NUTRACEUTICAL ADJUNTS TO BHRT

It’s never just about the hormones: Vitamins, Supplements, Herbs used in support of hormone

healthBy

Mark Burger, Pharm.D., RPhHealth First! Pharmacy &

Compounding Center

Introduction

… Compounding Pharmacists

Objectives Give compounding pharmacists some

Evidence Based logic supporting the use of vitamins, nutraceuticals and herbs in augmenting BHRT;

Discuss the hormone mimicry, homonogenics and general phytocrinology of plant substances;

Discuss and demonstrate the physiology of PCOS, endometriosis, breast and (?) other cancers as related to estrogen metabolism;

Discuss the individual nutraceuticals, their clinically effective dose ranges and commercial products that contain them

Discuss the support of the thyroid gland with nutraceuticals and phytotherapy.

Consults and Testing

BHRT Supplement Reviews Medication Therapy Management Symptom Driven Saliva Testing for Hormones Nutrient Testing (Serum) Neurotransmitter (AM Urine) NeuroEndocrine (AM Urine/Saliva)

Genomics and Epigenomics

TIME Magazine, January 6, 2010: Why Your DNA ISN’T Your Destiny (cover story)

WHAT WE DO TODAY AFFECTS THE NEXT GENERATION (Darwin was wrong, Lamarck was right)

Lamarck, Darwin, Mendel

(which one DON’T you know?)

Homunculi in sperm as drawn by N. Hartsoecker

in 1695

What Grandpa ate, affects

how long the Grandkid lives

[by as much as 32 years!]

Nutritional & Functional Medicine Approaches to Hormone Balance

Obesity = ↑ Estrogen ↑ Insulin ↓ Leptin High-Protein = ↓ insulin +↑ glucagon

(especially important in the AM when cortisol is naturally elevated)

Upper GI Support: ↑ Acid = ↑ protein +↑methyl donors (Vitamin B’s & FA)+ ↑Fe/Mg/Zn absorp.

Liver Support: ↑ Phase I & II metabolism → effective elimination of estrogen metabolites

Lower GI Support: Pre- & Probiotics, N-3 Fish Oils, Fiber (lignans)

Genomic & Epigenomic Infuences(remember: you CAN change this!)

Low or Slow METHYLATORS (exacerbated by ↓ gastric acidity)

High AROMATIZERS (driven by ↑ insulin) Nrf2 (NF-E2-Related Factor 2: transcription

factor) ↑ production of SOD and glutathione ↓ production of NF-kappa B & other pro-

inflammatory factors In Norrbotten, if you were born during the

abundant years, your kids might live 32 fewer years!

How Do Nutraceuticals Compare?

Drugs

Celec

oxib

Nutraceuticals

“For a long time, doctors thought that testosterone, the male sex

hormone, fueled the growth of some prostate tumors, he says. Prostate cancer treatment, therefore, has

focused on blocking testosterone.

But more recently, "we began to realize that

estrogen is involved as well.””

“But by a year later, 25% of men taking Acapodene had developed

prostate cancer compared with 31% of those on a placebo.

"For every 100 men with PIN treated with the drug for a year, [nearly

seven cancers] are prevented," Price says.”

By Charlene  Laino WebMD Feature Reviewed Below

“Conclusions: In men undergoing RP

BMI was associated with adverse pathological

features

and a greater risk of biochemical

progression.”FREEDLAND, STEPHEN J. Et al. OBESITY

AND RISK OF BIOCHEMICAL PROGRESSION FOLLOWING RADICAL

PROSTATECTOMY AT A TERTIARY CARE REFERRAL CENTER.

Journal of Urology. 174(3):919-922, September 2005. BELOW

http://www.wmfurology.com/pca.htm

Conclusion: The percentage of obese men

undergoing RP in our data set doubled in the last 10 years. Obesity was associated with

higher-grade tumors, a trend toward increased

risk of positive surgical margins, and higher

biochemical failure rates among men treated with RP. A BMI 35 kg/m2 was associated with a higher risk of failure than a BMI

between 30 and 35 kg/m2.

Journal of Clinical Oncology, 10.1200/JCO.2004.04.181Received April 28, 2003

Accepted November 10, 2003

“First my nads shrink, then my willy won’t work, now my

prostate is whacked. I have got to lose some weight!”

“The diet known as calorie restriction (CR) is the most reproducible way to extend the lifespan of mammals.

Many of the early hypotheses to explain this effect were based on it being a passive

alteration in metabolism. Yet, recent data from yeast,

worms, flies, and mammals support the idea that CR is not simply a passive effect but an active, highly conserved stress response that evolved early in

life's history to increase an organism's chance of surviving

adversity.” Sinclair DA. Toward a unified

theory of caloric restriction and longevity regulation. Mech Ageing

Dev. 2005 May 10; PMID: 15893363 PubMed Below

http://images.art.com/images/PRODUCTS/large/10087000/10087743.jpg

“The wooly mammoths are getting harder and hard to find.”

Liver Support

Diet,

Exercise,

Stress Mgmt.

Product Information Below

2 with meals 2 scoops 1 – 4+ / day1 TID 3 with UC

Lipotropic Factors Detox Medical FoodLiver Tonic Detox Buffer

Milk Thistle Extract 70 mg [standardized to 80%

silymarin (56 mg)]to supports healthy liver

function and helps protect liver tissue

Nutrients involved in fat metabolism,

including inositol, choline, and taurine, methyl donors, folic acid, vitamins B6 &

B12, and select herbs that are traditionally used to support bile flow & healthy liver

fxn.

15 Gm N2, 160 Kcal, 19 Gm CHO, 3 Gm Fat + catechins + B vites + A, D, E, C, Biotin + AAs

for liver detox

Vitamins A, C, D, E, Thiamin, B6, B2,

Niacin, L-5-methyltetrahydrofolate, B12 to support Phase

I and Phase II liver detoxification

“DALLAS - March 3, 2005 - Cholesterol, often stigmatized for its role in heart disease, has long been known to be essential for the health

of the fat-laden membranes that surround individual cells.”

“Through an interaction with a protein called the oxysterol binding protein (OSBP), cholesterol holds together a group of enzymes that deactivates extracellular signal-related kinase (ERK). Overactive ERK is associated with multiple

cancers.”Researchers discover a good side to cholesterol in controlling cell signals http://www.utsouthwestern.edu/utsw/cda/dept37389/files/210108.html

Media Contact: Megha Satyanarayana 214-648-3404

e-mail: megha.saty@utsouthwestern.edu

ARTICLE BELOW

"Cell signals have to be tightly controlled," said Dr.

Richard G.W. Anderson, chairman of cell biology and senior author of the study.

"If the signaling machines do not work,

which can happen when the cell doesn't have

enough cholesterol, the cell gets the wrong

information, and disease results."

Statin Sales

Cholesterol prevents cancer.

FIGURE 2. Hypothetical scheme showing potential mechanisms whereby

n–6 (promote) polyunsaturated fatty acids (PUFAs) and n–3 (suppress) PUFAs

may promote and suppress carcinogenesis, respectively.

Am

J Clin

Nu

tr. 2004 Jun

;79(6):935-45. P

MID

: 15159222

Therefore, our results raise the possibility that GLA-induced

transcriptional repression of the Her-2/neu oncogene may

represent a molecular approach

to treat Her-2/neu–overexpressing carcinomas, i.e.,

in combination with trastuzumab. Although extensive

preclinical and clinical studies are necessary before GLA can

enter clinical trials, our findings suggest that future studies

assessing the clinical relevance of GLA-regulated Her-2/neu

promoter activity are warranted.

J Natl Cancer Inst. 2005 Nov 2;97(21):1611-5. PMID:

16264182 Below

“GLA exerts selective toxic effects on cancer cells without

affecting normal cells.”http://www.northwestern.edu/newscenter/stories/2005/11/gammalinolenic.html

Below

Picture:http://www.esew.org/warning_lists/plants/plants5.htm

Omega 3 Oils & Cancer Prevention1. Reduce inflammation2. Reduce angiogenesis3. Decrease Oncogenes4. Induce differentiation5. Suppress NFKB6. Suppress bcl-2 (apoptosis blocker)7. Reduce cachexia

NFKBCOX-2

CancerSupply

Line

EPA/DHAVirus / Inflammation

1,5

2

3

4

6 7

Anti -Cancer

Pro -CancerArticle

Below

The Ultimate DetoxComplete Protein

- Methionine - Cysteine

MCT’s (energy)Fiber (transit time)Energy Nutrients - B1, B2, B3, B5, Mg

Phase II conjugates - NAC, (GSH synthesis)

- Sodium Sulfate, - Amino Acids

Methylation Support - 5MTHF, B12, B6

- Methionine, CholineBi-functional modulators - Ellagic Acid, (pomegranate)

- Catechins, (green tea) - Watercress (PEITC)

Additional Support - Silymarin (SOD)

- Artichoke (anti oxidant) - Vitamins, minerals,

- additional anti oxidants

Big 8

GeneticNutritioneering

Pleo + PolyMorphic

Functional Medicine

Plant Nutrients1 Scoop QD

Pancreatic Enzymes5 TID away from food

Multi No Iron2 BID

Immune Support15 drops QID

Product info Below

Omega 3’s 4 to 10 + / day

Activated Omega 62 BID

2 scoops BID to TID 3 BID to TID

Detox + Buffer

Any Green Food

300 mg EPA + 200 mg DHA per Softgel

Protease  104,000 USP, Amylase  104,000 USPLipase  16,640 USP

Per 1 tablet

Any borage seed oil, an essential fatty acid that is converted in the body

to DGLA (dihomo-gamma-linolenic acid), the direct precursor of beneficial series 1 prostaglandins

15 Gm N2, 160 Kcal, 19 Gm CHO, 3 Gm Fat + catechins + B vites + A, D, E, C, Biotin + AAs

for liver detox (conjugation)

Vitamins A, C, D, E, Thiamin, B6, B2,

Niacin, L-5-methyltetrahydrofola

te, B12 to support Phase I and Phase II liver detoxification

Extracts from live mycelial and fruiting stages of specially

cultivated mushroom strains

Any good, absorbable, professional-line

multivitamin

Estrogen Metabolism

1.Diet, Exercise, Stress Management

– FLT2. Increase

Brassica Family (2-OH)

3. Support for Liver

(glucoronidation, sulfation,

methylation)4. Support for

Bowel Clearance4. Antioxidant

Support

© Rakowski, 2006

Life Pyramid

Think, Drink, Sleep, Eat, Poop, Move, Talk

Vegetables, Fruits (9 + Colorful Servings)

Lean, CLEAN (organic if possible) Protein (Maintain BCM - BIA)

Unprocessed Grains (mostly Gluten Free)

Pure Fats / Oils 1:1 Omega 3 to 6

P

L - Love; discipLine

Supplments: EFA’s, Multi (92% sub RDA), Plant Nutrients

7

The M agnificent Seven

Eat right

Drink rightThink right Poop rightM ove right

Talk rightSleep rightEat right

Drink rightThink right Poop rightM ove right

Talk rightSleep right

Estrogens, whether you make them, whether you

take them . . . whether you have been unknowingly,

intoxicated by them . . .

Whether you are a man or a woman . . .

You need to get rid

of them every day . . .

IN A HEALTHY WAY!!!!

© Robert Rakowski, DC, PA 2003

(Cytochrome P450)

PHASE 1- oxidation- reduction- hydrolysis- hydration

- dehalogenation

ROS

(Conjugation)

PHASE II- SULFATION

GLUCORONIDATION- glutathione conjugation

- acetylation-METHYLATI ON

- amino acid conjugation- glycine- taurine

- glutamine- ornithine- arginine

HO

CH3

CH3

HESTRIOL

OH

HOH

CONCLUSIONS: This study supports the

hypothesis that

breast cancer can be initiated by

estrogen exposure

and that

estrogen metabolizing

genes are involved in

this mechanism.

Chin Med J (Engl). 2005 Sep 20;118(18):1507-16. PMID:

16232327 Below

HO

CH3

CH3

HOH

12

4

16

17Estrogen Metabolism

A B

C D

4 -0H = “dangerous” estrogen

2 -0H = “good” estrogen

DANGER

16 -0H = “caution” estrogen

© Rakowski, 2006

The Fate of Estrogen

1B1(4-OH)

Glucoronidation, Sulfation, Methylation, Anti-Oxidants

1E1 (16-OH)1A2 (2-OH)

Estrogen Metabolism is

important.

“We believe it would represent a serious error in judgment with regard to public health to ignore the clear message from these combined studies

published in the Journal of the National Cancer

Institute and the Journal of the American Medical

Association that estrogen/progestin

therapy increases the risk to breast cancer.”

Kuller LH. Effect. Effect of hormone replacement

therapy on breast cancer risk: estrogen versus

estrogen plus progestin. J Natl Cancer Inst. 92(4):328-332.

Hey, why do you cells

continue to proliferate?

I’m just following orders. Estrogen says

divide, I divide.

CONCLUSIONSAdipocytokines were shown

to participate to some extent in the process of

carcinogenesis, …”

“It is well documented that obesity increases the risk of some types of cancer such

as that ofcolon, breast and prostate.”

Leptin, the most widely studied member of a family,

stimulatesgrowth, migration and

invasion of cancer cells in vitro and also potentiates

angiogenesis, thushaving the capacity of promoting malignant

biological behavior of cancer in vitro.

Physiol Res. 2005 Oct 17; PMID: 16238454 Below +

article below

obesity has been linked to leptin resistance”

Nat Clin Pract Gastroenterol Hepatol. 2005 Jun;2(6):273-80. PMID: 16265231

http://www.svimr.unimelb.edu.au/price1.htm

“Leptin, the most widely studied member of a family, stimulates

growth, migration and invasion of cancer cells” “also potentiates angiogenesis”

Physiol Res. 2005 Oct 17; PMID: 16238454 Below + article belowLeptin (from

fat)

is aPro-carcinogen

The increasing risk of breast cancer and other

cancers has paralleled the proliferation of

synthetic chemicals

since World War II. An estimated 85,000

synthetic chemicals are registered in the United

States, yet

toxicological screening data are available for

only 7 percent of these chemicals.

http://tuftsjournal.tufts.edu/archive/2003/february/oped/in

dex.shtml Below

Ana M. Soto, M.D.

“85,000 synthetic chemicals

are registered”

7% are screenable.

7% is approximately 1 in 14200 chemicals found in newborns

Theoretically could be 2800.

"One of the first duties of the

physician (pharmacist?) is to educate the masses not to

take medicine."

William OslerThe Principles and

Practice of Medicine (1892)

http://goanimal.com/newsletters/2005/big_pharma/big_pharma.html

http://www.health.library.mcgill.ca/osler/archives/index.htm

William Osler

http

://m

cgo

vern

.libra

ry.tmc

.edu

/O

slersW

eb/O

P1

/F

P00

00

aB.h

tm

Can We Eat to Starve Cancer?: William Li, MD

Turmeric Soy Vitamin E Artichoke Selenium Vitamin D3 Tea Green Tea Lavender Brassica Grapes Garlic

http://www.ted.com/talks/william_li.html

Ferlitsch K, et al. Body mass index, follicle-stimulating hormone and their predictive value in in vitro fertilization. J Assist Reprod

Genet. 2004 Dec;21(12):431-6. PMID: 15704518 BELOW

“16% decrease in fertility for each unit increase of BMI”

Not Enough Too Much

“Cortisol is regenerated from cortisone by 11ß-

hydroxysteroid

dehydrogenase type 1 (11HSD1),

amplifying glucocorticoid action in adipose tissue and liver. (11)HSD1 inhibitors are

being developed for type 2 diabetes and

may be most effective inobesity, where adipose 11HSD1 is increased.”

Diabetes. 2005 May;54(5):1364-70. PMID: 15855321 Below with

article

FIG. 1. Metabolism of d4-cortisol to form d3-cortisone and d3-cortisol. D, deuterium = 2H.

“Life was not as

stressful when I was

thin.”

Adipose magnifies cortisol

Progesterone to Estrogen

Ratio“Before menopause,

progesterone-to-estrogen ratios vary from about 20:1 to about 170:1, at different phases of the menstrual cycle. For a pregnancy to occur, an ideal ratio of 30:1 or possibly 60:1 may be

needed. . . A low progesterone-to estrogen

ratio, such as 10:1, can result in infertility in pre-menopausal women and

abnormal uterine bleeding in women of

menopausal age.”

HO

CH3

CH3

OH

CHC

1000 X

Ethinyl Estradiol(birth control pill)

“These birth control pills

work great. I have not had a cycle in 6

years.”

Bland, New Approaches to Anti-Aging: 2001, page 71

“Insulin resistance, per se, seems to be necessary for the

components of Syndrome X to develop, but it is not sufficient. In

order to understand the pathophysiology of Syndrome X, it

must be realized that not all tissues respond similarly to insulin

within the same individual. For example, although the ability of

insulin to stimulate glucose uptake by muscle and inhibit adipose

tissue lipolysis is highly correlated within an individual, insulin resistance at the level of the

muscle and adipocyte does not mean that insulin action on the

kidney is impaired.”Reaven, Gerald M. SYNDROME X

INSULIN RESISTANCE, HYPERINSULINEMIA, AND

CORONARY HEART DISEASEChapter 28 - April 1, 2002,

http://www.endotext.org/diabetes/diabetes9/diabetes9.htm

ARTICLE BELOW

How will dysglycemia affect your body?

- Fatty Liver- Heart Attack

- Stroke- Neuropathy

- Hypertension- Dementia- Depression- Retinopathy

- Obesity- inflammation

- Infertility- Gout

- Sexual Dysfunction

“In a 1981 landmark report, Doll and Peto, 1

estimated that

35% of US cancer deaths were

attributable to dietary factors.”

“Although recent findings on fruit and vegetable

consumption and cancer may be disappointing, reductions

in blood pressure and epidemiological evidence for lower risks of cardiovascular

disease provide sufficient reason to consume these

foods in abundance.” Willett, W. Diet and Cancer An

Evolving Picture JAMA. 2005;293:233-234.

ARTICLE BELOW

2004 Estimated US Cancer Deaths*

ONS=Other nervous system.Source: American Cancer Society, 2004.

Men290,890

Women272,810

•25% Lung & bronchus

•15% Breast

•10% Colon & rectum

• 6% Ovary

• 6% Pancreas

• 4% Leukemia

• 3% Non-Hodgkinlymphoma

• 3% Uterine corpus

• 2% Multiple myeloma

• 2% Brain/ONS

•24% All other sites

Lung & bronchus 32%

Prostate 10%

Colon & rectum 10%

Pancreas 5%

Leukemia 5%

Non-Hodgkin 4%lymphoma

Esophagus 4%

Liver & intrahepatic 3%bile duct

Urinary bladder 3%

Kidney 3%

All other sites 21%

Lung 13%, 12%

Prostate 33%

Breast 32%

CancerCases

Tobacco Use in the U S, 1900 -2000

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

1900

1905

1910

1915

1920

1925

1930

1935

1940

1945

1950

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

Year

Per

Cap

ita C

igar

ette

Con

sum

ptio

n

0

10

20

30

40

50

60

70

80

90

100

Age

-Adj

uste

d Lu

ng C

ance

r D

eath

R

ates

*

*Ag e-adjusted to 2000 US standard population. Source: D eath rates: U S M ortality Public U se T apes, 1960-2000, US M ortality Volum es, 1930-1959, National Center for Health Statistics, Centers for D isease Control and Prevention, 2002. C igarette consum ption: US Departm ent of Agriculture, 1900-2000.

P er capita c iga rette consum ption

M a le lung cancer death rate

Fem ale lung cance r death rate

1/3 + of cancers are

related to poor diet.

February 23, 2004

Talk

Stress Adipose Toxins Insomnia

Poor DietImpaired Cellular Communication

Lack of Anabolic Hormones

The Oxidative Seven

“ . . .oxidation of the carcinogenic 4-hydroxy

catechol estrogens (CE) of estrone (E1) and estradiol (E2) to catechol estrogen-3,4-quinones (CE-3, 4-Q) results in electrophilic

intermediates that covalently bind to DNA to

form depurinating adducts. The resultant apurinic sites

in critical genes can generate mutations that

may initiate various human cancers.”

Cavalieri,E.L. et al.; Molecular origin of cancer: Catechol estrogen-3,4-quinones as endogenous tumor initiators Proc. Natl. Acad. Sci.

USA Vol. 94, pp. 10937-10942, September 1997

4-OH estrogens increase

cancer risk.

Nutritional Influences on Estrogen Metabolism

http://www.cabecahealth.com/media/sites/36/files/NutrInfluencesEstrogen.pdf

{ The Good

{ The Bad

{ The Ugly

Table 1. Sources of Estrogens

Environmental

Estrogens 31Dietary Estrogens 32-35

(“Phytoestrogens”)

Endogenous Estrogens

• Organochlorine chemicals such as vinyl chlorides, dioxins, PCBs, and perchloro-ethylene (~1/2 of “endocrine disrupters” are in this class)• Non-organochlorine chemicals such as phthalates and phenols (plasticizers),aromatic hydrocarbons, & some surfactants• Medications such as hormone replacement, oral contraceptives, tamoxifen, & cimetidine• Agricultural hormones in animalproducts consumed by humans

• Isoflavones (e.g., genistein, daidzein, equol, puerarin, coumestrol, glycitein, biochanins) (from soy, beans, peas,clover, alfalfa, & kudzu)• Lignans (e.g., matairesinol, pinoresinol, secoisolariciresinol) (especially from flaxseed, rye, wheat, & sea vegetables esp. Sea Buckthorn Oil)• Certain flavonoids (e.g., rutin, naringenin, luteolin, resveratrol, quercetin) (especially from citrus fruits and grapes)

• Estradiol (E2)• Estrone (E1)• Estriol (E3)• Hydroxylated (2-OH, 16-OH, 4-OH) estrogen metabolites• Methoxylated (2MeO, 4-MeO, estrogen metabolites• Other estrogen metabolites (3,4-quinones !!!!)

“Bisphenol A (BPA), a chemical that mimics

the action of the human hormone estrogen, can

leach from polycarbonate plastic.3 Human exposure to BPA

is widespread. A Centers for Disease

Control study detected BPA in the urine of 95

percent of adults sampled.4 Scientists

have measured BPA in the blood of pregnant women, in umbilical

cord blood and in the placenta, all at

levels demonstrated in animals to alter

development.5,6”

SOURCE BELOW: http://www.environmentalobser

vatory.org/library.cfm?refid=77083

© Rakowski, 2004

Women with extra Testosterone,Men with Extra

Estrogen

HO

CH3

CH3

H OH

12

4

16

17

A B

C D

Xenoestrogens

BPA95%

penetrance

Table 2. Mechanisms through which dietary and nutritional factors may influence estrogen

metabolismMechanism of Action Nutrient

↑ C-2 hydroxylation over C-4 and/or C-16α hydroxylation of estrogens

Cruciferous vegetables, indole-3-carbinol, isoflavones (soy, kudzu, flax)

↓ the oxidation of catechol estrogens (2-OH and 4-OH)

A, E, & C, N-acetylcysteine, turmeric, green tea, lycopene, ALA, flavonoids (resveratrol)

↑ the methylation of catechol estrogens(2-OH and 4-OH)

Folate (5-FormylTHF), vitamins B2, B6, & (metyl- & hydroxy-)B12 , tri- and di-imethylglycine, Mg

↑ circulating concentrations of sex

hormone binding globulin (SHBG), thus ↓ levels of unbound, active estrogens

Fiber, lignans (flaxseed), isoflavones (soy, kudzu) NOTE: ‘flavus = yellow’

↓ the activity of aromatase, which

converts T & androstenedione → E2 & E1 respectively

Lignans (flaxseed), flavonoids [flavones, flavonol, flavanone, flavanonol, isoflavones, proanthocyanidins]

↑ the detoxification of estrogens by ↑-regulating Phase I (MAO, Flavin-containing, Cytochrome P450, Esterases, etc.) & Phase II Enzymes

Turmeric (curcumin), D-limonene, magnesium, vitamins B2, B6, & B12, flavonoids

↓ the activity of β-glucuronidase, which decon-jugates estrogens in the large intestine, allowing them to be reabsorbed & re-metabolized

Fiber, probiotics (acidophilus, bifidobacteria), calcium D-glucarate

Modify estrogen receptor activity Isoflavones (soy, kudzu), lignans (flaxseed), I3C

“The effects of 2-Methoxyestradiol (2ME)-induced apoptosis was

examined in human leukemia cells (U937 and Jurkat) in relation to mitochondrial

injury, oxidative damage, and perturbations in signaling pathways. 2ME induced

apoptosis in these cells in a dose-dependent manner”

Gao N. et al. 2-Methoxyestradiol-induced

apoptosis in human leukemia cells proceeds through a

reactive oxygen species and Akt-dependent process Oncogene

(2005) 24, 3797−3809.

ABSTRACT BELOW

Nutrients to Promote 2-methoxy estrogensFlax Lignans, Kudzu, Soy, I3C (also Aromatase Inhibitors)Folic Acid, 5-Formyl THF, TMG/DMG, Choline, Betaine HCl, B6, B12 (methyl donors)Magnesium (co-factor for COMT)

This peripheral blood smear shows several very immature myeloid precursors. These cells are leukemic cells circulating in large numbers in the peripheral

blood. Wright-Giemsa stain.http://edcenter.med.cornell.edu/CUMC_PathNotes/Neoplasia/Neoplasia.html

Notes + Picture links below2-Methoxyestrogens kill Leukemia cells.

“Among 2266 women with breast cancer, as compared

with 7953 controls, the use of antibiotics was more

common; the risk of breast cancer was greater with

longer duration of antibiotic use and was consistent across

antibiotic classes. This observation is potentially

worrisome in that antibiotic exposure is common and sometimes nonessential.”Roberta B. Ness, MD, MPH;

Jane A. Cauley, DrPH ,Antibiotics and Breast Cancer—What's the Meaning of This? JAMA Vol. 291 No. 7,

February 18, 2004ARTICLE BELOW

Prescriptions FilledZITHROMAX 39,535,047AMOXICILLIN 35,768,145 75,303,192

2004 Estimated US Cancer Deaths*

ONS=Other nervous system.Source: American Cancer Society, 2004.

Women272,810

•25% Lung & bronchus

•15% Breast•10% Colon & rectum• 6% Ovary• 6% Pancreas• 4% Leukemia• 3% Non-Hodgkin

lymphoma• 3% Uterine corpus• 2% Multiple myeloma• 2% Brain/ONS•24% All other sites

Antibiotics are associated

with increased breast cancer.

Breast CancerConditions causally related to obesity.

1. arthritis, 2. breast cancer, 3. heart disease, 4. colorectal cancer, 5. type 2 diabetes, 6. endometrial cancer, 7. end-stage renal disease, 8. gallbladder disease, 9. hypertension, 10. liver disease, 11. low back pain, 12. renal cell cancer, 13. obstructive sleep apnea, 14. stroke and 15. urinary incontinence.16. Sexual Dysfunction *17. Infertility *18. Fatigue *19. Depression

http://www.obesity.org/treatment/cost.shtml Below

http://www.kbsplit.hr/rakdojke/breastcancer.htm Below

ETIOLOGY

genetic, endocrine and exogenous factors (28).

The Ugly: 3,4-quinones of E2 and E1

Use of CEE (Premarin or PremPro) promotes

Presence of BENZENE RING (critical to effect on DNA) [NOTE: also dopamine!]

2-double bonded OXYGENS at the 3 & 4 positions

Formation of DNA Adducts (Adenine & Guanine)

Leaves a –OH (hydroxyl) “stub” on DNA May be responsible for MANY cancers See work of Ercole Cavalieri, et al Univ

Neb.

Anti-Oxidant Influences

Vitamins A, E, C, D3, Selenium Curcumin (turmeric) Grean Tea (polyphenols like EGCG) Flavonoids

Flavonols: myricetin & quercetin Flavones: apigenin & luteolin Flavanones: herperidin & naringenin Flavan-3-ols: catechin, epicatechin,

epicatechin gallate, epigallocatechin, & EGCG Anthocyanidins: cyanidin, pelargonidin

(Umcka)

Anti-Oxidant Influences (cont.)

Scutellaria barbata extract Astragalus root extract N-acetylcysteine (→ glutathione-S-

transferase →GSH mercapturates) Resveratrol Iodine Methyl-donors (B6, B12, 5-MTF, Di- & Tri-

methyl glycine aka betaine HCl (Phase II) Calcium D-glucarate (Phase II)

Anti-Oxidant Influences (cont.)

Mushrooms (esp. Coriolus & Reishi) Lycopene 5 mg PO QD Vitamin D3 (at levels 50-80 ng/mL) Alpha Lipoic Acid (ALA) [↓ insulin’s ↑

effect on aromatase] Magnesium [necessary co-factor for

COMT]

Phytocrine Infuences

Four types of HormonesI. Endo-crine (from some other place in body)II. Auto-crine (from the same place/cell)III. Para-crine (from an adjacent cell)IV. Phyto-crine (from a plant outside the body)

3 main mechanisms of action (for AGONISTIC action)i. Functional Mimetic (doesn’t sit on hormone receptor)ii. Improved hormone production (phytohormonogenic)iii. Direct binding to HR (phytohormone)

a. Phyto-estrogen (flax, soy, hops, sesame oil, tofu, etc.)b. Phyto-progestins (diosgenin)c. Phyto-androgens (pine pollen extract)

Phytocrine Infuences (cont.)

Phyto-Anti-Hormones (antagonists) Saw Palmetto (serenoa repens) 320 mg QD Holy Basil (ocimum sanctum) aka Tulsi 2 caps

QD Nettle root (urtica dioca) 300 mg/day Fenugreek (trigonella foenum-graecum) Sweet fennel (foeniculum vulgare) [beta-

sitosterol] Pygeum (africanum) [beta-sitosterol] 100

mg/day Sea buckthorn oil [highest beta-sitosterol

content at 1650 mg/100mL]

Phytocrine Infuences on Thyroid

Sea Kelp (iodine source) Bladderwrack (iodine source+anti-estrogen) Hops (enhances uptake of iodine &

suppresses NF-Kappa B →↓TNFa & ↓IL-6 Coleus forskolii (mimics TSH ↑Na-I-symporter

or NIS, promotes secretion of T3 & T4) L-Tyrosine (source of thryoxine backbone) Ashwaganda (↑ production of thryoid horm.) Bacopa moniera (↑ T4 with →T3)

Phytocrine Infuences on Thyroid(continued)

Anything that reduces inflammation (↓NF-kappa B) will improve 5’-deiodinase and therefore ↓ rT3 formation!

Guggul, Rosemary oil, Sage, Hops, Coleus and Asragalus all do this to some extent

They also increase the expression of the RXR receptors (retinoid-X-receptors) where thyroid receptors (TR) couple with RXR to form a heterodimer that is thought to be the principle mediator of target gene regulation on target cells by the T3 hormone! (↓BPA)

Dosing of Nutraceutical and Products

Betaine HCL (BPP by Thorne) 2-6 w/meal Detox Factors (ITI) or LiverMax (Adv Naturals) Ultra-Clear (MG); Medi-Clear (Thorne) or Clear

DeTox (PE) [medical foods] BID meal R-Plus NAC (Geronova Research) [R-LA + NAC] Meta Lipoate 300 (Metagenics) 1 cap PO BID Resvoxitrol (OrthoMolec) 1 cap PO BID w/food Resveratrol Plus (PE) 1 cap BID w/food Nrf2 Activator (Xymogen) [brocc, turm, green

tea, bioperine, pterostilbenes] 1 cap QD to BID w/f

Dosing of Nutraceutical and Products (cont.)

Breast Defend (ecoNugenics): DIM, coriolus, reishi, turmeric, scutellaria, quercetin, astragalus 1-4 caps PO BID w/food

Cell Guardian (Natura): NAC, DIM, CDG, B6, B12, FA, Se, broccoli, cabbage, wasabi & pomegranate 3 caps QD to BID

CDG EstroDIM (OrthoMolecular): DIM + Calcium d-glucarate + I3C 2 caps QD w/food

DIMension 3 (Xymogen): Turmeric + DIM + Bioperine 2 caps QD to BID w/food

Dosing of Nutraceutical and Products (cont.)

LifeShield Immunity (New Chapter): 18 mushrooms 1 cap BID anytime

Reishi (New Chapter) 2 caps QD anytime Coriolus-MRL (Mycology Research Labs) 2 to

6 tablets PO QD Alapars (niacin + NAC) 1 tablet PO TID Clinical Nutrients for Diabetics (ITI) 2 tabs

PO w/each meal Methyl-SP (Apex) [B6, B12, FA, Mg, choline,

TMG, MSM, beet root, betaine HCl] 2 caps TID

Dosing of Nutraceutical and Products (cont.)

Prostate Optimizer (Jarrow) [D3, SP, Lyco, N3, Milk thistle, Nettle, Lignans, Grean tea, Broccoli]

1 sofgel PO TID w/food Testo-Gain (Douglas Labs) [2.25 grams of an

herbal blend of ashwag, damiana, mucuna, etc.] 3 caps PO QD w/food

ITI Man (ITI) [maca, yohimbine, rhodiola, horny goat weed, ginseng, tongat ali] 1 cap BID

Maca-3 (PE) [macamides, macaenes, tuber]1 cap BID anytime (AM & mid-afternoon)

“Another effective strategy for prolonging the lifespan

is caloric restriction: in data presented here, the persistence of estrogen-

sensitive cells in the hypothalamus of caloric restricted 22-month-old

female mice, may explain the persistence of

reproductive function at an age, when reproductive

function has long ceased in ad libitum fed controls.”

Timiras PS et al. The ageing phenome: caloric restriction and hormones promote neural cell

survival, growth, and de-differentiation Mechanisms of Ageing and Development

Volume 126, Issue 1 , January 2005, Pages 3-9 ABSTRACT BELOW

“Obese men are 30% more likely to experience

erectile problems than those of normal weight.”

Lewis RW.  Can weight loss improve the erectile function of

obese men? Nature Clinical Practice Urology (2004) 1, 68-69

ARTICLE BELOW

Dysglycemia Support

1 or 2 BID PC

2 scoops 1 to 5x / day

Diet,

Exercise,

Stress Mgmt

Exercise & Diabetes

are virtually

incompatible

600 mg / day

2 BID

1 or 2 TID 1 or 2 TID

Neuropathysupport

Islet Cell Support PPAR supportHerbal Glucose Support

Dysglycemia Medical

Food

Dysglycemia Support

tabs

Containing: 15 Gm N2, 175 kcal, chromium,

biotin, cinnamon, etc.

Alpha Lipoic Acid, Cinnamon,

L-carnosine, Taurine, B-vites, Chromium, Zinc,

Biotin, Selenium, EGCG, Vanadium, Etc.

Fenugreek Seed 6.5:1 Extract 1,000 mg; Bitter Gourd 10:1 Ext. 152 mg; Gymnema Leaf 10:1 Ext.

100 mg

Niacinamide 500 mg,

N-acetylcysteine 200 mg. to inhibit PARS, free radical

generation, cytokines, and collagenase.

Conjugated Linoleic Acid 1 Gm. + Rosemary Leaf

40 mg. to support healthy glucose and insulin

metabolism through its activation of PPAR alpha

and PPAR gamma—potent insulin sensitizers.

Alpha Lipoid Acid 200 mg/2 tabs to support

the health and function of

neurological tissue, especially peripheral nerves. Crosses the blood-brain barrier.

“OBJECTIVE: Physicians’ suicide rates have repeatedly been reported to be higher than those of the general population or

other academics,” “RESULTS: The aggregate suicide rate ratio for male physicians,

compared to the general population, was 1.41, with a 95% confidence interval (CI) of 1.21–1.65. For female physicians the

ratio was 2.27” Schernhammer, ES et al. Suicide Rates Among Physicians: A

Quantitative and Gender Assessment (Meta-Analysis), Am J Psychiatry 161:2295-2302, December 2004 PMID: 15569903 Below

Maybe I should

consider natural

medicine!

Be a Badger

Aggressiveness, Reliance, Self-ExpressionThe power of the Badger totem is its aggressiveness

and the willingness to fight for what it wants.This aggression can also be turned to healing – for Badger is the keeper  of Earth's healing herbs. 

Badger people are quick to express their feelings with concern for the consequences.  They are often healers who have the courage to use unconventional methods.Badger has the ability to persist to find a cure.

Badger people are often leaders and bosses, the one who will get the job done.

If you have a Badger as a totem, you will likely be solitarybut comfortable being alone.You are comfortable within yourself and very self-reliant.

Badger anger can get you out of apathy,but be careful not to cut yourself (or others) to ribbons using.Badger is a powerful totem when used properly.

Thank you!