references appeared, but none of those references were about fertility in women. Two studies did report an association between low CoQ10 levels and miscarriage.

When I used the keywords,"fertilization" and"CoQ10", abstracts from the list of studies done on men were all that appeared.

Bottom line: CoQ10 could be important for conception and maintaining pregnancy, but there have been very few studies on the topic, and none of them that I found had a recommended dose. It may be important with this particular supplement to consider the father's regimen as well.

What is CoQ10, anyway? CoQ10 is an antioxidant made by our own bodies. As the Mayo Clinic writes, CoQ10 levels are reported to decrease with age and to be low in patients with some chronic diseases such as heart conditions, muscular dystrophies, Parkinson's disease, cancer, diabetes, and HIV/AIDS. Since PCOS is a pre-diabetic, inflammatory condition, it makes sense that there would be interest in its role in this diagnosis as well. The link I provided above also evaluates the strength of the evidence supporting the use of CoQ10 for a variety of medical conditions.

For adults, Mayo also reports a dose 50-1,200 milligrams of CoQ10, in divided doses, by mouth, to be what was commonly reported.

Even though CoQ10 may help prevent miscarriage, it has also been known to reduce blood glucose levels. This can be a plus…but when another life is being taken into consideration, and the detailed effects of exactly how blood glucose responds to CoQ10 in supplemental amounts, given the fact that the use of CoQ10 has not really been studied during pregnancy, my first inclination is to not recommend it for women with PCOS who are trying to conceive and who may be pregnant without knowing it.

CoQ10 levels have been found to be lower in people using certain medications, such as statins (which lower cholesterol), beta-blockers (which stabilize heart rate), and blood pressure medications. If you are not trying to conceive and you are on medications in any of these categories, it wouldn't hurt to ask your pharmacist and physician about the potential benefits of supplementation.

CoQ10 is an antioxidant. It makes sense to me that in an inflammatory condition such as PCOS, there would be a risk of lower levels. But rather than view this as a situation where you have PCOS because you have low levels of CoQ10, I encourage you to consider whether your CoQ10 levels are lower than they should be, because of choices you are making that promote inflammatory processes. This blog is full of information about ways to slow down inflammation (which, in essence, is accelerated aging). There are many things you can do which can head off the need for even needing a supplement.

And you thought this potentially magical compound was going to replace the need for healthy eating, activity, stress management, and sleep hygiene choices. Cyster friends, if that was true, you wouldn't have spent all that money on all that CoQ10 and still be here looking for another answer. Dang!

Mancini A, Leone E, Festa R, Grande G, Silvestrini A, de Marinis L, Pontecorvi A, Maira G, Littarru GP, Meucci E. Effects of testosterone on antioxidant systems in male secondary hypogonadism. J Androl. 2008 Nov-Dec;29(6):622-9. Epub 2008 Jul 17.

Littarru GP, Tiano L. Bioenergetic and antioxidant properties of coenzyme Q10: recent developments. Mol Biotechnol. 2007 Sep;37(1):31-7. Review.

Li W, Li K, Huang YF. [Biological function of CoQ10 and its effect on the quality of spermatozoa]. Zhonghua Nan Ke Xue. 2006 Dec;12(12):1119-22. Review. Chinese.

Mancini A, De Marinis L, Littarru GP, Balercia G. An update of Coenzyme Q10 implications in male infertility: biochemical and therapeutic aspects. Biofactors. 2005;25(1-4):165-74. Review.

Li K, Shi Y, Chen S, Li W, Shang X, Huang Y. Determination of coenzyme Q10 in human seminal plasma by high-performance liquid chromatography and its clinical application. Biomed Chromatogr. 2006 Oct;20(10):1082-6.

Sheweita SA, Tilmisany AM, Al-Sawaf H. Mechanisms of male infertility: role of antioxidants. Curr Drug Metab. 2005 Oct;6(5):495-501. Review.

Balercia G, Mosca F, Mantero F, Boscaro M, Mancini A, Ricciardo-Lamonica G, Littarru G. Coenzyme Q(10) supplementation in infertile men with idiopathic asthenozoospermia: an open, uncontrolled pilot study. Fertil Steril. 2004 Jan;81(1):93-8.

Mancini A, Milardi D, Conte G, Bianchi A, Balercia G, De Marinis L, Littarru GP. Coenzyme Q10: another biochemical alteration linked to infertility in varicocele patients? Metabolism. 2003 Apr;52(4):402-6.

Balercia G, Arnaldi G, Fazioli F, Serresi M, Alleva R, Mancini A, Mosca F, Lamonica GR, Mantero F, Littarru GP. Coenzyme Q10 levels in idiopathic and varicocele-associated asthenozoospermia. Andrologia. 2002 Apr;34(2):107-11.

Ducci M, Gazzano A, Tedeschi D, Sighieri C, Martelli F. Coenzyme Q10 levels in pigeon (Columba livia) spermatozoa. Asian J Androl. 2002 Mar;4(1):73-6.

Palmeira CM, Santos DL, Seiça R, Moreno AJ, Santos MS. Enhanced mitochondrial testicular antioxidant capacity in Goto-Kakizaki diabetic rats: role of coenzyme Q.
Am J Physiol Cell Physiol. 2001 Sep;281(3):C1023-8.

Sinclair S. Male infertility: nutritional and environmental considerations. Altern Med Rev. 2000 Feb;5(1):28-38. Review.

Alleva R, Scararmucci A, Mantero F, Bompadre S, Leoni L, Littarru GP. The protective role of ubiquinol-10 against formation of lipid hydroperoxides in human seminal fluid. Mol Aspects Med. 1997;18 Suppl:S221-8.

Lewin A, Lavon H. The effect of coenzyme Q10 on sperm motility and function. Mol Aspects Med. 1997;18 Suppl:S213-9.

Angelitti AG, Colacicco L, Callà C, Arizzi M, Lippa S. Coenzyme Q: potentially useful index of bioenergetic and oxidative status of spermatozoa. Clin Chem. 1995 Feb;41(2):217-9.

Mancini A, Conte B, De Marinis L, Hallgass ME, Pozza D, Oradei A, Littarru GP. Coenzyme Q10 levels in human seminal fluid: diagnostic and clinical implications. Mol Aspects Med. 1994;15 Suppl:s249-55.

Noia G, Littarru GP, De Santis M, Oradei A, Mactromarino C, Trivellini C, Caruso A. Coenzyme Q10 in pregnancy. Fetal Diagn Ther. 1996 Jul-Aug;11(4):264-70.

Noia G, Romano D, De Santis M, Cavaliere AF, Straface G, Alcaino S, Di Domenico M, Petrone A, Caruso A, Mancuso S. [The antioxidants (coenzyme Q10) in materno-fetal physiopathology][Article in Italian] Minerva Ginecol. 1999 Oct;51(10):385-91.

The last time I wrote about marijuana it brought enough traffic to this blog with the search words,"PCOS" and"marijuana" I figured the subject should be addressed in more detail.

Did you know that our bodies naturally make their own cannabinoids? They are compounds that are needed for a variety of processes, ranging from appetite to pain sensation to mood to memory.

Cannabis, an external cannabinoid, affects these functions as follows:

1. Interferes with both long and short term memory. If you're smoking pot and experiencing brain fog, there just might be a connection.

2. Increases appetite (like I had to tell you that!) When your internal (endo) cannabinoid system is out of balance, it too affects appetite. Leptin and endocannabinoids antagonize each other, and when the latter levels become higher, obesity is more likely. Just as cannabis intensifies cravings for sweets, so do high levels of endocannabinoids.

3. Affects fertility. In both directions. Cannabinoids can increase or decrease the probability of an embryo implanting in the uterus. My guess would be that if you're a person who is craving sweets and struggling with weight, you layer smoking pot on top of that…you're pushing that baby farther away from reality, rather than in the positive direction.

What is fascinating is that omega-3 fatty acids, the ones you see all the time mentioned in this blog, are crucial for good endocannabinoid function. If you're omega-3 deficienct, you're more likely to make it harder for your body to respond to its own naturally produced cannabinoids. So that craving for pot may have a valid foundation. The problem is, it's not the lack of cannabinoids that's causing the problem. It's that they are there, all dressed up, ready to help regulate memory, mood, appetite, and hormone function, but the body has lost the ability to understand what those chemicals are trying to tell them. Flooding your system with more of those chemicals holds potential to create an even worse imbalance, even worse cravings, a vicious cycle that it can feel impossible to break out of.

In addition, omega-3 fatty acids help to be sure that when it comes to maintaining muscle mass and reducing fat mass, the endocannabinoids push that relationship in the right direction.

Why not try improving how your body uses these chemicals and see if it helps reduce your need for the external stuff?

1. Work really, really hard on getting those omega-6 fatty acids out of the diet. They are likely to be found in baked goods, chips, all the stuff you tend to want to eat when you have the munchies. So it seems like a really important strategy is to not bring your munchie foods into the house. Fill your kitchen with fruits, vegetables, crackers made with olive oil, etc., to turn to while you're transitioning to a better hormone balance. Remember, the oils you want to stay away from begin with the letters"s" and"c"--safflower, sunflower, soybean, sesame, corn, cottonseed. Canola is ok.

2. Get as many omega-3 fatty acids as you can in your diet. If you supplement, start with a dose of 500 mg DHA per day. If, combined with #1, you don't see a change within 2 weeks, add 500 mg more DHA. I've seen some cases where titrating up like that, over time, the end dose was 1000 to 1500 mg per day. Hang in there. If you're diligent, it works.
Lafourcade M, Larrieu T, Mato S, Duffaud A, Sepers M, Matias I, De Smedt-Peyrusse V, Labrousse VF, Bretillon L, Matute C, Rodríguez-Puertas R, Layé S, Manzoni OJ. Nutritional omega-3 deficiency abolishes endocannabinoid-mediated neuronal functions. Nat Neurosci. 2011 Mar;14(3):345-50. Epub 2011 Jan 30.

Watkins BA, Hutchins H, Li Y, Seifert MF. The endocannabinoid signaling system: a marriage of PUFA and musculoskeletal health. J Nutr Biochem. 2010 Dec;21(12):1141-52. Epub 2010 Oct 8.

Kirkham TC, Tucci SA. Endocannabinoids in appetite control and the treatment of obesity". CNS Neurol Disord Drug Targets 5 (3): 272–92, 2006.

Ryusuke Y. Endocannabinoids selectively enhance sweet taste. PNAS 107 (2): 935–9, 2010.

Das SK, Paria BC, Chakraborty I, Dey SK. Cannabinoid ligand-receptor signaling in the mouse uterus. Proc. Natl. Acad. Sci. U.S.A. 92 (10): 4332–6, 1995.

Paria BC, Das SK, Dey SK. The preimplantation mouse embryo is a target for cannabinoid ligand-receptor signaling. Proc. Natl. Acad. Sci. U.S.A. 92 (21): 9460–4, 1995.

I recently found an interesting article about PCOS in PubMed. What it reported on was a study looking at how compliant women with PCOS are, with the recommendations given to them. In a fertility clinic, 99 infertile women with PCOS were interviewed. Turns out, only about 25% of them had been compliant with the recommendations given to them in an attempt to try to help them.

SEVENTY-FIVE PERCENT of these women weren't doing what they were told they needed to do in order to have the baby they said they wanted.

Well, readers, I love you all to death, and wish you success, but when I saw that…my first thought was, NO FREAKING WONDER we get so many complaints that"nothing is working"!!! It ain't gonna work if ya don't try it!
(BTW, if you're actively working on your PCOS, you can ignore this post. Since I've been informed that this applies to a good 75% of my audience I'm going to go ahead and rant. Know it doesn't apply to you. I'm just trying to get more of you on board here with what we are trying to do on your behalf.)
What was also found was that three types of women with PCOS were most likely to not comply with recommendations: (1) obese patients, (2) those for whom treatment was"inconvenient", and (3) those who were concerned about adverse drug reactions.

I tell you all, I'm a pretty compassionate and understanding person and I have dedicated my life to figuring out the PCOS puzzle…but I found myself in a tailspin over this one. Why would I try so hard on behalf of a demographic I only have a 25% chance of being able to help?

If you're in our Facebook group, you hear this from me all the time. It's YOUR PCOS, it's not mine. Information is dripping out of your computer, waiting for you to try. There are support groups being started in a whole lot of places, but you have to show up. If you haven't heard about them go to http://www.powerupforpcos.com/ for details.
There are options and there are answers. For starters, there is fish oil. I have lost track of the number of times I've corresponded with women wanting me to hear their stories, and I've patiently listened…then asked,"Are you taking the fish oil?", knowing full well from the duration of our friendship, they've heard it before. And knowing I'm going to hear"No."

Your infertility is not going to be resolved by a magic stork landing on your roof tonight, waving a wand, and just making it all go away. If you have been asked to start exercising, then you need to start moving. If you've been asked to make dietary changes, and they're"inconvenient" because they don't taste good, you need to decide — is the soda really that important — enough to cost you the baby you want? No more looking at other people and simply wishing you could have what they have. The reality is, there is a strong likelihood they have what they have because they're doing what they need to do.

If you're having trouble with motivation, it's time to ask for help. Or join a support group. We can give you great information. But we can't eat for you, exercise for you, practice good sleep hygiene for you. All I can tell you is…it works wonders. You should try them sometime.

OK. Rant over. Carry on.

Oh! And don't forget to take your fish oil. It's going to be the very first thing I ask you about if you write with personal questions.: )
Li S, He A, Yang J, Yin T, Xu W. A logistic regression analysis of factors related to the treatment compliance of infertile patients with polycystic ovary syndrome. J Reprod Med. 2011 Jul-Aug;56(7-8):325-32.

One of the main reasons women with PCOS are encouraged to take metformin is because it is widely believed that it can help to improve fertility and reduce the incidence of miscarriage.

A 2009 study challenges this belief. It comes from the Cochrane Collaboration, a not-for-profit organization that evaluates groupings of research independent of for-profit (read"drug company") funding. I like their studies because their sample sizes are large and their findings are evidence-based. It takes them a long time to adopt new ideas, but it is because they so heavily scrutinize the available information rather than jumping on any bandwagons.

In this study, authors searched several comprehensive medical databases for studies evaluating metformin used during in-vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI). They specifically looked at randomized, controlled trials containing a"no treatment" or placebo group to compare to a group receiving metformin. They evaluated several types of outcomes that metformin may have an opportunity to influence: live birth rate, pregnancy rate, miscarriage rate, incidence of ovarian hyperstimulation syndrome, patient-reported side effects, and several hormone levels (estradiol, androgen, fasting insulin and glucose).

This exhaustive review, under rigorous statistical analysis…

"found no evidence that metformin treatment before or during assisted reproductive technique (ART) cycles improved live birth or clinical pregnancy rates."

The one benefit of metformin appeared to be a reduced risk of OHSS in women with PCOS and undergoing IVF or ICSI cycles.

I'm not a physician and therefore, I am not able to prescribe metformin. And I am ABSOLUTELY NOT ENCOURAGING ANYONE READING THIS TO DISCONTINUE USING MEDICATION THAT THEY HAVE BEEN PRESCRIBED. I do, however, see a tendency to hand this medication out without evaluating whether or not it is appropriate. It's important to discuss such issues with your physician and to be sure they are aware of the research supporting (or not supporting) their recommendation.

Here is the reference for anyone who wishes to share it with their personal provider.

Tso LO, Costello MF, Albuquerque LE, Andriolo RB, Freitas V. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD006105.

Ringing in the New Year with visions, dreams and intentions is part of our contemporary culture. The ball drops in New York; the sun rises wherever you are, and we all seem to sense change is in the air. January 1 marks the time when many people decide to make a change and transform some aspect of their lives in ways they believe will make their lives better. Often resolutions are related to health and well-being. Here’s a new resolution: recognize health insurance is not heathcare; and vow to seek healthcare, not a payment system.
For the approximately 45% of Americans with health insurance through their employers, January 1 is also the start of the year for most health insurance policy annual contracts. The same holds true for the approximately 11% of Americans have some other type of insurance, and the 25% with a government plan. Whatever the type of insurance, it’s likely the insurance company changed the rules as of 12:01 January 1. And their changes may have a substantial impact on the care of your health, impacting what you envision as a means to have a better life in 2012.
The insurance company didn’t consult you on the policy changes. They didn’t ask you want you need or want to feel and be healthy. In the paradigm of the 80% of insured Americans, insurance companies are in the driver’s seat to decide what healthcare is and who can provide it. It could mean different types of treatments are covered or not covered; different types of allowable “doctors” are considered acceptable or not acceptable; and of course it all revolves around a method to parse the dollars between providers, patients and insurance companies – the power triad of today’s “healthcare system.”
Making money in the healthcare system: insurance & pharmaceutical companies

Insurance is a contractual payment system. It’s a method to pay to certain people what the company determines is allowable care, under the terms of the policy. The payment system has very little to do with actual care that relieves suffering and improves well-being. When you let a payment system determine what care or well-being is, that substantially limits your options to make your life better in any way that resembles your personal concept of well-being.

Stephan A. Schwartz, a regular contributor to Explore: The Journal of Science and Healing has coined our current healthcare system as the “illness profit system.” And there seems to be plenty of profit to go around. Insurance companies, by their very nature of being corporations, have as their number one job to return shareholder value – to make money. CEO’s get paid a lot of money to do this. The heads of health insurance companies, healthcare consulting firms and other health related companies are among the highest paid executives in any industry. According to the LA Times, McKesson CEO John Hammergren received $145.3 million in compensation in 2010. Fierce HealthCare reports Omnicare CEO John Figueroa was compensated 98 million last year; and Aetna’s Ronald Williams took home $57.8 million before retiring in April 2010.

Pharmaceutical companies are also big winners in the power triad. In 2009-2010, seven of the big pharmaceutical companies paid 17,700 presenters a total of $281.9 million to promote their products. These presentations to physicians were instrumental in a"combined prescription drug sales amounting to 36 percent of the $300 billion U.S. market in 2009." Only 10% of what big pharma makes is spent on research to cure diseases and save lives.

The losers in this system: patients and physicians

According to Bloomberg.com, “Forty-nine million Americans reported spending 10 percent or more of their income on insurance premiums and out-of-pocket costs last year, according to the Commonwealth Fund study.” Patients spend more and more. As of 2008, 38% of adults used some sort of “complementary alternative medicine” (CAM). Anything labeled CAM is generally not covered by insurance, with rare exceptions of some limited use of acupuncture or chiropractic. Not only do people spend money on insurance premiums, they’re paying providers directly for health care that actually works for them. No wonder we have the most expensive health care system in the world.

Many M.D.s are also struggling with this current power triad. Holistic physicians who want to spend more than 7 – 10 minutes with their patients, and want to provide CAM care that works are seeking ways walk away from the insurance model, and serve patients in ways that help patients fundamentally heal. While they’re reluctant to talk about it, a recent CNN article discusses the economic challenges for M.D.s trying to operate in this system, and how many of them are going broke. http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm?hpt=hp_t3&hpt=hp_c1

Your resolution for the care of your health

The month of January didn’t even exist until about 700 B.C. when the Romans adjusted the calendar and move the “new year” from March to the new January. Julius Caesar introduced the Roman calendar, a solar-based system, in 46 B.C., and decreed the new year would be January 1. During the middle ages the new year was celebrated on various days in December, January and March. Even today, cultures around the world celebrate the new year on dozens of different days.

So, while January 1 has passed, any day can be the start of a new year. What will you resolve about the care of your health? There is an opportunity for transformation just as significant, if not more significant, than the common “eat right and exercise” resolution. At the core of your being, what’s your vision for the well-being of yourself, your family, or even the planet? Bring your vision, your resolution, to fruition by really knowing what you mean by “health” and “care” and spend your money accordingly. Resolve to not confuse health insurance with healthcare. Those two terms mean vastly different things.

About the author:

Deb Andelt is co-owner of Experience In Motion, which equips organizations with tools to curate meaningful experiences for customers and employees. Deb’s personal journey from decay to wellbeing inspired an emphasis in improving healthcare experiences for patients and practitioners by focusing on experiences that heal and self-caring as a way of organizational being. www.experienceinmotion.net.