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Power Surge News

Issue 20

POWER SURGE NEWS
FOR AOL AND THE WEB
A Free E-Mail Newsletter
of the Power Surge Women's
Midlife and Menopause Community

The Power Surge Web Site
Dearest (Alice Stamm)
Founder and Facilitator

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POWER SURGE NEWS
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A large portion of this newsletter is devoted to the natural hormone, DHEA. A prescription is no longer required for DHEA. You can buy it OTC (over the counter) in any health food store. However, Power Surge recommends using only standardized products that meet the highest standards of quality. You must be careful when buying an OTC natural hormone like DHEA. For a low dose, 25 mg., OTC form of DHEA, pharmaceutical grade, I recommend the Power Surge label, which is made for Power Surge by a manufacturer whose vitamins, minerals and herbs are the finest supplements available. A stronger, prescribed version can be obtained from Bellevue Pharmacy Solutions', Pete Hueseman, who's a Power Surge pharmaceutical consultant on naturally compounded hormones.


Surgettes,

This month Power Surge celebrates another year as an online community for women in menopause. I sincerely hope the many women who've passed through Power Surge have taken away with them useful knowledge about menopause which has improved their quality of life, but even more importantly, a warm sense of friendship and SUPPORT. Almost predictable, each time a new woman enters a PS meeting, or begins participating in the message board discussions and chats, are the feelings of bewilderment, fear, and concern evident in remarks like, "What's happening to me?" or "What should I do?" or "Should I take hormones?" or "Can I make it through this the natural way?"... but most common is the singular question,

"Can anyone else possibly be experiencing the same thing as me?"

Somehow that last question manages to find its way into each and every PS meeting. The almost simultaneous answer from all those attending is a resounding: "YES!"

"Support!" The operative word during menopause. It can be a frightening time for many women, and it's okay to be frightened. There are those who might suggest, or even say, "C'mon, menopause is no big deal. It may not be for those who manage to sail through it with few or no symptoms. However, 75-85% of women experience difficult hot flashes, night sweats, depression, anxiety, internal shaking, plus a myriad of other symptoms. This community is here to support those women (and men) who need more information on menopause, who need support from others going through similar experiences. Share with other women experiencing the same issues as yourself on the very popular Power Surge Message Boards.

Over the years, a few cynics have dubbed me "pro-natural/anti-hormone." Not so. Granted, my inclination is always toward the natural in treating anything. After a great deal of investigation, I believe that under some circumstances it can be helpful for a woman to use HRT, BUT NON-SYNTHETIC hormones, such as bio-identical (the same as your body produces) naturally compouned hormones. There is comfort in knowing there are options to treat our menopause symptoms. The decision to take HRT is a very individual one. Since 1993, Power Surge has always provided information on every type of HRT available, even those we've said for years had more risks and dangers associated with them than benefits (i.e., Premarin, Prempro) because women have the right to know! It took the halting (July, 2002) of the biggest study on the effects of women and hormones, the Women's Health Initiative Study, to finally prove we were right -- that the risks of women taking synthetic hormones outweighed the benefits.

Power Surge has always invited traditional western medical practitioners to answer our questions about HRT. By providing a cross-section of opinions, women can extract the information they need to make educated decisions as to how to treat their menopause issues.

The bottom line is even if you decide to go the HRT route, you should ask your doctor about naturally compounded hormones. Plus, there are many natural methods of treatments for those who prefer not using HRT. Explore alternatives. All of life is a journey.

When you see your health care practitioner, ask questions! It's your body to do with as you see fit - OWN YOUR BODY!

None of us can claim to be pristine paragons of virtue at all times. We're not always the best keepers of our bodies. However, when we reach this stage of life - this 'pause' - this 'change' - this 'menomorphosis' (tm) - this less than stunning revelation that things don't feel quite the same, we're forced into the cataclysmic decision to fess up and get with the program - that we can't fool around with ourselves any longer - that tempus is fugiting fast - that being "clueless" is not cute - not in this day and age of the super information highway, replete with a gazillion gigabytes of information out there ready for the plucking.

In an attempt to keep up with what's current in the area of menopause and midlife-related issues, this Power Surge newsletter kicks off with information about the fascinating and controversial natural hormone, DHEA.

A pleasant journey and good health.

Dearest

DHEA_QUOTE

As featured on CBS' EYE TO EYE

"DHEA's ability to fight aging may be the most significant scientific find of the century."

WHAT IS DHEA?

DHEA is the abbreviation for dehydroepiandrosterone (pronounced dee-hide-row-epee-and-roster-own) - manufactured in and secreted by the adrenal glands, is called a master hormone, or mother of hormones in that it 'gives birth' or is converted to all other steroid hormones and active metabolites including estrogen in women and testosterone in men. It is these metabolites of DHEA that maintain and improve health, and the body knows how to use DHEA to get what it needs for optimum health. DHEA floods the body while we're young and has various and powerful beneficial effects on the human system. Also, research indicates that high levels of the hormone in the bloodstream appear to extend lifespan, block the formation of fat cells (even when food intake is increased), increase the body's ability to transform food into energy and burns off excess fat, and inhibit the enzyme responsible for activating chemical carcinogens

DHEA production peaks between the twenties and declines as we age. As we enter our thirties, production of DHEA begins to ebb. At 50, most people secrete only 30% of what they produced when they were young, and its deficiency increases the risk of breast cancer in women and heart attacks in men, as well as many age-related disorders.

In a recent article in "Health" Magazine, Benedict Carey stated, "What doctors know about DHEA's effects on the body could practically fit on the back of an envelope. Concentrations of the hormone peak during the mid-twenties. By around age 30 levels begin to taper off until, by 80, most people have less than one-fifth the DHEA they had in their youth. Why would the body produce such an abundance of a hormone and then suddenly tighten the spigot? No one knows. But researchers suspect the decline may be part of the reason we succumb to diseases like heart disease and cancer as we get older. Indeed, blood levels of DHEA--which vary from person to person but average between 300 and 500 micrograms per deciliter in 20-year-olds--may be the most reliable single measure of how quickly our bodies are aging. The fact that some people lose less DHEA than others may explain why some seem to age better than others."

"In a 1986 study published in The New England Journal of Medicine, for example, researchers at UC San Diego measured DHEA levels in 242 men 50 to 79 years old, then tracked their health for 12 years. Men whose initial levels were higher than 140 mcg were less than half as likely to have died of heart disease by the end of the study, even when researchers took into account such factors as smoking and cholesterol levels. Those with the highest levels fared the best: For every 100-point increase, there was a 48 percent drop in heart disease risk and a 36 percent decrease in death by any cause," states Mr. Carey.

DHEA is the only hormone that declines with age in both men and women, and its decline signals age-related disease. Dr. Norman Applezweig, a New York biochemist, maintains that unlike some hormones which "excite" cells into action, DHEA works as a de-exciter and slows down the body's aging process.

DHEA, is one of the most important substances needed for many vital metabolic function. Adequate levels help increase energy, control stress, maintain proper minerals levels, balance the production of sex hormones, and fight aging. It helps lean body mass while reducing fat tissue, making it ideal for weight control.

WHERE/WHEN DID ALL THIS DHEA TALK BEGIN?

DHEA is the brainchild of Dr. Emile-Etienne Baulieu, inventor of the French abortion pill RU-486 (which isn't available in the U.S., though clinical trials are underway). Baulieu isolated DHEA more than 30 years ago while working on testosterone and estrogen, the sex hormones of which the DHEA compound is a key component. Although scientists are not exactly sure how DHEA works, they do know that the effects of aging become palpable when it begins to dwindle.

Baulieu gives most of the credit for subsequent advances on aging to endocrinologist Samuel Yen, who conducted clinical tests on DHEA at the University of California at San Diego. In Yen's tests, DHEA was administered orally to 13 men and 17 women ranging in age from 40 to 70. Yen's patients said they slept better, had more energy, and were better equipped to handle stress, though none experienced any severe side effects. Baulieu stated that he is cautiously optimistic about the preliminary test results. "For example," he said, "elderly patients have noted the disappearance of non-specific joint pain and the reinforcement of immune deficiencies, which has justified giving DHEA to AIDS patients."

The hormone helps brain cells grow in the lab, seems to improve rodents' short-term memory, and has even shown some effect in humans. "We've already seen some correlation between DHEA levels and mental acuity in older people," says Baulieu.

DOES THE MEDICAL PROFESSION SUPPORT DHEA?

For his part, a Palm Springs doctor, Edmund Chein, is hedging all bets. He offers patients not only DHEA but a combination of other hormones, including testosterone for men; estrogen for women; melatonin, a sleep regulator; and human growth hormone--all of which decline with age.

Hormone replacement therapy, as Chein practices it, goes back at least to the late 1960s, when the late Russian gerontologist Vladimir Dilman began writing about what he called the Health Passport. If important hormones such as DHEA and hgh taper off as wrinkles and gray hairs proliferate, Dilman argued, then maybe this hormonal slide is biological aging, in some fundamental sense. So why not keep the tanks full, give the body a passport to youth?

"The idea is simple," says William Regelson, a medical oncologist at Virginia Commonwealth University's medical college and author of the bestseller The Melatonin Miracle. "If you want to maintain a youthful level of health, then you have to be youthful physiologically. You have to maintain youthful levels of these hormones."

"DHEA is one of the most abundant hormones in humans, so it stands to reason that it has some biological effects on us," says John Nestler, an endocrinologist at the Medical College of Virginia, who has been compiling evidence showing that a shortage of DHEA contributes to the plaque that builds up in the arteries of otherwise healthy elderly people. "If I had to guess which of those effects were the strongest, I would say protection against heart disease and boosting immunity."

"DHEA is the only hormone that declines with age in both men and women, and its decline signals age-related disease," Dr. Norman Applezweig, a New York biochemist, maintains that unlike some hormones which "excite" cells into action, DHEA works as a de-exciter and slows down the body's aging process."

"Health" Magazine's, Benedict Carey states, "Does that mean we should all go hunting for a doctor willing to write a prescription? Most researchers think there are still too many unknowns. "I'm not saying DHEA is dangerous. So far, it looks very safe," says endocrinologist John Nestler, "but we can't go recommending something we know so little about. The Hippocratic Oath says, 'First, do no harm.'"

"Edmund Chein not only disagrees but believes that it's never too early to start. "You ought to start replacing as soon as you start losing," he says. "I have patients in my waiting room right now, a businessman who has brought his son in. The son is about 30, I think."

WHAT DOES DHEA DO IN MY BODY?

The body uses DHEA in many different ways, and the benefits of maintaining high DHEA levels are truly staggering. Increasing levels of DHEA (using prescription DHEA or precursors such as Dioscorea) has been shown to effective in the following ways:

  • Control of Obesity
  • Reduction of blood sugar levels
  • Reduced cardiovascular risks
  • Reduce or eliminate depression (depression usually has a physiological root cause)
  • Reduce or eliminate symptoms of PMS (premenstrual syndrome)
  • Slow aging process and improve memory

DHEA has also been shown to have impact on AIDS (Acquired Immune Deficiency Syndrome) related afflictions. Because of its intimate relationship with the immune system, DHEA has been shown to forestall and reverse some of the debilitating effects of AIDS related infections.

Hormone Precursors (like Dioscorea) are not used by the body directly. Instead, they are converted to DHEA as needed. Like DHEA, precursors can be taken in any amount. The body will use only what it needs an ignore the rest.

Other clinical tests have shown that DHEA increased the levels of estrogen in women and testosterone in men to the levels found in younger men and women. Increasing the DHEA levels in older men and women appears to work better and is much more beneficial than directly increasing the level of estrogen and testosterone. As you increase the blood level of DHEA closer to where it was at a younger age, many of the diseases disappear. Documentation shows that the increased level of DHEA decreases the stickiness of platelets. These small particles in the blood often clump together and cause heart attacks and strokes. Cancer, Alzheimer's disease, multiple sclerosis, memory loss, chronic fatigue syndrome, Parkinson's disease, and many other ailments have received some correction. DHEA has also been credited with lowering blood cholesterol levels.

In laboratory tests, the steroid levels were lower in postmenopausal subjects, and this difference was significant. The significantly decreased peripheral level of steroids in the postmenopausal state can be explained by decreases either in ovarian secretion of steroids or in ovarian stimulation of the adrenal cortex. Since the contribution of the adrenal cortex to the peripheral levels of DHEA-S or dehydroepiandrosterone sulfate is greater than 95% in premenopausal women, a plausible explanation for the marked drop observed in peripheral DHEA-S levels after menopause is that the ovary influences the steroidogenic activity of the adrenal cortex. In such cases a decrease in the stimulation of the adrenal cortex by some ovarian steroids would be expected. Estrogen therapy in 10 postmenopausal women resulted in significant increases in the serum levels of 3 of the steroids compared to those in untreated subjects, confirming the postulate that ovarian estrogens stimulate the secretion of adrenal androgens

Dr. Arthur Schwartz, a Temple University biologist and a leading U.S. authority on the DHEA hormone, reported that in laboratory animals, high- dose DHEA feedings reduced body fat by one-third, prevented atheroscleros is, alleviated diabetes, reduced the risk of cancer, enhanced the immune response, inhibited the development of certain autoimmune diseases and extended the normal life span of mice by 20 percent. (reported in LIFE magazine, October 1992).

Dr. Ward Dean, in his two books, "Smart Drugs" and "Smart Drugs II: The Next Generation" tells us more about DHEA: "DHEA protects brain cells from Alzheimer's disease and other senility-associated degenerative conditions. Nerve degeneration occurs most readily umder low DHEA conditions. Brain tissue naturally contains 6.5 times more DHEA than is found in the bloodstream in order to protect the brain from aging damage. "DHEA also enhances long-term memory in mice. Perhaps it plays a similar role in human brain function."

Today, many more doctors are teaching prevention than ever before. Julian Whitaker, M.D., well-known for his television appearances, has long been an advocate of a natural, non-toxic approach to living a healthy life. Some things Dr. Whitaker has to say about DHEA in his Health Healing newsletter (with nearly one-half million subscribers):

DHEA is extraordinarily safe. You should find DHEA safer than most over-the-counter items such as Tylenol, Sudafed, Motrin, or even aspirin, and far safer than almost all other prescription drugs.

In a large population study in Great Britain, it was found that women who had a blood level of DHEA of less than 10% of that expected for their age group, developed and died of breast cancer. Other researchers picked up on this observation and gave DHEA to rats who were inbred to develop breast cancer. DHEA blocked it.

DHEA's effectiveness at ameliorating so many age-related diseases is consistent with its anti-aging properties. Think back to when you were 20 years old and had your highest blood levels of DHEA. What were your health problems then?

ALWAYS PROCEED WITH CAUTION

DHEA (dehydroepiandrosterone), although a naturally occurring hormone, has been deemed 'experimental' by the FDA, who forced its removal from the general marketplace in 1984. The FDA halted over-the-counter sales because the hormone had no proven benefits and its long-term effects are unknown. A supplement made from wild Mexican yams that claims to be a "precursor" to DHEA is available in some health food stores and through ads on the Internet. Many researchers say the body doesn't convert the stuff to DHEA. The drug is available, however, because of a loophole in FDA regulations that allows pharmacies to mix up any drug for patients with a prescription. Prescriptions for DHEA are getting easier to come by. Scores of maverick doctors across the country are doling them out to patients with everything from flagging libido and joint pain to early Alzheimer's disease and cancer.

In the 1930s, Japanese scientists discovered that among the more than 600 species of the plant dioscorea, some contain a glucoside very similar to some natural hormones found in the human body. Later, in the 1950s, a Spanish chemist named Zafarelli isolated the female hormone precursors of progesterone and estrogen from one of the dioscorea herb species. Later, other hormone precursors (raw materials) of testosterone and corticosterone were discovered. Today, research has revealed that the dioscorea herb is a storehouse of phytochemical precursors that can be converted naturally in the body to give support to the endocrine (glands) and immune systems.

Phytochemicals have been found to work like anti-oxidant in that they scavenge free radicals, but phytochemicals can go beyond basic nutrition and disease prevention. They have the added ability through enzyme production to actually repair the damaged cells.

Scientific evidence strongly supports the conclusion that certain prohormones like DHEA can be added back to the body with full rejuvenating potential. DHEA is a naturally occurring "motherlode" hormone shown to enhance the immune system, produce the body's sexiest hormones, and extend life.

DHEA is available now only by prescription. As you surf the Internet, you will probably encounter many sites claiming to be a source for DHEA. These products do not contain DHEA, but probably contain wild yam (Dioscorea) in one form or another. Currently, there is only one known food that contains significant amounts of naturally occurring sterols that are considered DHEA precursors. That food is a certain species of Wild Yam (dioscorea) plant which is non-toxic and has no known side effects. It is a food, and like any food, it must be assimilated by your body to be of benefit to you.

Please *inform* yourselves before you purchase any precursor product. If you are currently under doctor's care for any condition, consult him or her before introducing any herbal or natural food supplement or changing your diet. Don't expect your doctor to jump up and down with glee (although Mannatech products are converting doctors all over the country), just make sure that none of the product ingredients are contraindicated for you

DHEA is produced in your body by your adrenal glands which are situated on your kidneys. The $64,000 question is, "Will your individual body respond to a supplementary herbal complex from the Wild Yam, by converting it to DHEA? If the answer is yes, your body then converts DHEA, when needed, into active hormones such as estrogen, testosterone, progesterone, corticosterone, etc. If not . . . it's the big *if* in the ongoing drama unfolding before our very eyes while more women enter menopause than at any other time in our country's history.

Q & A ABOUT CONTINUOUS HRT AFTER MENOPAUSE

Q. What is continuous hormone replacement therapy?

A. Continuous hormone replacement therapy involves taking hormones every day after menopause, when the ovaries stop making enough of the female hormones, estrogen and progesterone, or after surgery to remove the ovaries.

Q. Are there different types of hormone replacement therapy?

A. Yes. There are different types of hormone replacement therapy. One type involves taking estrogen alone, but hormone replacement therapy with estrogen alone can increase the risk of cancer of the uterus (womb) and endometrium (lining of the uterus). Adding progesterone to your treatment seems to keep the risk of these two cancers down.

There are the conventional forms of HRT, many of them using synthetic versions of estrogen and progestins, which have been recently studied and scrutinzed by the Women's Health Initiative (WHI) Study, the largest study of its kind on women and HRT. The study was abruptly halted in July of 2002 and women on the hormone being used, Prempro (a combination of Premarin, conjugated estrogen made from the urine of pregnant mares, and Provera, a synethic progestin, not nearly as safe and effective as natural forms of progesterone) because it was found "the risks outweighed the benefits." There was an increase in heart episodes, attacks, breast cancer, blood clots, stroke -- all not simply "adverse reactions," but dangerous and life-threatening reactions to conventional HRT. Hormone replacement therapy can also aggravate existing gall bladder problems and/or cause gallbladder disease. Many women using HRT experience headaches or migraines. Others have developed elevated blood pressure on HRT. These are all important issues to take into consideration before starting HRT.

A viable option Power Surge recommends, which has become much more popular while women have been reluctant to use conventional HRT, and are now more interested in than ever before due to the results of the WHI Study, are Maturally compounded hormones, or NHRT, also known as bio-identical or human-identical hormones, derived from plants. Read more about Naturally Compounded Hormones.

In the past, women taking these two hormones would take estrogen for the first part of the cycle and progestin during the latter part of the cycle. But this form of hormone replacement therapy may cause bleeding every month, much like having a menstrual period. Many women quit taking the hormones because of this monthly bleeding.

Taking both of the hormones every day throughout the month seems to fix this problem for many women - most women taking continuous estrogen and progestin therapy quit having bleeding after three to six months.

Q. How is continuous hormone replacement therapy taken?

A. Your doctor will probably start you on the estrogen and progestin at the same time. He or she will probably start you on a low dose of progestin to see if you have bleeding on the lowest dose.

Take both pills every day. You don't have to stop on certain days of the months. If you have bleeding, tell your doctor. The dose of progestin may need to be increased.

Q. What are the benefits of hormone replacement therapy?

A. Hormone replacement therapy can be beneficial in many ways.

It can reduce your risk of osteoporosis, a condition that causes the bones to become porous and thin and more likely to break.

It can relieve symptoms of menopause, such as flushing, night sweats and vaginal dryness.

It used to be said of HRT that it could increase heart health and decrease your risk of heart attacks. Again, this has come under scrutiny by the WHI Study.

Q. What are the risks of hormone replacement therapy?

A. As mentioned before, estrogen taken alone can increase the risk of cancer of the uterus and endometrium.

Progestin can cause tender breasts, fluid retention, swelling, moodiness and cramps. these side effects seem to be less for some women who take continuous hormone replacement therapy. Progestin may also reduce how well estrogen works to protect against heart disease. Studies are still being done on the use of progestin.

Generally, women who have had endometrial cancer, breast cancer, blood clots, stroke, unexplained vaginal bleeding or liver disease shouldn't take hormone replacement therapy.

Q. Are there any signs of problems I should look for?

A. Yes. If you bleed after you haven't had any periods for several months , call your doctor. Also call your doctor if you notice any breast lumps or pain, or if you have any questions.

This information provides a general overview on continuous hormone replac ement therapy and may not apply in each individual case. Consult your phy sician to determine whether this information can be applied to your perso nal situation and to obtain additional information.

TESTOSTERONE

For many women menopause means hot flashes, mood swings, and sometimes a decline in sex drive. Why does menopause cause this ...possibly because testosterone levels drop. Thats right testosterone, the very same hormone found in men. Interest in testosterone replacement in women is growing. What do women need to know about this trend? Dr. Emily senay gives us som e answers.

Testosterone is typically thought of as a male hormone. But it is also no rmally found in women...produced by the ovaries.

Dr. Penny Wise Budoff, Women's Health Specialist, North Shore University Hospital says "After menopause when their ovaries stop producing estroge n the core, the inside of the ovary still continues to produce male horm one for some period of time."

Testosterone is known to regulate energy level and sexual desire in men a nd is believed to do the same in women. When she was still her twenties, Cathy Colella had her ovaries removed. It meant early menopause and even tually lagging energy. She tried many different hormone treatments, but f inally, when she tried testosterone..."The energy level even the mental e nergy level was incredible."

Linda Hamel Finely also had her ovaries removed. A lack of sex drive on h er part was starting to affect her marriage and she decided to try testos terone...but so far she hasn't experienced any dramatic change.

Linda Hamel Finley commented, "I'm feeling positive about it but I still need time to really be honest to feel if I feel it's really making this g reat difference on the desire end or not. I feel very fortunate that I ha ve a wonderful husband, we're happily married, he's been very supportive."

So is testosterone the new prescription for passion? And is it something more post-menopausal women should be taking? The fact is little is really known about testosterone replacement in women.

Dr. Lila Nachtigall, Professor of Obstetrics and Gynecology, New York Uni versity School of Medicine, "Testosterone hasn't been studied in men who make it from puberty to age 90 and it certainly hasn't been studied in wo men, we don't know the correct dose."

Despite the lack of research on the risks and benefits, for years doctors have been using testosterone replacement in women like Cathy and Linda w ho've had their ovaries removed. But there is little evidence to suggest that post-menopausal women who still have their ovaries should be getting testosterone for decreased libido especially since many other things can cause sex drive to drop off.

Dr. Penny Wise Budoff, Women's Health Specialist, North Shore University Hospital remarks, "Depression certainly affects libido, that's one of th e major things."

For Cathy improvement in evergy level was accompanied by a number of side effects which forced her to stop taking the medication.

"I noticed bloches breakouts and then I noticed hair loss and I also noti ced some weight gain."

But the side effect doctors most worry about is heart disease. Testostero ne may affect adversly affect cholesterol levels and this in turn may lea d to heart disease. One thing almost all experts agree on is that more re search is needed.

Dr. Lila Nachtigall, Professor of Obstetrics and Gynecology, New York Uni versity School of Medicine says, "I think it's good to get interested in it. I think we should look into it but I certainly don't think we should make the mistake of using it widely yet."

Experts hope women and their doctors will heed this advice. Though some w omen are reporting dramatic results...the benefits of testosterone replac ement in women have yet to be scientifically proven.

DEPRESSION

As many of us know, depression is a common symptom of menopause

First the bad news: As many as 25 percent of all Americans will suffer fr om depression this year. And depression impairs people's ability to funct ion more than any other disease except heart disease.

Now the good news: Depression is one of the most treatable illnesses know n. Drug therapy and psychotherapy can help victims of depression feel bet ter, become more productive and improve their relationships.

By Mindy Machanic

Depression will strike up to 25 percent of all Americans this year, and m any of them will fight the disease with drugs like Prozac. One of the mos t widely prescribed drugs for depression, Prozac has sales that top $1 bi llion annually. Prozac falls under a family of antidepressants developed in the late 1980s called the selective serotonin reuptake inhibitors (SSR Is). "SSRIs work by increasing the availability of the neurotransmitter s erotonin between the nerve cell endings in the brain. Enhancing serotoner gic neurotransmission usually results in improvement in the symptoms of d epression," says Lawrence R. Gulley, M.D., a psychiatrist affiliated with West Paces Medical Center, a Columbia affiliate in Atlanta, Georgia. SSR Is including three relatively new drugs, Zoloft, Paxil and Effexor - help lift the symptoms of depression quickly. Some SSRIs also help people who se depression is coupled with anxiety.

If side effects do occur, they are usually minor. The SSRIs may make peop le feel "speedy" at first, and a few people experience this feeling as a need to "get out of their skin." The drugs also may suppress the appetite . These symptoms usually subside in several weeks. SSRIs may also lower s exual desire for as long as the patient takes the drug.

Doctors recommend that most people should be on any antidepressant for a minimum of six months to prevent a recurrence. In fact, although SSRIs ar e not addictive, many people taking them feel so much better that they ar e hesitant to come off them.

The Prozac Controversy

Some reports claim that Prozac and the other SSRIs make some people suici dal or cause violent, aggressive behavior. Studies thus far do not suppor t these claims, and a recent jury verdict upholds those findings.

In November 1994 the first of 160 lawsuits filed against Eli Lilly, Proza c's manufacturer, reached trial. (Currently, 92 of those cases have been dismissed.) A Louisville, Kentucky, jury ruled that Prozac was not respon sible for pushing a man into a homicidal rage that left eight people dead , including the man responsible for the attack, and 13 wounded.

Eli Lilly claims that Prozac is not linked to violence and may actually i nhibit aggression. There have been reports of people committing suicide w hile taking Prozac, but those people had prior histories of suicidal thou ghts or even prior suicide attempts.

Other Solutions

Before the SSRIs were introduced only two types of antidepressant drugs w ere available: monoamine oxidase inhibitors (MAOIs) and tricyclic antidep ressants. MAOIs work well, but people have trouble staying on them becaus e they interact dangerously with many foods. People who do not respond we ll to other drugs may use MAOIs. For many others, the tricyclic antidepre ssants are the drugs of choice, although they may cause a number of side effects, including dry mouth, dizziness and blurred vision.

For many people, psychotherapy offers relief from depression's grip witho ut any of the side effects drugs may cause. Psychotherapy can help give p eople hope, and usually does so relatively quickly. Still, it can be seve ral weeks to several months before the depression lifts - and by that tim e, it may well have lifted on its own. But good psychotherapy can help pr event depression from recurring, or keep a recurrence less devastating. O ften, a psychotherapist will refer a person to a psychiatrist for drug tr eatment and continue to see the person for psychotherapy.

Signs that "Sadness" Is Serious

Depression's victim's need to seek some sort of treatment - willpower alo ne usually can't conquer depression. If you suspect that someone you know suffers from depression, call your local Columbia/HCA hospital for help. Several of the following symptoms lasting for more than a few weeks are cause for concern:

  • Feelings of worthlessness, helplessness or hopelessness.
  • Lack of interest in things that formerly gave him or her pleasure.
  • Difficulty sleeping or a need to sleep much more than before.
  • Major changes in appetite, leading to weight gain or loss.
  • A desire to be alone and to stay away from other people.
  • Becoming easily irritated by little things or tearful for no reason.
  • Feelings that he or she would better off dead, or an inability to foresee himself or herself in the future.

Although most depressions have several of these typical signs, some depre ssion sufferers don't show the major symptoms. Instead, they may show sig ns of "irritability, low energy, poor concentration and diminished intere st in usual activities," says Gulley. If these symptoms are present sched ule an evaluation with your doctor to rule out depression as a possible c ause.

Depression affects the body as well as the mind. Its victims sometimes ga in or lose large amounts of weight. And "some medical problems, such as t hyroid disease, may be associated with depressed mood," says Gulley. It i s important for depression sufferers to see their doctors to rule out the possibility of an underlying physical illness.

Depression's victims need to seek some sort of treatment-willpower alone usually can't conquer depression.

Sorting Through The Names

Type of AntidepressantGeneric NameBrand Name
Monoamine oxidase phenelzine Nardil
inhibitors (MAOIs) tranylcypromine Parnate
Tricyclic antidepressants desipramine Norpramin
" " imipramine Tofranil
SSRI's fluoxetine Prozac
" " sertraline Zoloft
" " paroxetine Paxil
" " venlafaxine Effexor


Whom Should I See for Help?

A variety of mental health professionals can provide treatment for depres sion. Here are the differences between them:

Psychiatrist: A medical doctor (M.D.) specializing in medical treatment o f mental illness. Prescribes drug treatments and may or may not also offe r psychotherapy.

Psychologist: Licensed with a Ph.D., Ed.D. or Psy.D. Provides psychologic al testing and assessments for treatment planning and does psychotherapy. Some have hospital admitting privileges.

Psychiatric Nurse: R.N. with special training in mental health who provid es psychotherapy.

Social Worker: Certified or licensed with a master's degree. Provides psy chotherapy and also offers case management and assistance with navigating through social service agencies.

Counselor: Certified or licensed with a master's or doctoral degree. Prov ides psychotherapy.

Marriage and Family Therapist: Certified or licensed with a master's or d octoral degree. Provides psychotherapy, focusing on issues in relationshi ps and the family system.

IMPORTANT MENO_NUTRITIONAL SUPPLEMENTS
Power Surge's Comprehensive Recommendations

by Edythe Vickers, N.D., L.Ac., An Hao Natural Health Care Clinic, Portland, Oregon and Subhuti Dhaurmananda, Ph.D., Institute for Traditional Medicine, Portland, Oregon

Nutritional supplements become necessary, even with a good quality diet, to compensate for lowered nutritional absorption (and, in some cases, r educed ingestion of high nutrient foods) with aging. Below are some ex amples of important nutrients.

Calcium: total intake should be 1200-1500 mg. per day; typical dietary in take is 500-600 mg/day in menopausal women, so up to 1,000 mg supplementa tion may be necessary. Hydroxyapatite (derived from bone) is currently thought to be the best source for preventing and treating osteoporosis.

Magnesium: 600-800 mg per day. Current recommendations are to consume a t least half as much magnesium as calcium, possibly as much as the calciu m intake. Magnesium increases calcium absorption and retention. Note: so me women may experience diarrhea with this amount.

Vitamin D: 400 IU per day; for women over 65, use 400-800 IU per day. Vit amin D increases calcium absorption. Vitamin D is produced in the body i n response to exposure to sunlight (15 minutes per day without sun blocki ng agents); those who do not get sun exposure must supplement with vitam in D. Milk has vitamin D added; for those who do not consume milk product s (lactose intolerance is a frequent problem in post-menopausal women), v itamin D supplements should be used.

Boron: 1-3 mg per day (more can be harmful). Boron helps calcium absorp tion by the bone and may potentiate the action of estrogen.

Manganese: 2.5 mg per day. Manganese is necessary for bone mineralization

Vitamin E: 800-1600 IU per day. Sudden introduction of high doses of thi s vitamin is contraindicated in cases of high blood pressure, as it can c ause an increase in blood pressure; gradual increase in dosage avoids thi s problem. Dry forms of vitamin E are preferred over oily forms when usi ng higher dosages. Vitamin E is anti-oxidant and potentiates the action of estradiol.

Zinc: 15 mg per day. Zinc is necessary for bone formation; it also incre ases vitamin D activity and promotes immune functions. When supplementin g with zinc at higher doses, it is necessary to also ingest copper, since high dose zinc reduces copper absorption and may produce copper deficien cy. Avoid high dose zinc in cases of autoimmune disorders.

Silicon: this mineral is often available in the form of plant extracts, s uch as from "horsetail." Silicon aids calcium absorption into bone. The appropriate dosage level has not been determined as yet.

Chromium: 200-400 mcg per day. Chromium helps to stabilize blood sugar.

Fluoride: 25-40 mg of sodium fluoride, twice daily. Fluoride helps incr ease bone density. Black tea has 1-4 mg fluoride per cup. Fluoride is c urrently available only by prescription; excessive ingestion can harm bon es and is toxic.

Most of these vitamins and minerals are available in a single multivitami n. Check also for hydrochloric acid deficiency, which occurs more frequen tly and with greater severity with increasing age; if a women has this condition she will not absorb minerals as well. Additional nutritional s upplements include:

Essential Fatty Acids: Fish oils provide omega-3 fatty acids, mainly eico sapentaenoic acid (EPA) and docosahexanoic acid (DHA); they are recommend ed to be taken in the dosage of 3 grams per day. Vegetable oils provide omega-6 and sometimes omega-3 fatty acids; rich sources of these fatty a cids are evening primrose oil, black currant seed oil, borage seed oil, a nd flax seed oil; suggested dosage is 3 grams per day. They decrease ex cessive plasma lipids and soften the skin. Avoid excessive supplementat ion, as essential fatty acids can cause lipid oxidation and can lower imm une functions in high doses.

l-Carnitine: 750 mg each time, 2 times per day. l-Carnitine is an amino acid that helps improve lipid metabolism and strengthens the heart muscle . As with other amino acid supplements, it should be taken apart from me als to assure longer maintenance of high plasma concentration.

Tryptophan: 1 to 6 grams per day. Tryptophan binds to albumin, a protein found in the blood; estrogen also binds to this protein. When estrogen l evels decline with menopause, there is more albumin for tyrptophan to bin d to, lowering free plasma tryptophan. The metabolism of brain serotonin depends partly on the concentration of free plasma tryptophan. Thus whe n tryptophan is low, serotonin metabolism is low and this adversely influ ences moods and sleep. Tryptophan supplements have been unavailable in r ecent years due to safety concerns arising from a contaminated batch prod uced in Japan; the Food and Drug Administration has not deemed uncontamin ated tryptophan safe as yet. Tyrosine, which is metabolized in the same pathway, may be used as a substitute.



Index

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The Power Surge Newsletter disclaims any representation for the accuracy or completeness of information contained herein. The sharing of information herein is not indicative of Power Surge's personal endorsement of same. It is purely for informational purposes. Health matters should be taken up with one's personal physician. Nothing in the Power Surge Newsletters, chats, message base, bulletin boards is intended as a substitute for professional medical advice. Opinions expressed are Dearest's and the authors who contribute to Power Surge and don't reflect the opinions of America Online.


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