… Growing Older without aging
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JANUARY 1999

CyberHealth Index


Contents:

  1. Readers’ responses to the thyroid/Vit A/hysterectomy story
  2. How to diminish heavy bleeding
  3. Supplements: mega-longevity or mega-hype?
  4. Hot tip: prevent winter dryness with NaPCa
  5. Care of the soul: Living the good life now

More on thyroid, progesterone, and hysterectomies: Reader’s responses

Susan writes:

I feel like a poster child for this article.

I had a complete hysterectomy last year at age 41 for a diagnosis of endometrial cancer. My main symptom was extremely heavy bleeding and short cycles (something I had complained about for 5 years to my HMO — but that’s another story). My oncologist theorized that I had been anovulatory for some time (with corresponding low/no progesterone), leading to the abnormal growth and cell development. Had this been discovered earlier, it is possible that I could have been successfully treated with hormone therapy.

I was also discovered to have high anti-thyroid antibodies, a test I insisted upon when my then primary doctor, based only on TSH level, disputed that I could be hypothyroid despite my weight gain, intolerance to cold, constipation and very dry skin, never mind my menstrual problems. He refused to treat me for subclinical hypothyroidism, despite noting in my record that I had a multinodular goiter!

After surgery I was ok’d for estrogen based on the early stage of the disease combined with heart and bone protection issues (I already have low bone density). The “default” prescription of Premarin did little for my hot flashes, and I had aches, pains and headaches while using it. A switch to Estrace solved these issues, but the use of estrogen sent my TSH out of normal range. My new primary (of course I ditched the other loser) started me on thyroid meds.

Vitamin A? After a lifetime of a “peaches and cream” coloring I had to switch foundation colors a few years ago when the saleswoman noted that my skin tones were orange-yellow. And my new primary looked at my feet and asked me on my last visit if I ate a lot of carrots! I am a lovely hue….

Thanks to your tip I will look for pre-formed vitamin A — any brand suggestions?

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Ivy comments:

I certainly understand, having myself ALMOST had a hysterectomy in a very similar context. The dr said, “If you bleed like that one more time, we’ll have to do a hysterectomy. We can’t just be giving you blood” (referring to my blood transfusion).

And wow, on Armour, suddenly this rosy skin! I’d thought I was somehow genetically diff from the rest of my family, I’d been yellow from hypothyroidism for so long.

This thyroid/P/bleeding situation is SO common — while a bit of P supplementation starting whenever P deficiency becomes apparent (some women are deficient starting in adolescence; seems to run in families) — would probably be an effective and inexpensive preventive solution.

All this needless, easily preventable suffering!

Vit A that I recently discovered is NOW — in shark liver oil! It’s inexpensive. They also have a A+D combo. And then there is the dry form for poorer absorbers. BTW, when you feel a cold coming, taking 5 shark oil A’s can sometimes stop it, or at least make it milder. A relatively high dose won’t hurt you if it’s just for a day or two (or even a week, but I wouldn’t push it beyond that without a doctor’s supervision).

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Joy writes:

I want to respond to CyberHealth 19 regarding heavy bleeding.

When I turned 44, I started having occasional episodes of hemorrhaging, where I leaked through all my protection and stained my clothes. The first time was on a soccer field 3 hours from home. As I got closer to menopause, these surprises came more frequently, sometimes on long car trips. When I was 49, I had a period that lasted 3 months, until hyst put an end to it. During that 3 months, I had several uncontrollable floods, where I was literally unable to get off the toilet for 2 – 2.5 hours. Once I put in a new tampon, left the bathroom, then turned right around and went back in – I had soaked through everything in 10 seconds. I was terrified that it would happen at work or someplace public, and I would be humiliated. I was desperate to resolve this problem.

I had an ultrasound which revealed a huge fibroid. Yet the doctor denied that the fibroid had anything to do with it, said it was hormonal, and instead prescribed Loestrin. On day 18 of the Loestrin, I had the worst bleed of all.

When I called this doctor, he referred me to another gyn, who wound up doing a hyst. If he had told me nothing could be done, or just to wait it out, I would have killed myself, if I hadn’t bled to death first. The only way I could get my life back was to have a hyst. This doctor stated that absolutely, the fibroid was the cause of the bleeding. So the first doctor was either incompetent or deliberately lied to me.

I cannot comprehend at all Mary’s remarks about trying this and that for 4 years. I was desperate to stop the bleeding – RIGHT NOW. I could not have endured trying special diets and special pills in the hopes that over a period of time the bleeding would get under control. I was afraid to leave the house. I had to always be near a bathroom. The last week before my hyst, I was bleeding too much to go to work.

Sorry, but I value my lifestyle and my normal routine more than I value a uterus that had betrayed me. The only way I could get my normal life back was to have the hyst. It is now almost 2 years. I have never regretted my decision for a second. I am on estradiol and natural progesterone, thanks to the ladies on the meno list, and probably you most of all. I feel fine, my moods are more stable, I recently lost 24 pounds on the Atkins diet.

I can’t relate to Mary’s complaints at all. Everyone is different, of course, but I don’t know how she could endure heavy bleeding for so long, just for the sake of saving her uterus. She complains that Dr. Northrup had a ‘non-committal’ attitude. It sounds like Dr. Northrup was very committed to recommending hyst in this case (‘constant urging’), before and after everything else had failed. Why would Mary continue seeing a doctor whose medical advice she refused and dis-respected?

It is good to spread the information that Vit. A has been shown to cure menorrhagia. Had I known about this 4 years ago, I might have tried, but even if I had known about it during the 3 months before my hyst, I still would have opted for the hyst. I could NOT LIVE with the bleeding. I don’t know how Mary could.

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Ivy comments:

First, a word of caution about the Atkins diet —because of how it can affect the thyroid. It’s a marvelously effective diet for weight loss, but if you push the carbohydrate restriction to the extreme, it can slow down your T4 (thyroxin) to T3 (tri-iodothyronine) conversion (the body’s defense against perceived starvation — trying to conserve energy by slowing down metabolism). Thus YOU MAY FIND YOURSELF HAVING HYPOTHYROID SYMPTOMS even after you add more carbohydrates. (The extremely rapid regain of weight once more carbohydrates are added should also give us pause.)

I believe that eliminating processed, high-glycemic carbohydrates is an excellent idea, but —for the sake of multiple health benefits, you do need to keep the good low-glycemic carbohydrates such green apples (they are relatively low-glycemic), berries, raw salad veggies as well as semi-raw, stir-fried vegetables, and some root vegetables such as beets (terrific for cancer prevention), yams, and carrots (always eat them together with protein and healthy fat; and don’t overcook those carrots). And of course salad, salad, salad; postmenopausal years are the real salad years! With the exception of sweet fruit, you can’t gain weight on raw food (that’s why porkers always get cooked or otherwise heavily processed feed; cooking, mashing, grinding, blending etc pushes carbohydrates much higher on the glycemic index by breaking down fiber).

I know that these opening remarks on diet may seem like a strange comment considering that we are dealing here with Mary’s horrifying story, but believe me, the diet part does relate to it: first of all, you’ve got to take care of your thyroid, or your estrogen metabolism will never be right, and heavy bleeding will be almost guaranteed — particularly as you approach menopause and are not producing progesterone as you should. Thyroid and progesterone deficiency indeed often go together.

(Parenthetically, there was recently an editorial in the Journal of Experimental and Clinical Endocrinology pointing out that iodine deficiency is widespread in this country, now that people are avoiding salt. When you don’t get enough iodine because you followed the advice of the gurus to “throw away your salt-shaker,” and when you don’t get enough Vitamin A because, following the same gurus, you are not eating eggs and have cut down on animal products in general, which may also be making you zinc deficient, well, is it really so surprising that thyroid supplements are the second most prescribed drug after Premarin?)

If the only thyroid supplement you are taking is Synthroid or Levoxyl, which provides only T4, a severe cutting back on carbohydrates can only result in a shortage of T3 because of low conversion. Because T3 is so crucial to women’s gynecological health I argue for caution with the Atkins diet — for not pushing it to the extreme. I do admit the diet works spectacularly well, and does show the power of protein as hardly anything else can.

The reason I’ve gone into this at length has a lot to do with my experience. I was elated when I lost weight on the Atkins diet. It was a wonderful high every time I looked in the mirror. What I didn’t realize was that I was converting less and less T4 to T3. As for the yellow tinge to my face (showing lack of conversion of beta carotene to Vitamin A), well, that was easy enough to conceal with make-up. To make the story short, I ended up riding in an ambulance, having an emergency D&C to stop the bleeding, and getting a blood transfusion.

But back to the thyroid hormones. Remember that blood tests are indeed not an accurate way to assess thyroid function; you need to examine your symptoms. High cholesterol and persistent hypoglycemia (in spite of eating a protein and fat-adequate diet) are among the many symptoms that may be due to hypothyroidism (caution: hypoglycemia and chronic fatigue may also be due to adrenal exhaustion, i.e. not producing sufficient cortisol; if your thyroid panel comes back normal, ask for the cortisol am and pm test).

Another way in which thyroid problems show is, not surprisingly, breast tissue abnormalities such as the fibrocystic disease (don’t let anyone tell you that it’s not a disease; it is clearly pathology, and macrocysts are one of the risk factors for breast cancer). When estrogen metabolism is slow, with slow clearance out of the body and the more estrogenic metabolites that result from the hypothyroid-dominant “long path,” that’s when uterine and breast problems are practically guaranteed to follow.

Vitamin A deficiency, iodine deficiency (practically all the women who have eliminated salt, meaning iodized salt), sedentary life, and STRESS are all enemies of good thyroid function.

But back to Mary’s story. If the uterine abnormalities have reached a point where a woman can’t lead a normal life, I also don’t see why surgery should be the end of the world — but then, we need to be tolerant of individual differences. Some women are not particularly bothered by the prospect of losing their uterus; others are. If Mary really wanted to avoid hysterectomy, for whatever reason, it is a pity that she wasn’t treated right. I agree that it is strange and really sad that she persisted with a doctor with whom she had such bad chemistry. If you sense that your doctor does not like you, run for your life.

Women thrive on empathy and a sense of emotional connection. The fact that the physician is a woman does not guarantee anything; she could be even more indoctrinated in the rushed, impersonal, mechanical, disease-centered rather than patient-centered approach. Still, I do believe that this is a “seek, and ye shall find” situation. Keep looking for your “Dr. Right” — or at least Dr. Almost-Right.

Mary’s story is not by no means the worst. I know worse horror stories, where women truly got butchered, their ovaries removed without their consent (“You are forty-four, what do you need ovaries for?”), the surgery botched, with life-threatening complications. Going to the Mayo Clinic, or to celebrity “holistic” doctors does not guarantee first-class treatment. Your own respect for your body and your ability to acquire knowledge are your best starting points. Learn all you can about your condition and your options: if you have access to the Internet and to a decent library, you are on your way.

Gail: I would argue that the poor uterus didn’t betray Joy — it was only responding to the hormonal signals as best it could!

Ivy: Correct. Most often the deficiency of progesterone due to aging and stress is to blame.


How To Diminish Heavy Bleeding

Why is heavy bleeding — technically known as menorrhagia, and popularly as “floods” or “periods from hell”– so very common in perimenopausal women?

One answer is progesterone deficiency. This is particularly severe if there has been no ovulation; once periods get irregular, they are more likely due to the overcrowding of the endometrium (caused by the stimulation by unopposed estradiol) than due to ovulation followed in due time by progesterone withdrawal.

Another reason, also related to progesterone deficiency, is uterine abnormalities such as fibroids, polyps, endometriosis, and endometrial cancer (fibroids have the potential of becoming cancerous). Uterine abnormalities are extremely common in women who have had no pregnancies or one late pregnancy. My personal observation is that stress also has a lot to do with it; since stress diverts progesterone into cortisol, stress and progesterone deficiency are practically synonymous.

Can anything be done? First, you need to realize that MENSTRUATION IS AN INFLAMMATORY CONDITION. If you significantly diminish the release of inflammatory chemicals (such as prostaglandin F2alpha — but it’s not the only one), you should lessen the bleeding, cramps, and other ghastly symptoms.

TRY THE ANTI-INFLAMMATORY TREATMENT

1. Starting two days before your period, take 4-6 or more Advils (or generic ibuprofen; do not substitute aspirin) a day in divided doses (adjust your daily dose depending on how severe your problem is), continuing for the first two days of your period. If you have more than two “heavy days,” continue for as long as needed.

Yes, I know about the side effects of NSAIDs. Believe me, they are nothing compared to the “side effects” of heavy bleeding. It may help to eat half a banana with each dose of Advil.

If you don’t have regular periods and bleeding often starts unpredictably, take 3 Advils at the first sign of a period. Repeat this dose 4 hours later.

Soon we are going to have “super-aspirins” such as Celebrex. These will be more effective than today’s NSAIDs, and, being selective for the inflammatory prostaglandins, should have no side effects. But they will be very expensive.

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Lynne writes:

I find Aleve works better than Advil to diminish bleeding and prevent cramps. It can be rough on the stomach tho and absolutely must be taken with food. I take a Zantac too with it for at least one of the twice daily doses. Also, I read on the meno list that while Advil diminishes cramps/ bleeding, one of the other NSAIDS can increase bleeding. I can’t remember which one. Also, the naproxen (Aleve) takes about three days to get maximum effectiveness so if you can get a longer head start, I’ve found better results.

Ivy:

Aspirin is to be avoided. If anyone knows of any other drugs that might increase bleeding, please write to CyberHealth.

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TRY THE NATURAL ANTI-INFLAMMATORIES

2. Try if these beneficial FATTY ACIDS work for you: MegaEPA (from Life Extension Foundation, 800-544-4440; Trader Joe’s also has a good brand; other brands do not provide sufficient potencies and in my opinion are a waste of money) and CLA (Jarrow’s is my current favorite). EPA is regarded as the most potent prostaglandin modulator; CLA (conjugated linoleic acid) has the additional advantage of suppressing the production of leukotrienes, another nasty, pain-causing variety of an inflammatory chemical). Take these, especially megaEPA, throughout your cycle, increasing the dose during the premenstrual week.

EPA is an example of an omega-3 fatty acid. Omega-6 fatty acids are found in seed oils such as corn oil and safflower oil; in excess, omega-6 fats are pro-inflammatory. While experts debate whether the ideal omega-6 to omega-3 ratio is 4:1, 3:1, or 1:1, everyone agrees that the current American ratio of 20:1 is pathological, and is probably at least partly responsible for the epidemic of inflammatory disorders that we are witnessing (and also for the epidemic of obesity; it is the omega-3 fats that increase metabolism). Oxidized polyunsaturated frying oil appears to be particularly harmful.

Gail: What about Evening Primrose Oil? And flax seed?

Ivy: EPA is regarded as the most powerful anti-inflammatory fatty acid. Again: quality and potency makes all the difference here. I have found only two brands that work for me: Trader Joe’s and MegaEPA from Life Extension Foundation, 800-544-4440. It’s OK to take 6 or more MegaEPA capsules a day if you badly need to suppress the production of inflammatory prostaglandins (overproduced in massive amounts in conditions such as arthritis and menstrual dysfunction). One positive change that you should see quickly after you start taking EPA and reduce your production of inflammatory prostaglandins is easier bowel movement and darker color of the stool.

3. See if the anti-inflammatory action of BIOFLAVONOIDS works for you. Grape seed extract is now available in convenient 100mg, 200mg, and even 250mg potencies. 300mg is quite powerful, though you may want to go up to 400 or 500mg/D, depending on the severity of your problem. Do not expect anything from 50mg; you have to be serious about dosage. You will get great antioxidant benefits besides lowering inflammation. (Seems to be wonderful for fading age spots, too.)

4. KEEP YOUR INSULIN LOW WITH A LOW-GLYCEMIC DIET. Few people know that ELEVATED INSULIN IS PRO-INFLAMMATORY. Low-glycemic diet and daily exercise keep insulin within the normal range. For more information on low-glycemic foods, see www.anndeweesallen.com/dal_gly. htm. I also recommend Barry Sears’s latest (and best) book, “The Anti-Aging Zone.”

Testosterone, CoQ10, CLA, and other “bioenergetic” agents may also help lower insulin by enhancing the production of energy from glucose and fatty acids.

I also stress RAW FOODS. Raw foods are anti-inflammatory — maybe it’s because they keep insulin low, or maybe there is yet another mechanism involved. You will be amazed at the improvement in your health as you reduce the amount of processed food in favor of food straight from the earth. (Note: flour products do not count as “straight from the earth.” Even whole-grain bread is a heavily processed food, providing an excess of proinflammatory omege-6 fatty acids.)

TRY TO RESOLVE THE HORMONAL IMBALANCE (PROGESTERONE AND THYROID)

5. Call College Pharmacy, 800-888-9358, and Women’s International Pharmacy, 800-279-5708, for a referral list of doctors who prescribe natural progesterone. ONLY PRESCRIPTION PROGESTERONE will work — forget the costly, low-potency OTC progesterone creams. These may do something for women who need only a light supplement; if you have uterine abnormalities and heavy bleeding, don’t kid yourself: you need prescription progesterone.

I know we all hate going to a doctor, but there is no other way. You need to find someone who has at least heard of natural progesterone and is willing to give it a try.

If a doctor suggests Provera, you can point out to him/her that Provera is a progesterone analog, notorious for nasty side effects (most women just loathe it), and you would rather try the real thing, more compatible by far with the human body.

Progesterone not only normalizes your uterine tissue, shrinking fibroids and endometrial implants, but it is also anti-inflammatory, acting to inhibit inflammatory cytokines, especially in the pelvic area. It is proven to protect against endometrial cancer, and there is more and more evidence that it protects against breast cancer also (Dr. Zava estimates that up to 90% of breast cancer cases could be prevented with progesterone supplementation).

All perimenopausal women could probably profit from supplemental progesterone.

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Interestingly, some perimenopausal women report that FALLING IN LOVE completely normalizes their periods, even if they had already become erratic and heavy. This is not surprising, considering that falling in love increases hormone levels (hence the “radiant” skin), and in many cases those women start ovulating again and producing progesterone. It is also known that women of any age who have regular sex also tend to have more regular periods than celibate women. Too bad that falling in love can’t be considered a practical solution.

STRESS REDUCTION, on the other hand, may definitely preserve whatever progesterone you still produce from being turned to cortisol (our main stress hormone). When you are under stress, your stores of pregnenolone are being diverted into cortisol production; on top of that, whatever progesterone has already been synthesized can also end up as cortisol. Thus not enough progesterone is available to protect the uterine endometrium and prevent pelvic inflammation. Hence it is no surprise that we see an epidemic of menstrual disorders, fibroids and endometriosis among working women who are also wives and mothers. A study has found that such women have chronically elevated cortisol.

6. If you need thyroid supplementation (and one estimate is that 40% of perimenopausal women do), be sure to insist on Armour Thyroid or a similar brand that PROVIDES PREFORMED T3. Do not count on your own ability to convert T4 (Synthroid, Levoxyl) to T3. One of the signs of the doctor’s competence and flexibility is if s/he knows that the conversion problem exists. Another sign is if s/he orders the thyroid antibody test. And yet another sign — don’t count on it — is if s/he knows that the higher the T3, the less heavy the periods (because of the way T3 affects estrogen metabolism, so less estrogenic metabolites are produced, and estrogen clearance is increased).

Naturally, there is no need to push T3 into the hyperthyroid range. While that would make your periods very scanty, it might also overstimulate your heart, and increase the production of free radicals to pro-aging levels (see CyberHealth 19). The high-normal range is recommended. Do not settle for low-normal, particularly if your bleeding doesn’t normalize.

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Side note: Another reason for trying to find a competent physician is that if your fibroids are so bad that surgery is the recommended option, it is still possible to avoid a hysterectomy and just have the fibroids removed — if the doctor knows what he is doing. A fertility clinic may be an option for a woman who really wants to keep her uterus — some fertility specialists know how to do surgery for fibroids and endometriosis that preserves the woman’s reproductive organs.

Another type of surgery to consider is ENDOMETRIAL ABLATION. The endometrium is destroyed with a laser or using heat, but the uterus is not removed. This makes great sense to me, and I don’t understand why we so rarely hear about this type of surgery.

7. If the side effects of ORAL CONTRACEPTIVES are not a problem for you, that is another solution that usually works — but note that there may be nasty surprises if it doesn’t. Loestrin is yucky (I’ve tried it). The brand that women like (see Dr. Vliet’s book), and that typically produces very scant bleeding, is Ovcon. It is quite anti-depressant too. You will feel so cheerful you won’t mind the sore breasts.

I think nearly all gynecologists would agree that putting post-forty women on the Pill would be likely to prevent endless perimenopausal misery, but this option is not usually presented to women on a PREVENTIVE basis. Many perimenopausal women are told that the Pill is helpful against heavy bleeding only when periods have already gotten very bad, as an alternative to hysterectomy.

A progestin-only contraceptive may be very effective at abolishing periods (it was for me), but the side effects can be pretty awful. Daily progesterone is a better solution, as long as the doses are in the effective high range. I really don’t understand why compounding pharmacies are so afraid to recommend daily (continuous) progesterone for perimenopausal women, who are often in dire need of it because of horrible periods. If daily progestin is OK, safe, approved etc., then daily progesterone would be even more effective, with fewer side effects — a true godsend for many (most?) perimenopausal women.

An antifibrinolytic drug such as tranexamic acid may also be used to increase the ability of the uterus to stop the bleeding. Again, if antifibrinolytics are so effective, why aren’t women told about them? Why not explain their options to them?

IF YOU WANT TO TRY MEGADOSES VITAMIN A, YOU ABSOLUTELY NEED MEDICAL SUPERVISION

8. Vitamin A therapy may work for some women, but it is not something to attempt on your own. You need frequent liver tests when on high doses of A. I realize it may be very difficult to find a doctor who is experienced with this treatment. I’d call Dr. Jonathan Wright and ask if he has a referral for your area. I repeat: don’t do this on your own. Don’t even think about it.

9. DAILY EXERCISE HELPS BALANCE YOUR HORMONES. The benefits of exercise are so manifold and profound that no perimenopausal woman can afford to be a couch potato. Exercise does affect hormone levels; above all, it increases the conversion of thyroxin (T4) to the more active T3. The healthier (high-normal) your levels of T3, the less likely you are to experience heavy bleeding. The current consensus is that for best results you should alternate aerobics with weight training. Aim at burning 300 cal/day doing some form of exercise (a brisk 50 minute walk will do; it doesn’t take that long for men, who have a higher metabolic rate due to testosterone and greater muscle mass).

There is no need to engage in really strenuous exercise, although yes, that certainly would make your periods much lighter or nonexistent — but at a price (you’ve heard of the problems that female athletes have, including osteoporosis). Strenuous exercise causes excess cortisol, excess free radicals, and is pro-aging. Moderate daily exercise, on the other hand, is a must for older women. It lowers insulin, enhances the immune system, and as you have probably been told a million times, decreases your risk of both heart disease and breast cancer.

Note: if you take Premarin or any form of oral estrogen replacement, moderate daily exercise is absolutely essential to keep your triglycerides from rising.


A RADICAL SUGGESTION: USE MELATONIN AND PROGESTERONE TO ELIMINATE YOUR PERIODS

If you have endometriosis or are at a high risk for breast cancer, it would be highly desirable for you to stop having periods.

OK, first let us consider the conventional ways. You could opt for taking some form of birth control pill without the withdrawal period. This is quite OK, and is the way some physicians treat endometriosis. You see, the only reason that the artificial period is induced in typical Pill usage is that the male developers of first oral contraceptives took it for granted that women wished to have periods.

On the other hand, there might be some annoying breakthrough bleeding, unless it is a high-progestin pill, with the nasty side effects of progestins.

You may opt for the progestin-only pill. This kind may produce a few irregular periods at first — then none. But your immune system is depressed, you gain weight, retain water, suffer from yeast infections, and usually don’t feel so good. (On the other hand, women who start taking generous doses of natural progesterone every day as they near menopause report that they still get irregular light periods now and then, far and few between, and feel great — if they are the kind of woman who thrives on progesterone.)

As for the drugs that act on the brain to shut down the ovaries, personally I’ve heard only bad stories about those. Well, maybe I just don’t hear from women for whom such drugs work without making them miserable.

Now, the newest and still very experimental option is taking 75mg melatonin at bedtime and 300-400mg natural progesterone per day. Actually for many women 20 mg melatonin is enough; 40 mg will work for the great majority of women; but there are some stubborn ovulators out there who require as much as 75mg, and that’s why Dr. Michael Cohen decided to make 75mg melatonin the core of his revolutionary contraceptive. The other part is progestin, and since we already know that natural progesterone is better for you, and since Pincus determined that 300mg is what it takes to stop ovulation, well, there we have it. The two together should work very reliably. Caution: this is still very experimental. Still, thousands of women in Holland have been thriving on this regimen for several years now. No, the melatonin does not make them groggy.

This hormonal combination should normalize not only the uterine tissue, but also the breast tissue.

High-dose melatonin can be obtained from Life Extension Foundation, 800-544-4440.

BUT WHAT ABOUT THE VEGETARIAN DIET?

My personal experience with vegetarianism has been an interesting disaster. I must admit, however, that excessive bleeding certainly was taken care of. All bleeding was taken care of. I stopped having periods. And since periods returned as soon as I returned to the omnivorous diet, that was not yet menopause. That was malnutrition-induced amenorrhea.

I loved not having periods. What bothered me was that I felt chronically hungry, so I ate every two hours in the hope of finally feeling full and satisfied. I’d even wake up in the middle of the night, ravenously hungry! Since in my ignorance I relied on grains a lot, I gained weight very quickly. I also couldn’t get rid of those white spots on my nails that go with zinc deficiency. And my libido and sexual sensation decreased terribly. I could go on, but I think you get the picture. There came a point when I realized, belatedly, that, FOR ME, the cure was worse than the disease. The drop in estrogen levels was fine in terms of not stimulating the endometrium, but I wasn’t producing any progesterone either, and apparently very little DHEA and testosterone.

I realize, however, that some women do reasonably well on a vegetarian diet. If your blood sugar is stable, if you don’t overdo the carbohydrates, if you know how to get enough quality protein etc etc, then yes, a low-fat vegetarian diet is one of the solutions. But remember that there will be A DROP IN ALL YOUR BENEFICIAL STEROIDS, not just estrogens. This will have an impact on your energy and your libido. Rather than achieving hormonal balance, you make yourself even more hormone-deficient across the board. And high-carbo vegetarian diet generally lowers HDLs and raises triglycerides, unless you exercise a lot to burn those carbs. Finally, don’t forget that vegetarian diet was the first line of treatment that Mary tried; it didn’t work for her. As we keep saying, everyone is different.

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In summary, there is no easy solution, and one size definitely doesn’t fit all. For some women, Advil and natural anti-inflammatories may be enough, especially when combined with daily exercise; for other women, prescription progesterone (and not in skimpy doses either) is a must, and sometimes a thyroid supplement as well; for yet other women, surgical intervention — though not necessarily hysterectomy — may indeed be the best option. And then there are women who do quite well on the Pill, and don’t understand what the fuss is about — they have “mini periods” by comparison. Some women even tolerate Depo-Provera, and happily have no periods at all.

Just thinking about it all makes me extremely grateful for being menopausal. Still, if women were routinely tested for progesterone and thyroid deficiency, wouldn’t a lot of suffering be prevented?


SUPPLEMENTS: MEGA-LONGEVITY OR MEGA-HYPE?

Linda writes:

I know what you mean about the LEF orders adding up. I take the GLA, EPA, Lipaen (Ivy: that’s LEF’s brand of the fatty acid CLA, also available in health food stores as Tonalin and Jarrow’s CLA 600), grape seed extract, B combo and mix, then I add the DHEA, melatonin and pregnenolone — but when I see the 10 meds that my father-in-law takes every day (and that doesn’t include his chemotherapy meds) I know I’d rather pay to enjoy health that pay to control illness. My husband says I’m “high-maintenance” and he’ll probably outlive me anyway. Whatever!

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Ivy:

Statistically speaking, he is not likely to outlive you, whether or not you take supplements. Almost half of American men don’t make it past their 75th birthday.

If just being female is such a big factor in longevity, does it pay to buy supplements? Likewise, we know that good genes are very important; I have a relative in his late nineties whose only disability is some hearing loss (of course he refuses to wear a hearing aid; long-lived people tend to be the feisty and stubborn), and he has never taken a vitamin pill in his life. Not only that, but he eats precisely the kind of high-protein, rather high animal-fat diet that makes the low-fat high-carbo gurus shudder. He does walk every day, though.

Likewise, we shouldn’t forget that research points to CALORIE RESTRICTION as the most reliable method of extending life span and preventing disease. During World War II, an unintentional human experiment on calorie restriction was carried out in Europe. When food was rationed, the rate of heart disease and cancer dropped spectacularly. Once food was abundant again, heart disease and cancer shot up.

(Because calorie restriction is such an unpalatable prospect, it is encouraging to hear that MILD CALORIE RESTRICTION, COMBINED WITH EXERCISE AND HORMONE REPLACEMENT, shows signs of being as effective as severe calorie restriction. Apparently it’s a matter of insulin reduction and better metabolism and antioxidant protection — melatonin, DHEA, and estrogens are all antioxidants.)

Another interesting factor is the high correlation of longevity with IQ and sustained mental function. The fact that college professors tend to live longer than athletes does make some experts question the value of exercise, but the answer here appears fairly simple: athletes overdo the exercise, and end up on the minus side because of excess free radical production and increased cortisol. We need more brain research, however, to tell us more about how an active brain keeps the body alive longer.

So if genes, gender, calorie restriction, high IQ, and moderate daily exercise are such important factors, does it make any sense to bother with supplements? Do they really affect how long a person lives?

Let’s face it, supplements are a pain financially, as well as a chore: once you seriously get into supplements, it becomes almost a part-time job to take a bunch of tabs and capsules first thing in the morning, with meals, at bedtime etc. But I agree with what you say: it’s better to pay for maintaining health than for illness. And yes, there are studies that show improved human life span just with Vitamin C. Animal studies show extended life span with Vitamin B5 (pantothenic acid), and with various supplements such as DMAE. Almost anything that raises dopamine levels has been shown to extend life span in animals (maybe because dopamine lowers insulin).

Life span experiments on humans are impractical because we are such an amazingly long-lived species. That’s why mice and fruit flies are used, in spite of all the problems of extrapolating from their different physiologies. Perhaps we should rather concentrate on “health span” rather than life span. No one wants to live ten more years if you are disabled and demented. That’s not progress.

I believe that supplements are a part of preventive maintenance. True, to people who are not in the habit of taking supplements, those who do take them seem like hypochondriacs. Yet studies do show that people who take certain supplements really are healthier and live longer. Folic acid, selenium, Vitamin E and Vitamin C have already been shown to be very effective for disease prevention.

Let us take a look at some supplements that are less well known, but whose effectiveness has also been documented.

Now that we are learning more and more about the importance of efficient aerobic metabolism, COENZYME Q10 has emerged as possibly the most important anti-aging supplement. CoQ10 is without a doubt effective against heart problems, and in larger doses it may even protect against cancer. It is now available in the more absorbable soft-gel form, and Life Extension Foundation even makes it as a combo with tocotrienols, relatives of tocopherols (Vitamin E) that have an antioxidant, anti-cancer, and cholesterol-lowering properties.

GREEN TEA EXTRACT protects the arteries and the brain: new studies confirm again and again the powerful antioxidant protection provided by green tea. Just as important, green tea extract also inhibits the enzyme amylase, thus making starches less glycemic — i.e. glucose is released more slowly from rice, pasta, bread etc, and thus you are spared those fattening insulin surges. Furthermore, green tea, like coffee, speeds up peristalsis (instestinal motion), so that fewer calories are absorbed (estrogens also speed up peristalsis; progesterone slows it down).

NAC (N-acetyl-cysteine) is another rising star — it increases the levels of glutathione, and glutathione is unquestionably one of the keys to longevity. It is also very important in cancer prevention, since DNA protection depends to a great extent on glutathione (that’s one reason why maintaining high glutathione levels is a key to longevity). NAC also seems to protect against respiratory infections; if you do get sick, it will keep the mucus thin (my own experience bears this out). And NAC protects against heavy metals, alcohol and Tylenol toxicity, and certain pathogens such as E. coli.

GRAPE SEED EXTRACT, ow available in potencies of up to 250mg/capsule (remember when 30mg was the most you could get?), is alas still little known as an amazingly effective anti-inflammatory, though its antioxidant powers are well recognized.

METHYLCOBALAMIN (methyl B12) is still little known. It is a powerful neuroprotector, and, as a methyl donor, it also protects against cancer.

Speaking of methyl donors, it makes sense to take TRIMETHYLGLYCINE(TMG) or FOLIC ACID, or both. The older we grow, the more we depend on getting some extra help with methylation.

EPA (fish oil) and CLA (conjugated linoleic acid) are increasingly recognized as very valuable fatty acids that lower triglycerides and insulin, help increase the metabolic rate (the new “eat fat to lose fat” motto in fighting obesity is based on the ability of beneficial fatty acids to increase the metabolic rate and lower insulin), and protect against heart disease and cancer.VINPOCETINE is an extract of the vinca plant. It could be called “Viagra for the brain.” It improves brain circulation by increasing the same enzyme (cyclic GMP) that Viagra increases in a different place. Vinpocetine also increases aerobic metabolism in the brain cells; it seems to be a bioenergetic agent, like thyroid and testosterone.MSM is a derivate of DMSO, and a godsend to arthritics. Anyone could use it for the sulphur it provides. Every cell in the body needs sulphur.LIPOIC ACID (aka alpha-lipoic acid) is an interesting antioxidant that helps recycle other antioxidants, including CoQ10. It also helps with blood sugar control.LYCOPENE is emerging as the most important carotenoid for cancer prevention. Also, people with highest serum lycopene seem to have the most protection against Alzheimer’s disease.

PANTOTHENIC ACID

is a golden oldie that is simply not getting the attention it deserves. It helps us cope with stress. Animal experiments show that it extends life span. Arthritics have discovered that 1g/d (it takes more for some people) can provide profound pain relief. Dieters too should get interested in pantothenic acid, since it too speeds up peristalsis, so you don’t absorb as many calories (maybe that’s the main mechanism of B5-induced life extension).

B5 is also necessary for good brain function. Among other things, it is needed for the synthesis of acetylcholine (memory). B5 also improves endurance, and helps fade age spots by removing lipofuscin, the so-called “age pigment.”

Some women claim that 1500mg/d helps with hot flashes. I suspect pantothenic acid is just too cheap to merit promotion in the eyes of supplement sellers. Otherwise it would be in the top ten wonder supplements. (There exists an expensive form of pantothenic acid, known as PANTETHINE. It’s more bioavailable, and apparently more effective as an anti-inflammatory and cholesterol reducer. The problem here is that pantothene is just too expensive.)

If prices come down and potencies go up, I’d also like to experiment with resveratrol, SAM, phos-serine, carnitine, acetyl-l-carnitine, NADH, and yes, pantethine. I know that the body can absorb only so much, but it’s so fascinating to experiment and see if something actually does have an effect! I hope we’ll eventually devise more efficient ways of taking supplements.

Right now it is anything but efficient. I have supplements all over the place — it’s awful, the way those bottles accumulate. What keeps me going is that I’ve had amazing results with my severe knee arthritis in spite of the surgeon’s verdict that pretty soon I wouldn’t be able to walk and would have to have knee replacement — that was back in 1993 or so. Now I can work out on a treadmill and even run for a while. Not too long — I’m still “knee-challenged” when it comes to strenuous effort (the arthritis is the result of an accident and knee surgery), but hey, when I went to see the guy just walking was quite difficult and very painful. I couldn’t kneel, couldn’t cross my legs. Could barely, barely negotiate a flight of stairs, stepping down on one foot only, like a child. Now nobody would guess that I have a problem — only I know, because I know how far I can push it without pain. Basically, as long as I don’t overdo strenuous activity, I am pain-free after having been in severe chroni c pain for many years. And all this just with supplements; hormones also helped enormously, since hormones are just as important for joint health as they are for bone health — but this is not to place to go into that.

So I know taking the RIGHT stuff in the RIGHT DOSES works — and I’ve seen it work even against cancer (in megadoses; you have to know what you are doing, or have competent guidance from places like Life Extension Foundation and/or alternative physicians). Yes, the right supplements can just shrink the whole tumor to nothing — I have witnessed it more than once, and it’s absolutely thrilling. Same about heart disease: here I have both personal experience and have witnessed supplements work for others. People who say that supplements do not work most likely have never experienced or witnessed the use of megadose nutrients against serious disorders.

Another thing: after menopause, I’ve seen so many women age really fast. It’s not even the change in their looks that is so striking; what really upsets me is the way they suddenly lack the energy to enjoy life, particularly anything in the evening. They say they have so little energy that they can’t handle any lectures, appointments, anything past a certain hour in the afternoon. “I’m too wiped out for that” is the phrase I seem to hear much too often from older women who do not take hormones and supplements (or take just a multi, and perhaps use some form of totally inadequate HRT, like 1mg of Estrace or the weaker patch). My big worry in the evening is that I often feel too energetic, too alert, and need to learn to quit working sooner and spend more time relaxing. Between the two, I’d rather have my problem than too little energy.

My overall verdict on supplements is positive, but with the caveat that you need to know what you are doing, try to find the right doses for you, and don’t expect that taking supplements can compensate for the wrong diet and lack of exercise. Or for toxic emotions, for that matter — I still believe that positive emotions are the main factor in longevity. Joy of life, insulin reduction, cortisol reduction, enough exercise to maintain muscles and bones, these have priority, not supplements. The right (low-glycemic) diet and the right (moderate) exercise, together with stress reduction, positive emotions, as well as staying mentally active and productive, are the primary pillars of the anti-aging lifestyle; supplements are just that: they supplement.

I saw a dramatic example of this when a diabetic friend confessed she was spending almost $300 a month on vanadyl sulfate, various fatty acids, herbs, chlorella, green drinks, bee pollen, and so forth in the hope of controlling her blood sugar. I suggested that she cut out bread — surely six or eight slices a day is too much for anyone, particularly a diabetic — sweet fruit (she fiercely defended her constitutional right to eat sweet fruit), and was honey really recommended for diabetics? She reacted with great indignation to my very modest (I thought) proposals. Nevertheless, when I saw her several months later, she was a different person. She’d lost 60 lbs, her insulin dose was minimal, and she was taking ballet. True, now she was spending money on glucosamine for her ballet-strained joints, but with the money she was saving by cutting out vanadyl sulfate, that was minor.

By the way, 200mcg of chromium with each meal (600mcg/d) is the recommended dose for diabetics, one that showed results in a study. But I find that a lot of people are totally scared of taking a dose that is above the one indicated on the container. And I don’t blame them. Until we have more and better research, we all feel like laboratory rats in a massive, chaotic, uncontrolled experiment.

WORTHLESS SUPPLEMENTS

  1. Non-standardized herbs in capsules. You just don’t know how much of the active ingredient you are getting — in most cases too little to make any difference.
  2. Low-potency “Advanced” formulas. These tend to combine lots of trendy ingredients, but the amounts of each are so small you’d have to take 10-20 tablets or capsules to obtain an effect. Be aware that such formulas (often mail-order) are designed to sell, not to work.
  3. Tablets containing dicalcium phosphate. Now, I am not sure that these are entirely as worthless as many experts claim. But the explanation that dicalcium phosphate is extremely alkalizing and thus interferes with the action of the stomach acid, making absorption difficult if not impossible, does make sense. It’s better to err on the side of caution and buy the same thing formulated without dicalcium phosphate.

WILL WE EVER HAVE RESEARCH TO ESTABLISH WHICH SUPPLEMENTS WORK, AND WHAT DOSE RANGE IS BEST?

Wouldn’t it be great if someone really compared various dosages of Vitamin C, A, selenium and so on? I think partial and not very adequate research of this sort is beginning, here and there, in Germany, in Japan, as it becomes obvious that, for one thing, the government could save billions on Medicare or foreign equivalents if people took some effective supplements (including hrt for both men and women). If a modest pilot study indicates that a mere 200 mcg of selenium can cut prostate cancer rate by 64%, shouldn’t big studies follow? Wouldn’t it make sense to put money into studies like that rather than into studies that explore the limited effectiveness of various chemotherapy combos (the criterion being “time to treatment failure”)? But we know that logic and common sense have a very tough time prevailing in our world. Maybe we’ll have better luck in the next millennium.


HOT TIP: MOISTURIZE WINTER-DRY SKIN WITH NAPCA

Louie writes:

I’ve tried LEF’s NaPCA with aloe vera — it is wonderful and immediately effective on dry itchy skin. Every winter my arms and legs get so itchy — problem from the rougher fiber of the clothes I wear. Sometimes I could just scratch my skin raw. Creams were of minimal help. LEF’s moisturizing spray is unbelievable — I just mist it all over my body when I get out of the shower. It’s not greasy — don’t even know its on my skin, but all itching is gone!

Ivy:

NaPCa stands for sodium pyrrolidone carboxylate. Our bodies produce it from glutamic acid; as we age, we produce less. As TwinLab, the producer of various NaPCa sprays, explains, “This is not a cosmetic cover up; it is a physiological correction of an age-related deficiency state.”

If you still haven’t discovered NaPCa, it is usually as close as your nearest health food store. It IS effective. Nothing else comes close. And it’s inexpensive. Sometimes the best things cost very little.


* * * CARE OF THE SOUL * * *

LIVING THE GOOD LIFE NOW

Sometimes I think that museums
are just closets for the rich

— this is the provocative opening of one of Diane Wakoski’s poems. Then she considers her own closet:

A silk robe.
There’s one in my closet of baby
shoes and old fountain pens.
On its back, an embroidered
dragon coils and froths.
( – – -)

It is unused beauty.
I have feared wearing it,
not wanted to stain it with water
or carelessly spilled tea.
I ask myself what the difference is
between my closet and these museum walls.

Many women keep wishing they were rich and had beautiful clothes. But when you look in their closets, the beautiful clothes are there. It is just that these women aren’t wearing them. And quite as likely, there is fine china, but it is never used, and beautiful bowls and vases, but they are all put away.

But it is not the material objects that really matter in life. One can be perfectly happy wearing jeans and t-shirts, and eating off paper plates — if there is an abundance of love in one’s life. While women have always understood the importance of close relationships, they are only now beginning to learn about the importance of doing the kind of work that one loves, that engages one’s soul.

Permitting yourself to take an hour or two every day to do whatever gives you deep pleasure — soul pleasure — should be an inalienable right. Come to think of it, it IS an inalienable right: “the pursuit of happiness.” So don’t think of your painting, writing, jewelry making, choir singing, gardening, visiting sacred sights, or whatever activity you find especially fulfilling, as something unimportant, something for which you have no time — or else your psyche will become a dusty museum of unfulfilled dreams — like a closet filled with beautiful clothes that are never worn.

So live the good life now. Instead of making self-improvement resolutions, decide to enjoy 1999 to the fullest. Follow your bliss. It is your inalienable right.

Menopause is a wake-up call. It tells us that the time is up. If we do not act now to make ourselves happy, we never will be. Because if not now, when? When are we going to wear those beautiful clothes, when are we going to do the things we love doing? When we are eighty?

One story that haunts me is that of an old woman dying in a hospital, weeping. A nurse remarked, “She isn’t crying because she is dying. She is crying because she hasn’t lived.” I translate that as “has not dared to do the things she really wanted to do.”

It is an interesting phenomenon that when one feels fulfilled, one is also ready to die. A friend once remarked to me, “I feel so happy, I could go any time.” When you feel you have truly lived, even death loses its terror.

Following your dream NOW takes supreme courage. It is the greatest gift you can give yourself. Do not wait for retirement. Start while you are still relatively young and energetic, even if it means doing it only part-time.

Once when I was still in graduate school getting my MA and working part-time, I mentioned to a friend that I wished I could attend a writing workshop — but it meant a long commute to a bad part of town at the end of a long day. “I am simply too tired,” I complained. “Being tired is a state of mind,” was my friend’s merciless reply. The following week I dragged myself to the workshop. Within minutes, my fatigue was gone, replaced by excitement. It was the first step to the quantum leap from WANTING to be a writer to BEING a writer (“A real writer is one who really writes”).

Artists are an example of people who have the courage to do what they want to do. As the German poet Hoelderlin said,

Once I lived as the gods;

more is not needed.


Disclaimer

The material contained herein is intended as information only, and not as medical advice.