Media Blasts Oprah for Supporting Alternative Medicine

In January of this year, Oprah Winfrey invited Suzanne Somers on her show to talk about health tips. The 62-year-old actress uses bio-identical estrogen cream and progesterone on her other arm two weeks a month. Read more

Testosterone Therapy May Reduce Bone Loss in Older Men

(HealthDay News) -- Injections of testosterone appear to improve bone density and reduce bone loss in older men who have low testosterone levels and may help to prevent osteoporosis, a new study suggests.

Testosterone therapy has been used to improve bone strength and muscle mass in some men. However, the hormone treatment is controversial, because it has been associated with increasing the risk of prostate cancer and high levels of red blood cells. And other potential effects of long-term use of testosterone therapy aren't known.

"These preliminary data show beneficial effects of testosterone therapy on bone turnover markers in older men with low-to-normal testosterone concentrations using both continuous and monthly cycled testosterone replacement," lead researcher E. Lichar Dillon, of the Department of Internal Medicine at the University of Texas Medical Branch in Galveston, said in a prepared statement. "The effects of sex hormones on markers of bone formation are complex, but this is an important step in understanding how the process works."

Preliminary study results were expected to be presented April 7 at the American Physiological Society's annual meeting, during the Experimental Biology 2008 conference, in San Diego.

For the study, Dillon's team studied 13 men, ranging in age from 60 to 85. During the five-month trial, the men were either given weekly injections of testosterone, weekly injections of testosterone every other month, or a placebo.

The researchers found that men receiving testosterone had reduced bone turnover, compared with men on a placebo. While the effects of testosterone therapy over the long term aren't clear, the researchers said they believed the treatment would be beneficial by preserving bone mass and preventing osteoporosis.

One expert said the study was too small to prove or disprove the value of testosterone therapy in preventing bone loss and, perhaps, preventing osteoporosis.

"This small, short-term study indicates that men with low levels of testosterone respond to appropriate replacement as far as turnover markers indicate," said John Eisman, director of the Bone and Mineral Research Program at the Garvan Institute of Medical Research, in Sydney, Australia.

While calling the study "too small and too short to provide any insight into fracture-risk reduction or safety outcomes," Eisman said it does complement research he has done. "Our study showed that men with testosterone in the lowest quartile of the population had much higher risk of osteoporotic fractures," he said.

A large, long-term trial testing whether testosterone can prevent osteoporosis in men is needed to settle the question, Eisman said.

More information
To learn more about men and osteoporosis, visit the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Older Men With Low Testosterone Face Greater Depression Risk

(HealthDay News) -- Low testosterone levels in older men are associated with an increased risk of depression, an Australian study says.

Between 2001 and 2004, researchers at the University of Western Australia in Perth studied 3,987 males aged 71 to 89. The men provided demographic and health information and were tested for depression and cognitive difficulties. The researchers also checked the men's testosterone levels.

The 203 men who met the criteria for depression had significantly lower total and free (not bound to proteins) testosterone levels than those who weren't depressed. After controlling for other factors, such as cognitive scores, education level and body-mass index, the researchers concluded that men in the lowest quintile (20 percent) of free testosterone were three times more likely to have depression compared to those in the highest quintile.

The findings were published in the March issue of the Archives of General Psychiatry.
While more research is needed to determine how low hormone levels may be linked to depression risk, the study authors believe it may be caused by changes in the levels of neurotransmitters or hormones in the brain.

"A randomized controlled trial is required to determine whether reducing prolonged exposure to low free testosterone is associated with a reduction in prevalence of depression in elderly men," the researchers wrote. "If so, older men with depression may benefit from systematic screening of free testosterone concentration, and testosterone supplementation may contribute to the successful treatment of hypogonadal (with low hormone levels) older men with depression."

Between 2 percent and 5 percent of people are affected by depression at any given time, according to background information in the study. Women are more likely than men to be depressed, but that difference disappears at about age 65. A number of previous studies have suggested that sex hormones may be a factor.

More information
The U.S. National Institute of Mental Health has more about men and depression.

Cancer Death Rates Still Declining

(HealthDay News) -- Good news continues to come forth from the cancer front: U.S. death rates from the disease have declined by 18.4 percent among men and by 10.5 percent among women since mortality rates first started going down in the early 1990s.

In 2008, an estimated 1,437,180 new cancers will be diagnosed, and 565,650 people will die of the disease, according to a report released Wednesday from the American Cancer Society (ACS). Death rates were at their highest for men in 1990, and for women in 1991.

Although the rate of cancer deaths decreased from 2004 to 2005, there was an increase in number of actual deaths (5,424) in 2005 compared to 2004, the report showed.

"We do not know why the declines in death rate from 2004 to 2005 slowed, compared to the previous two years," said Ahmedin Jemal, strategic director for cancer surveillance at the ACS. "But we can say that this occurred for almost all of the major cancer sites for men and women, which include colon and rectum in both men and women, breast cancer in women, and prostate cancer in men."

"Death rates from cancer continue to decrease because of prevention, early detection and treatment," Jemal added. "These have been decreasing from the early '90s and, really, because of this decrease, over half a million deaths from cancer have been avoided."

Jemal is first author of Cancer Statistics 2008, which is published in the March/April issue of CA: A Cancer Journal for Clinicians. The report has been an annual fixture since 1952.

"This is both good news and bad news," said Dr. Louis Weiner, director of the Lombardi Comprehensive Cancer Center at Georgetown University in Washington, D.C. "The good news is that cancer rates continue to decline, and that the lives of hundreds of thousands of Americans have been saved over past 15 or 16 years as a result of this improvement in cancer death rates."

"The bad news is that more than a half a million Americans can be anticipated to die of cancer this year," Weiner continued. "That's equivalent to nearly the entire population of Washington, D.C., and losing more than the entire population of New Orleans in 2003. Viewed from that perspective, we have a long way to go."

According to Jemal, "smoking is a big part [of the decline.] Smoking rates have been decreasing for the last 30 to 40 years, when the Surgeon General came out with his report."

Screening for colorectal, breast and cervical cancer have also contributed to the decrease, he added.

Today, about one-quarter of deaths in the United States today are due to cancer, killing more people under 85 than heart disease.

Some specifics from this year's report:

• In men, cancers of the prostate, lung, colon and rectum represented about half of all newly diagnosed cancers. Prostate cancer alone accounted for one-quarter of the total cancer cases in men.
• In women, the three most commonly diagnosed cancers in 2008 will be breast, lung and colorectal. These account for about half of all cancer cases in women. Breast cancer alone accounts for 26 percent of new cancer cases among women (although the incidence decreased by 3.5 percent per year from 2001 to 2004, part of which may be due to declines in the use of postmenopausal hormone replacement therapy). About one-quarter of all deaths from cancer in women in 2008 will be from lung cancer.
• In men aged 40 and younger, leukemia is the most common cause of cancer death, while lung cancer is the leading killer in men over the age of 40.
• Leukemia is also the leading cause of cancer death among females under 20, while breast cancer takes the greatest toll in women aged 20 to 59. Lung cancer is the biggest cancer killer in women over 60.
• The incidence of cancer is 19 percent higher and the death rate 37 percent higher among black men compared with white men. For black women, the incidence rate is 6 percent lower, but the death rate is 17 percent higher than for white women.
• The five-year survival rate for children with cancer has improved from 58 percent for those diagnosed between 1975 and 1977 to 80 percent for those diagnosed between 1996 and 2003.

This year's report also includes a special section that discusses the impact of health insurance status on cancer prevention, diagnosis, treatment and outcomes. Earlier this week, researchers from the American Cancer Society reported that people who either have no health insurance or rely on Medicaid are more likely to be diagnosed with advanced cancers.

More information
Visit the American Cancer Society for more on this report and on different types of cancer.

Report Finds 'Widespread Steroid Use in Baseball'

(HealthDayNews) -- New York Yankees pitchers Roger Clemens and Andy Pettitte, Houston Astros All-Star shortstop Miguel Tejada and home run king Barry Bonds are among the big-name players cited in a highly anticipated report into the use of performance-enhancing drugs in Major League Baseball.

The report climaxed a 20-month probe by former U.S. Senate Majority Leader George Mitchell, who was hired by baseball Commissioner Bud Selig to examine the use of performance-boosting drugs during the so-called "steroids era," which began in the mid-1990s and was marked by record-shattering performances by many players.

"For more than a decade, there has been widespread anabolic steroid use in baseball," Mitchell said, adding that all 30 major-league teams have players involved with drugs, ESPN.com reported.

"Everyone involved in baseball over the past two decades -- commissioners, club officials, the players' association and players -- shares to some extent the responsibility for the steroids era,'' said Mitchell, who called for stricter drug testing. "There was a collective failure to recognize the problem as it emerged and to deal with it early on."

It was not clear if the report would result in any penalties or suspensions, the Associated Press reported.

Clemens was one of the most prominent names in the report. Others include Most Valuable Player award-winners Barry Bonds, the late Ken Caminiti, Jose Canseco, Jason Giambi, Juan Gonzalez, Mo Vaughn and Tejada. The report also includes the names of three of the top 10 home-run leaders of all time: Bonds, Mark McGwire and Rafael Palmiero, The New York Times reported.

Anabolic-androgenic steroids are man-made substances that help build muscle tissue and increase body mass by acting like the body's natural male hormone, testosterone. But they can produce a variety of dangerous side effects, including heart trouble.

According to the U.S. National Institute on Drug Abuse, the major side effects can include high blood pressure; increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol); liver tumors and cancer; kidney tumors; severe acne; and trembling. There are also some gender-specific side effects:

• For men -- shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, and increased risk for prostate cancer.
• For women -- growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, a deepened voice.
• For teens -- growth halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short for the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt.

"For males in the U.S., heart disease is the number one cause of death, and steroid abuse makes heart disease even worse," Dr. Linn Goldberg, a professor at Oregon Health and Science University, and an expert on steroid abuse, told HealthDay following the 2004 heart-attack death of Caminiti, who had admitted to abusing both steroids and cocaine.

Dr. Nieca Goldberg, a spokeswoman for the American Heart Association and medical director of the Women's Heart Program at New York University School of Medicine, said steroids raise almost all heart disease risk factors.

"One, steroid use raises blood pressure," she told HealthDay. "Two, it can also alter your sugar metabolism, so you have an increased risk of diabetes. Three, it makes the arteries vulnerable since, because of elevated cholesterol, you get cholesterol plaque buildup."

Steroid abuse can also cause a dangerous thickening of heart muscle called hypertrophy --- the same kind of heart-muscle enlargement seen in patients with congestive heart failure, experts warn.

Linn Goldberg (no relation to Nieca Goldberg) said his biggest concern remains the health risks to America's teenagers, who are increasingly influenced by the behaviors of their favorite sports stars.

"These are very dangerous drugs, and their effects on children are even greater than on adults, because they affect all their biological systems," he said. "It's a shock to their body, because the hormones are so powerful."

More information
To learn more about steroid dangers, visit the American Academy of Pediatrics.

New Drug Treats Rare Hormonal Disorder

(HealthDay News) -- The U.S. Food and Drug Administration has approved Somatuline Depot (lanreotide acetate injection) to treat a rare growth hormone-related disorder called acromegaly, the agency said Friday.

The disorder, caused by an abnormal secretion of the hormone, is characterized by enlarged hands, feet, facial bones, and internal organs such as the heart and liver. If untreated, people with the disorder often die prematurely because of heart and respiratory problems, diabetes, or colon cancer, the FDA said. The disorder affects about 15,000 people in the United States and Canada.

The drug's safety and effectiveness were evaluated in two clinical trials involving 400 people. The most frequent side effects were diarrhea, gallstones, skin reactions, slow heart rate, and changes in blood sugar levels.

Samatuline Depot is marketed by Beaufour Ipsen, based in Paris, France.

More information
The FDA has more about the approval.

Reevaluating Hormone Replacement Therapy

(HealthDay News) -- Five years after the results of the Women's Health Initiative sounded the supposed death knell for hormone replacement therapy, experts gathered Wednesday to reassess those results and discuss the fine-tuning and evaluation that has taken place since.

"The science has evolved substantially in the past five years," Dr. JoAnn Manson, chief of the division of preventive medicine at Brigham and Women's Hospital in Boston, said at a press conference sponsored by the Society for Women's Health Research. "There's been mounting evidence that a woman's age and amount of time since onset of menopause may influence the effect of hormone therapy."

The Society for Women's Health Research is a nonprofit organization but has received funds from companies such as Amgen, Cytyc, Eli Lilly, Ethicon and Wyeth.

The original Women's Health Initiative (WHI) was halted when U.S. researchers found an increased risk of adverse events which, depending on whether the woman was taking estrogen alone or estrogen plus progestin, included heart attack, stroke, breast cancer and blood clots.

Manson was one of the principal investigators on the WHI trial.

The average age of women enrolled in the WHI was 63, or about 12 years past menopause.
And the trial was designed not to look at how well hormone therapy combated menopausal symptoms such as hot flashes, but whether it could play a role in chronic disease prevention.

"The WHI was designed to evaluate the balance of benefits and risks of hormone therapy in generally healthy postmenopausal women when used for chronic disease prevention," Manson said. "At the time WHI was started in the early 1990s, it was becoming increasingly common in clinical practice to use hormone therapy in older women who were at high risk of cardiovascular disease, or who already had a diagnosis of cardiovascular disease, in order to prevent future cardiovascular events."

Since then, it has become increasingly clear that hormone therapy has different benefits and risks, depending on the age of the woman.

Just last week, Manson and her colleagues reported in the New England Journal of Medicine that women in their 50s who take estrogen therapy have lower levels of dangerous calcium deposits in their arteries, suggesting they're at reduced risk for heart disease.

But in older women, hormone therapy appears to increase the risk of cardiovascular problems and blood clots, a phenomenon confirmed by a study in this week's British Medical Journal.

And researchers have speculated that a decline in the incidence of breast cancer in recent years is due to a decline in the use of hormone therapy after the WHI results were announced. But a cause-and-effect link is not at all clear.

"I think it's possible that declining use of hormone therapy has contributed at least a little to a decreased incidence rate, but there could be other explanations," Manson said. "There's some suggestion that the decline in breast cancer may have begun as early as 1999, which was well before there was decreasing use of hormone therapy. And there is also some evidence that mammogram screening has decreased over the past several years and that this could contribute to lower rates of detection and diagnosis of breast cancer."

That being said, combined estrogen and progestin has been linked to a risk of breast cancer after four to five years of use. It's not clear if estrogen has a similar risk.

There was some evidence in the WHI study that combination hormone therapy reduced the risk of colon cancer, but the evidence isn't enough to recommend hormones as a preventive strategy, Manson said.

Similarly, while estrogen reduces the risk of fracture and enhances bone density, this benefit would require long-term treatment. Other medications are available and should be tried first, Manson said.

Overall, the bulk of the research today, five years after the WHI, should serve to reassure younger women who may need hormone therapy to alleviate menopausal symptoms.

"The most important reason to go on hormone therapy is for menopausal symptoms," said Dr. Nieca Goldberg, medical director of the Women's Health Program at New York University Medical Center and associate professor of medicine at New York University School of Medicine.

"Younger women who need to go on hormone therapy for this reason can relax. But hormone therapy should never be given to women with cardiovascular disease."

Manson added: "I don't think that hormone therapy should be started or continued for the express purpose of preventing cardiac disease or other chronic diseases, because there are known risks. However, this is very different from the situation in a recently menopausal woman who has moderate to severe hot flashes and night sweats which interfere with sleep and quality of life. Hormone therapy is known to be the most effective treatment for menopausal symptoms.

It's still a very appropriate short-term treatment, but we still recommend using the lowest effective dose for the shortest duration of time necessary."

More information
Visit the U.S. National Library of Medicine for more on hormone replacement therapy.

FDA Panel Backs Prostate Cancer Vaccine

(Healthday News) -- A U.S. Food and Drug Administration advisory panel voted Thursday to support approval of Provenge, a vaccine aimed at extending survival for patients with deadly metastatic prostate cancer.

The FDA panel voted unanimously that the vaccine was "reasonably safe," noting that while it failed to meet some study endpoints, it did extend patient survival, according to published reports.

The panel then voted 13-to-4 to say there was substantial evidence to show the vaccine was effective for treating advanced prostate cancer that no longer responds to standard hormone treatment.

The FDA does not have to follow the advice of its advisory panels, but it typically does. The agency is expected to make its final decision by May 15.

Hopes have been high for the vaccine, which researchers said was the first ever shown to have an impact on cancer patients' survival. Those claims were based on a three-year study, released early in 2005, of 127 men with advanced, metastatic prostate cancer.

The trial found that patients infused with Provenge experienced an average 18 percent increase in survival, compared to those on a placebo. That worked out to 4.5 months of extra survival -- 25.9 months for those receiving Provenge vs. 22 months for those not taking the vaccine.

Provenge was developed by Seattle-based Dendreon.

"The concept behind the vaccine is to try to stimulate the patient's own immune system to recognize the prostate cancer cells and keeps them in check," said Dr. Simon Hall, a prostate cancer specialist at Mount Sinai Medical Center in New York City who worked on the trials for the vaccine.

In one phase III trial, men who had metastatic prostate cancer were three to four times more likely to be alive three years after vaccination, Hall said.

"However, the intent of that trial was not to show survival," Hall said. "The intent was to see if you could get patients to delay pain or new lesions in their bones. But they found it had no effect on that."

Before the panel met Thursday, FDA officials had expressed some reservations about the data submitted by Dendreon.

"The submitted data tend to support a finding of clinically meaningful increased survival, but doubts remain about the persuasiveness of the efficacy data," agency officials stated in documents released ahead of the meeting.

The advisory panel also noted that neither of the two studies submitted by Dendreon convincingly showed that Provenge met the primary goal of delaying progression of prostate cancer.

As reported by UPI, an increase in the frequency of "cerebrovascular accidents," such as stroke in men treated with Provenge, also "constitutes a potential safety concern," the FDA said. Stroke risk was 3.9 percent in treated patients compared to 2.6 percent in patients receiving a placebo.

Besides promising a potential benefit to men with prostate cancer, the therapy gives "proof of principle" to the idea that immune-based treatments can have a real impact on prostate cancer and other malignancies, experts said.

"There have been many failures with this kind of approach, and many have wondered if we shouldn't set the bar lower, somehow lower our expectations, and not hope for extended survival," Dr. Bruce Roth, a prostate cancer researcher at Vanderbilt University, told HealthDay when the 2005 study was released.

"But these findings are saying, 'No, looking for a survival advantage is a valid endpoint to look at for these agents,'" he said.

If caught early, prostate cancer remains very curable. However, despite advances in early detection, the disease remains the second leading cancer killer of U.S. men, according to the American Cancer Society. Even among men who develop the disease while it is still confined to the prostate, between 30 percent to 40 percent will experience a recurrence in years to come.
Because prostate cells depend heavily on testosterone to grow, therapies that reduce levels of circulating testosterone are often the first course of action in men who experience a recurrence. However, prostate cancer cells gradually grow resistant to hormonal therapy, and until very recently, doctors could only offer patients palliative therapies once that relapse occurred.
Hall said there was a new trial underway that was starting to confirm the survival results from the first study.

One advantage of the vaccine is that it has fewer side effects than chemotherapy, Hall added.
"The vaccine doesn't cure the disease, but it controls the disease for a period of time," he said. "And it is much less toxic than chemotherapy."

More information
For more on prostate cancer, head to the American Cancer Society.

Embolization for Fibroids Leads to Faster Recovery

(HealthDay News) -- Women with uterine fibroids who are treated with embolization, a minimally invasive procedure, may get out of bed and back to work faster. But after a year, their quality-of-life scores are about the same as for women who had surgery to treat the non-cancerous growths, a new study found.

In the Jan. 25 issue of the New England Journal of Medicine, Scottish researchers report that hospital stays for embolization average just a day, compared to about five days for surgical treatments.

"The choice is essentially up to the patient. Hysterectomy has a very high success rate, but longer recovery. Embolization has a slightly lower success rate, but faster recover, and you keep your uterus," said the study's lead author, Dr. Jonathan Moss, a consultant interventional radiologist at Gartnavel Hospital in Glasgow.

A fibroid is a non-cancerous growth that develops in the uterus. As many as 20 percent of women of child-bearing age have one or more fibroids, according to the U.S. National Institutes of Health. The incidence of fibroids increases with age. Most fibroids don't require treatment, but some cause excessive bleeding and may cause pain.

When fibroids cause symptoms, treatment options may include hormone therapy, surgery or uterine-artery embolization. Surgical options include hysterectomy, the surgical removal of the entire uterus, or myomectomy, which is the removal of each individual fibroid. Embolization is a minimally invasive procedure that reduces the blood supply to the fibroids, causing them to shrink. For women who may still want to have children, myomectomy is currently the recommended treatment.

Because embolization is a relatively new technique -- it was introduced in 1995 -- the researchers wanted to assess how it compares to surgical options.

For the study, 157 women were randomly assigned to undergo embolization or surgery. One hundred and six women had embolization, 43 had hysterectomies and eight had myomectomies.
The average hospital stay was one day for embolization, compared to five days for surgery. Those who underwent embolization also got back to their daily activities faster than women in the surgical group. Women in the embolization group were able to drive a car after an average of eight days, compared to 34 days for the surgical group.

The embolization group was back at work, on average, 20 days after the procedure, versus 62 days for the surgery group. And women in the embolization group were able to resume sexual activity within an average of 21 days, compared to 53 days for those who had surgery, the researchers said.

The complication rates were similar overall, with 15 percent of those in the embolization group and 20 percent of those in the surgery group reporting serious adverse events.

Yet, after one year, there were no statistically significant differences in quality-of-life scores.
"The biggest problem of surgery, whether myomectomy or hysterectomy, is the time to recover from the operation. This was much faster following embolization," Moss said. "The other problem with hysterectomy is not every woman is happy with that option. The biggest problem with embolization is that it doesn't always work. Ten to 20 percent of patients will ultimately need it repeated or to have a hysterectomy."

Dr. William Romano, an interventional radiologist at William Beaumont Hospital in Royal Oak, Mich., said he would have liked to have seen more women in the myomectomy group, because women today are often choosing between embolization and myomectomy. He said he was surprised by the larger numbers of hysterectomies in this study.

For women who know they don't want to have any more children, Romano said, "Patients should consider embolization as a first-line procedure, because, in many situations, it may be all they need."

For women who still want to have children, embolization is rarely considered because its safety for pregnancy hasn't been well-studied, he said.

"The data doesn't support embolization as a viable primary option for women interested in childbearing," Romano said.

Still, he added, it could be an option for women who are afraid to have surgery or for women with many fibroids, because myomectomy can be a more difficult procedure for multiple fibroids.

More information
To learn more about uterine fibroids and their treatment, visit the U.S. National Library of Medicine.

Hangover Helpers

(HealthDay News) -- Don't look to Khursheed Navder for sympathy if you drink too much on New Year's Eve and wake up with a wicked hangover.

Navder, a registered dietitian and associate professor in the nutrition and food science program at Hunter College in New York City, is willing to offer you some advice on how to deal with the party-fueled problem, however.

But first, it may help to understand the science behind that throbbing, queasy, mouth-full-of-cotton malaise. According to Dr. Christine Lay, a neurologist at The Headache Institute at St. Luke's-Roosevelt Hospital Center in New York City and co-author of an upcoming article on hangovers in the journal Headache, the culprits are:

• Dilation of blood vessels. This may contribute to the throbbing headache.
• Low blood sugar. Alcohol can interfere with the liver's ability to produce glucose, which leaves you feeling weak and tired, clouds your thinking and makes you moody.
• Poor sleep. While alcohol is sedating and promotes sleep initially, the sleep is often of poor quality with frequent awakenings due to factors such as decreased rapid eye movement (REM) sleep.
• The accumulation of toxins. The main byproduct of metabolized alcohol, acetaldehyde, is a toxin that can make your heart race and lead to headache, sweatiness, flushed skin, nausea and vomiting.
• Dehydration and electrolyte imbalance. Alcohol promotes urination by inhibiting the release of the brain hormone that normally protects against dehydration. When dehydration is accompanied by sweating, vomiting or diarrhea, there is additional fluid and mineral loss leading to electrolyte imbalances The result? Excessive thirst, lethargy, dizziness and light-headedness.

So, if you do consume too much alcohol, drinking plenty of water is essential because dehydration is perhaps the most common cause of hangover symptoms.

"Those pounding headaches and everything else are related to the shriveling of the cells because they lose so much water," Navder said. "Before sleeping, force yourself to drink water. If you throw up, very good, because you're going to get some of the alcohol out that way."

If you forget to drink water before going to bed, then do it first thing in the morning. The sooner you replenish your fluid loss, the quicker you'll bounce back, Navder said.

If you don't feel like drinking water, then sports drinks are a good option because they replace essential salts and minerals that were flushed out of your body during frequent urination. Non-acidic fruit juices are another good choice because the sugar in them helps prevent hypoglycemia and feeling weak and lightheaded.

Also, avoid coffee and other caffeinated beverages. Caffeine does not speed up the body's metabolism of alcohol. All it does is irritate the stomach lining and prevent you from falling asleep, which is one of the best ways to escape a hangover, she said.

Navder's next bit of advice involves a bit of tough-love: exercise. While being active is the last thing you may want to do when you have a pounding head, it increases blood flow to the brain and the rest of the body and induces sweating, which helps the body purge alcohol, she said.
Other tips, courtesy of Navder and the U.S. National Institutes of Health:

• Try to eat because food will reduce the irritation to your stomach lining. Soups are good for replacing salt and potassium depleted by alcohol, and fruits and vegetables can help replenish lost nutrients.
• You can take pain relief medications such as ibuprofen and naproxen sodium to reduce your headache and muscle aches as long as your stomach isn't upset and you have no history of ulcers or bleeding problems. Antacids can help ease nausea and gastritis.
• Drink a glass of water in between drinks containing alcohol. This will help you drink less alcohol, and will also decrease the dehydration associated with drinking alcohol.

Navder also has some hangover-prevention advice. Drinking lighter-colored alcohol and higher brands of alcohol may reduce the severity of a hangover. That's because lighter-colored drinks, such as vodka, gin and white wine, have fewer congeners -- a toxic byproduct of fermentation and aging -- than darker-colored drinks such as whisky, brandy and red wine.

And more expensive alcohol generally contains fewer congeners because it goes through a more rigorous distillation process that filters out more congeners.

She also suggests that you eat while you drink, because food in your stomach slows the absorption of alcohol. But don't munch on salty snacks because they'll just make you thirsty and likely to drink more.

Or, Navder said, you could just avoid booze altogether. "With a hangover, I think prevention is definitely better than the cure," she said.

More information
The U.S. National Library of Medicine has more about hangover prevention and treatment.

Chronic Fatigue Syndrome Campaign Launched

(HealthDay News) -- U.S. health officials on Friday launched a major campaign to increase awareness of chronic fatigue syndrome, an illness that has labored under an intense level of controversy.

"This disease has been shrouded in a lot of mystery. Sometimes people question if it's real or not real," Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, said at a news conference. "We hope to help patients know they have an illness that requires medical attention and help physicians be able to diagnose the illness, and be able to validate and understand the incredible suffering that many people and their families experience in this context."

The campaign will consist of public service announcements, brochures, a "tool kit" for health-care professionals and a photo exhibit called "The Faces of Chronic Fatigue Syndrome," which will travel to cities across the country throughout 2007.

"We hope this will be a turning point in the public's awareness of the disease as well as in health-care professionals' ability to diagnose and treat it," Kim McCleary, president and CEO of the CFIDS Association of America, said at the news conference.

"This launch is so important to increasing understanding of this illness," added Dr. Nancy Klimas, of the University of Miami Miller School of Medicine. "Historically, lack of credibility of this illness has been a major stumbling block."

According to Dr. William Reeves, of the CDC's National Center for Infectious Diseases, the level of impairment experienced by people with chronic fatigue syndrome is comparable to that of multiple sclerosis, AIDS, end-stage renal failure and chronic obstructive pulmonary disease.

One CFS patient, Adrianne Ryan, said that sometimes taking a walk or a shower was too much, and resulted in her collapsing for weeks afterwards. Ryan is a former marathoner.

Doctors still don't know what causes CFS or how to treat it successfully, but more than 4,000 studies over the past two decades show definite underlying biological abnormalities, said Dr. Anthony Komaroff, of Harvard Medical School.

"This is not an illness that people can imagine they have. It's not a psychological illness," he said. "That debate, which has raged for 20 years, should now be over."

Among other things, Komaroff pointed out, the brain hormone systems of people with CFS are different than those without the disease. Brain functioning is also impaired and cells' energy metabolism seems to be compromised.

Analyses of the activity levels of 20,000 genes in people with CFS have found abnormalities in genes related to the part of brain activity mediating the stress response, Reeves said.

Some 1 million Americans suffer from the disease. Women are affected at about four times the rate as men and non-white women are affected more than white women. The disease can affect any age and demographic but is most likely to strike when a person is 40 to 59 years of age.

According to a large study conducted in Wichita, Kans., only half of people with CFS have consulted a physician and only 16 percent have been diagnosed and treated, although studies have shown that those who get appropriate care early in the illness have better long-term results. A quarter of people with the disease were unemployed or receiving disability, with the average affected family foregoing $20,000 annually in income. That amounts to $9.1 billion in lost income and wages for the U.S. economy as a whole, the study found.

While there's reason to be happy with advances in the basic scientific knowledge of the disease, Klimas said she was less happy with advances in care. Over the past 20 years, she said, she has treated more than 2,000 people with CFS who were "angry and defiant, frustrated, trying to convince physicians, friends and families that this was a real illness."

"We need much more work to understand the biological underpinnings and translate this into clinical practice," she said. "At the same time, there are effective strategies we can use right now, treatments that do help and help significantly."

More information

Visit the U.S. Centers for Disease Control and Prevention for more on chronic fatigue syndrome.

Yohimbe: Restoring Sexual Potency?

Q: Yohimbe: Restoring Sexual Potency?
What do you think of yohimbe or other natural supplements for Erectile dysfunction as an alternative to Viagra?

A: Yohimbe is an herbal remedy that comes from the bark of an African tree, Pausinystalia yohimbe. Before Viagra, drugs containing yohimbine hydrochloride, the active ingredient in yohimbe bark extract, were used to treat erectile dysfunction (ED). However, levels of yohimbine in yohimbe bark extract vary considerably and are often very low.

Yohimbe bark extract, by itself, never has been shown to work as effectively as drugs containing yohimbine hydrochloride. What's more, yohimbe can have serious side effects including paralysis, fatigue, stomach disorders, even death. I don't recommend it, and harvesting of its bark is driving the yohimbe species to extinction.

Viagra and related drugs are the most effective treatments for ED by far, but you can try the following non-drug approaches if you wish:

Stop smoking. Nicotine can reduce genital blood flow and impair potency.
Check your meds. ED is an unfortunate side effect of many drugs. Ask your physician or pharmacist about alternatives.

See your physician. A general medical examination should be done to rule out physical causes as well as any signs of vascular, hormonal or neurological disorder.
Limit alcohol consumption. Alcohol's depressive effects can have a negative impact on sexual functioning.

Shape up. ED is often linked with restricted blood flow to the penis. Keep your heart and arteries in good condition by maintaining a healthy weight, and following a diet high in fruits, vegetables and whole grains. Avoid saturated fats and trans-fats. Regular aerobic exercise can improve blood flow to the genitals and reduce the stress that can contribute to ED.

Deal with anxiety, depression and stress that may undermine desire and potency. Try breath work, meditation or yoga to reduce stress. Be open and honest with your partner about your mutual needs to help ease any tension or misunderstandings.
Don't worry about your age. Discard the myth that sexual activity ends with age.

In addition to the measures above, the following supplements may help:
Arginine, an amino acid used by the body to make nitric oxide, a substance that relaxes blood vessels to help increase blood flow to the penis. Arginine appears to be safe at lower doses however, there is some concern about its increasing stomach acid and potassium levels when taken at higher doses, and recent evidence suggests it may have negative effects in people with existing heart problems. Individuals with a history of stomach problems, cardiac problems or who are on medicines for high blood pressure should use this with caution.
Ginkgo biloba, which may help by increasing blood flow to the genitals. The usual dose is 120 milligrams a day, in divided doses with food.

Ashwaganda, an Ayurvedic herbal remedy reputed to act as a mild aphrodisiac, or Asian ginseng (Panax ginseng), a good stimulant and sexual energizer. For either, follow the dosage on the package, and give it six or eight weeks to have an effect. Both ashwaganda and Asian ginseng are generally safe (but Asian ginseng can raise blood pressure and cause irritability and insomnia in some people).

Andrew Weil, M.D.

Sex Drive Need a Tune-Up?

Q: Sex Drive Need a Tune-Up?
What is female sexual dysfunction? Is it a medical term for low sex drive? If so, what can be done about it?

A: You ask a provocative question. In its January 4, 2003 issue, the British Medical Journal published an article arguing that pharmaceutical companies are trying to create a medical diagnosis called "female sexual dysfunction," a condition that may not exist. And yet, according to some estimates, 43 percent of women suffer from it. One source for that figure was an article in the February 10, 1999 Journal of the American Medical Association, which reported on responses from more than 1,700 women to questions on whether they had experienced sex-related problems such as lack of desire or lack of lubrication that had lasted for at least two months. The authors did note, however, that some of the problems were related to non-medical issues, such as a drop in income, having young children at home, or stress.

A study from the University of Pennsylvania published in October, 2002, found that women who reported declining libido had fluctuating levels of testosterone, the hormone that governs sex drive in both men and women. Those who had the most variability in testosterone levels were two to three times more likely to report decreased libido than those who had the most stable levels. In the past, researchers believed that decreased levels of testosterone, particularly after menopause, were to blame for declining sex drive among women. Apart from fluctuations in testosterone levels, the only other factors affecting female sex drive discovered in this study were depression and the presence of children in the house.

Testosterone replacement can restore a flagging sex drive, but new evidence suggests that it may be a risky strategy. In July 24, 2006, a study published in the Archives of Internal Medicine found that taking estrogen and testosterone together appears to more than double the risk of breast cancer. The findings came from the long-running Nurses Health Study, which includes more than 120,000 women.

Over 24 years of follow-up the researchers found that the risk of breast cancer among women taking the combination of estrogen and testosterone (most often in the form of the prescription drug Estratest) was 2.5 times higher than it was among women who never took hormones. Even after researchers accounted for other breast cancer risk factors, such as family history, age, and weight at menopause, they still noted an increased risk associated with taking the combination. Given these findings, testosterone replacement may not be the best option for women, at least not until we know more about the risks it presents.

Unfortunately, there are no other proven remedies for low sex drive in women. Damiana (Turnera diffusa), a plant native to Mexico with a reputation as a female aphrodisiac, may be worth a try, although it hasn’t been well studied. Look for it in health food stores and follow the dosage recommendations on the label. If vaginal dryness, a menopausal symptom, is the source of the problem, the over-the-counter lubricant Replens vaginal lotion can help. Topical estrogen, available by prescription, can also relieve vaginal dryness.

Andrew Weil, M.D.

What Causes Gallstones?

Although they are often symptom-free, gallstones can lead to abdominal pain, gas, and nausea.

Gallstones are rocklike nuisances that can form inside the gallbladder. The gallbladder is a pouch that collects bile as it flows from the liver to the intestine through the bile ducts. Bile is a fluid that is made, in part, to help with digestion. The salts in bile make it easier for you to digest fat. However, bile also contains some waste products including cholesterol and bilirubin (created when old red blood cells are destroyed). Gallstones form in the gallbladder when cholesterol or bilirubin particles begin to cluster together into a solid lump. The stone grows in size as the bile fluid washes over it, much like a pearl forms inside an oyster.

Most of the time, gallstones do not cause any symptoms or problems. Small gallstones can leave the gallbladder and pass out of the body through the intestines. However, gallstones can cause symptoms if they become caught in the narrow outlet of the gallbladder. After meals, especially meals high in fat, a muscle in the wall of the gallbladder squeezes to help empty bile into the intestines. If this muscle squeezes against a gallstone, or if a gallstone blocks the draining fluid, the gallbladder can ache with a strong, steady pain. More serious problems can develop if a gallstone gets into the drainage-duct system but does not make it all the way through to the intestines. In this case, the stone can cause a buildup of bile as well as infection in the gallbladder or liver or inflammation of the nearby pancreas.

Gallstones are very common. They occur in one out of five women by age 60, and they are half as common in men. Gallstones occur more commonly in older people and in people who are overweight or who lose weight suddenly. They also occur more frequently in women who have been exposed to higher amounts of the hormone estrogen over their lifetime by having multiple pregnancies, by taking birth control pills, or by taking hormone replacement after menopause.

Walking Away from Breast Cancer?

Walking Away from Breast Cancer?I heard that exercise and weight loss can protect against breast cancer. If this is true, how much exercise is necessary? What kind? What about weight loss?
Exercise can protect against breast cancer, but until recently, we thought that it mostly helped lower the risk of the disease among women who did strenuous physical activities when they were young. In September of 2003 the Journal of the American Medical Association published results of a study involving more than 74,000 women followed for nearly five years showing that even those who don't begin exercising until later in life can lower their risk by 20 percent, and that a brisk, half hour walk five days a week will do the trick. The exercise effect was seen among women at all levels of risk, even those with a strong family history of breast cancer, those who hadn't had children (a long-recognized risk factor), and those who had taken hormone replacement therapy.
The same study found that the more you exercise and the slimmer you are, the greater the risk reduction. For example, the researchers found that women of low to normal weight and even those who were slightly overweight were able to cut their risk by more than 30 percent if they devoted 10 hours a week to exercise.
The researchers suggested that exercise influences breast cancer susceptibility by lowering body fat, which in turn reduces levels of circulating sex hormones. Another study, published in the August 20, 2003 issue of the Journal of the National Cancer Institute, found that obese, postmenopausal women were at higher-than-normal risk of breast cancer because their fat cells release too much estrogen. The more the women in the study weighed, the higher their risk of breast cancer and the higher their levels of the hormone estradiol, a potent form of estrogen.
Some breast cancer risks can't be controlled: about 10 percent of all cases are hereditary, and getting older also increases the risk. But these studies show women what they can do to improve the odds.
Andrew Weil, M.D.

Banishing Breast Cancer?

Banishing Breast Cancer?
I was treated for breast cancer five years ago and have been taking Tamoxifen ever since. I'm supposed to stop now. What can I do to prevent a recurrence?

Tamoxifen is an oral drug that blocks the effects of estrogen, the hormone that promotes growth of some breast cancer cells. It can help prevent recurrences of estrogen-receptor-positive breast tumors and is usually prescribed for five years after the primary treatment. Oncologists see no benefit to taking Tamoxifen for more than five years, both because patients are then past the time of highest risk for recurrence and because Tamoxifen can become less effective after an extended period of use, and yet half of breast cancer recurrences occur five or more years after diagnosis.

Results of a clinical trial involving 5,187 women in the United States, Canada and Europe show that another drug, letrozole (trade name FemaraTM), can nearly halve the risk of breast cancer recurrence among postmenopausal women with estrogen-receptor-positive tumors. The results were so dramatic that investigators halted the trial so that they could offer letrozole to women taking a placebo. The study results were announced on October 9, 2003 and published in the November 6, 2003 issue of The New England Journal of Medicine.

Letrozole works by blocking an enzyme (aromatase) that converts hormones from the adrenal gland to estrogen. The effect is to reduce blood levels of estrogen by more than 95 percent. Side effects include hot flashes, night sweats, sore muscles and an increased risk of osteoporosis. A separate sub-study is trying to determine the exact long-term effects of Femara on bone density. There is also concern that this drug might raise cholesterol levels over time.

Cancer experts still don't know how long women should take letrozole and whether doctors should recommend it to all women who have been on Tamoxifen. The current consensus seems to be that women just finishing their five years on Tamoxifen should consider taking letrozole.
You also can try to lower your estrogen levels, and thus your risk of breast cancer recurrence, by losing excess fat if you're overweight, getting regular exercise, reducing or eliminating consumption of alcohol, and eating only hormone-free beef and dairy products (if you eat those foods). Adding soy foods to your diet can also help. Make sure you eat plenty of fresh fruits and vegetables and fish or flaxseed to get omega-3 fatty acids, and consider supplementing with CoQ10, which may be beneficial.

Andrew Weil, M.D.

The medical significance of the water channels

"During the past ten years, water channels have developed into a highly topical research field. The aquaporins have proved to be a large protein family. They exist in bacteria, plants and animals. In the human body alone, at least eleven different variants have been found.

The function of these proteins has now been mapped in bacteria and in plants and animals, with focus on their physiological role. In humans, the water channels play an important role in, among other organs, the kidneys.

The kidney is an ingenious apparatus for removing substances the body wishes to dispose of. In its windings (termed glomeruli), which function as a sieve, water, ions and other small molecules leave the blood as 'primary' urine. Over 24 hours, about 170 litres of primary urine is produced. Most of this is reabsorbed with a series of cunning mechanisms so that finally about one litre of urine a day leaves the body.

From the glomeruli, primary urine is passed on through a winding tube where about 70% of the water is reabsorbed to the blood by the aquaporin AQP1. At the end of the tube, another 10% of water is reabsorbed with a similar aquaporin, AQP2. Apart from this, sodium, potassium and chloride ions are also reabsorbed into the blood. Antidiuretic hormone (vasopressin) stimulates the transport of AQP2 to cell membranes in the tube walls and hence increases the water resorption from the urine. People with a deficiency of this hormone might be affected by the disease diabetes insipidus with a daily urine output of 10-15 litres."
More information:

Dense Breasts Raise Cancer Risk

(HealthDay News) -- Two new studies suggest breast density is nearly as important as age in predicting who is going to develop breast cancer.
The information may help better identify women at high risk for the disease, the researchers noted.
"After age, it's probably the most important factor," said William E. Barlow, lead author of one of the studies and a senior investigator at Group Health Cooperative in Seattle. "If we wanted to identify women who were really at high risk for chemoprevention efforts or more intense screening surveillance, then any model that incorporates breast density is going to be better at picking out those women."
Both studies are in the Sept. 6 issue of the Journal of the National Cancer Institute.
Since the late 1980s, medical professionals have relied on the Gail model to assess breast cancer risk in women undergoing annual mammography. That model uses risk factors known at the time, such as current age, age at first menstrual period, age at birth of first child, number of first-degree relatives with a family history of breast cancer and number of previous breast biopsies. More recently, race and atypical hyperplasia were added to the model.
Experts had speculated that adding newly identified risk factors for breast cancer such as breast density and use of hormone therapy might improve the test's predictive powers.
Barlow and his colleagues looked at 11,638 women who had developed breast cancer, out of a larger group of about 1 million.
Among premenopausal women, age, breast density, family history of breast cancer and a previous breast procedure were significant risk factors for developing breast cancer. Having any type of prior breast procedure was associated with about a 50 percent increased risk. Women with extremely dense breasts had about a fourfold greater risk than women whose breasts were not dense.
For postmenopausal women, factors included age, breast density, race, ethnicity, family history of breast cancer, a prior breast procedure, body-mass index, natural menopause, hormone therapy and a prior false-positive mammogram.
The model may perform better than the Gail model, although the accuracy was far from perfect. This suggests that the major determinants of breast cancer are still unknown.
A second study, conducted at the National Cancer Institute, used an updated version of the Gail model to assess the absolute risk of developing breast cancer. This model also included breast density, along with weight, age at first live birth, number of previous benign biopsies and number of first-degree relatives with breast cancer.
Again, this model predicted that women with high breast density had an increased risk of breast cancer.
It's unclear if breast density can be considered a modifiable risk factor.
"It may be modifiable, but we don't know that for sure," Barlow said. "It is related to hormone use in women. Their breasts can be denser during the time they're on hormone replacement therapy."
It's also not clear exactly how this new information will be incorporated into practice. Breast density generally needs to be measured by a radiologist. "It's not something that a woman can judge for herself," Barlow explained. "There really isn't a feedback mechanism from the radiologist back to the woman to say what the breast density is."
In the future, however, Barlow envisions mammography facilities becoming more like risk-counseling facilities that incorporate breast density along with other risk factors and past mammogram results. "But that would require an evolution of mammography centers," he noted.
Even in the more immediate present, the findings reinforce the notion of taking steps to prevent breast cancer in high-risk and other women.
"We as a medical community still have not accepted the paradigm that we can identify women who are at a high risk for developing breast cancer," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "We could intervene with a treatment to reduce their risk."
"We don't use the tools we already have to identify women at a high risk for breast cancer and offer them potential treatment to reduce their risk like we do for cholesterol and heart disease," he continued. "Now, we're further defining the model that will predict even better who could potentially benefit from these tools."

More information
For more on breast cancer, visit the American Cancer Society.

Balancing Your Hormones Without Drugs... You Can Feel Good Again

Balancing Your Hormones Without Drugs... You Can Feel Good Again $19.95 [ learn more ] Hormone imbalance can be reversed! Look and feel better than ever, just take the time to learn about yourself and read the information contained in this just released e-book about reversing hormone imbalance. Are you ready to finally look and feel great? If so... read on... - E-Book Version.(BH)

Does Drinking Milk Lead to Breast Cancer?

Does Drinking Milk Lead to Breast Cancer?
Provided by: DrWeil.com

Q: Is there any correlation between milk-drinking and breast cancer? I've been reading vegetarian Web sites online that say there could be a link. -- Allison P.

A: Evidence connecting milk consumption to breast cancer is contradictory, but results of a recent study from Denmark suggest that it may play a role in the increasing incidence of the disease during the past 50 years.

In a study involving more than 117,000 women, researchers from the Statens Serum Institut found that height is a risk factor for breast cancer, particularly when it stems from a growth spurt between the ages of eight and 14. In Japan, an increase in women's average heights over the last 50 years may be related to milk consumption.

During that time breast cancer incidence doubled from 40 to 80 cases per 100,000 women. The findings were published in the October 14, 2004, issue of the New England Journal of Medicine. Commenting on the results in the same issue, two experts from Harvard Medical School noted that milk consumption increases circulating levels of insulin-like growth factor 1, a growth hormone associated with higher stature.

It isn't known yet exactly how this might contribute to childhood growth and breast cancer risk. But if milk drinking is to blame for the increased incidence of breast cancer, the amount consumed during childhood could be the key, not the amount adult women are drinking today.
To confuse matters, an earlier study had suggested that the vitamin D and calcium women get by consuming low-fat dairy products, including skim or low-fat milk lower the risk of breast cancer before menopause but not afterward.

These findings came from data drawn from the famed Nurses Health Study, which began in 1976 and includes more than 120,000 nurses in 11 states. In 2002 Harvard researchers published an analysis of information from more than 88,600 of the women showing that consumption of dairy products - either before or after menopause - had no effect one way or the other on the breast cancer risk among postmenopausal women. The study was published in the September 4, 2002, issue of the Journal of the National Cancer Institute.

Another study, from Norway, published in 2001 also suggested that milk consumption was protective. Data from more than 48,000 premenopausal women researchers showed that childhood milk consumption (regardless of the type of milk and its fat content) was associated with a lower breast cancer risk among women aged 34 to 39 but not among women in their forties. Adult milk consumption also seemed to lower the risk. Among women who drank more than three glasses of milk per day, risk was lowered by about half. The study was published in the Sept. 15, 2001 issue of the International Journal of Cancer.

I recommend against using cow's milk and products made from milk if you have a personal or family history of eczema, asthma, bronchitis, sinusitis, or autoimmunity. If you do drink milk, I urge you to buy only organic brands without the residues of antibiotics and hormones found in conventional brands. In my opinion, those hormone residues may be the factor responsible for increased risks of cancer, especially hormonally driven cancers.
Andrew Weil, MD