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Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders
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3. Campos, A.C., et al., Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders. Philosophical Transactions of the Royal Society B: Biological Sciences, 2012. 367(1607): p. 3364-3378.
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SculpSure and CoolSculpting have a similar basic purpose: to target and injure fat cells so they eventually die and are disposed of through your body’s lymphatic system. The difference is that while SculpSure uses controlled heat to eliminate fat cells, CoolSculpting uses the process of controlled cooling, also known as cryolipolysis.
The potential risks and side effects, as well as the pain level and downtime, are similar for both procedures. As of 2016, the average cost of SculpSure was about 50% less than CoolSculpting.
CoolSculpting was cleared by the FDA in 2012, while SculpSure received clearance in 2015. Because CoolSculpting has been around for a few more years, there’s more available information on it, including more formal studies and clinical trials.
SculpSure is a convenient body contouring treatment that can be done in a medical office in less than an hour without disrupting the skin’s surface. SculpSure utilizes targeted laser energy to heat up fat cells and melt them away. The laser that’s used in a SculpSure treatment causes a process that’s called apoptosis, which gently heats up fat cells and shrinks them so they can be expelled through the body’s lymphatic system as waste.
SculpSure is FDA approved to treat the abdomen and flanks (love handles). But because of its flexible applicator frame design, we are able to treat others areas such as the buttocks, inner and outer thighs, calves, back, and arms. This advanced treatment method provides lasting results because it actually destroys and eliminates fat cells from the body, not just shrinks them.
In the weeks after your treatment, you’ll see a permanent reduction in those persistent, unwanted pockets of body fat.
Since SculpSure is not an invasive treatment like surgery, there is no downtime.
SculpSure is the latest innovation for non-invasive body contouring.
It is the only laser that permanently destroys fat in a targeted area with heat. After 25-minutes, the treatment is complete you can resume with your day and activities. There is no post-treatment downtime.
You use the term “bioidentical hormones”. What does this mean and how is it different than traditional hormone therapy?
Bioidentical means that the hormone is exactly the same, in both structure and function, to the hormones made in the body. The hormone has to stimulate the receptor on the cell in order to get the effect of the hormone. A bioidentical hormone fits into the receptor exactly the same as the body’s own hormones. The cell will not be able to tell the difference between a hormone made by a compounding pharmacy and by the ovaries/testes. This explains, in part, the safety and ideal response of hormones when suing topically applied bioidentical hormones, properly balanced and dosed.
What is the most common type of hormone deficiency?
All hormones decline as we age. The most notable are the reproductive (sex) hormones, estrogen, progesterone and testosterone. There is quite a bit of scientific literature attesting to the many health benefits of proper hormone restoration n men and women and showing the dangers of non-bioidentical hormones, especially the progestins found in birth control pills and conventional post menopausal hormones.
What does hormone deficiency feel like or look like?
Most men and women describe many similar symptoms of hormone deficiency. Women note, most commonly, hot flashes, night sweats, vaginal dryness, emotionality, anxiety, depression, poor libido, sleep issues, fatigue, orgasmic difficulty, urinary symptoms, dry and wrinkled skin and anhedonia (loss of enjoyment of life’s pleasures). Men will describe many of these same symptoms including urinary difficulty (enlarged prostate) and erectile dysfunction. Most people will report a noticeable change in appearance, advanced aging, etc.
How is BHRT treatment different than regular hormone replacement?
Topical applied bioidentical hormones are the preferred route of administration allowing the use of smaller doses that are delivered directly to the tissue bypassing liver metabolism. There is evidence that oral estrogen may result in some loss of benefits and even may negate some of the positive benefits of estrogen on the blood vessels. Dosing and balance is critical for safe and effective hormone replacement. Topically applied hormones are most accurately measured in the saliva. Serum levels do not accurately reflect the dose of hormones. Blood testing for topically applied hormones often results in overdosing. Overdosing can result in unwanted side effects and increased risk as well overstimulation of hormone receptors resulting in a reduced response to hormones and return of symptoms which leads to an increase in hormone dose which perpetuates this problem.
Who can benefit from BHRT treatment? What are the benefits?
All patients are a candidate for proper hormone restoration. In fact, I consider all patients candidates for hormone replacement unless proven to have a contraindication to hormone restoration. There is literature supporting the benefits of hormone restoration on preventing cardiovascular disease, protecting the breast and uterus from cancer, preventing osteoporosis and bone loss, regulating cholesterol and blood sugar. In men, all causes of death are associated with testosterone deficiency including prostate cancer. I must emphasize that this means “proper” hormone restoration using the correct hormones at the correct doses and in the correct balance. This requires a thorough understanding of hormones and hormone restoration.
What’s A Guy To Do?
Traditionally, the term Menopause has been associated with women and their transition from the fertile, childbearing years to the post fertility years. This transition can be long and arduous. Well, men can experience a similar sympathetic transition as well. So why has there been so little talk about this male counterpart to Menopause?
Andropause or commonly calle “male Menopause” has significant health implications for men. We often experience many of the same symptoms as women, such as, cognitive and memory issues, decreased libido, sexual dysfunction (erectile an orgasm that dysfunction), sleep difficulty, anxiety and depression, anhedonia (loss of life’s enjoyments), fatigue, decreased exercise tolerance, decreased energy and weight gain, etc.
Typically, women are much more open about their feelings and freely discuss them with each other. Men are typically the opposite. You don’t often hear men talking in the locker room or at a restaurant about their sexual difficulties, loss of muscle and their once muscular bodies’ or their emotional difficulties, that is until recently. Men are now beginning to recognize that their feelings are not just something that they have too accept because it is the “manly” thing to do. men, today, want to live long, healthy and productive lives, so they are seeking out practitioners who are able to hep them safely maintain their best overall health. There has been more publicity about men’s issues, magazines that are devoted to male topics and books being written about topics from testosterone deficiency and prostate health to how to maintain our sexual function and how to cope with divorce. Since more women are seeking bio identical hormone balance and are feeling better, they are also encouraging their partners to seek similar hormone restoration.
There has been a fear of cancer from hormones and both men and women. For men, the case of prostate cancer has been associated as cause & affect with testosterone. However, there is an abundance of literature that not only supports the fact that testosterone does not cause Prostate Cancer but actually lessen the incidence. A Harvard-based Urologist, Dr. Abraham Morgentaler has written extensively on the subject and cites the evidence in the literature that supports the claim the testosterone does NOT cause prostate cancer.( Morgentaler A. Testosterone Replacement Therapy and Prostate Risks: Where’s the Beef? Can J Url. 2006. Feb;13. Suppler. 1:40-3).
In 2007, a study was published which reported that “all cases of mortality in men are associated with low testosterone” Khaw KT, Dowsett M, Folkerd E, et al. Endogenous testosterone and mortality causes, cardiovascular disease and cancer in men: European prospective investigations into cancer in Norfolk (EPIC-Norfolk) prospective Population Study. Circulation. 2007 Dec 4; 116923) : 2694-701. Testosterone has also been shown to improve insulin response and glycemic control and diabetic men. (Haffner S. SHBG, Hyperinsulinemia, Insulin Resistance and NIDDM. Hormonal Research. 1996; 45 (3-5) : 233-7.).
Testosterone can help to improve cholesterol levels by increasing reverse cholesterol transport which helps to clear cholesterol from the artery. Men with low testosterone are at increased risk for coronary artery disease. Malkin CJ, et al. Testosterone as a Protective Factor Against Artherosclerosis-immunomodulation and Influence Upon Placque Development and Stability. J. Endocrinology. 2003 Sept; 128 (3) : 373-80.
And proper testosterone restoration does note make men “angry”.
Many medications many lower a man’s circulating levels of testosterone. Statins to lower cholesterol, beta blockers to lower blood pressure and SSRI’s for depression are among the most commonly used medications that affect testosterone levels.
There are some important considerations when restoring testosterone to physiologic levels that must be considered. First, the expectation of men may be more than can be expected with proper restoration of hormone balance. That is, we will not return to the lean muscular body, exercise tolerance, and strength that we enjoyed in our late teens and 20s, when testosterone peaks and testosterone receptors and maximal. Rather, we can expect improvement in reduced body fat and improved lean muscle provided that we also address diet and exercise. Second, sexual function often improves, but there are many other factors to consider in male sexual performance, namely, vascular issues, stress, fatigue, etc. We have complicated hydraulics and there are many factors that must be working to achieve and maintain an erection. There are many psychological issues that must also be addressed. Thirdly, return of better function takes time. After all, it took many years are slow, almost imperceptible decline, to get to this point and it will take time to see a change and improvement. Lastly, and probably most importantly, the physician must take the time to discuss these issues and make sure that the patient has realistic expectations. It is simple not acceptable to just prescribe a topical testosterone gel or weekly injections and not consider these other factors.
There are many ways to restore testosterone baleen in men. These include topical gels, injectables, pellets places under the skin, Human Chorionic Gonadotropin (HCG) injections, patches, nasal sprays, and dissolvable lozenges place in the mouth. I most commonly use injectable subcutaneous testosterone or HCG and occasionally, topical testosterone. Proper testing can help to determine who is a candidate for testosterone restoration and what options are available to them.
A physical trained in hormone restoration will be able to help men achieve a better state of health & wellness. We can optimize our health, enjoy a more productive and rewarding life and do it safely.
Dr. Monaco practiced for over 35 years as an OB/GYN. After he retired from that specialty, he redirected his career to integrative medicine. Dr. Monaco has nearly 20 years of experience with bioidenticle hormones. He has lectured extensively throughout the United States, Canada and the Middle East on topics including hormone restoration for men and women, adrenal and thyroid dysfunction, functional medicine, weight loss, and most recently the relationship of hormones with cardiometabolic disease. He has been awarded many prestigious awards including Connecticut Top Doctor Award and Excellence in Clinical Teaching Award.
He is a member of the Teaching Faculty for the American Academy of Anti-Aging Medicine, an Oral Board Examiner and a Clinical Assistant Professor of Family Medicine at the University of New England College of Osteopathic Medicine. He is the Medical Director of the Nashville Hormone and Integrative Medicine Center as well as the Division of Hormone Restoration at The Hypertension Institute. He is also the Associate Medical Director of Integrative Medicine at The Hypertension Institute, Nashville, TN. We are honored to have Dr. Monaco on our Health Advisory Board and look forward to sharing his knowledge with our readers.
-Bownam Gray School of Medicine, MD
-St. Francis hospital & Medical Center, Residency in Obstetrics & Gynecology
-Fellowship in Anti, Functional & Metabolic Medicine
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