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#34 From: <grehert@...>
Date: Wed Dec 18, 2002 3:27 am
Subject: Alternative medicine: Vitamin E - YES; Echinacea - NO 		grehert
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First the latest news on Echinacea - not so good.

Echinacea Capsules May Not Fight Colds: Study
Mon Dec 16, 5:27 PM ET 
Health - Reuters 
 
NEW YORK (Reuters Health) - People looking to shorten a bout with the common cold or reduce their symptoms by popping capsules of Echinacea (news - web sites) may not find relief, new study findings suggest.
 
Despite a few studies that found the herb made a difference for cold sufferers, "there is no clear consensus about whether Echinacea can benefit human health," lead author Dr. Bruce P. Barrett and colleagues write in the December 17th issue of the Annals of Internal Medicine.
 
To investigate, Barrett and a team of researchers at the University of Wisconsin in Madison compared the effects of Echinacea in capsule form with a placebo pill in college students who believed they were coming down with a cold.
 
The investigators did not detect a difference in cold duration between the Echinacea and placebo groups, nor did they find any difference between the two groups in symptom severity, according to the report.
 
Barrett's team is calling for more research on Echinacea's cold-fighting potential.
 
SOURCE: Annals of Internal Medicine 2002;137:939-946.    Click Here For Complete Story
 And now the latest on vitamin E - prevents bladder cancer.

Vitamin E, Bladder Cancer Risk Studied
Mon Dec 9, 5:22 PM ET  Add Health - Reuters to My Yahoo!
 
By Suzanne Rostler
 
NEW YORK (Reuters Health) - People who take vitamin E regularly are less likely than those in the general population to die of bladder cancer, researchers report, but it's not clear if the vitamin itself is responsible for the reduced risk or some other lifestyle factor. Researchers tracked nearly 1 million US adults for 16 years and interviewed them about their diet. Those who reported taking vitamin E supplements for at least 10 years were less likely to die from bladder cancer, compared with adults who did not use supplements for as long.
 
There was no association between regular vitamin C use and bladder cancer, report researchers in the December issue of the American Journal of Epidemiology.
 
The results support those of two other reports that showed a link between bladder cancer and vitamin E intake.
 
At this point, it is not clear why vitamin C, also an antioxidant, would not have the same effect.
 
SOURCE: American Journal of Epidemiology 2002;156:1002-1010.   Click Here For Complete Story
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

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Gerald M. Rehert, M.D.
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#33 From: <grehert@...>
Date: Wed Dec 11, 2002 2:51 am
Subject: Two stories: Sickle Cell Disease; and More Aspirin Benefits. 		grehert
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Here is a revolutionary story that may change the way we look at and treat sickle cell disease.  Personally, I'm impressed.
French Doctors See Transplant Success
Sun Dec 8,10:10 PM ET 
 
By MARYCLAIRE DALE, Associated Press Writer
 
PHILADELPHIA (AP) - A group of French doctors said Sunday they believe they can cure children with severe sickle cell disease through stem cell transplants without risking serious complications or death. The researchers, who have performed 69 transplants since 1988, reported an 85 percent disease-free survival rate — and even better results since revising their mix of anti-rejection drugs in 1992.
 
"It's going to change the way we treat individuals with this disorder," said Dr. Ronald Hoffman of the University of Illinois, the society's president. "If they're truly cured ... they're going to be freed of the consequences of a chronic disease." Sickle cell disease is an inherited blood disorder that affects about 70,000 Americans, most of them black.
 
Most sickle cell patients used to die in childhood, but better treatments now enable them to live into their 40s and 50s. However, doctors have been frustrated in their attempts to improve the patients' quality of life. "Maybe if a new drug appears which seems efficacious, we will stop again, but for the moment, stem cell transplant remains the only treatment offering the cure," Bernaudin said.
 
 
And here's more reason for eligible persons over 50 to take an 81 mg. aspirin every day.  (Call my office if you have questions about whether you qualify.)
Monday, 23 September, 2002, 23:47 GMT 00:47 UK
Aspirin 'protects against Alzheimer's'
 
Aspirin may protect against a range of diseases
 
Scientists have found yet more evidence to suggest that taking Aspirin could help to protect against major health problems.  Researchers in the United States believe the wonder drug, which is more than 100 years old, delays and may even protect against Alzheimer's disease.
 
Their findings follow recent studies which suggest Aspirin can help fight cancer, heart disease, blood pressure and arthritis among other conditions. However, experts have warned that this latest study does not mean people should take Aspirin on a regular basis without first seeking medical advice.
 
Their study, published in the journal Neurology, showed that patients who had taken Aspirin or NSAIDs, such as Ibuprofen, for more than two years were half as likely to develop Alzheimer's than those who did not take the pills regularly. 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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Gerald M. Rehert, M.D.
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Atlanta, GA 30312
404-688-2800

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#32 From: <grehert@...>
Date: Sat Dec 7, 2002 1:07 pm
Subject: Two studies about trauma: from roller coasters and from riding bicycles. 		grehert
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First a little controversy for you Six Flags fans:
Study disputes theory that roller coasters can injure brain
By Michael Rubinkam (Associated Press)
October 17, 2002
 
PHILADELPHIA - Researchers who looked at the impact of G-forces on the head and neck say in a new study that roller coasters aren't as dangerous as previous studies suggest.  Other researchers disputed the findings.
 
The University of Pennsylvania researchers who conducted the latest study looked at data from rides at three parks and developed a mathematical model calculating the effect of gravitational force.  They found that roller coasters don't produce enough ''head rotational acceleration'' to cause either bleeding or swelling of the brain.
 
Dr. Robert J. Braksiek, who co-wrote a study of roller coaster injuries in January's issue of Annals of Emergency Medicine, said the new research fails to account for reported injuries.  ''Roller coasters do cause brain injury. ... Although rare, it does happen,'' he said.
 
Markey said the researchers based their conclusions on the effect of coasters on ''normal healthy individuals'' rather than children or adults with pre-existing medical conditions. 
 
And now something for the male bicycle enthusiasts.

Mountain Biking Linked to Infertility
 
By LINDSEY TANNER, AP Medical Writer
 
CHICAGO (AP) - Frequent mountain-biking may reduce fertility in men, according to a small Austrian study that adds fodder to a debate over cycling and male sexual function. The research suggests frequent jolts and vibration caused by biking over rough terrain may cause abnormalities, including small scars within the scrotum and impaired sperm production.
 
Dr. Ferdinand Frauscher, a urology-radiology specialist at University Hospital in Innsbruck, Austria, said he studied about 55 avid mountain bikers and found nearly 90 percent had low sperm counts and scrotal abnormalities. Only 26 percent of the 35 non-bikers he studied had similar damage.
 
Whether the abnormalities were severe enough to make fathering a child difficult is uncertain, though some of the bikers studied had already experienced difficulty conceiving, Frauscher said.
 
His study looked at fertility rather than impotence, which was linked to recreational cycling in research heavily publicized in 1997.
 
Frauscher said men shouldn't avoid mountain biking because of the study, but should perhaps consider investing in bikes with shock absorbers or suspension systems designed to reduce the jolting.
 
On the other hand, Dr. Sangili Chandran, a sports medicine specialist at Christ Hospital and Medical Center in Chicago said, "Even if the results are corroborated in future studies, very few mountain biking enthusiasts are logging enough miles to worry about any fertility impairment."
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert
 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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information that you wouldn't mind sharing with the entire group.

Gerald M. Rehert, M.D.
285 Boulevard, NE, #520
Atlanta, GA 30312
404-688-2800

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#31 From: <grehert@...>
Date: Sun Dec 1, 2002 9:49 pm
Subject: Nuts and olive oil - the good fats. 		grehert
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New research confirms that not all fats in your diet are bad for you. 
 
Dr. Rehert
Peanuts stave off diabetes
By Patricia Guthrie / Cox News Service
10-27-02
 
ATLANTA - Want to lower your odds of getting diabetes? Eat more peanut butter.  But not too much, or you'll get too fat, which is the biggest predictor of Type 2 diabetes.
 
Sound nuts?
 
It's scientific fact, appearing in today's Journal of the American Medical Association. Women who consume nuts or peanut butter at least five times a week significantly lowered their risk for Type 2 diabetes compared with those who never or rarely ate nuts or peanut butter, concluded Harvard School of Public Health researchers.
 
"We were not really surprised by our findings," said Dr. Rui Jiang, a Harvard nutrition researcher. "Nuts contain lots of fat, but most fats in nuts are mono- and polyunsaturated fats, which are good for insulin sensitivity and cholesterol."
 
Mono- and polyunsaturated fats are unsaturated fat and are considered healthier than animal-derived saturated fat. Foods such as olives and olive oil also contain unsaturated fats.
 
But you can't go nuts with the heavenly sticky stuff because peanut butter is high in calories.
 
"You can't just dip your spoon in a jar," said Chris Rosenbloom, associate dean for Health and Human Science at Georgia State University. "And you can't just open a jar of peanuts and sit in front of the TV and eat all those nuts. I'm afraid consumers will hear this and say, 'All I have to do is eat more nuts and peanut butter and I'll avoid diabetes or heart disease.' And we know it's more complicated than that."
 
Diets high in nuts have also been shown to have a beneficial effect on cholesterol.  "Nuts are coming back into vogue as more healthful food," Rosenbloom said.    Click Here For Full Article
 
Patricia Guthrie writes for The Atlanta Journal-Constitution.
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
go to the website www.yahoogroups.com/group/drrehertsalerts and follow the “Join
This Group!" instructions.  Also, as a member, you can read all the earlier
Emails by clicking on http://groups.yahoo.com/group/DrRehertsAlerts/messages.

Be very careful if you respond to this Email list.  Though it is configured so
that all Email responses only go to the original sender, your Email may
inadvertently be sent to the list.  Be sure you do not include any personal
information that you wouldn't mind sharing with the entire list.

Gerald M. Rehert, M.D.
285 Boulevard, NE, #520
Atlanta, GA 30312
404-688-2800

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#29 From: "Adams, Diane" <diane.adams@...>
Date: Mon Nov 25, 2002 2:32 pm
Subject: RE: My views on hormones. 		diane.adams@...
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While estrogen may be no more dangerous than being a woman, let's remember that if God wanted us to have estrogen on a permanent basis, he would have made us that way.  There is a time for everything, and old age is not one of them for estrogen!
-----Original Message-----
From: grehert@... [mailto:grehert@...]
Sent: Saturday, November 23, 2002 7:51 AM
To: DrRehertsAlerts
Subject: [DrRehertsAlerts] My views on hormones.

As many of you know, I don't accept all the dangers being linked to estrogen therapy.  (As someone recently said, "Estrogen's no more dangerous than being a woman.") 
 
Here is an article I totally agree with which begins to question the validity of the WHI study.
 
Hormone study results raise more questions
November 23, 2002
 
If you thought this summer's damning news about hormone-replacement therapy was bad, hang on to your Midol, ladies. It gets worse. Titans in the medical world are clashing. Respected docs are raising disturbing questions about the methodology, politics and conclusions of the Women's Health Initiative, a long-term trial involving 16,600 postmenopausal women.
 
To refresh your memory: In July, one portion of a $600 million WHI study was abruptly halted because researchers felt there was too much danger to the women in the study to continue it. Five years into the eight-year study, researchers found that women in the trial taking HRT had a higher incidence of heart attack, stroke, breast cancer and blood clots than the control group taking placebos.
 
But now, some medical experts are questioning the massive WHI study. Dr. Leon Speroff, professor of obstetrics and gynecology at the Oregon Health and Science University in Portland, for example, suggests WHI picked the wrong group of women to study. Therefore, he says, the results are alarmist and misleading. The 16,600 female subjects were POST-menopausal. The study measured the effects of HRT on women who already could be expected to have the beginnings of heart disease and cancer, in other words.
 
This is how Speroff stated it in a paper he distributed to colleagues:
 
"Women with significant menopausal symptoms were excluded from the study to avoid an exceedingly high dropout rate in the placebo group. For this reason, less than 10 percent of the subjects were close to their age of menopause (the number is probably even smaller.) Therefore, the study was not a primary prevention study of cardiovascular disease, but a study of older women who undoubtedly already had a significant degree of atherosclerosis."
 
The elephant in the living room - the question the study failed to address - is this: Will HRT begun at or near the time of menopause protect women against heart disease? Speroff maintains we shouldn't read too much into the highly publicized WHI study. "The impression that this is the gold standard is incorrect."
 
And so, dear HRT-concerned readers, thanks for staying with me, and once again I must end on this wholly unsatisfying note: Stand by. We'll keep you posted.   Click here for complete article
 
2002 © The E.W. Scripps Co
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert

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#27 From: <grehert@...>
Date: Sat Nov 23, 2002 12:51 pm
Subject: My views on hormones. 		grehert
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As many of you know, I don't accept all the dangers being linked to estrogen therapy.  (As someone recently said, "Estrogen's no more dangerous than being a woman.") 
 
Here is an article I totally agree with which begins to question the validity of the WHI study.
 
Hormone study results raise more questions
November 23, 2002
 
If you thought this summer's damning news about hormone-replacement therapy was bad, hang on to your Midol, ladies. It gets worse. Titans in the medical world are clashing. Respected docs are raising disturbing questions about the methodology, politics and conclusions of the Women's Health Initiative, a long-term trial involving 16,600 postmenopausal women.
 
To refresh your memory: In July, one portion of a $600 million WHI study was abruptly halted because researchers felt there was too much danger to the women in the study to continue it. Five years into the eight-year study, researchers found that women in the trial taking HRT had a higher incidence of heart attack, stroke, breast cancer and blood clots than the control group taking placebos.
 
But now, some medical experts are questioning the massive WHI study. Dr. Leon Speroff, professor of obstetrics and gynecology at the Oregon Health and Science University in Portland, for example, suggests WHI picked the wrong group of women to study. Therefore, he says, the results are alarmist and misleading. The 16,600 female subjects were POST-menopausal. The study measured the effects of HRT on women who already could be expected to have the beginnings of heart disease and cancer, in other words.
 
This is how Speroff stated it in a paper he distributed to colleagues:
 
"Women with significant menopausal symptoms were excluded from the study to avoid an exceedingly high dropout rate in the placebo group. For this reason, less than 10 percent of the subjects were close to their age of menopause (the number is probably even smaller.) Therefore, the study was not a primary prevention study of cardiovascular disease, but a study of older women who undoubtedly already had a significant degree of atherosclerosis."
 
The elephant in the living room - the question the study failed to address - is this: Will HRT begun at or near the time of menopause protect women against heart disease? Speroff maintains we shouldn't read too much into the highly publicized WHI study. "The impression that this is the gold standard is incorrect."
 
And so, dear HRT-concerned readers, thanks for staying with me, and once again I must end on this wholly unsatisfying note: Stand by. We'll keep you posted.   Click here for complete article
 
2002 © The E.W. Scripps Co
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
go to the website www.yahoogroups.com/group/drrehertsalerts and follow the “Join
This Group!" instructions.  Also, as a member, you can read all the earlier
Emails by clicking on http://groups.yahoo.com/group/DrRehertsAlerts/messages.

Gerald M. Rehert, M.D.
285 Boulevard, NE, #520
Atlanta, GA 30312
404-688-2800

Reply | Forward | Messages in this Topic (2)
#26 From: <grehert@...>
Date: Tue Nov 19, 2002 3:25 am
Subject: Two articles regarding weight gain. 1.) A new harm, and 2.) an old treatment. 		grehert
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First, a newly reported reason to avoid obesity . . . (plus a reason to take folic acid)
Obesity Doubles Bowel Cancer Risk in Women -Study
 
— LONDON (Reuters) - Obesity doubles the risk of young women developing bowel cancer, American researchers said on Thursday.  A study of nearly 90,000 women, by researchers at the Albert Einstein College of Medicine in New York, showed that excessive weight increased the chances of developing the disease in women before the menopause.
 
"Our data suggest that obesity is associated with a two-fold increased risk of colorectal cancer. Obesity, which is reaching epidemic proportions in some countries, also increases the risk of diabetes, respiratory disease, muscle and skin problems, infertility, high blood pressure, stroke, heart disease and hormone-related cancers.
 
In a separate study published in the journal, scientists at the Royal Victoria Hospital in Belfast, Northern Ireland reported that folic acid could help to cut the chances of developing the disease in high risk patients.
 
All of the patients in the study had pre-cancerous growths in their bowel. Half received folic acid supplements and the remainder were given a placebo or dummy pill.
 
The researchers took biopsies at regular four week intervals to determine the impact of the supplements. In patients taking folic acid the scientists found the fewer proliferating cells than in the placebo group.  "The report highlights the need for further investigation on the role of folate as a chemopreventative agent in patients at risk of colon cancer," the scientists said in the study.
 
Copyright 2002 Reuters News Service. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. 
 
And second, another positive article about low carbs . . . it really works.
Study: Atkins Good for Cholesterol
Mon Nov 18, 6:16 PM ET  Add Health - AP to My Yahoo!
 
By DANIEL Q. HANEY, AP Medical Editor
 
CHICAGO (AP) - Multitudes swear by the high-fat, low-carbohydrate Atkins diet, and now a carefully controlled study backs them up: Low-carb may actually take off more weight than low-fat and may be surprisingly better for cholesterol, too.
 
For years, the Atkins formula of sparing carbohydrates and loading up on taboo fatty foods has been blasphemy to many in the health establishment, who view it as a formula for cardiovascular ruin. But now, some of the same researchers who long scoffed at the diet are putting it to the test, and they say the results astonish them. Rather than making cholesterol soar, as they feared, the diet actually appears to improve it, and volunteers take off more weight.
 
At least three formal studies of the Atkins diet have been presented at medical conferences over the past year, and all have reached similar results. The latest, conducted by Dr. Eric Westman of Duke University, was presented Monday at the annual scientific meeting of the American Heart Association (news - web sites), long a stronghold of support for the traditional low-fat approach.
 
Westman studied 120 overweight volunteers, who were randomly assigned to the Atkins diet or the heart association's Step 1 diet, a widely used low-fat approach. On the Atkins diet, people limited their carbs to less than 20 grams a day, and 60 percent of their calories came from fat.
 
"It was high fat, off the scale," he said.
 
After six months, the people on the Atkins diet had lost an average of 31 pounds, compared with 20 pounds on the AHA diet, and more people stuck with the Atkins regimen. Total cholesterol fell slightly in both groups. However, those on the Atkins diet had an 11 percent increase in HDL, the good cholesterol, and a 49 percent drop in triglycerides. On the AHA diet, HDL was unchanged, and triglycerides dropped 22 percent. High triglycerides may raise the risk of heart disease.
 
"More study is necessary before such a diet can be recommended," Westman said. "However, a concern about serum lipid (cholesterol) elevations should not impede such research." Click here for complete story.
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
go to the website www.yahoogroups.com/group/drrehertsalerts and follow the “Join
This Group!" instructions.  Also, as a member, you can read all the earlier
Emails by clicking on http://groups.yahoo.com/group/DrRehertsAlerts/messages.

Gerald M. Rehert, M.D.
285 Boulevard, NE, #520
Atlanta, GA 30312
404-688-2800

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#25 From: <grehert@...>
Date: Wed Nov 6, 2002 2:39 am
Subject: Two very recent articles on Hormones and Alzheimer's Disease. 		grehert
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First the good news:
 HRT might reduce Alzheimer's risk

From the Science & Technology Desk,  Published 11/5/2002 4:05 PM

BALTIMORE, Nov. 5 (UPI) -- Hormone replacement therapy seems to protect women from developing Alzheimer's disease but the treatment apparently does so only during a limited and as-yet-undefined period of time, researchers reported Tuesday.
 
Researchers from several institutions reached these conclusions after analyzing data from the Cache County Study, a long-term investigation that has examined the prevalence and rate of Alzheimer's disease among a group of elderly individuals living in Utah.
 
Thirty-five men and 88 women developed Alzheimer's disease during the study period. Researchers found women who used HRT had a 41 percent reduction in their risk for Alzheimer's, a degenerative disease that eats away at brain tissue, compared to women who never had used HRT. The longer the duration of use, the lower the risk, researchers report in the Nov. 6 issue of Journal of the American Medical Association. Women who used HRT for a decade or longer showed a 2.5-fold decreased incidence of Alzheimer's risk, a risk rate comparable to what was observed among the men.
 
Dr. Pierre Tariot, professor of psychiatry, neurology, aging and developmental biology at the University of Rochester in New York, said hormones could make a good preventive medicine, but not a very good treatment.
 
"I think it's important to stay aware of the distinction between using medications to treat Alzheimer's disease once it's present and using medications to prevent illness," Tariot told UPI. "HRT does not appear to help women who already have Alzheimer's disease."
(Reported by Katrina Woznicki, UPI Sciences News, in Washington)   Click here for full story
And now the bad news:
Hormone worsens Alzheimer's

November 5, 2002

Oestrogen may aggravate memory loss in post-menopausal women suffering from Alzheimer's disease, according to a new animal study.  Researchers at the University of Arizona in Tucson examined the effects of oestrogen on the cognition of 40 female rats, and say their findings could have implications for humans.
 
To induce menopause, the researchers surgically removed the rats' ovaries.  After testing the rats' memories by observing their performances in a water maze, the investigators found that ovary removal hadn't impaired the rodents' functioning.  But once the rats were given either regular oestrogen replacement therapy or induced chronic brain inflammation - which simulated the effects of Alzheimer's - their functioning worsened.   Click here for complete story
Bottom line:  Estrogen seems to prevent Alzheimer's Disease if you are a woman but not if you are a female rat. 
 
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc.                      
Best wishes.  Dr. Rehert
 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
go to the website www.yahoogroups.com/group/drrehertsalerts and follow the “Join
This Group!" instructions.  Also at this website you can read all the earlier
Emails.

Gerald Rehert, M.D.

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#24 From: <grehert@...>
Date: Tue Nov 5, 2002 3:54 am
Subject: RE: Organic Foods . . . Are they really better? 		grehert
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And now for something about Organic Foods:
 
Experts disagree whether organic food is healthier
By Lisa Marshall, Camera Staff Writer
October 13, 2002
 
Debbie Enssle is a picky eater. Once a week, the petite mother of six piles her children into her white Suburban and makes the trek from her mountain home to a Boulder health food store to fill her cart with organic food.
 
She buys organic produce at farmers' markets, and special-orders organic chicken, eggs and beef from area farms. She estimates she spends 30 percent to 40 percent more than if she bought conventionally produced food. But it's worth it, she says. "My children are really important to me. It's about better health."
 
But is it?
 
On the eve of a sweeping new federal labeling program that aims to standardize what can be called organic , the question of whether organic foods are better for your health is becoming increasingly controversial. Sixty-six percent of shoppers who buy organic list better health and nutrition as their motivator for buying organic, according to the Washington-based market research firm. Fewer than one-third cite environmental concerns.
 
But some food experts say that while there may be many reasons to buy organic foods, there is little proof yet that they are better for you. "The health question is really tough," says Boulder writer Elaine Lipson, author of "The Organic Foods Sourcebook."  "The reasons to buy organic are environmental reasons. It has not been proven that organic is more nutritious."
 
"I think the new standards are going to confuse consumers," says Avery, who along with his father, Dennis Avery, launched a campaign four years ago to expose what they call the "myth" that organic foods are healthier. USDA officials have made a point of clarifying that the agency, "makes no claim that these foods are more nutritious or safer," says Demaris Wilson, National Organics Program specialist with the USDA.
 
But Ronnie Cummins, national director of the Minnesota-based Organic Consumers Association, disagrees. "There is no doubt that organic food is better and safer than conventional food," Cummins says. The fact that an organic carrot has not yet been proven to have more nutrients than a non-organic carrot is irrelevant, he says, because most shoppers are "more concerned about what is not in it than what is in it."         Click here for the Complete Article.
 
Well that's the story, and I thought organic foods were supposed to taste better.  (The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc.) 
Best wishes.  Dr. Rehert
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
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to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
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#23 From: <grehert@...>
Date: Tue Oct 29, 2002 1:31 am
Subject: Don't take too many analgesics. 		grehert
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From Harvard, a warning not to take too much Motrin, Aleve or Tylenol.  These new findings surprised me so I thought I'd pass them on.    "Everything in Moderation"    Dr. Rehert
 
Frequent Pain Medication Use Linked to Hypertension
 
October 28, 2002 10:31 AM ET 
 
By Alison McCook
 
NEW YORK (Reuters Health) - Women who frequently take certain over-the-counter pain-relief medications appear to have a higher-than-average risk of developing high blood pressure, new study findings suggest.
 
Dr. Gary C. Curhan of Harvard Medical School in Boston, Massachusetts, and his colleagues found that women between the ages of 31 and 50 who take nonsteroidal anti-inflammatory drugs (NSAIDs)--such as ibuprofin (Motrin) and naproxen (Aleve)--at least 22 days per month appear to be 86% more likely than others to develop high blood pressure.
 
The investigators also discovered that similarly frequent users of acetaminophen (Tylenol) may be twice as likely as others to develop hypertension, or high blood pressure.
 
The relationship between analgesic use and hypertension persisted even when Curhan's team removed the influence of factors that might lead to both long-term pain problems and high blood pressure, such as obesity and rheumatoid arthritis.
 
Curhan and his team report their findings in the October 28th issue of Archives of Internal Medicine.
 
In an interview with Reuters Health, Curhan said that this is the first study to show that analgesic use may be linked to high blood pressure, so further studies are needed to confirm these findings. That said, however, he pointed out that it makes good biological sense that NSAIDs and acetaminophen could increase a frequent user's blood pressure over time.
 
SOURCE: Archives of Internal Medicine 2002;162:2204-2208.
 

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#22 From: <grehert@...>
Date: Sun Oct 27, 2002 1:28 pm
Subject: Hormone patches and creams. 		grehert
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The more I think about it, the more I'm convinced that absorbing hormones through the skin (transdermally), rather than by mouth (orally), is the safest and most natural way.  It's an exact imitation of how the ovaries secrete their hormones -- at a steady rate, 24/7 . . . and you don't hear any experts advising woman to have their ovaries removed to avoid heart disease.  On the contrary, there's a lot of evidence that having your ovaries removed at a young age significantly increases heart disease risk.  The article, below, addresses transdermal hormone treatment. 
Nonoral HRT (Patches and Creams) May Be Safer Alternative
 
Women in European Study Had Lower Cardiovascular Risks, Blood Pressure
 
By   Salynn Boyles 
WebMD Medical News  Reviewed By Brunilda Nazario, MD
 
Oct. 10, 2002 -- Women wishing to stay on hormone replacement therapy (HRT) who are concerned about the potential health risks may want to consider abandoning oral treatment in favor of other delivery routes, new research suggests.
 
Investigators conducting a small European study in which HRT was given in the form of estrogen skin patches and vaginally administered natural progesterone say these methods may be free of the cardiovascular risks that have recently been associated with oral hormone therapy. As an added benefit, postmenopausal women who were on the regimen for one year lost weight, lowered their blood pressure, and had less vaginal bleeding.
 
In light of the recent controversy surrounding HRT, a NAMS (North American Menopause Society) panel recently issued a report clarifying its position on the treatment. The panel concluded that relief from the symptoms of menopause should be the primary reason for being on HRT and that women should take the treatment for the shortest time possible. Panelists also called on physicians to consider alternatives to oral HRT, such as creams and patches.
 
Utian says there is good evidence that women who are extremely overweight, diabetic, or have high blood pressure should avoid oral therapy, but it is not clear whether women without specific risk factors need to do so. Utian is a consulting gynecologist at The Cleveland Clinic and an emeritus professor at Case Western Reserve School of Medicine.
 
The European study included 35 postmenopausal women who were treated for one year with estrogen patches and a natural progesterone gel, administered twice weekly. Though uterine bleeding is a common side effect of HRT, two-thirds of the women had no such bleeding during the one year of the study. The women also lost weight and lowered their blood pressure. The study was published in the September issue of the American Journal of Obstetrics and Gynecology.
 
For the complete article, click here:
http://my.webmd.com/content/article/1825.51480?page=1
© 2002 WebMD Inc. All rights reserved.
 
Now wouldn't you know it but because of the current HRT controversy, the FDA just rejected a new hormone patch.  Click here for the story:  Feds Nix Menopause Treatment Patch
 
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert
 
 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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#21 From: "Dr.Rehert" <grehert@...>
Date: Sun Oct 20, 2002 7:24 pm
Subject: Two articles about birth control pills. 		grehert
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First, here's an article about suppressing your periods by taking birth control pills continuously.  I totally agree with Dr. Sulak and have several patients on continuous pills -- 9 weeks on, 1 week off.  That's a menstrual period every 10 weeks or about 5 per year.
 
Skipping Periods: Is It Safe?
Woman Skip Periods By Taking Continuous Birth Control Pills
 
BAKERSFIELD, Calif. -- Karen Matous doesn't dread her monthly periods anymore, because she no longer has them. Extreme premenstrual syndrome prompted her to stop her periods altogether. "I was a bear. I mean, I had a monster living in me and it would just come out. It was uncontrollable," Matous said.
 
Her OB-GYN suggested taking continuous birth control pills. Matous has been taking them for two years now. "I usually can go about three months and then I start to get a little breakthrough and then I quit taking them for four to five days and then get right back on them again," Matous said.
 
"Rather than taking 21 days of pills and then taking a week off, a woman just continues to take real pills," Dr. Patricia Sulak said. Period suppression also helps with menstrual migraines and mood swings.
 
Sulak stresses that skipping your period is safe and healthy. In fact, she believes monthly periods can actually increase your chance of endometriosis and ovarian cancer. "We think this is going to be an option that many women are going to chose, now with their own pills, or with new pills that will be coming on the market," Sulak said.
 
Copyright 2002 by TheBakersfieldChannel.com. MedStar contributed to this report. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
 
Next here's a reassuring article that didn't get as much press as the WHI study which condemned  hormone therapy.  This doesn't all make sense since birth control pills have 4 to 7 times as much estrogen as HRT.
 
Study Finds No Link Between Birth Control Pill and Breast Cancer
 
June 30 , 2002
 
The question of whether a link exists between birth control pill use and the development of breast cancer later in life has been the subject of numerous research studies. This research has been driven by the knowledge that exposure to estrogen and progesterone, which the pill contains, is linked to increased breast cancer risk. But a new study published in the June 27 issue of the New England Journal of Medicine should help ease women's fears. After interviewing thousands of women who chose to take the pill and thousands who chose not to, researchers found that the pill does not appear to increase breast cancer risk.
 
The new data comes from interviews researchers conducted with more than 9000 women between the ages of 35 and 64 as part of the Women's CARE (Contraceptive and Reproductive Experiences) Study. Their goal was to compare women who had been diagnosed with invasive breast cancer with women who were similar to them but who had not been diagnosed with the disease.
 
The researchers found that when they compared the risk of breast cancer between these groups of women, there was no evidence that the pill increased risk. The risk did not increase for women who began taking the pill as teenagers, nor did it matter how long a woman had been on the pill. There also were no differences seen in the risk of breast cancer between white women and black women who were on the pill.
 
References:
 
Marchbanks PA, McDonald JA, Wilson HG et al. Oral Contraceptives and Risk of Breast Cancer. New England Journal of Medicine. 2002; 346: 2025-32. www.nejm.org or ...more here...
 
Davidson NE and Helzlsouer KJ. Good News About Oral Contraceptives. Editorial. New England Journal of Medicine. 2002: 346: 2078-09. www.nejm.org
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert
 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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Gerald Rehert, M.D.

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#20 From: <grehert@...>
Date: Tue Oct 15, 2002 3:00 am
Subject: About children and duct tape. 		grehert
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Here are two interesting articles that may help you deal with your children (or your grandchildren). 
 
First . . .  they say you can do almost anything with duct tape:

Duct Tape Can Get Rid of Warts
Mon Oct 14, 6:08 PM ET
 
NEW YORK (Reuters Health) - The next time you're in need of a wart cure-all, forget combing the aisles of the local pharmacy and head over to the hardware store instead. According to the findings of a small study in children, applying plain old duct tape to the common wart (scientifically known as Verruca vulgaris) appears to be superior to traditional cryotherapy with liquid nitrogen.
 
In the current study, the researchers compared duct tape therapy to cryotherapy, which involves several visits to the doctor's office. During the treatment, a physician freezes the wart by applying a quick, narrow blast of liquid nitrogen to the offending blemish. This is repeated once every two or three weeks until the wart is gone.
 
In the study, the researchers randomly assigned 51 patients between the ages of 3 and 22 to receive either a maximum of 6 cryotherapy treatments, once every two to three weeks, or two months of duct tape therapy.
 
In duct tape therapy, a nurse covered the wart with a piece of duct tape roughly the same size as the wart. Patients (or their parents) were instructed to keep the duct tape on for 6 consecutive days and if the tape peeled off during that time, apply another at home. At the end of 6 days, patients soaked the wart in water and rubbed it with an emery board or pumice stone. The next morning a new piece of tape was applied. The routine was repeated for a maximum of two months.
 
The investigators found that 85% of those in the duct tape group, compared to 60% of those in the cryotherapy group "had complete resolution of their warts. "This study shows that duct tape occlusion therapy is not only equal to but exceeds the efficacy of cryotherapy in the treatment of the common wart. It's not clear exactly how the duct tape sends warts packing, according to the report, "but, as with other therapies, it may involve stimulation of the patient's immune system through local irritation."
 
SOURCE: Archives of Pediatric and Adolescent Medicine 2002;156:971-974.
 
 
And if you thought you knew about SIDS . . . .
New Study Sends Strong Message on SIDS (Sudden Infant Death Syndrome)
 
The research brings some of the most convincing evidence yet that putting infants to sleep on their backs can save lives. It's a message doctors and advocacy groups have been preaching for years. The Back to Sleep campaign to prevent Sudden Infant Death Syndrome has been plastered on everything from diapers to door hangers.
 
Now, a new study in the journal Pediatrics makes the strongest case to date that putting babies on their stomach increases the risk of SIDS. Researchers compared the sleep habits of more than 200 SIDS victims under age one and compared them to the habits of same number of healthy infants. According to researcher Dr. Fern Hauck, "Prone sleeping or stomach sleeping was a significant risk factor for SIDS. In fact it accounted for 31% of the deaths."
 
While the cause of SIDS is still largely a mystery, researchers say their study reaffirms the message that many deaths can be prevented simply by putting babies to sleep on their backs. The study found that almost all of the SIDS deaths happened within the first four months of life, with most happening between the first month and the third month.
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are solely intended to entertain, inform and educate its readers.  They are not
to be considered medical advice.  You should not alter any of your lifestyle
behavior without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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Gerald Rehert, M.D.

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#19 From: <grehert@...>
Date: Sat Oct 12, 2002 1:26 pm
Subject: Two interesting articles. 		grehert
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Is your weight a threat to your health?  Do you have a tape measure?    Here's a novel and easy way to check your heart disease risk:
 
Waist Circumference Helps Predict Cardiovascular Risk
Fri Oct 11, 4:07 PM ET
By Amanda Gardner
HealthScoutNews Reporter
 
FRIDAY, Oct. 11 (HealthScoutNews) -- If you want to determine your risk for cardiovascular disease, maybe you should throw out your scale and grab the measuring tape.
 
A study appearing in a recent issue of the American Journal of Clinical Nutrition (news - web sites) suggests waist circumference is more strongly associated with cardiovascular risk factors than body mass index (BMI).
 
"There's been some research that shows that it may not be the total amount of fat in your body but where it is stored. In other words, fat distribution," says Stanley Heshka, a co-author of the study and a research associate at the New York Obesity Research Center at St. Luke's Roosevelt Hospital in New York City.
 
Body mass index (the measure of body fat based on height and weight) is the most widely used gauge to tell if adults are overweight or obese. Meanwhile, various studies have found body fat distribution is a better predictor for many diseases.
 
In the new study, the researchers looked at information on white men and women gathered for NHANES III, the National Health and Nutrition Examination Survey, which collected data on the health and nutrition of 9,019 Americans. Then the researchers correlated BMI values of 25 and 30 (which indicate overweight and obese, respectively) with cardiovascular and diabetes risk factors. They set out to determine what waist circumferences have the same degree of risk for cardiovascular disease and diabetes as the BMI guidelines.
 
To minimize the risk of heart disease, men should not go above a 35-inch waist and women should not go above 33 inches, Heshka says. Men whose waists are 39 inches or more and women whose waists are 37 inches or more should lose weight -- and inches, he says.
 
Though the study data involved exquisitely precise measurements (taken just above the top of the hip bone and at the end of a normal exhalation), regular folks don't need to be quite that exact. If you come close to the recommended cutoff points, though, you need to take them seriously, Heshka cautions.
 
To learn more about cardiovascular disease, visit the U.S. Centers for Disease Control and Prevention (CDC).   www.cdc.gov
 
And if you have some extra time, here's an internet link to a very interesting article that explains the intricacies of drug company marketing:        CLICK HERE
 
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert
 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are intended to entertain, inform and educate its readers.  It is not to be
considered medical advice.  You should not alter any of your lifestyle behavior
without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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#18 From: <grehert@...>
Date: Thu Oct 10, 2002 2:28 am
Subject: Depression treatments. 		grehert
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Ever depressed?  Here are two innovative ways to treat depression; one over-the-counter, one prescription.  Hope they cheer you up.  First something OTC:
Chocolate maintains mental health
 
By Trice WhitefieldDaily Texan (U. Texas-Austin)
 
October 07, 2002
 
 (U-WIRE) AUSTIN, Texas ; Next time you're tired, but need to cram for that 8 a.M. Exam the next day, try eating some chocolate.
 
For centuries, people have known that food can affect your mental and emotional health. Think of comfort foods like apple pie and mashed potatoes. Research has shown that there are several scientific reasons behind one's desire to consume massive amounts of chocolate after a stressful day.
 
The brain produces chemicals called neurotransmitters that trigger action, speech, thought and emotion. The types of food people eat alters the production and activity of these neurotransmitters. After repeated experiences with certain foods, people often relate specific items with sensations like comfort, alertness or passion. "These chemicals do not compel a person to eat (certain foods), but they intensify the urge," said University of Texas-Austin psychology professor Devendra Singh. This knowledge, conscious or subconscious, triggers that insatiable inclination to dive headfirst into the pantry.
 
Found in milk, cake, candies and the mind of every dieting person in this country, chocolate is a food demanded equally for its taste and emotional-healing properties. Americans, after all, eat about $5 billion worth of chocolate every year, the equivalent of 11 pounds per person. The calming effect of a pint of rocky road ice cream lies in the neurotransmitter anandamide, a cannabinoid chemical that attaches to specific brain receptors. This part of the brain also catches similar chemicals found in marijuana smoke and creates a mellow, calm feeling.
 
"There are few other foods that evoke the sort of sensory response that chocolate elicits," writes cooking instructor and consultant Carole Kotkin in her article, "Chocolate ; The Original Comfort Food." But in order to replicate a marijuana-like high, a person would need to devour 400 ounces of chocolate, or 25 pounds, according to an article on www.Dummies.Com.
And now something that requires a prescription:
Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double-blind, randomized, placebo-controlled trial.
 
Soares CN, Almeida OP, Joffe H, Cohen LS.
 
Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital, Harvard Medical School, 15 Parkman St, WACC 812, Boston, MA 02114, USA. csoares@...
 
BACKGROUND: Results of previous studies suggest that estrogen improves somatic and mild depressive symptoms experienced by perimenopausal women. This study investigated the efficacy of 17beta-estradiol for the treatment of clinically significant depressive disorders in endocrinologically confirmed perimenopausal women.
 
METHODS: Perimenopausal women meeting criteria for major depressive disorder, dysthymic disorder, or minor depressive disorder, were randomized to receive transdermal patches of 17beta-estradiol (the estrogen patch) or placebo in a 12-week, double-blind, placebo-controlled study. 
 
RESULTS: Fifty women were enrolled in the study; 26 met criteria for major depressive disorder, 11 for dysthymic disorder, and 13 for minor depressive disorder. Remission of depression was observed in 17 (68%) women treated with 17beta-estradiol compared with 5 (20%) in the placebo group (P =.001). Subjects responded similarly to estradiol treatment, regardless of diagnosis. Patients treated with estradiol sustained antidepressant benefit of treatment after the 4-week washout period, although somatic complaints increased in frequency and intensity. Treatment was well tolerated and adverse events were rare in both groups.
 
CONCLUSION: Transdermal estradiol (the estrogen patch) is an effective treatment of depression for perimenopausal women.
 
Arch Gen Psychiatry. 2001 Jun;58(6):537-8.
The above is not meant to be medical advice.  Please read the attached Disclaimer, Etc. 
Best wishes.  Dr. Rehert
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are intended to entertain, inform and educate its readers.  It is not to be
considered medical advice.  You should not alter any of your lifestyle behavior
without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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#17 From: <grehert@...>
Date: Fri Oct 4, 2002 1:57 am
Subject: Two News articles on weight loss. 		grehert
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If you are post-menopausal and can't seem to lose any weight, Dr. Cynthia Ferrara thinks she has the answer.  Interesting but don't let it be an excuse for diet and exercise:
Menopause boosts fat storage
 
September 26, 2002
 
Women who notice their bodies growing rounder as they get older, may be pleased to hear that their weight gain isn't entirely their fault.  A new study has found that during menopause, a woman's fat metabolism may change, making the body more likely to store fat, less likely to lose it.

Dr Cynthia Ferrara and collegues at the University of Maryland in Baltimore took fat samples from the abdomen and buttocks of 24 women of similar weight and body mass index (a weight to height ratio used to measure obesity). Half of the women were postmenopausal, while the other half were perimenopausal.
 
The researchers found that an enzyme, called adipose tissue lipoprotein lipase (AT-LPL), was more active in postmenopausal women than perimenopausal women. AT-LPL breaks down fat into its separate components for absorption into the fat cells.
 
The postmenopausal women also had reduced lipolysis, the process by which stored fat is released from fat cells. The amount of lipolysis In the buttocks was cut by 75% in postmenopausal women, the researchers found.
 
The accumulation of body weight and the changes in fat distribution after menopause increases not only the risk of Type 2 diabetes, but also heart disease.
 
Preventing weight gain.
Although the reasons for the change in fat metabolism is not understood, the researchers believe that hormonal changes during menopause, such as lower levels of oestrogen, may affect fat cell metabolism.
 
Despite these unavoidable changes, the researchers recommend following a healthy diet and exercise programme to prevent weight gain as women age. – (Health24)
 
And don't trust those diet ads:
Many Weight-Loss Ads Are Misleading

WASHINGTON (Reuters) Sept 17 - Nearly 40% of weight-loss advertisements made at least one representation that was almost certainly false, according study by US regulators released on Tuesday. About 55% of the ads included at least one representation that was very likely to be false or lacked adequate substantiation of its promises, the analysis by Federal Trade Commission staff said.
 
The report urged Americans, who spend billions annually on weight-loss products and services, to look skeptically at advertisements that promise a "quick-fix" for weight loss. Consumer testimonials and before-and-after photos were common in diet promotions, but "rarely portrayed realistic weight loss," the report concluded.
 
"False or misleading claims are common in weight-loss advertising, and, based on our comparison of 1992 magazine ads with magazine ads for 2001, the number of products and the amount of advertising, much of it deceptive, appears to have increased dramatically over the last decade," the report said.
 
Claims that are too good to be true include assertions that a user can lose 1 pound a day or more for extended periods; that substantial weight loss, without surgery, can be achieved without diet or exercise; and that users can lose weight regardless of how much they eat, the report said.
Best wishes,  Dr. Rehert.  (Be sure to read Disclaimer, Etc. - attached)
 
DISCLAIMER:  The articles discussed in "Dr. Rehert's Medical Alerts Email List”
are intended to entertain, inform and educate its readers.  It is not to be
considered medical advice.  You should not alter any of your lifestyle behavior
without the advice of your personal physician.

“Dr. Rehert’s Medical Alerts Email List” is open to anyone who wants to join. 
Either send your Email address to RehertHRT@... (recommended)  OR  you may
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#16 From: <grehert@...>
Date: Wed Sep 25, 2002 10:41 am
Subject: More news on hormones and your heart. 		grehert
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Two articles:  The first one confirms some of the findings of the WHI study which said hormones (HRT) increase the risk of heart attacks  and strokes a small amount.  The second discusses the benefit of taking a baby aspirin every day which seems to decrease the risk of a heart attack by 28%.  This is why I recommend a baby aspirin for anyone on hormone therapy.  To see my complete opinion letter on hormone therapy - click here.
 
First Article:  Analysis confirms hormone replacement dangers
 
Sep 23(Reuters) - A British study backed US findings on the side-effects of hormone replacement therapy (HRT) on Friday, saying the treatment taken by women to relieve menopause symptoms increases the risk of breast cancer and stroke.
 
A review of four major studies into the effects of HRT found that women who took the treatment for five years had a higher risk of breast cancer, stroke and blood clots in the lung but were less likely to suffer from bowel cancer or hip fractures.
 
"The four major trials that have been done, although in different settings and with different combinations (of HRT), really show consistent results," Professor Valerie Beral, of Britain's Cancer Research UK charity, told Reuters.
 
US FINDINGS BACKED
 
Beral said her analysis of four trials involving 20,000 postmenopausal women, which is published in The Lancet medical journal, confirm the findings of the US study.
 
Second Article:  Aspirin can cut heart risk for the healthy
January 14, 2002 Posted: 5:05 PM EST (2205 GMT)
 
By Rhonda Rowland
CNN
 
ROCKVILLE, Maryland (CNN) -- Healthy adults with even a small risk of a heart attack and no history of cardiovascular disease could benefit from taking aspirin daily, the U.S. Preventive Health Services Task Force said Monday.
 
Previous studies have recommended aspirin use by people who have already suffered a heart attack or a certain type of stroke.
 
But the task force also warned that serious side effects are possible, and said some people might be better off taking so-called baby aspirin than regular aspirin. It strongly encouraged doctors to discuss with patients the benefits and dangers of aspirin use in healthy adults
 
The task force said those who could benefit from aspirin use are men over the age 40, postmenopausal women, and younger people with risk factors such as smoking, diabetes, high blood pressure and high cholesterol.
 
The new report shows regular aspirin use reduced the risk of coronary heart disease by 28 percent in healthy people who have never had a heart attack or stroke.
 
The report also emphasizes that aspirin can have serious side effects such as gastrointestinal bleeding and bleeding in the brain, known as a hemorrhagic stroke. Because of the potential harm, cardiologists say it's important to carefully assess the benefits and risks of using aspirin. The risk of complications is lower with so-called baby aspirin, which has about 81 mg. aspirin compared with full-strength, which has about 325 mg. aspirin.
 
"There are many, many people who believe everyone in the world should be on aspirin," said Dr. Valentin Fuster of Mount Sinai Medical Center, who has conducted research on aspirin and heart disease and co-authored the American Heart Association's statement on aspirin use in cardiovascular disease.
So if you take hormones, you must accept a small increased risk of getting breast cancer, heart attack, blood clots and strokes.  Compared to other risks we take every day, these risks are small.  But hormones shouldn't be taken unless the benefit to how you fell and to your general well-being out-weigh these small risks...and don't forget your baby aspirin.  Dr. Rehert

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#15 From: <grehert@...>
Date: Wed Sep 18, 2002 10:40 am
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Here's a good article that tells you everything you need to know about birth control pills.  The benefits of "the pill" are far more than just contraception.         Dr. Rehert

Pill poppers
Women turn to pill for more than birth control
 
By Susan Ferraro, New York Daily News
September 9, 2002
 
NEW YORK — The real reason Ali Bartolone has been taking the pill for 11 years has nothing to do with birth control.
 
"My periods were heavy, painful, long and very irregular," says Bartolone, 27, who lives in Queens, N.Y. "My first years in high school I'd get my period maybe twice in six months, or ridiculously often — every two or three weeks."
 
But after a doctor prescribed birth-control pills to settle down her cycle, Bartolone says that her "periods grew regular, the cramps minimal, if they were there at all." Once, hoping her system had learned its lesson, she went off her regimen.
 
"Right away, my period was heavier and very painful," she says. She went back on the pill.
 
Oral contraceptives revolutionized women's lives in the 1960s. For the first time, they could manage their bodies and plan their families — each a significant boon to their health. Today, 10 million women in the U.S. use the pill, which is available in more than 50 brands and formulas, adding up to a $2.4 billion-a-year market. Long controversial, they have been scrutinized more heavily than just about any other drug.
 
Now, experts say, decades of research finds that the benefits of the pill outweigh its risks. It blocks pregnancies that can, even in modern America, end badly, and it protects against certain cancers and cures other ills. And it does not pose the same risks as hormone replacement therapy in menopausal women. However, the pill is still inappropriate for some women, and many are wary of using hormones to disrupt natural cycles.
 
Birth-control pills work by fooling Mother Nature: They supply hormones women make naturally during pregnancy, and the body either prevents the ovaries from releasing new eggs or blocks sperm trying to reach them.
 
Used correctly, pills that contain both estrogen and progestin, the key female hormones, fail just 0.1 percent of the time — with minimal aggravation, maximum freedom and no "Just give me a minute, Honey" delays that can wreck romantic moods.
 
Progestin-only "minipills" that block sperm do almost as well, studies find. Because most pill use is not perfect, and ovulation is very sensitive to missed doses, the pill's overall success rate is about 95 percent.
 
The pill's chief longterm benefit is also its short-term goal: controlling pregnancy.
 
In addition, the pill can:
 
Be a cancer shield. Pill use cuts the risk of ovarian cancer, possibly because blocking ovulation limits the damage caused by eggs bursting out of the ovaries. Also, research suggests that progestin itself may chemically block cancer.
 
Ovarian cancer is rare, typically posing a 1.2 percent or 1.3 percent lifetime risk, says Dr. Allan Klapper, director of gynecology at Beth Israel Medical Center in New York. But it is usually caught late, when it is often already poised to kill. The pill can reduce risk by 40 percent, Klapper says: "That's important in someone who has a family history."
 
Also, women who take oral contraceptives for one year halve their risk of getting cancer of the endometrium, the lining of the uterus and the most common gynecological cancer, says Westhoff. Better still, the protection lasts for 15 years after stopping the pill.
 
Cure acne. The Food and Drug Administration has already approved two brands for use in suppressing acne, "but probably most of them can," says Krause. Some women ask for it for that reason, she says.
 
Reduce pain. As Bartolone learned, the controlled release of hormones can steady wildly irregular cycles, limit excessive flow and quiet gut-wrenching, nauseating cramps. So successful is the pill in easing monthly discomfort that some doctors put women on extended regimens; one company is developing a formula, now under FDA review, that creates an 84-day "cycle" with just four periods a year.
 
Limit benign cysts. Oral contraceptives seem to decrease two painful conditions, fibrocystic breast disease and polycystic ovarian syndrome, says Krause, probably because it regulates cycles and hormone levels.
 
Treat symptoms of menopause. "There is a huge indication now for birth-control pills to control symptoms leading up to menopause, such as moodiness, vaginal dryness, hot flashes and irregular bleeding," says Krause.
 
Prevent osteoporosis. Some studies show that women who take birth-control pills have greater bone density and, as a result, the prospect of better long-term health: Osteoporosis can be excruciating, and older women often die within a year of breaking a hip.
 
Control endometriosis. Properly managed, oral contraceptives may also ease or control endometriosis, a ravaging disease that occurs when uterine tissue migrates to places where it can only cause trouble.
 
Looming over the benefits of the pill are known or long-suspected risks linked to its use. Most feared, perhaps, is a possible link between taking hormones, which many think seems "unnatural," and developing breast cancer.
 
Moreover, early studies based on the first pills — which had double or more the amount of estrogen than the modern, low-dose pills — showed a connection between oral contraceptives and such medical problems as blood clots, heart attack and stroke.
 
However, as the amount of hormones in the pills has dropped, the dangerous side effects linked to them have diminished, as the studies have grown more sophisticated and doctors have learned more about how women's bodies work, proved unrelated.
 
Most studies over the years show no link between birth-control pills and breast cancer, says Hoyt G. Wilson, Ph.D., an epidemiologist with the Centers for Disease Control and Prevention. To clarify concerns, the CDC and others have done a study of 9,200 women, including the largest sample ever of black women.
 
Results released by the CDC and the National Institutes of Health last month found no connection between use of hormonal birth-control pills — past or present — and breast-cancer incidence in women 35 or older.
 
Other data are not as comforting. Women who have human papilloma virus (HPV), the chief cause of cervical cancer, have a higher risk of developing that cancer if they also take the pill.
 
Though low-dose pills have virtually eliminated the increased risk of a heart attack or stroke in healthy women, there remains some danger of developing blood clots in the legs (a three- to sixfold increase, according to the Kaiser Family Foundation). Also, "a small percentage of women" may have elevations in blood pressure.
 
"Anything you take has potential risk, whether it is the food that you eat, antibiotics for a bug or over-the-counter cough suppressants," says Klapper. "You have to weigh everything against the proven benefits."
 
 

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#14 From: <grehert@...>
Date: Sun Sep 15, 2002 1:37 pm
Subject: Better Health Care Through Patient Education 		grehert
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September is Cholesterol Awareness Month.  Here are two articles that will teach you about your lipids -- which include HDL, (the good cholesterol), LDL, (the bad cholesterol) and triglycerides.  Your lipids are usually checked by your primary care physician.  But if not, my office will be glad to check them.  (Some managed care plans only cover this if ordered by your PCP.)    Dr. Rehert
 
This first article is everything you need to know about your lipids:

SUNDAY, Sept. 8 (HealthScoutNews) -- If the risk of heart disease isn't enough to convince you to check your cholesterol levels, here's another incentive: September is Cholesterol Awareness Month, so now's the time to learn your cholesterol count.
 
"High cholesterol is a major risk for atherosclerosis and stroke," says Dr. Roger Blumenthal, a cardiologist at Johns Hopkins School of Medicine. "But you can significantly reduce cholesterol by a combination of improving your lifestyle and appropriate use of medication."
 
Cholesterol is not always a bad thing. A waxy substance produced by the liver, it insulates the nerves, makes cell membranes and produces certain hormones. However, the body produces enough for its own needs. If, through a combination of poor diet or a genetic predisposition, you produce more cholesterol than needed, the excess stays in the blood, forming plaque that lines the arteries. Eventually, the arteries harden and put you at risk for heart disease.
 
So, you should first find out what your cholesterol levels are through a blood test at a doctor's office. There are two types: LDL cholesterol and HDL cholesterol.
 
LDL is often called the "bad" cholesterol because it stays in the blood, forming the plaque that lines the arteries. Eventually it hardens the artery walls, making them thicker and less flexible so that blood flow to the heart is restricted, which can cause heart attacks.
 
"Optimally, your LDL level should be less than 100 milligrams per deciliter of blood," Blumenthal says.
 
HDL is known as the "good" cholesterol because high levels are associated with less heart attack risk, and Blumenthal says a count above 40 milligrams per deciliter is considered healthy.
 
Also important is your level of triglycerides, which are fats present in the blood that are associated with the risk of heart disease. Blumenthal says they should not be higher than a count of 150 milligrams per deciliter of blood.
 
Ironically, many people try to avoid fat in their foods, and wind up omitting healthier fats from their diets. "Olive oil, canola oil, fatty fish and peanuts, for instance, are good fats that reduce cholesterol," Diekman says.
 
Exercise is equally important in reducing cholesterol, and Diekman recommends her clients try for 30 to 40 minutes of aerobic exercise most days of the week -- "walking, jogging, biking, dancing, whatever they like to do."
 
If your cholesterol is still too high after lifestyle changes, then it's time to look at medications, Blumenthal says. "Diet and exercise are the cornerstones of cholesterol management, but medication can be helpful," he says.
 
A group of drugs called statins, which decrease the production of cholesterol in the liver, are the most common treatment for high cholesterol, Blumenthal says. They reduce the risk of subsequent heart attacks in people who have already had one, and are equally helpful for people who have never had a heart attack but who are at risk for one, he adds.
Below is an article about the influence of vitamins on your lipids.
Vitamins C, E May Prevent Artery Damage
Wed Sep 11,11:56 AM ET
 
NEW YORK (Reuters Health) - Both vitamins C and E, taken alone, may prevent a type of oxidative damage tied to cardiovascular disease. In a study of 184 non-smoking adults, investigators found that taking either vitamin C or E reduced the oxidation of blood fats called lipids. Oxidation is a normal chemical reaction in the body, but the process can also damage cells. 
 
A number of studies have suggested that antioxidant vitamins like C and E may help ward off oxidative damage--and that these two vitamins may enhance each others' protective powers. But much of this research has been in the lab rather than in people. So the researchers, led by Dr. Han-Yao Huang of Johns Hopkins University in Baltimore, Maryland, looked at how vitamins C and E, alone or together, affected lipid oxidation in middle-aged and older adults.
 
Over 2 months, participants followed one of four daily regimens: 500 milligrams (mg) of vitamin C alone; 400 international units (IU) of vitamin E alone; both vitamins together; or placebo (inactive) pills.
 
The researchers found that both vitamins C and E lowered urine levels of a particular substance that is a byproduct of lipid oxidation--a substance that has been found to be elevated in cigarette smokers and people with diabetes and high cholesterol.
 
They also note that the daily vitamin C dose used in this study is attainable through diet, while the vitamin E dose is "virtually impossible" to come by through food alone. Food sources of vitamin E include wheat germ, nuts and vegetable oils. Citrus fruits, strawberries, tomatoes and broccoli are among the top sources of vitamin C.
 
SOURCE: American Journal of Clinical Nutrition 2002;76:549-555.
 
Vitamins are important.  But they shouldn't be a substitute for proper diet and exercise.  
Dr. Rehert

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#13 From: <grehert@...>
Date: Sat Sep 14, 2002 1:57 am
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I have three important news stories about breast disease.  The first relates to hormone therapy.  The second reflects on mammograms, and the third describes breast reduction surgery.  Contact me if you have any questions about how these articles might effect your own personal situation. 
First, the latest news on HRT (hormone replacement therapy).
Good (Breast Cancer) News for HRT Users
 
Most Tumors Are Small, Slow-Growing, Treatable
 
By   Jeanie Davis 
WebMD Medical News  Reviewed By Michael Smith, MD
 
Sept. 12, 2002 -- Women who take hormone replacement therapy and later develop breast cancer are more likely to have tumors that are smaller, slow-growing, and treatable, a new study shows. In fact, HRT users may not even be more likely to get breast cancer at all.
 
This summer, a huge clinical trial -- the Women's Health Initiative -- showed that the oral high-dose combination of estrogen and progestin in Prempro increases a woman's risk of breast cancer, heart disease, and stroke. "When that study came out, it really scared a lot of people," says Rodney F. Pommier, MD, associate professor of surgery at Oregon Health & Science University in Portland. He is the lead investigator of a study appearing in the September issue of Archives of Surgery. "We think that a big part of the story wasn't really looked at," Pommier tells WebMD. "We've known for years that taking HRT [hormone replacement therapy] for a few years increased risk of breast cancer slightly. But without HRT, women are deprived of an important survival advantage -- they could get worse tumors. That advantage could be so big that it would outweigh all the disadvantages."
 
Pommier's study is "one more bit of reassuring information that there's not an enormous downside to HRT regarding breast cancer," says William Wood, MD, chairman of surgery at Emory University School of Medicine in Atlanta. Wood reviewed Pommier's study for WebMD.
 
In their study, Pommier and colleagues analyzed medical records for 290 women with breast cancer -- half had used HRT at some point in the past and the other half had not. On average, HRT users had been on hormones for 16 years. Contrary to the Prempro study, Pommier found virtually no difference in the frequency of breast cancer between the women who did and did not take HRT.
 
"In the [Prempro] study, 300 women had breast cancer in a scant five years -- which shows it's a very common disease," he says. "Most of them clearly got it whether they got the hormones or not. Only a few may have gotten it because they took estrogen, but I don't think in five years you can show that."  However, the other differences were "very stark," Pommier tells WebMD.
 
HRT users were more likely to have small, early stage cancers that were not aggressive and had not spread. Plus, HRT users were more likely to have precancerous lesions rather than full-blown cancer.

"Our study is saying that when you take [HRT], you're getting much better cancers, and that needs to be weighed in," he says.
 
Woods says there are many benefits to estrogen replacement therapy, including the following:
 
Reducing hot flashes.
Reducing short-term memory loss.
Reducing risk of depression.
Protecting against Alzheimer's disease.
Keeping the vagina young and increasing lubrication.
Protecting the urethra so you don't get vaginitis.
Reducing risk of colon cancer.
Preventing osteoporosis hip and shoulder fractures.
 
© 2002 WebMD Inc. All rights reserved.
Now regarding mammograms:
Study Shows Mammograms Lower Breast Cancer Deaths
Screening Saves Lives
 
Article date: 2002/07/31 
 
Mammography works. That’s the conclusion of a study and an editorial reported in the August 1 issue of the journal Cancer (Vol. 95, No. 3: 458-69, 451-57).  The study was conducted by Stephen W. Duffy, MSc, from Cancer Research UK in London, United Kingdom, and 22 other experts from around the world. They looked at deaths from breast cancer in seven counties in Sweden, both before and after community mammography programs began.
 
Recently, there have been conflicting reports about the value of mammography, and whether it decreases deaths from breast cancer.
 
By carefully examining information from the seven Swedish counties before and after community screening programs were started, the study found a large decrease in the number of women dying from breast cancer after screening had been in place for several years.
 
For the seven counties together, breast cancer deaths decreased 45% in women who actually had a screening mammogram. In one county, where screening had been in place for over 10 years (Dalarna county), deaths from breast cancer decreased 60% compared to death rates before screening. 
 
The authors pointed out that not all of the decrease in breast cancer deaths is due to screening alone.  Before mammography was available in these counties, the death rates from breast cancer had been falling by about 1% per year, according to the authors. "This can be considered to be the combined effect of increased public awareness resulting in more rapid reporting of breast symptoms, changes in the availability of diagnostic and treatment facilities, improvements in therapy, and patient management," they said.
 
But, they said, at the same time, the incidence of breast cancer was increasing in these counties. That means that the majority of the benefit in decreasing breast cancer deaths is related to mammography, the authors reported.
 
Robert Smith, PhD, one of the study authors and director of screening for the American Cancer Society, emphasized the importance of this study.  "This study represents an important new direction for breast cancer screening," said Smith. "There is not likely going to be another trial for mammography. This study measures how screening is performing in the community. We can measure the benefit in women who actually got tested.  "These data show that well-organized screening programs can achieve high quality and contribute to a reduction in breast cancer deaths," said Smith.
And last, if you've ever considered breast reduction therapy:
 Getting It Off Your Chest
Thu Aug 29, 7:06 PM ET
By Jennifer Thomas
HealthScoutNews Reporter
 
THURSDAY, Aug. 29 (HealthScoutNews) -- Most people may think breast size is a matter of personal preference, but for many large-breasted women it can be a medical issue.
 
April Borry-Black, 47, lived with years of chronic back pain and deep grooves in her shoulders from her bra straps. As she got older, she got tired of having to wear two heavy-duty bras when she went running and dealing with people staring at her breasts rather than her face.
 
Borry-Black is one of the growing number of women who are opting for breast reduction surgery. Last year, 114,926 women in the United States had surgery to have their breasts made smaller, according to the American Society for Aesthetic Plastic Surgery.  Breast reduction surgery is up 28 percent from 2000 and 140 percent from 1997.
 
Meanwhile, plastic surgeons are trying to get the word out that breast reduction surgery is often done for medical, rather than cosmetic, reasons. "It is a medical procedure," says Dr. Alexander Moya, a plastic surgeon at Geisinger Medical Center in Danville, Pa. "These patients present with low back pain, shoulder pain and even numbness and tingling in their fingers because of nerves that are being compressed by their bra."
 
Because it's widely considered a cosmetic procedure, insurance companies often won't pay for breast reduction surgery, Moya says. Even among insurance companies that will cover it, there are often strict guidelines for how much breast tissue must be removed for it to be considered a medical procedure.
 
Doctors usually remove from 2 pounds to 4 pounds of tissue. "That's a huge amount of weight to have off your chest," Moya says.
 
Of all the procedures he does, women who get breast reduction are among the most pleased with the outcome.  "It's amazing," Moya says. "Once you go ahead and perform the surgery, they are so happy. They can wear normal clothing. They can do activities they couldn't do before and not be bothered by any pain."
 
If you're considering breast reduction surgery, check out the American Society for Aesthetic Plastic Surgery or the American Society of Plastic Surgeons for more information about what to expect or how to find a surgeon.
I hope you've learned something here about breast disease.  Until next time.   Dr. Rehert

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#12 From: <grehert@...>
Date: Wed Sep 11, 2002 10:29 pm
Subject: September 11th. 		grehert
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I hope everyone had a thoughtful and introspective September 11th, at least for part of the day.  Here is a moving remembrance of the events that reinvigorated America.
 
Dr. Rehert
 
Click below - (best with a fast connection and sound.)


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#11 From: "Dr.Rehert" <grehert@...>
Date: Thu Sep 5, 2002 10:08 pm
Subject: Better Healthcare Through Patient Education 		grehert
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Here's an interesting article for those of you who listen to me and are into exercise. 
Posted on Thu, Aug. 29, 2002  
 
Joggers Beware, Stretching Does Not Stop the Pain
Reuters
 
LONDON - Joggers beware. Stretching before or even after exercise does not prevent muscle soreness or reduce the risk of injury, according to a controversial survey published in the British Medical Journal on Friday.
 
The finding comes from an assessment by researchers in Australia of five existing studies which concluded that so little was the benefit from stretching that it simply wasn't worth the effort.
 
"The studies showed that stretching reduces soreness by less than two mm on a 100 mm scale. Most athletes will consider effects of this magnitude too small to make stretching worthwhile," the authors said.
 
Most athletes stretch religiously before running, jumping or lifting to warm up their muscles and tendons ready for action.
 
But even more startlingly, the researchers also found that stretching before training by army recruits -- considered to be a high-risk group -- on average prevented just one injury every 23 years.
I run about 5 to 20 miles per week and I never stretch beforehand.  I always figured running the first mile stretched me enough for the second and third miles.  Now a scientific study supports the idea that stretching isn't really necessary.  Of course this is only one person's opinion and if stretching makes you feel good, keep doing it -- it should do you no harm.
 
Dr. Rehert

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#10 From: <grehert@...>
Date: Wed Sep 4, 2002 4:18 am
Subject: Dr. Rehert's Alerts 		grehert
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And for men, a story on a related subject - "male menopause."

WEST PALM BEACH, Fla. - Here we go again.
 
Just as women find themselves flailing about, knee-deep in controversy over the safety of hormone replacement therapy, men are jumping in.
 
Not into the women's HRT battle. But into a battle of their own. The battle over male menopause, myth or menace?
 
The July 29 issue of The New Yorker magazine does a good job of outlining the sides in this battle. Basically, reporter Jerome Groopman concludes that whether or not "andropause" is a real and treatable condition, it's premature to use testosterone to boost men's flagging libidos and pump up their flaccid erections and flabby muscle mass.
 
Its safety is unproven, he writes, calling this trend a "vast, uncontrolled experiment."
 
While everyone agrees that men with prostate cancer shouldn't be given testosterone (it feeds the cancer,) there is major disagreement over giving it to men who just want to regain that old charge again.
 
"If testosterone is low and you have symptoms, it's probably worthwhile trying treatment," says Dr. John Morley, an endocrinologist and geriatrician at Saint Louis University in Missouri, who is a passionate advocate of testosterone therapy.
 
"The drop (in testosterone levels) is no longer debated. That's no longer controversial. The question is like estrogen, we know it goes down in women.
 
"What we know from controlled studies is that (giving testosterone) will increase muscle mass, and improve strength and bone density, similar to what you might expect with estrogen (in women.)
 
"It makes their enthusiasm for sex improve. For some people, that never was important, but for others, it's important forever."
 
But even if you support the use of this steroid hormone, you have to listen to this laundry list of improvements and wonder, what about abuse?
 
Morley doesn't think there will be abuse among older men, and as for others?
 
"No one will stop people abusing things. Should we hold it back from the people where it's really helpful? You can't protect the stupid from themselves."
 
Why, even Ernest Hemingway took it, for 10 years, from age 52-62, Morley said. Of course, Hemingway committed suicide, although we're not implying any link here.
 
"I would look at it like taking Viagra," Morley says. "It's a quality-of-life drug. It makes you feel better. If you get low, fueling your engines with testosterone makes sense."
 
At least to some.
 
Carolyn Susman writes for The Palm Beach Post.
That's it for now.           Dr. Rehert

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#9 From: <grehert@...>
Date: Wed Sep 4, 2002 4:05 am
Subject: Dr. Rehert's Alerts - Better HealthCare Through Patient Education. 		grehert
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Here are two recent news stories dealing with libido in women:
Hormone Patch May Heat Up Women's Desires
Mon Aug 19, 7:06 PM ET
 
MONDAY, Aug. 19 (HealthScoutNews) -- A skin patch that may help restore sexual desire in post-menopausal women is being tested in clinical trials at more than 150 sites in the United States and Canada.
 
The thin, nearly transparent hormone patch is worn on the abdomen. It's main ingredient is testosterone, a hormone long-associated with sexual desire and aggressiveness in men.
 
Millions of women have decreased sexual desire because of lower hormone levels following menopause or hysterectomy. That can lead to frustration, unhappiness and relationship problems.
 
"More than 40 million women suffer from the lack of sexual desire, which often leads to personal distress or relationship issues," says Sheryl Kingsberg, a clinical psychologist at MacDonald Women's Hospital at University Hospitals of Cleveland, one of the study sites.
 
"Since no medications currently are approved by the U.S. Food and Drug Administration ( news - web sites) for the treatment of diminished sexual desire, these clinical studies are an important step in the development of new therapeutic options to help many women and their partners regain a satisfactory sex life," Kingsberg says.
And the second one.
 
Researchers explore DHEA for postmenopausal health
 
The importance of DHEA (dehydroepiandrosterone), a precursor of estrogen and testosterone, in psychological and sexual health has been underlined in a number of studies. For example, a German study found that DHEA-deficient women supplementing with 50 milligrams DHEA daily for four months had decreased symptoms of depression and anxiety, and improved libido [Wiebke A, et al. NEJM 1999 Sep 30 341(14):1013-1020].
 
A new study by an Italian team of investigators now suggests that DHEA may be an effective option for preserving health in postmenopausal women. The study [Genazzani AD, et al. Fertil Steril 2001 Aug;76(2):241-8] concluded that oral administration of 50 milligrams of DHEA daily for six months mimics the benefits of traditional HRT (hormone replacement therapy), namely estrogen- progestin in terms of its effects on the GHRH-GH-IGF-1 (growth hormone-releasing hormone-growth hormone) axis.
 
Lead author, Alessandro Genazzani, M.D., Ph.D., at the University of Modena, says that, “DHEA can be considered a possible replacement therapy since it has a lot of beneficial effects on brain as well as on the neuroendocrine functions in postmenopausal women, [as it] induces the production of allopregnanolone, the most potent endogenous anxiolitic (anxiety-relieving) compound.” Further research will be required to firmly establish the use of DHEA as HRT.
 
-AP
Now regarding the first story, I think it will be some time before the testosterone patch is put on the market.  Safety issues, especially masculinization of women and possible deleterious effects on the heart will hold up its release.  Regarding story number two, many of you know that DHEA is over the counter.  I have some patients who take 25 mg., 3 or 4 times per week to increase libido, energy and a sense of well-being.  (I feel 50 mg is too much.) It's benefits are not appreciated by all patients who try it.  Too much DHEA will cause masculinizaion and possibly other deleterious effects similar to those of testosterone.
 
Dr. Rehert

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#8 From: <grehert@...>
Date: Fri Aug 30, 2002 1:35 am
Subject: Pill Splitting at Stanford University. 		grehert
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Here's a novel idea ( from California of course ) that might save you some money . . . but I'd advise you not to try it with your birth control pills.                         Dr. Rehert
 
Pill-Splitting Can Yield Cost Savings On Common Prescription Drugs, Stanford Researchers Find
Thursday August 29, 7:01 pm ET
 
STANFORD, Calif.--(BUSINESS WIRE)--Aug. 29, 2002--Squeezed by the rising cost of prescription drugs, health plans and other health-care organizations are pursuing cost-saving strategies such as encouraging the use of generics, using narrowly tailored drug formularies and implementing multi-tiered co-payment systems.
 
Now, researchers at Stanford University Medical Center have confirmed that a less-common strategy -- pill-splitting -- could yield significant cost savings without compromising drug efficacy or safety. They emphasize that pill-splitting must be implemented with careful controls and begin with a doctor-patient conversation.
 
"When properly implemented, pill-splitting can be a safe, viable cost-saving strategy," said Randall Stafford, MD, PhD, a researcher at the Stanford Center for Research in Disease Prevention and lead author of an article published in the August issue of the American Journal of Managed Care. "Physicians should consider using pill-splitting with selected medications and patients, and patients may want to bring it up with their doctors."
 
Many prescription drugs are available at increased dosages for the same or similar costs as smaller dosages. When physicians prescribe half as many higher-strength pills and have the patient split them to achieve the desired dosage, the cost of certain medications can be reduced as much as 50 percent.
 
"As a cost-saving approach, pill-splitting has significant potential," said Stafford, who is an assistant professor of medicine at the Stanford School of Medicine. He calculated that if pill-splitting were fully implemented within the health plan he studied, the plan would save $259,500 annually.
 
The researchers emphasized that pill-splitting must be implemented with drug-specific and patient-specific criteria to ensure patient safety. Just as certain types of medications are unsuitable for pill-splitting -- including extended-release medications and those with enteric coatings -- certain patients may be unable to split tablets consistently and accurately.
 
Pill-splitting should be embarked upon only after a discussion between physician and patient, Stafford explained. "We're not advocating this as a global solution.
 
              Examples of potential cost savings from pill-splitting
 
Drug                                           Clinical uses                                 % Savings*
 
Clonazepam (Klonopin)  Panic disorder; epilepsy                          41
Doxazosin (Cardura)    Hypertension; prostate enlargement        46
Citalopram (Celexa)    Depression                                                       46
Atorvastatin (Lipitor) High cholesterol                                                33
Paroxetine (Paxil)     Depression; anxiety                                          46
Pravastatin (Pravachol)High cholesterol                                           23
Nefazodone (Serzone)   Depression                                                    49
Sildenafil (Viagra)    Impotence                                                             50
Lisinopril (Zestril)   Congestive heart failure; hypertension          38
Sertraline (Zoloft)    Depression                                                           46
Olanzapine (Zyprexa)   Schizophrenia; bipolar disorder               31
 
*average potential cost savings of pill-splitting, in percentage
terms, over varying dosages of each medication
 
 
 
--------------------------------------------------------------------------------
For More Information Contact:
     Stanford University Medical Center
     Sara Selis, 650/723-7798 (Media Contact)
     selis@...

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#7 From: <grehert@...>
Date: Wed Aug 28, 2002 8:44 am
Subject: Fw: DrRehertsAlerts - The Benefits of Soy. 		grehert
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Here's an article that says soy reduces the risk of a heart attack.     
-----------------------------------------------------------------------------------------------------------------------------------------
 
Health - Reuters
 
Soy May Help Keep Postmenopausal Arteries Healthy
Tue Aug 20,10:21 AM ET
 
NEW YORK (Reuters Health) - A Western diet rich in tofu and other soy products may help protect older women from artery disease, new study findings suggest.
 
According to the report, phytoestrogens were associated with less artery stiffness among more than 400 postmenopausal women. The benefit was most pronounced among the oldest women, or those who had been postmenopausal the longest.
 
Arterial stiffness increases as the blood vessel disease atherosclerosis progresses, and atherosclerosis can lead to heart attack or stroke, explain researchers in the August issue of Arteriosclerosis, Thrombosis and Vascular Biology: A Journal of the American Heart Association ( news - web sites).
 
The sharp drop in estrogen following menopause is associated with an increased risk of heart disease among women. Phytoestrogens, plant-based estrogen-like compounds found in soy, may mimic the beneficial effects of estrogen on the heart, some research suggests. Soy also contains antioxidants--compounds that neutralize disease-causing free radicals before they can damage cells.
 
Many studies have demonstrated that Asian populations, which consume far more soy than Western populations as a whole, have lower rates of heart disease--suggesting that this dietary difference might play a role. And soy-based diets have been linked to lower levels of artery-clogging LDL cholesterol.
 
SOURCE: Arteriosclerosis, Thrombosis and Vascular Biology 2002;22:1316-1322.
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So have some tofu with those blueberries . . . and you can give some to your man.

Dr. Rehert


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#6 From: "Dr.Rehert" <grehert@...>
Date: Wed Aug 21, 2002 9:28 pm
Subject: DrRehertsAlerts: Two brainey studies. 		grehert
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Two brainey articles.  One on Blueberries (praised), and one on Ginko Biloba (panned).  I report, you decide.                  Dr. Rehert
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
 
Blueberries May Help Old Folks Keep Their Smarts
Mon Aug 19, 6:23 PM ET
By Anne Harding
 
BOSTON (Reuters Health) - A cup of blueberries a day may keep "senior moments" away, new findings suggest.
 
A team of Massachusetts and Florida researchers has shown that the fruit reduces aging-related damage in rat brains, and can also prevent mental decline in mice genetically engineered to develop Alzheimer's-like plaques in their brains.
 
The findings, along with early results from a human study, suggest a healthy diet can go a long way toward preventing the mental decline that often accompanies aging, Dr. James A. Joseph of the Center on Aging at Tufts University in Boston and USDA Human Nutrition Research told Reuters Health.
 
Cell-damaging products of normal metabolism known as free radicals can injure tissue, an effect known as oxidative damage. Antioxidants -- found in several fruits and vegetables, including blueberries -- help prevent this damage, which has been implicated in a number of conditions including cancer, Alzheimer's and heart disease. Oxidative damage is also a factor in aging.
 
Aged rodents that consumed the human equivalent of one cup of blueberries a day showed less oxidative damage in tissue from two distinct brain regions, Joseph and his team found.
 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
 
Health & Science: Study finds ginkgo doesn't aid memory of healthy
 
Copyright © 2002 AP Online     
By LINDSEY TANNER, AP Medical Writer 
CHICAGO (August 20, 2002 11:19 p.m. EDT) - A new study suggests ginkgo supplements do nothing to quickly improve memory in healthy people, a finding that goes against years of well-publicized claims that helped turn the supplements into a multimillion-dollar industry.
 
The over-the-counter supplements are made using extract from the fan-shaped leaves of the ginkgo biloba tree.
 
Early studies suggested the supplements could boost mental function in people with and without mild dementia, however, those studies had methodological flaws and were too short to measure a true effect, according to the authors of the new study.
 
The new study, reported in Wednesday's Journal of the American Medical Association, involved 230 people over age 60 who had no signs of memory impairment and found that the ginko supplements worked no better to improve memory than dummy pills over a six-week period. Some of the supplements are advertised to have a noticeable benefit in four weeks.
 
"We don't see any benefit," said lead author Paul Solomon, a psychology professor at Williams College.
 
Solomon said his study involved the same type of rigorous testing required by the Food and Drug Administration for pharmaceutical drugs, though supplements like gingko are not FDA-regulated. The same battery of mental tests was given at the beginning and end of the study.
 
While both groups' scores improved slightly, that likely was because they'd taken the tests before, and the placebo and ginkgo patients performed equally well the second time around, Solomon said.
 
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
 
So spend your money blueberries, not Ginko.  Until next time . . . Dr. Rehert

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#4 From: "Jerry Rehert" <grehert@...>
Date: Sun Aug 18, 2002 2:16 am
Subject: Two news items on HRT from Dr. Rehert. 		grehert
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HERE ARE TWO RECENT NEWS ARTICLES ABOUT HORMONES, ONE POSITIVE, ONE NEGATIVE . . . AND THEN A LITTLE STORY.  THE CONTROVERSY REGARDING HORMONES CONTINUES DUE TO THE PREMATURE  HALT OF THE "WOMEN'S HEALTH INITIATIVE" STUDY ON PREMPRO.  HOPEFULLY A CONTINUED DIALOG WILL LEAD TO THE TRUTH.                                 . . . DR. REHERT
 
FIRST THE POSITIVE ARTICLE:
HRT Truth
August 13, 2002, 8:45 a.m.
 
IT'S NOT ALL BAD!
 
By Jacob Veltman
 
Hormone Replacement Therapy has been all over the news since a recent trial revealed that HRT comes with some significant health risks. The trial, funded by the Women's Health Initiative, was terminated prematurely after its safety-monitoring board found HRT responsible for a 26-percent increase in breast-cancer incidence. Even women who have taken estrogen and progestin for decades have consequently decided to forego treatment for postmenopausal symptoms altogether, after learning of HRT's supposed carcinogenic properties. Similarly, the drug industry is now forced to consider the possibility of liability for any serious medical condition incurred while on HRT.
 
However, while WHI's study is as thorough an examination of the risks of HRT as we are likely to see, the logic behind its conclusions leaves a bit to be desired. The most oft-repeated finding of the study is that HRT resulted in a 26-percent increase in breast-cancer incidence. While this is alarming, the relevance of that statistic is mitigated by less-publicized details. Although the study found a 26-percent increase in breast-cancer incidence, it also found a 37-percent decrease in colorectal cancer and a 17-percent decrease in endometrial cancer. There was therefore actually a two-percent decrease in total mortality rates of HRT patients and only a three-percent increase in total cancer incidence, which is essentially negligible.
 
In fact, a majority of recent studies have found induced abortion to cause a similar increase in breast-cancer incidence (20-31 percent). However, many of the same critics now labeling HRT as a carcinogenic nightmare perpetrated by the drug industry found it equally convenient to disregard the dangers of induced abortion.
 
Moreover, although the WHI did study approximately 16,000 women, it did so only for an average of 5.2 years per person. This is lengthy by medical-study standards, but wholly insufficient to judge the effects of a treatment taken for several decades by many women. HRT has been proven to reduce the debilitating effects of osteoporosis, and one can only speculate as to what therapeutic benefits this provides to women who remain much more robust in their old age than previously was possible. Even in just the short timeframe of the study, HRT was found to reduce hip fractures by 44 percent. It may well be that HRT's value increases steadily over time.
 
The most deficient aspect of the findings by the WHI though, is that although the study was meticulous in examining the various potential complications or HRT, it makes no attempt to quantify, or even acknowledge, the relief HRT grants to postmenopausal women. Although HRT has been labeled as a cure (often mistakenly) for everything from heart disease to Parkinson's Disease, most women take it primarily because of the relief it grants from the symptoms of menopause. HRT has been as effective as promised in relieving women of hot flashes, cramps, and many other encumbrances. The WHI however, has chosen to scrutinize the risks of HRT while totally ignoring its most basic advantages. Given such an environment, very few of today's most common medications would pass the test. Aspirin, Prozac, and Viagra certainly wouldn't.
 
As one long-time HRT user who was diagnosed with breast cancer at age 70 said, "I would still prefer the high quality years I have had and, to an extent, am still having even breast-less — to the long, drawn-out miseries of the symptoms that once plagued me."
 
WHI's study is certainly worth considering when determining the relative merits of HRT, but it should by no means disqualify HRT from remaining the treatment of choice for the relief of the symptoms of menopause.
 
— Jacob Veltman is a research associate at the Competitive Enterprise Institute.
 
NOW THE NEGATIVE ARTICLE:
FDA to reassess hormone replacement risks
August 14, 2002 Posted: 1:40 PM EDT (1740 GMT)
 
WASHINGTON (CNN) -- The Food and Drug Administration's Center for Drug Evaluation and Research has announced it will reassess the risks and benefits of Prempro, a hormone replacement therapy drug.
 
In a statement Tuesday, the FDA said that the Department of Health and Human Services will host public sessions on the issue in the fall. It said that other combination estrogen/progestin products will be considered and that the findings may affect future clinical trials of hormone replacement therapy.
 
In July, the National Heart, Lung and Blood Institute announced that it was stopping a hormone replacement study assessing whether long-term use of Prempro, the leading estrogen-progestin combination, would reduce the risk of coronary heart disease in postmenopausal women.
 
The study by the Women's Health Initiative was halted early because of health risks, primarily breast cancer and coronary heart disease, and lack of overall benefits of the drug.
 
Prempro, made by Wyeth Pharmaceuticals, is used for the treatment of moderate to severe menopausal symptoms such as hot flashes, night sweats and vaginal dryness and for the prevention of osteoporosis in postmenopausal women.
 
 
And now a little story . . .
 
The other day Arlesia, my nursing assistant, came to me and said, "Dr. Rehert, there's a patient in the waiting room who claims she's invisible."
 
I thought for a moment and then I said, "Well, then I won't see her."
 
Until next time                   . . . Dr Rehert
 

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#3 From: <grehert@...>
Date: Fri Aug 16, 2002 11:06 am
Subject: Another reason or two to be on a diet. Dr. Rehert 		drrehert
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I THOUGHT THIS WAS AN INTERESTING ARTICLE.  IT GIVES ANOTHER
REASON OR TWO TO WATCH YOUR CALORIES.                  DR. REHERT
----------------------------------------------------------------------------------------------------------
 
High Fats May Boost Alzheimer's Risk
Wed Aug 14, 4:03 PM ET
By LINDSEY TANNER, AP Medical Writer
 
CHICAGO (AP) - A diet high in calories and fat may
increase the risk of Alzheimer's disease in people
who are genetically susceptible to
the mind-robbing disorder, new research suggests.
 
The study found that people who consumed the most
calories and fat faced double the risk of developing
Alzheimer's.
 
The findings, which are reported in this month's
Archives of Neurology, are the latest evidence that
lifestyle factors including diet may play a role in
Alzheimer's.
 
Some researchers believe that restricting calories may
slow the aging process by reducing production of
cell-damaging oxygen molecules called free radicals,
formed during the body's breakdown of food. The latest
study, though preliminary, suggests that for some
people, calorie restriction might lower Alzheimer's
risks by curbing nerve-cell death in the brain.
 
A study published in the same journal earlier this
year linked high cholesterol levels with Alzheimer's
and suggested that cholesterol-lowering drugs could
reduce the risk. That research did not examine whether
a low-fat diet would achieve the same results.
 
William Thies said the findings suggest fats may play some
sort of role in Alzheimer's that needs more study. But
he also said the study is in line with general
recommendations for a healthy diet - avoiding
overeating and too many fat-rich foods.
 
 

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#2 From: <grehert@...>
Date: Thu Aug 8, 2002 3:39 am
Subject: What Every Woman Needs To Know About Hormones 		grehert
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I've attached "What Every Woman Needs To Know About Hormones," a letter I've written for my patients.  I hope you enjoy it and learn a lot from it.  If you have any difficulty viewing it, just let me know.

 

Please print and pass this letter on to anyone who might benefit from its information.  There's been a smear campaign against estrogens lately and I don't think it's justified.  I'm trying to set the record straight with honest information and rational advice.

 

Gerald M. Rehert, M.D.

285 Boulevard, NE, #520

Atlanta, GA 30312

404-688-2800
 
Gerald M. Rehert, M.D., F.A.C.O.G.


What Every Woman Needs To Know About Hormones


Because of the on-going controversy over hormone therapy, I am putting my
thoughts and opinions down on paper so that you, my patients, can understand the
reasons for my advice and recommendations.

This “Letter To My Patients” will be in 4 parts: (A.) - a brief introduction; 
(B.) - my conclusions about the recent research on hormone therapy; (C.) - my
recommendations; and (D.) - the detailed reasons and minutia that led to my
opinions and conclusions.  I think all of my “hormone” patients will want to at
least read parts A, B & C.  I encourage you to pass this letter on to your
friends and loved ones who share your concerns about this on-going controversy. 
Requests for email copies of this letter can be made to reherthrt@....

(A.) Introduction:

On July 9th, 2002, the Woman’s Health Initiative, (WHI), (a large – 16,000 women
– and the “first randomized, controlled” research study on hormone’s role in
disease prevention) reported that the drug PremPro – a combination of Premarin
(an estrogen) and Provera (a progestin) – was associated with an increased risk
of breast cancer; and they felt that the overall risk of taking PremPro was
greater than its benefit.  Therefore they discontinued the PremPro part of the
study.

Another part of the study looked just at Premarin (estrogen only).  Here they
found no increased breast cancer risk and therefore did not cancel that part of
the study.

(Note:  Premarin, taken alone, may cause uterine cancer.  Therefore it is only
taken by women who have had a hysterectomy.  PremPro is a combination pill of
Premarin and Provera.  The Provera prevents uterine cancer and therefore women
who have a uterus take PremPro.)

(B.) My conclusions from this new study:

It appears that PremPro (but not Premarin) increases the risk of getting breast
cancer a small but significant amount after you are on it for at least 4 years. 
This is something we already knew.  Also PremPro was shown to increase the risk
of heart disease, strokes and blood clots a small amount.  On the other hand,
PremPro decreased the risk of hip fractures and colon cancer a small amount –
also nothing new.

In this most recent study, for some reason unknown to me, they did not consider
the main reason that my patients take hormones – that is to stop hot
flashes/night sweats and for emotional health.  They failed to consider the idea
that hormones add to a woman’s “quality of life”. . . that it makes them “feel
better.”

(C.) My recommendations are:

Since the risk of taking PremPro (and possibly all estrogens and progestins) is
very small, I recommend that all of my “hormone patients” who

(1.)  “feel better” on hormones,
(2.)  want to continue them, and
(3.)  accept a small increased risk of breast cancer, heart disease, stroke and
blood clots,

continue taking their hormones.  After taking hormones continuously for more
than 4 years, I recommend that you take a 2 week “break” to see if you feel as
good “off” the hormones as you feel “on” them.  (This may induce one light
menstrual period.)

If you find you feel no different “on” or “off” hormones, then I advise you to
consider stopping them for good.  If you “feel better” on them, then you may
continue your hormones and take another break every 1 or 2 years to see if at
some point in the future you won’t need them anymore.  An excellent compromise
is to continue taking hormones at a dose reduced 50% to 75%.

If you have been taking hormones to prevent osteoporosis and choose to stop
them, there are satisfactory alternative therapies.  If you suffer with vaginal
dryness, that can be treated with estrogen creams.

The best “natural” substitute for hormone replacement therapy, one that reduces
hot flashes and night sweats, is a soy product.  Soy can be taken in pill form
(i.e. Estroven – OTC) or as “soy milk” which can be purchased at your grocery
store.

I am recommending that most of my patients who are on hormone therapy, or who
are over 50 years of age, take at least a baby aspirin everyday, if this is not
prevented by some medical condition such as stomach upset or being on blood
thinners.  Aspirin seems to reduce the risk of heart attacks, strokes and blood
clots.  Also you should take Calcium and vitamin D daily.  Mammograms are
recommended every 12 to 18 months.  Lipid profiles should be checked
periodically.  We can discuss these points at your next visit.

After reading this letter, if you want to consider changes to your hormone
regimen, call my office for a consultation where we can discuss your individual
situation as it relates to this evolving subject that is so important to your
physical and emotional health.  Or we can discuss it when you come in for your
next routine yearly check-up.

(D.) Now the detailed reasons that led to my conclusions and recommendations:

So what does all this research really mean?  Does it mean PremPro is dangerous? 
Does it mean Estrogen is dangerous?  Has this study found anything new?

Before we move on, I must explain the difference between absolute risk and
relative risk.  If something has an absolute risk of 1 in a million (like being
hit by lightning), then you have a 1 in a million chance of it happening to you.
But let’s say the risk of being hit by lightening is 2 in a million if you live
in Georgia, but only 1 in a million if you live in W. Virginia.  Your relative
risk of being hit by lightening in Georgia versus W. Virginia is increased by
100%.  That sounds like a large number.  But this 100% increased risk probably
wouldn’t cause you to leave Georgia and move to W. Virginia, because your risk
in Georgia is still only 2 in a million – a very small number.  So it seems that
the absolute risk is far more important to an individual then the relative risk.

For a while now we have suspected that estrogen might increase breast cancer a
small amount.  I have said for years that woman from 50 to 70 years of age who
do not take estrogen have a 2.4% risk of getting breast cancer, while woman who
take estrogen have a 3.2% risk of getting breast cancer.  This gives the
estrogen patient an increased absolute risk of getting breast cancer of 0.8%,
(3.2% – 2.4%), which is a small amount.  The relative risk is measured by
comparing 3.2% to 2.4%, which gives an increased relative risk of 30%.  The new
research found that PremPro increased the relative risk of getting breast cancer
by 26%.  So it seems to me that the idea that estrogen increases breast cancer
by 26 or 30% is old news, and it surprises me that the study was stopped for
this primary reason.

So how large is a relative risk of 30%?  Let’s compare it to some other relative
risks.

The relative risk of getting lung cancer if you smoke cigarettes is 2000%.  The
relative risk of having an accident if you drive while talking on a cell phone
is 300%.  The relative risk of having a car accident after two alcoholic drinks
is 100%.  30% is the same relative risk as getting lung cancer from second-hand
smoke if you live with a smoker.

In life we must continually decide what behavior to participate in.  To make
that decision, we generally compare the benefits of a behavior with the risks of
a behavior.  A 30% relative risk is significant, but usually not great enough to
have us avoid a certain behavior if significant benefit results.  Even the 300%
increased risk of using a cell phone while driving, rarely stops us.

Regarding absolute risk, the study concluded that each year PremPro would cause
8 new breast cancers per 10,000 women.  This gives an increased absolute risk of
breast cancer of 0.08% per year, which is lower than I had previously thought.

It is also important to note that there was no increased breast cancer risk
until you took it at least 4 years.  Because of this, many doctors automatically
stop hormone therapy after 4 or 5 years.

Also a quote from the WHI webpage says: ”It is important to note that, to date,
women in the estrogen alone study have not shown an increased risk of breast
cancer.”   This totally surprised me as most earlier studies did find a small
increased breast cancer risk from taking Premarin alone.  Maybe Premarin is
safer than we had thought!  What this really demonstrates is how indefinite and
ambiguous medical research occasionally is.

So what other effects did PremPro demonstrate besides its effects on breast
cancer?

The study found a disturbing trend toward an increased risk of heart disease,
strokes and blood clots, though here too the risks were small.

The absolute risk of getting heart disease was increased by 0.07% per year or 7
more cases of heart disease per 10,000 women.  The absolute risk of getting a
stroke was increased by 0.08% per year or 8 more strokes per 10,000 women.  The
absolute risk of getting a blood clot was increased by 0.18% per year or 18 more
blood clots per 10,000 women.

It is thought that these increases are due in part to hormone’s effect on the
body’s clotting system.  There is a theory that most of this effect is due to
the fact that when you swallow a pill, the hormone takes its “first pass through
the liver” in an elevated concentration.  This more concentrated “first pass
through the liver” seems to stimulate the liver’s production of blood proteins
that can enhance clotting.  This may partially explain the increase in heart
attacks, strokes and blood clots.

So those are the risks that you have to accept if you take PremPro.  What if you
take Premarin?  I suspect from all the research I have read that the risk of
Premarin is small and similar to the risk of PremPro.  But maybe Premarin will
turn out to be safer than PremPro when this large study is completed – planned
for March 2005.  With this new study, we can say that there is concrete evidence
that PremPro has slight risks.  The risks of Premarin are more uncertain.

Did PremPro have any positive effects?

PremPro significantly decreased colon cancer and hip fractures.  The absolute
risk of getting colon cancer was decreased by 0.06% per year or 6 less cases of
colon cancer per 10,000 women.  The absolute risk of getting a hip fracture was
decreased by 0.05% per year or 5 less hip fractures per 10,000 women.

It is interesting to note that the number of overall deaths in the PremPro and
the placebo groups were statistically identical.

In my practice of 25+ years I have seen many woman who have experienced positive
effects of hormone therapy that were not analyzed in the study.  Hot flashes are
the chief complaint of menopause.  These symptoms of warmth and sweating occur
day and night.  When they interfere with sleep, the resulting sleep deprivation
and insomnia leads to tiredness, moodiness and depression.  These effects seem
to be completely eliminated by estrogen therapy.  I have seen many patients who
report unexplained crying “spells” that are reversed with estrogen therapy.  The
vast majority of my patients on estrogen therapy say they “feel better” and
wouldn’t want to be without it.

Now let me tell you how I really feel:

So what is this drug called estrogen?  Where did it come from?  Which
pharmaceutical company invented it?

Estrogen is not really a so-called “drug.”  Estrogen is a natural chemical
present in every human body (mainly in females but also present in males.)  It
wasn’t invented in any pharmaceutical lab.  It was the result of millions of
years of natural selection – of evolution.  If this offends your religious
beliefs then you might say God created estrogen.

Estrogen is a hormone – (Definition: A substance, usually a peptide or steroid,
produced by one tissue and conveyed by the bloodstream to another to effect
physiological activity, such as growth or metabolism.)

Estrogen is like growth hormone, which we can’t grow without.  Estrogen is like
Insulin, which we can’t regulate blood glucose without.  Estrogen is like
cortisone, which we can’t regulate our immune system without.

It seems bizarre to me that the chemical that defines and establishes the
individuality of womanhood, is being characterized in the medical and lay press
as a dangerous poison.

What about the various options we have in Hormone therapy:

If you have had a hysterectomy, you may take estrogen alone. If you still have
your uterus, you must take a progestin in addition to estrogen.

There are 3 popular estrogens.  They are 17-beta estradiol, ethinyl-estradiol
and the estrogens in nature like Premarin (from animals) and Cenestin (from
plants).  I have never read anything that differentiates the effects or risks of
these 3 different estrogens.  So I think it’s safe to think of them all as
having the same risk profile.

There are 4 popular progestins:  Provera (MPA), Norethindrone Acetate (NETA),
Micronized Progesterone and the newer Norgestimate.  Far more research has been
done on Provera than the others.  Therefore the dangers of Provera are better
documented.  The others have undergone basic drug testing and, like all approved
drugs, have been found to be extremely safe.  It seems prudent to take a
progestin with a seemingly spotless risk profile, rather then one with
well-documented risks.

What if you want to continue an estrogen-progestin combination pill, but want to
avoid Provera.  We have several alternatives to choose from.  Activella and
FemHRT are combination pills that manage menopause but substitute NETA for the
progestin Provera.

What about the patient who is only interested in safety?  She doesn’t care which
drug she takes, what it costs or how inconvenient it is.  She only wants that
which is theoretically the safest form of hormone therapy in the world – the
most natural therapy in the most natural delivery system.

For her I would have to recommend transdermal (across the skin) therapy (by
patch, vaginal ring or skin cream) because only transdermal therapy delivers the
drug without the “first pass through the liver” which may contribute to some of
the small risks described above.  Also transdermal therapy delivers the drug
steadily, 24/7, exactly like it is delivered by a woman’s ovaries, without the
24 hour up and down swings that are characteristic of taking pills.  What could
be more natural?  In fact the recent WHI study stated,  “It remains possible
that transdermal estradiol with progesterone, which more closely mimics the
normal physiology and metabolism of endogenous sex hormones, may provide a
different risk-benefit profile.”

These are my opinions, my conclusions and my recommendations.  I share them here
with you.   The final decision is yours.  As Fox News sincerely and
unequivocally proclaims,  “I report. You decide.”

Yours truly,

Gerald M. Rehert, M.D.
© Copyrighted 2002, Gerald M. Rehert, M.D.

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