Posts Tagged "estrogen"

Wednesday Bubble: is weight loss all in your head?

Posted by on Jul 7, 2010 in Uncategorized | 17 comments

It appears that weight loss, might indeed be in your head. But not the way that you think. This week’s bubble focuses on the brain and how it helps to regulate weight gain. In fact, researchers from the University of Texas Southwestern Medical Center are reporting that an enzyme in the brain, better known as P13 kinase, may help burn extra calories after eating a high-fat meal. Mind you, these findings are from a study conducted in mice so it is too early to assume that if there was a way to enhance the activity of P13 kinase in humans, then it would be easier to lose or maintain weight.

In the current study, researchers examined mice who had reduce P13 kinase activity and then fed them a high fat diet but did not alter their physical activity levels. When they compared them to normal mice, they found that their body heat did not increase and they became more likely to become obese. regardless of physical activity level. (Evidently, when we eat too many calories, the body tries to assist by expending more energy, in order to balance out our calorie intake. )

Interestingly, brown fat, or brown adipose tissue, is a key tissue that appeared to generate enough body heat in the mice to help them burn off excess calories. Two other important factors that appear to play a role include the hormones leptin which help regulate how the body uses energy.

Brown fat?

I contributed a post to MizFit Online last October that provides a bit more information about brown fat and I’m reposting it here to provide a bit of background to make the current study findings easier to understand:

What you need to know…

In mammals, fat (known among the medical set as “adipose tissue”) comes in two varieties: white and brown.

* White adipose tissue (or “WAT”)  is used for energy storage and to provide warmth. It also protects the organs by acting as a cushion. Most of the fat in our bodies is white.
* Brown adipose tissue (or “BAT”), is mostly found in newborns and tends to diminish as a person ages.  Brown fat is used by the body to regulate temperature and quickly burns sugar to keep infants warm, meaning that exposure to cold activates brown fat cells. This last point may be important when it comes to weight loss.

For decades, brown fat was believed to significantly decline as we grew older, mainly because as we become more able to regulate our body temperatures, we no longer solely rely on biology.  However, PET scanning has shown that healthy adults actually have stores of brown fat  scattered throughout the front and back of the neck and chest areas.

So, is brown fat an equal opportunist? NO!

In fact:

* Women with lean body mass have at least twice the ratio of brown fat compared to men.
* Exposure to temperatures of around 61º F appears to kick off brown fat cell activity, at least in leaner people.
* The higher your body mass index (BMI), the lower the amount of brown fat in your body.

Turning down the thermostat can help lose weight, right?  Well yes. And no.

In controlled situations, volunteers left “chilling” for at least two hours were shown to have a surge in brown fat activity. However, keep in mind that the body is fine-tuned to maintain equilibrium, so, what goes out often goes right back in.In other words, expend more energy, eat more food. And the “chill factor” hasn’t been extensively tested in people under normal, everyday conditions. Still, based on what researchers are able to learn from animal studies, they believe that having as little as 1 to 2 ounces of brown fat in your body could potentially burn about 20% of the average daily caloric intake, that is, if brown fat cells were properly activated.

If you combine the information from the mouse study with the information on brown fat, it seems that the combination of brown fat plus activating P13 kinase may produce a way to burn calories more efficiently. And, leptin and estrogen help regulate the process.

The question however, is how do we get there from here?

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Wednesday Bubble: An ‘Evolutionary’ not ‘Revolutionary’ Rx for Hot Flashes?

Posted by on Jun 23, 2010 in menopause, new approaches | 2 comments

This week’s bubble brought to you by the manufacturers of Amberen™, a new menopausal treatment that bills itself as revolutionary not evolutionary. What they mean by this is that Amberen, a novel, non-hormal treatment for menopausal symptoms, does not represent an evolution of the same herbs (e.g. black cohosh, chaste berry) used by other manufacturers but a revolutionary new approach and strategy to addressing troublesome symptoms during menopause. Personally, I believe that anything that isn’t HRT based is evolutionary, however that aside, this week’s bubble is pretty darn solid and early data, pretty encouraging!

What is Amberen?

Amberen is a food supplement mostly composed of an enzyme known as succinate that is involved in metabolism. Dramatic swings in estrogen that result during menopause significantly affect the sensitive functioning of the  hypothalamic-pituitary-ovary (HPO) axis (part of the neuroendocrine system that regulates many processes in the body, including interactions between the glands and hormones).  According to published research, very small doses of succinate help to restore the way that the aging HPO axis functions, thereby promoting hormonal balance. In turn, this appears to boost estradiol levels and alleviate menopausal symptoms.

In small clinical studies, Amberen appeared to act as hormones in the body, resulting in self-reported reductions in the frequency of hot flashes, declines in insomnia and headache, and improvements in mood, anxiety and impaired sexual desire. Honestly, it sounds a bit too good to be true, so I am not entirely convinced. However, the researchers are quoted as saying that this approach to jump-starting HPO sensitivity could open the way for safer treatments for a variety of conditions, and not just menopause.

Amberen is not for everyone as it is not inexpensive, requiring at least a $90 commitment upfront (although there is an offer on the website for a 30 day free trial, a further dive shows that it takes at least 90 days to realize its full effects). However a three month on, three month off dosing schedule might be more convenient for women who have trouble remembering to take pills regularly.

Importantly, I did not see any reported details on side effects in the clinical studies I looked at, although the website cautions against women using Amberen if they have any thyroid or high blood pressure issues. I”d like to see more information on that as well.

Like any treatment for menopause, it’s essential to speak to your healthcare professional before diving in and trying Amberen. Personally, I’d like to see larger studies and specific information on side effects before making any real commitment to the product. However, I am intrigued by Amberen’s potential and certainly by this new approach to treatment, a seemingly viable and effective alternative to hormone replacement.

Have you tried Amberen? What do you think?

[Disclosure – I was approached by Amberen’s PR agency to see if I’d be interested in the product. After requesting and reviewing the clinical studies, I decided to write about it. I was not compensated for this piece nor was I sent or accepted any product.]

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Wednesday Bubble: HRT – wait a moment!

Posted by on Jun 16, 2010 in HRT | 0 comments

Back in early May, I wrote a post about the difficulties in stopping hormone replacement therapy (HRT) and the disturbing fact that doctors have no guidelines to follow in order to advise their patients on the best strategies. Today’s Bubble is a perfect companion to that piece, as it addresses the fact that research now shows that women who start HRT and then stop it have a tendency to have significantly greater and more severe  menopausal symptoms than had they never started HRT at all.

Writing in the online edition of Menopause journal, researchers say that among 3,496 postmenopausal women who completed a pre- and post- stopping therapy survey during the Women’s Health Initiative study (a trial that compared estrogen/progestin to placebo and was subsequently halted when HRT was found to double the risk of breast cancer) :

  • Those who had not reported having hot flashes at the start of the study were more than five times as likely to report moderate to severe hot flashes after stopping HRT compared with women with no symptoms who took sugar placebo pills. However, women who had reported having hot flashes at the study’s start were only slightly more likely to report hot flashes after stopping HRT
  • A similar pattern was seen for night sweats, i.e. women who had none at the study’s start were almost twice as likely to report them after stopping HRT
  • Age at stopping HRT was increasingly associated with more joint pain, i.e. the older the woman, the higher the risk for experiencing joint pain

The researchers say that although there have been previous reports of  a surge in vasomotor symptoms like flashes and sweats after stopping HRT, these findings show that estrogen, either alone or with progestin, may promote symptoms when HRT is stopped, even if a woman was not experiencing them when she started therapy. More specifically, the risk for menopausal vasomotor symptoms and joint stiffness is four to seven times more in women with and without prior symptoms when HRT is stopped.

The takeaway message is that it’s not only important to consider the health risks associated with HRT but also, what happens when you stop it. Clearly, even if your symptoms disappear while on HRT, your risk for symptoms after stopping therapy is fairly high.

You should always weigh the risk benefit ratio before starting any type of therapy. HRT may not be worth the trouble. Or the multiple risks.

p.s. More on this study from my friends at Reuters Health.

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Wednesday Bubble: The HRT patch – is it safer?

Posted by on Jun 9, 2010 in HRT | 9 comments

Remember the diva and the doctor sitting on the roof espousing the benefits of the HRT patch? Well, it turns out that some of these patches might not be so safe after all. Results of a study of over 75,000 women published in the British Medical Journal, show that the use of high-dose transdermal (through the skin) HRT patches increases stroke risk by as much as 88%.

Granted, transdermal or through the skin delivery bypasses the liver, which typically makes patches safer than their oral counterparts. However, if the drug isn’t safe, well, then the patch might not be either.

In this latest bit of news, researchers evaluated women between the ages of 50 and 79 who had participated in the ongoing Study of Women Across the Nation (SWAN). Every woman who had had a stroke were matched for comparison to four women in the study, with similar characteristics, who had not. The women were further divided into groups based on their use and type (i.e. oral or patch) of HRT, including estrogen only, estrogen plus progestogen, progestogen only, and the estrogen alternative, tibolone (which is not available in the US).

The researchers say previous and recent studies suggest that oral HRT, including estrogen only or estrogen plus progestogen, is associated with a 30% increased risk of stroke. However, stroke risk differs between high- and low-dose patches. Overall, they report that:

  • Low-dose patches do not appear to increase stroke risk, at least in the short-term (they say that they cannot rule out an increased risk with long-term use)
  • High-dose patches, regardless of whether or not they are estrogen only or estrogen plus progestogen, appear to increase stroke risk by anywhere from 25% to 88%
  • Risk was the highest among women who had used oral HRT before trying transdermal HRT, although this risk appeared to decline the longer the time period between stopping oral and starting the patch
  • Findings remained even after adjustments were made for factors that might influence results, including age

What the findings mean

Despite claims to the contrary, it does not appear that HRT offers much protection against heart disease during and after menopause. What’s more, the HRT patch may not actually be safer than oral HRT, at least in so far as the high-dose HRT patch goes. Although the researchers state that they were unable to distinguish between types of stroke when evaluating the SWAN study data, they say that these data show the need to look further into how HRT is delivered, especially as use of the HRT patch becomes the norm.

As I’ve written previously, if your doctor suggests you try HRT for menopausal symptoms, it behooves you to ask the hard questions. While you may save your sleep, mood and a few articles of clothing, you may be placing yourself at a higher risk for cancer, heart disease and other serious conditions.

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Wednesday Bubble: rhubarb rules the day

Posted by on May 26, 2010 in herbal medicine | 10 comments

Today’s Bubble is straight from the research files and it’s not burstable. In fact, I’m pretty excited about this.

Researchers say that a phytoestrogen extract from Siberian rhubarb (rhapontic rhubarb), better known in studies as “ERr 731,’ is an effective alternative to HRT for alleviating menopausal symptoms.

Evidently Siberian rhubarb has been used for decades to treat menopausal symptoms, both in Germany, where it is readily and commercially available, and in Chinese medicine. Clinical studies suggest that ERr works very similar to estrogen in the body and in fact, has been shown to have properties that are equivalent to SERMS – selective estrogen receptor modulators – which are synthetic compounds that mimic the action of estrogen in the body without necessarily causing some of its harmful effects.

When I delved further into ERr 731, I found numerous, well-designed studies that demonstrate its benefits in perimenopausal women including:

  • A significant decline in the number and severity of hot flashes over the short-term (i.e. 3 months) by as much as 50%, with further improvements through the long-term (i.e. 6 months).
  • Improvements in other menopausal symptoms such as sleep disruption, mood and vaginal dryness.
  • Improvements in self-reported quality of life.
  • Minimal if any side effects and no changes in uterine or vaginal tissues among women taking the extract, suggesting that it may be safe in terms of breast or uterine cancer.

In the U.S., ERr 731 is marketed as a supplement called Estrovera. Although it appears to be safe, like any drug, you should speak to your practitioner before trying it.

I’m heartened to see that an herb that been in use for decades in both Western and Eastern cultures in finally available to US women. I’ll continue to monitor for additional studies but in the interim, I’d love to hear from you if you are taking Estrovera.

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