See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog WHAT YOU WILL LEARN: How to SCULPT YOUR MUSCLES AND TIGHTEN YOUR SKIN after weight loss! How to decrease VISCERAL FAT A new way to IMPROVE MUSCLE MASS by 30% for strength and beauty in 4 weeks DECREASE SUBCUTANEOUS FAT by 25% in 4 weekly treatments INCREASE MUSCLE DEFINITION with Emsculpt Neo A way to REHABILITATE AFTER SURGERY PRE-TREAT BEFORE SURGERY: Improve your post op joint surgery condition by increasing muscle around the joint HOW TO RECOVER Quickly AFTER CHILDBIRTH A Way to IMPROVE CORE AND PELVIC FLOOR STRENGTH How EM-Sculpt-Neo works Most of you know me as the expert in Bioidentical Hormone Pellet Replacement, but I am also expert in Skin and body care.  If my patients have problems that your PCP has not been able to solve.  I will refer you for new therapies, cutting edge treatments that work to treat your problem. The most common problem that my patients complain of is loss of muscle mass and changes in body fat that make them look old.  I found a treatment that is not a laser, but the Emsculpt Neo uses safe and effective magnetic energy plus RF treatment to reduce fat and build muscle in a 30-minute painless treatment. Today I am going to talk about a painless treatment that we offer at my medical spa, BioBalance® Skin that has just been approved by the FDA for rehab after joint surgery.  The magnetic energy (HIFEM) combined with RF energy increases muscle size and strength by 30%, dissolve fat by 25%, as well as tightens skin with the same treatment! EM Sculpt Neo is a 30-minute treatment that uses magnetic energy to make your muscles contract and is equal to thousands of crunches for 30 minutes. The RF portion breaks down subcutaneous fat in the same area.  There is no work on your part, you just lie there, and your muscles respond to the magnetic pull by increasing in size and strength.  Four sessions one week apart is the ideal number of treatments, and they come a in a package of four treatments to one area. The areas that most of us want to build muscle and lose fat in are our abs, upper arms, thighs, calves, love handles, and hips. If you need to do more than one area at a treatment you can do up to three areas, each for 30 minutes. If you have had joint surgery and need to increase your strength around that joint, EMSculpt Neo is very effective, after your doctor releases you to exercise. One of the big concerns with the new weight loss medications is that people often lose muscle as they lose weight.  This is especially common after age 40, in those people who are not on testosterone pellets. EMSculpt Neo adds a tool that can preserve or even increase muscle mass and decrease fat where you want to lose it. EMSculpt Neo for fat loss and muscle building (not for rehabilitation) should be saved for those weight loss patients who lose enough weight to achieve a BMI under 30. For the best results, we suggest a high protein low carb diet, protein, low carb diet, to give your body the building blocks for muscle tissue. We also will suggest supplements for nutrition and to abstain from alcohol to get the best results. Healthy fat loss takes combination of EMSCULPT NEO, Weight Loss Medication, activity, Low carb high protein diet.  We advise our patients over BMI of 30 to get started on weight loss first and continue diet medications while you are receiving EM-Sculpt Neo treatments. How do you lose weight without losing muscle? The Best Combination for the best results while you are losing weight on medication: EMSCULPT NEO to the areas you want to remove fat from Semaglutide or Tirzepatide medication to treat obesity for weight loss Testosterone Pellets if you are a woman over 40, and man over 50. Regular exercise like walking High protein diet Supplements to improve your ability to make muscle Who should do this EMSCULPT treatment? People who are working out but cannot do sit ups because of back injury Those folks who want fast muscle mass increase in specific areas Anyone who is on a weight loss program who is losing muscle and fat, or who has saggy skin in areas where they lost weight Patients anticipating a joint surgery Patients healing from joint surgery after PT Patients who cannot lift weights because of injury Those people who lift weights but cannot develop definition People with a Beer Belly with a lot of visceral fat Some people may not be able to enjoy this sculpting, muscle building method: We will do a free consultation before you sign up for a package of EMSculpt Neo and some patients will not get optimal results if they have any of the factors below: BMI greater than 30 Metal implants anywhere that are not titanium. Titanium is not magnetic, so it is ok to have a treatment if you have a titanium joint implant. No Rods or pins. Any pacemaker implant, pain pump under your skin, nerve stimulator or you are in the first 6 weeks post-surgery for any muscle area in the area. If you have a large abdominal hernia that was not repaired, then abdominal treatment is not advisable. You can still have other areas treated. If you have unrepaired joint damage, you can still have this treatment but let us know so we can slowly work the energy up around that joint. Those people who have a pannus, an apron of skin that hangs down below the vulva, or penis will not get enough relief from this procedure. These patients will need an abdominoplasty. This surgery is done by a plastic surgeon who removes excess skin and fat and repairs the muscles and fascia. You should not waste your money if you continue to drink alcohol while undergoing this treatment. Alcohol is a toxin and will prevent the growth of muscle and loss of body fat. Don’t waste your money if you are not going to follow a low carb high protein diet during and after our treatment.  How does EMSCULPT Work? EMSCULPT combines HIFEM (High Intensity Focused Electromagnetic technology) and RF (Radio Frequency). HIFEM uses magnetic energy to contract muscles in a particular area at intensities that are not achievable with routine weightlifting. Fat tissue in the treated area is also reduced by increasing metabolic activity.  This results in Body Contouring. HIFEM is approved by the FDA for Body contouring, muscle stimulation, growth and to rehabilitate patients with injuries or after surgery. The second treatment that occurs at the same time as HIFEM is RF, Radio Frequency treatment. RF is a low frequency electromagnetic wave that heats up fat in 4 minutes to stimulate collagen and elastin to tighten skin. All this happens in 30 minutes with minimal discomfort.  4 treatments, one a month, is all that is needed to increase muscle 25% and to decrease fat by 30%, and to visibly improve skin tone. Answers to questions about this procedure: What should my diet consist of to optimize my treatment? To gain muscle you must eat your weight in pounds equivalent to grams of protein every day. E.g. If you weigh 200 lbs. and you want to gain muscle, you should eat 200 grams of protein a day. What foods should I eat to optimize my treatment? The best most concentrated protein is found in animal products-eggs, milk products, fish, chicken and red meat. What supplements will help support my treatment? You may want to supplement your diet with our BioBalance Magnesium combination twice a day, Probiotics, Creatine or Arginine and Ornithine combination. You should also take a methyl B12 and Methyl Folate while you are sculpting your body. Why can’t I eat a lot of carbs and drink alcohol during or after the treatment? If you eat a high carb diet, your fat loss portion of Em-Sculpt will be limited, because whatever carb you eat over-stimulates insulin, which increases insulin resistance, and increases fat deposition. Whatever is eaten goes directly to fat again and replaces what you just lost. When can I start EMSculpt after joint surgery? After PT is completed or your surgeon releases you for exercise. Can I lift weights while I am being treated? Yes, but we advise not to lift weights the day before, the day of or the day after your EMSCULPT treatment. What does hydration have to be optimal for the treatment to work effectively? The human body is almost all water, and hydration is needed for muscle contraction. Muscles don’t contract optimally when you are dehydrated. We put you on a body composition machine to both document your muscle mass and fat mass, as well as tell if you are hydrated adequately. Now that you know how EMSculpt Neo can change your body composition and build muscle, I hope you are comfortable enough to let us help you get the body you have always wanted. BioBalance Skin phone for an appointment:

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you ever doubted your doctor because she wrote a script that you later “Googled” and found was not FDA approved, I hope you trusted your doctor enough to realize that she wouldn’t recommend any medication that would hurt you…. What is an unapproved use of a drug, also called “off-label”? Unapproved use of an approved drug is often called “off-label” use. This term can mean that the drug is: Used for a disease or medical condition that it is not approved to treat, such as when a chemotherapy is approved to treat one type of cancer, but healthcare providers use it to treat a different type of cancer. The drugs that are not approved by the FDA, yet are commonly used, have been used for decades before the 1964 law that required new drugs to go through extensive and very expensive testing before their release to the public. The operative word is NEW DRUGS AFTER 1964. Today I will talk about the safety of non-FDA approved drugs because they are: Older cheaper drugs used for many diseases and conditions before 1964 and are still used Drugs that are approved for one use, or one condition, but not for other conditions that it is effective and safe for. Drugs made by compounding pharmacies for diseases that the FDA has not approved a drug for, but there is research backing the drug and years of safe use. First, before we discuss the non-FDA approved drugs, I will discuss the safety/risks of FDA approved drugs, and why FDA approval doesn’t mean a drug will do no harm or even that it is effective for the use it is approved for. A little background will help you understand the problem and the reason an FDA approval does not necessarily mean a drug is safe.  Since 1964, a law was passed that established testing prior to a drug being approved by the FDA became mandatory.   Since that time several drugs that survive FDA approval and are released but are later removed or banned after their FDA release when the public finds side effects that the FDA didn’t discover in their trials. One such drug is Fen-Phen, Fenfluramine/Phentermine. This drug was released during my time practicing medicine and was withdrawn after one study claimed it caused heart valve disease…In the end the “one post approval study” that claimed that heart valves were affected by this drug that caused its bann was found to be false. The withdrawal of the drug followed one study by a single cardiologist from Kansas City had reviewed all of the cardiac valve echo tests and falsified the results to make Fen-Phen appear dangerous to heart valves, when in reality it wasn’t.  She lost her license, but the FDA never put Fen-Phen back on the market!  The FDA hates to be wrong twice, so they never allowed this drug back on the market after its removal. Other mistakes made by the FDA include not allowing women in the studies to approve a drug before 2014 which ignores or misses all of the side effects or lack of effectiveness for a drug when taken by women.  Despite all the expensive testing before the release of a drug by the FDA, many drugs not tested on women were later often found to have severe side effects only on women. A few examples follow: You might have heard of the FDA approved drug Ambien that causes many women to experience “night eating”, sleepwalking, and night terrors, while their male counterparts were not affected, so because they only tested men the drug was approved. In retrospect it should have been tested on women as well, and then either not passed through the FDA or should have had a black box warning for women. It takes years get action from the FDA, notifying doctors of these side effects. Women were not included in testing for any drugs except female hormones until 11 years ago, but no other drugs.   Before 2014 all (non-hormonal) drugs that passed the FDA were not tested on women so the effect on women was unknown until it was tested on the public. The FDA left women out of drug-trials because it viewed women as “mini men”, or they didn’t consider us important enough to test new drugs on…OR worse, they believed we were too complicated to easily test us because of pregnancy, menopause and other hormonal swings that normal healthy women have.  In any case, we are now suffering their decisions, when a medication works one way for men and another way for women! Finally, we are tested when drugs are being evaluated for approval by the FDA. Professional women have achieved a level of authority in medicine and pharmacology (2025) and are weighing in on the inequity. Women in the medical profession and the public are pulling back the curtain on the side effects of FDA approved drugs that are experienced by women only! Slowly, study by study investigators are now publishing the side effects and problems for women with FDA approved drugs….yet these findings are not included in the warnings on most of these drugs, even now over 15 year after they became obvious to the doctors who treat women! Drugs that either don’t work for women, or that have severe side effects include that were approved before 2014. All statin drugs for high cholesterol (Crestor, rosuvastatin, atorvastatin, etc.) cause women to have muscle breakdown and muscle pain. Synthroid (levothyroxine), doesn’t cure the symptoms of hypothyroidism in 80% of women, but just makes the TSH lower, so it appears as if it is working! This leads doctors to tell women that their symptoms are all in their heads!! Wrong.  It is the wrong medicine. Women have enzymes that differ from men that make it difficult for them to convert the inactive form (T4) into the active form (T3), so we can’t convert Synthroid (all T4) into the active form. Synthroid, the FDA approved drug for hypothyroidism, shouldn’t be given to most women. Women should be given the non-FDA approved drug Armour Thyroid or NP thyroid that have both T3 and T4 in them! Ambien Prednisone and other oral steroids We have reviewed the lack of testing on women before 2014, now we will discuss safe drugs that have been used for decades even before 1964 when the FDA required testing for FDA approval? Older, yet effective and inexpensive drugs have been tested by the public, some for almost 100 years that have saved thousands of lives, yet they are not given the FDA stamp of approval!  In fact, the FDA tries to put these drugs out of circulation, replacing them with very expensive drugs that are new! Or they just shut them down, because they are not FDA approved.  Young doctors are told not to use them by their medical schoolteachers who rarely have experienced these medications in private practice…. These doctors in training don’t know the history of older safer, cheaper drugs, or even why the FDA tells them avoid them. They comply not knowing why, so you are left with no drug that works for you, or you pay 3-10 times the amount for a newer FDA version of the older drug which may even have more side effects. Some of these older very effective and cheap drugs are Penicillin, Nitroglycerine for chest pain, Morphine (pain), Phenobarbital (seizures), Codeine, Armour Thyroid, hormone injections including estradiol injections and testosterone, Thorazine for psychiatric use, (Pitocin) oxytocin for labor, lactation support and Autism Colchicine:Used to treat and prevent gout. Progesterone in oil (IM) Estradiol in oil (IM) B12 for injection Testosterone Cypionate for injection Compounded Estradiol in any form Compounded Testosterone for women These drugs have been used for so long that any safety risks or side effects have been found through the use of these drugs in the population. Yet the FDA won’t grandfather them in and approve them based on their history! What do doctors do when the drug the FDA has approved a drug that doesn’t work for a group of their patients (gender, race, blood type, etc.)?  What happens when a doctor can’t find a drug that is FDA approved needed to treat a condition she is faced with? Why do we as citizens, allow the government to have power over doctors who are already controlled by their state licensing boards as to what medications they?  Lastly Why do taxpayers allow a government agency that they fund with tax dollars control their health by banning, or not approving drugs, or banning one drug so an outrageously expensive drug is put in its place? Compounded Medications/ Compounding Pharmacies: These drugs are made by mixing ingredients to meet individual patient needs and are not subject to premarket review for safety, effectiveness, or quality. However, they ARE subject to the success or failure for which they were prescribed. If a doctor prescribes a compounded drug that doesn’t work, she is apt to be confronted by her patient who is not getting the expected results.  Compounding pharmacies usually don’t get paid by insurance, so patients are more invested in getting a drug that works and that is one of the big reasons that Compounded medicines are at least as good or better than big pharma or generic drugs. I absolutely could not successfully treat the thousands of women and men that I have without compounding pharmacies.  They compound hormones/drugs that are safe and effective, mostly hormones that can’t be patented because they occur in nature and won’t ever be made by big pharma. More than that, big producers of drugs can’t produce in mass quantities many doses of a certain hormone like compounding pharmacies do.  Compounding pharmacies provide what people need and they continue to do so because patients prefer their dosing and quality.  FDA approved Generic Drugs can be legally 25 % lower dose than what they say they are.  That would be a big problem if my compounded pellets had that kind of variability. People might need pellets every 2months or every 5 months instead of every 4 months..it would be like guessing what you need ahead of time…..I believe dedicated compounding pharmacists are more accurate than any generic on the market. Compounding pharmacies: Unsung Heros Compounding pharmacies serve the public when big pharma fails and hasn’t developed a safety net for production if they have a problem and the FDA shuts them down. That situation leaves patients who take their medications, without an alternative. Compounding pharmacies step into the breech when big pharma has a problem with a particular drug and stop making a drug (e.g. Lidocaine, B12 injectable, IV Fluids, to name a few shortages and no production that have occurred in the recent past). What if patients couldn’t get the meds they need, and if there were no compounding pharmacies—Chaos and suffering and dying patients would closely follow! The FDA is Fickle and is not on your side! For years the FDA did not approve of Bioidentical estrogen and testosterone in any form, and just a few months ago all of a sudden, long after they scared women from taking the hormones they needed to improve their length of life and quality of life, they decided bioidentical hormones are better than the FDA approved hormones!!!  That is a little too late.  Some of us will never forget the stress lack of approval of compounded hormones caused for doctors and patients alike.  Other doctors criticized us and now most of them aren’t even in practice anymore.  Maybe the FDA read my blog!!! Compounded hormones have been approved by the masses of women who have taken them under my signature! Compounded BI hormones are medications with a long track record and should not have to be tested with the bloated expense required of testing for the FDA. For Gynecological Disorders that don’t have an FDA approved hormone drug because testosterone and estradiol have been used for so long that they don’t need testing. If there was a significant problem with them their history of use of over 5-7 decades has proven the efficacy and safety of the female hormones for treatment and hormone replacement. For Psychiatric Disorders: Some patients need compounded ketamine products for conditions like severe depression, despite lacking FDA approval for these uses and potential risks, yet it has been used for this purpose for decades and was used for childbirth for almost a century, until epidurals and saddle blocks took their place. Testosterone for women still is not recognized as a female hormone even though women produce over twice as much Testosterone as Estradiol when they are in their fertile years.   Replacement of T with bioidentical T pellets offers a treatment for dozens of symptoms women face after age 40, and it prevents the diseases of aging: osteoporosis, heart disease, sarcopenia, frailty, diabetes and more that have not been addressed by mainstream medicine and the FDA. Over a decade ago, the FDA turned down the approval of testosterone patch after over 3 years of positive research studies, the FDA said they didn’t approve T for women is because the side effect of T for women, facial hair, was dangerous for women.…I cry B—–S—-!  That is really men not wanting to share testosterone replacement with women. I say leave us alone and let women and their doctors determine what they need.  It is proven that only 5% of all professionals in any profession are not trustworthy, so give doctors their due and trust that we are looking for answers to our patients’ problems that you don’t even know about! The FDA is paid for by us…everyone in this country. I say hands off! Speed up the approval process or forget it for older drugs and BI hormones! ~

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog You will learn: What holds up new treatments for diseases and conditions How long the FDA sits on a known safe medical medication before it is released to the public. Why safe and effective drugs are NOT approved by the FDA Why doctors are forced to use medications off label How you can help During my 44 years of medical practice, I have encountered conditions for which there is no approved medication or surgical treatment available as recognized by the American College of OBGYN or the FDA. This situation can present challenges both for physicians managing these patients and for individuals seeking relief from their symptoms. This issue is not often addressed on Dr Oz, in the news, or at medical conferences. For many conditions, physicians wait for the development of approved medications or treatments, and in the meantime may inform patients that there is currently no treatment or cure available. Some doctors may attribute a patient’s concerns to aging, stating that it is a universal experience. While this may be accurate, such explanations may not provide comfort to patients seeking solutions to their symptoms. This lack of helpful guidance can discourage individuals from seeking medical care when they feel their concerns are not acknowledged. This seems to result from insurance companies prioritizing cost savings by minimizing patient care.  Every year insurance companies decrease what they pay doctors for their services, while their expenses go up, and the Government requires more and more work behind the scenes like HIPPA, OSHA, and Clia requirements that costs more to deliver the same service.  If you have a problem with the time your doctor spends with you then blame the insurance companies whose profits rise every year…Soon doctors will do what I do and only take cash.  The practice of medicine is not working in a free market. While insurance limits the prescriptions of medication to those meds that are FDA Approved, the FDA and medical specialty colleges often delay approval of new, low-risk treatments for up to 20 years after their effectiveness is demonstrated. This lengthy process should be reconsidered to treat people who are ill and suffering, now. There is plenty of research in the medical journals that explain the safety of new and effective treatments that can save peoples’ lives that are not FDA approved yet. The FDA is not interested in expediting the release of medication/ devices quickly to those people who need help now. They drag out the testing of a medicine that has been effective for years and may or may not approve it. On the flip side they have approved many drugs that later are found to have severe side effects, and they just change the warnings on the medication inserts. They don’t take them off the market except in severe cases. Drugs that have worked treating patients successfully are being used but are not FDA approved. These “grandfathered drugs” don’t need to go through the testing that new drugs go through because they work with few well-known risks. I use many if these medications because they are inexpensive for my patients and are often more effective than new meds for the same problem. One of the drugs that the FDA has not had to approve is Armour Thyroid, a natural thyroid replacement. My experience with treatments not approved by the FDA Armour Thyroid: Armour Thyroid (AT) has been prescribed by doctors to replace thyroid hormones for about 100 years. It is natural, made from Pig thyroid. It only comes from “medical Pigs” that are raised for medical purposes.  We use medical pigs for skin grafts, and other parts of the pig to treat human diseases like heart valve replacements.  Armour Thyroid is composed of the four thyroid hormones that humans make: T4, T3, T2, T1. The synthetic thyroid replacement, Synthroid/levothyroxine is only T4.  The active form of thyroid is T3, and it requires an enzyme to convert T4 into T3. If a person can’t convert T4 into active T3 then nothing improves except the blood levels of T4, and TSH. The majority of women cannot convert T4 into T3. Therefore, if they take Synthroid or levothyroxine and their doctor only checks their TSH level and not the level of free T3 and free T4 to see if the Thyroid is working, then women are told that they are healed, yet they know they are not because none of their low thyroid symptoms are resolved. When this happens, doctors tell female patients that it is all in their heads and dismiss us when we tell them we are not cured with this synthetic T4 medication. Yet Synthroid is a chemical, and AT is natural from medical pigs, so the FDA is trying to Bann the only drug that has successfully treated millions of women. PS. Synthroid was not tested on women like many other drugs that were passed through the FDA before 2014! If you think this is a small problem, think again. Thyroid hormones are vital to human life, and the thyroid gland requires Iodine in the diet. The Midwest US has no Iodine in the soil or water. Therefore, this area is overburdened with hypothyroidism. I have been on AT for 50 years without complication and I have prescribed it thousands of times ever since I went into private practice.  AT works to relieve the symptoms of hypothyroidism for women and men, and it works better for women that the “new” drug Synthroid/levothyroxine, which is FDA approved. You ask how could the FDA approve a drug that doesn’t successfully treat women? It is because Synthroid was not tested on women!  Until 2014 the FDA did not test women in the required drug trials.  AT works for us (women), Levothyroxine does not. Now the FDA wants to ban AT. It is not approved because it was around for decades before they started testing medications like they do now, and the history of successful treatment should stand on its own merit! Example 2: Bio-Identical Hormones BIH:  BIHs had not been approved by the FDA until recently and there was no announcement that they are now approved for women who have hormone deficiency symptoms or postmenopausal symptoms. Most doctors and women who have been afraid of the only hormones that can help them, bioidentical hormones, haven’t yet been told that NOW, FINALLY the medical colleges and the FDA finally have quietly approved BI hormones.  There are no pure estradiol and pure testosterone pellets that are made by a drug company for women. My patients get their estradiol and testosterone pellets from a compounding pharmacy.  I have been prescribing BIH since 1985 without FDA approval because the oral estrogen formulations that were available at pharmacies caused weight gain and put women at high risk for blood clots. Non-oral BI hormones have fewer risks than FDA approved estrogens.  I waited more than 45 years for the FDA to approve BI hormones for treatment of women.  All those women in the last 45 years who were taking FDA approved estradiol and those who couldn’t tolerate them have been harmed by FDA goals of never approving compounded or bio-identical hormones.  The delay has harmed 50% of American women. Example #3 Devices for Weight Loss I was involved in the discovery and testing of a unique device that stimulated acupuncture points with a TENS-unit-type patch connected to your cell phone for easy adjustment of your hunger or “fullness”. The FDA requires testing to approve any new device so the group of investors I was part of had to invest thousands of dollars for a device we already knew worked. The FDA told the investigators of all new devices who they should test, who they can’t have in the study, and how long the testing should take. I found their parameters for the study of this device to be unrealistic. The women in our test group could not be taking hormones of any kind (birth control, ERT, HRT), and could not be on antidepressants, could not have diabetes or insulin resistance or be on any drug that assisted in weight loss. These women subjects had to be a certain BMI (level of obesity) and had to be tested repeatedly with weight and body composition measurements None of my patients who needed weight loss could participate.  Most GYN patients are on some medication or supplement, so the FDA made this study of our device so narrow that REAL WOMEN weren’t tested! Sadly, we lost many women in the control group from the study because they were NOT losing weight while the ones on the device were obviously dropping pounds, so we had trouble maintaining test subjects. The testing phase of this simple device took 7 years! Our device works and no one will ever know about it or be able to use this non-medicinal weight loss device because when the FDA rejects your device you will be breaking the law if you produce and sell it directly to the public. It has no side effects or dangers..it just controls the amount you eat with stimulation of an acupuncture point. There are many ways to change this situation, and it takes years and billions of dollars to change the whole system of bringing treatments to patients quickly.  I’m afraid I won’t see a revolution of the way we bring medicines and devices to market during my lifetime. Currently there is a 17-year delay between proving a drug or device works for a particular illness or condition and when it becomes available to doctors and patients. So what do we do in the meantime?  I seek treatments for patients who are unresponsive to traditional medicine by reading journals like Life Extension, that inform doctors and patients alike about new effective solutions for common medical complaints and diseases that the FDA has ignored or stymied with endless drug trials.  Life Extension Magazine highlights studies on new medications for diseases without an FDA approved solution and publicizes diagnostic tests often overlooked by mainstream publications because they are not yet FDA approved. The medical journals I read (New England Journal of Medicine, JAMA, Menopause, Metabolism and Endocrinology, Journal of Age management, to name a few) offer treatments for orphan diseases or even common problems that haven’t been blessed by the FDA. It takes an average of 17 years from the culmination of research on a new drug, test or device until it is approved for use by the public! At the end of this Blog, I will give you a link to make your voice heard by signing a petition to shorten the approval of new treatments and medications from the average of 17 years to 3 years! My patients don’t have time to wait for relief, and that may be the case for you as well. If you want to do something to help, please click this link and let the FDA know how you feel. Please sign a Petition to enact an amendment to the FOOD, DRUG and COSMETIC ACT, by going to: https://age-reversal.net/fda/

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog When I go to Fitness Edge, the place I have worked out with weights twice a week for 38 years, I know I am increasing my muscle mass and my metabolism for the next 72 hours…that’s right, after just an hour of lifting weights, my body burns more calories over the next 3 days.  Lifting weights not only increases muscle mass, strength and is the key element in weight loss, because it raises resting metabolism throughout the day, even while you are sleeping. As long as I have been a physician, we always knew that exercise was important to health, but not until recently did medicine did not know WHY exercise is so important, and WHAT type of exercise is the most important to healthy aging. Recently the research has exploded with research that supports the metabolic truth that muscle mass, and resistance exercise (weight training, training with bands, calisthenics) is necessary for health and longevity! Even though this is a complicated science that is primarily addressed to professional athletes, there are several discoveries that everyone can understand and employ in their quest for a long and healthy life. Muscle Mass, Percent Body fat and Exercising Your total weight doesn’t matter as much as your total muscle mass and percent body fat.  So, the amount of muscle you have compared to the amount of fat is the key to metabolic health. Muscle burns calories and decreases blood sugar, while fat is metabolically inactive.  However, the amount of muscle you have isn’t as important as how often you use your muscles against gravity.  That is what weight training is: lifting weights against gravity, using barbells, free weights, resistance bands or Nautilus-type machines. Muscle Is the Major Site of Glucose uptake The more muscle you have, and the more you exercise them the more blood sugar is metabolized into energy. Your muscles soak up glucose from the blood for 120 minutes after weight training, and insulin sensitivity increases for 16 hours after exercise. Metabolic stimulation continues for 72 hours. Those people with less muscle who don’t exercise use extra glucose to make fat. Body Composition is Improved with Weight Training Body composition can be measured with our InBody Machine.  We follow each of our patient’s body composition instead of just getting a weight. We find that when measuring our patient’s progress, the percent body fat inversely relates to their Basal Metabolic Rate.  In other words, the lower the body fat percentage, the higher the metabolic rate. The higher the body fat %, the lower the number of calories that patient burns at rest. For example, a woman with 40% body fat, depending on her height, burns about 1,100 calories over 24 hours when at rest.  If the same woman achieves the ideal percent body fat with medical dieting and achieves less than 26% body fat, she will increase her BMI to over 1,400 calories/ day at rest. Weight training alone will increase muscle mass and decrease fat with the outcome of increasing basal metabolic rate, so she will burn her calories instead of storing them as fat. In short, weight training to increase muscle mass will decrease body fat and improve metabolic health. Weight Training Can Reverse the Loss of Muscle that Comes with Aging The above statement is a tricky statement.  Women can exercise with weights their whole life and maintain a healthy body composition until they turn 45, then weight training just can’t do the job without adding testosterone pellets.  It is the magic of testosterone pellets—Testosterone PLUS Weight Training increases and sustains muscle mass. “I have worked out with weights since my residency when I was 28 yo.  I realized that because I was 5-3 and 118 lbs, I would not be strong enough to do my job, delivering babies, operating and lifting patients on and off the table.  I began with a Nautilus circuit followed by 10 minutes on the treadmill 2-3 times a week. After I delivered my daughter, Rachel, I was 31 and I started training with a trainer because to get y body and strength back, I needed someone to make me accountable and to guide me to gaining strength where I needed it.  I have lifted weights 2-3 times a week ever since at my training facility, Fitness Edge, across the street from my current medical office. As of last week my body fat is 19%, and my weight is now 113.  I have shrunk a bit and am now 5-2. When I go to the Fitness Edge with my husband, John, I notice that many of the hardest working “fellow exercisers” never change their body composition. I would love to tell my fellow lifters that working out with weights is only part of the program to becoming strong and building good muscle mass.   The fact is they need to increase their testosterone level if they are over 40 for females and 50 for males, to improve their muscle mass and decrease body fat, and their hard work will be repaid with visible, stronger muscles, Fat loss and improved and metabolism.” Dr. Maupin’s Formula for Building Muscle after age 40: Weight Training 2-3 times a week Testosterone Pellet treatment in women over 40 and men over 50 Diet must include the number of grams of protein equal to your weight Low carb high protein/healthy fat diet Eliminate food with preservatives, canned food and processed food. Eat whole/fresh foods. Supplement with Creatine (if your kidneys are healthy), Arginine, Vitamin D, E, K and Vitamin C, multi vitamin with Methyl B12 and Methyl Folate, Probiotics, Magnesium 400-800 mg/day, Protein powder without Soy. Water consumption in oz = to ½-1x your weight in pounds If I have convinced you to start using weights regularly, here are the variety of types of resistance training that will build muscle and improve metabolism. Must exercise for 50 minutes at one time per day. Resistance Band Work Outs- you can do anywhere even at home. Body weight exercises like squats, push-ups, lunges, planks Free weights using dumbbells, kettle balls, bars Weight Machines that target one muscle group at a time.   Now I Can Almost Hear Half of You Asking What About Aerobic Exercise? My best friend is a runner, and she has run marathons for decades, and now in her 60s, she is still fit and healthy without joint damage.  Most of her fellow runners don’t know that she also lifts weights to keep her in the running game…and she takes testosterone pellets. Most runners are fit and have strong hearts, but their muscle mass is not always robust. Cardio-exercises can improve cardiovascular health and burn calories during the activity itself. Strength Training builds muscle mass which has a long-term effect on the metabolism.If nothing else, I hope you are inspired to initiate a resistance training program to benefit your metabolism now and for your longevity in the future.  YOU CAN DO IT!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog All testosterone pellet medical practices are not equal.  Most use pellets that are inferior to ours, inexpensive but have more side effects, and are not as effective as the testosterone and estradiol pellets that I use in my medical practice, BioBalance® Health. Most practices do not understand the many interactions between other hormones and sex hormones (testosterone and estradiol) like we do therefore you are not going to feel renewed, with all of your symptoms of testosterone and estradiol deficiency treated. At BioBalance® Health, we provide more than just testosterone pellets. We not only replace missing hormones like testosterone and estradiol, but also address other deficiencies, manage age-related diseases early, and offer nutrition guidance, medical weight loss, genetic nutrition advice, and exercise planning. Our comprehensive approach is unmatched in the US. Our use of non-micronized testosterone pellets and comprehensive care helps patients restore their health, leading many who leave to return when other practices do not meet their needs. These facts were impressed on me when one of my long-term patients who had moved to Florida, returned to me after a few years and related all of her efforts to find a doctor in Florida who would treat her like we did. A month or so ago I saw a familiar name on my appointment list.  When I reviewed her old chart, I saw that she had moved to Florida and had found a new pellet doctor there.  But I had no idea what she had gone through to find a doctor to treat her like she needed to be treated until she sat down in my office for her consultation. I will protect her identity, by calling her Beth, my best friend’s name.  At first, I didn’t recognize Beth sitting in my waiting room.  It appeared that she had aged more years than the two she had been in Florida.  She sat down and regaled me with this story of her experience.  Some background.  Beth had had a hysterectomy and had her ovaries removed before she saw me for the first time in 2007. She had been on some kind of hormones since then and pellets with me since 2007.  When she was my patient the testosterone and estradiol pellets literally cured all of her symptoms.  It wasn’t easy to come to the right dose of pellets and to treat her other problems:  She converts T into Estrone and Estradiol, and she is a fast metabolizer, so she needs a higher dose of testosterone that the average woman. I ushered Beth into my office and asked how she’d been, and she began a long and sad story about trying to find a doctor who would treat her with pellets so that all her symptoms were resolved.  She went to 5 different doctors, who had her BioBalance chart, and all of them said they had to treat her differently because they were not in line with my treatment.  She argued and got nowhere.  #1 Doctor: The first hormone doctor did not agree with giving her testosterone plus anastrazole (Arimidex), a TA Pellet, yet that was what I treated her with to lower her Estrone and Estradiol from testosterone conversion.  She got straight testosterone and her estrogens soared and inactivated her testosterone, so she felt no different on pellets than she did off of them.  She also gained belly fat and breast size and was very emotional. #2 Doctor: This doctor was a Bio T doctor who refused to give her TA pellets and also wouldn’t give her the dose she needed.  Bio T uses MICRONIZED testosterone which are cheap, and cause hair to fall out, acne and oily skin.  That is exactly what he got, and she didn’t go back. #3 Doctor: Not only did this doctor refuse her anastrazole in any form but he made her take progesterone even though she didn’t have a uterus and told him that progesterone made her fatigued. #4 Doctor was clueless and used a formula one size fits all Testosterone dose, which wore off in 2 months. #5 Doctor was essentially not educated in testosterone pellets. Because of these experiences, she now flies in three times a year and gets the pellets dose, Estradiol dose, with anastrazole in the pellets, without useless progesterone (because she had a hysterectomy), with NON-MICRONIZED pellets that last 4 months that are dosed for her unique metabolism. The moral to the story is all pellet treatment is not the same!  So many doctors have jumped on the bandwagon with a few days of training or no training at all so if pellets don’t work for you, PLEASE DON’T GIVE UP ON PELLETS.  Beth didn’t.  You need a doctor who understands the interactions of T and E2 and E1, and who use pellets who are non-micronized and who individually dose your pellets for YOU!  This Healthcast  is not about patting ourselves on the back, but it is aimed at informing patients who have been disappointed with their treatment using  testosterone and estradiol pellets because of inability to relieve their symptoms of menopause or testosterone deficiency, that they should find a practice who uses NON_MICRONIZED PELLETS and who have experience taking care of all interactions of hormones with other medications, who understand the trouble shooting for every unusual symptom that may occur after pellet replacement of hormones.  It is not easy to learn to take care of hormones like Dr. Sullivan our staff, and I do, so finding someone with a lot of years in practice, who is not in a “franchise practice” which is just a business and usually use the cheapest pellets. Don’t give up if at first you don’t feel better.  Just change pellet practices!  BioBalance® knows how to treat all hormone deficiencies, and we have 95% success rate!

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog The summer of 2025, the US has experienced record heat. Most Americans have been under a severe heat warning for months, which has caused me to review the symptoms, prevention and treatment for Heat Stroke.  This summer’s heat was unusual, however it may recur in the future, so we must learn to deal with the effect of prolonged exposure to dangerous heat. Heat stroke is not classically a stroke as you know it, however heat stroke is a condition of a different kind, but no less deadly.  The conditions that can lead to heat stroke are listed below. Please think of these signs of Heat Stroke before you go outside in severe heat. At Risk Conditions for heat Stroke: High ambient temperature High body temperature (body temp of 104 or more) High humidity, Prolonged sun exposure (more than an hour at a time) Dehydration Loss of electrolytes through sweating which can result in heart attacks, seizures delirium and can lead to death. The hot weather we have been experiencing has been prolonged and has  all the qualities described above that may lead to heat stroke: Temperatures above 90 degrees Fahrenheit, High Humidity (over 50%), Bright sunshine, causing body temp to rise rapidly and continue for a long time even after a person has gone inside to cool off in air conditioning. You Should be aware of the beginning signs of heat stroke so you can remove yourself from the heat before it becomes an emergency, and you can protect your family from heat stroke. The early signs/symptoms of heat stroke include: Heavy sweating/ or no sweating at all Thirst Weakness of muscles Headache And Dizziness When you develop these symptoms, please listen to the signs your body is sending you and seek a cool place inside away from heat and sunlight. If the symptoms don’t resolve quickly, then take the steps below to prevent progression of symptoms to result in heat stroke. Lie down (heat stroke can cause you lose consciousness and hurt yourself if you pass out) Drink cool but not cold water continually Drink Electrolytes (preferably products that contain Potassium, and sodium, chloride, magnesium) with every other 12oz of water. If you don’t have electrolytes, Gatorade can be substituted for electrolytes (It is only Potassium). If you are unprepared and away from civilization, put several shakes of salt into a glass of cool water and drink it. Apply icepacks on the areas of the body that can cool you quickly: Underarms, groin, and neck. This will cool your body down faster than just sitting in a cool space. Don’t be alone. Ask someone to sit with you in case you pass out or seize, and they can call 911 to take you to the ER. They can also make sure you continue to drink water and take electrolytes. If you feel your headache or weakness getting worse call 911 yourself. That is a late sign of Heat Stroke. Lastly, Heat stroke can make a person act out, with a temporary personality change. The affected person can hit and push the people trying to help him or her. That means they are in the late stage of heat stroke, and they need IV fluids a cooling blanket and Medical help. Remember, heat stroke can be deadly, and immediate action must be taken. If you or someone else has the following symptoms, then Call 911: passes out or seizes, gets confused and wanders around, acts out and hits or pushes has a rapid heart rate, has a bounding pulse, has either hot dry or very damp skin, complains of a headache or dizziness, nausea, vomiting rapid shallow breathing, like panting Often, they will complain of feeling cold and they shiver even though the temperature is very hot. Don’t Wait!  call 911! In these cases, tell the 911 operator that you suspect heat stroke. So how do you prevent heat stroke? There are many ways to prevent heat stroke, if you recognize the conditions outside will put you at risk. First determine whether you are at high risk (below are the risks). Anyone can get heat stroke but people with the following conditions will develop heat stroke faster and more severely than healthy young individuals. The following conditions should best be treated by staying in a cool area inside away from the sun. Know the Symptoms of heat stroke and follow the directions listed above. Prepare yourself for heatstroke by carrying electrolytes more water than you think you will need, plastic zip locks to put ice in if needed High Risk Medical Conditions and Medications  Previous History of a Heat Stroke The biggest risk for heat stroke is having had it in the past.  People who have a history of heat stroke should be extra careful to avoid going outside or exercising in the heat and humidity.  They should stay inside during the heat of the day or on days that put them at risk. If you have almost had a mild form that you acted promptly and were able to avert the severe symptoms, that still makes you at risk for heat stroke. Heart Disease or other Circulatory medical conditions Diseases of the circulatory system place you at risk for getting a more severe form of heat stroke more quickly, so limit your time in the heat. Sympathetic and Parasympathetic Imbalance, from genetics or medications Disease of the sympathetic and parasympathetic nervous systems that cause excessive fluid loss due to sweating or increased body heat can cause you to develop heat stroke with less time in the heat and sun.  These conditions affect your ability to sweat, which is the way humans cool themselves down. Patients with these diseases don’t sweat to cool yourself down like other people.  Stay inside until the temperature and humidity is safer. Age above 50 We all know that we are not as physically able as we age, even if we use testosterone pellets, so older age is a risk factor. Please limit your time outside in dangerous conditions to one hour at a time with 10 minutes or more inside a cool place before going back outside.  Medications that put you at risk for heat stroke when exposed to heat and humidity You may be unaware of the risk that some medications have when it comes to heat stroke.  Medications are part of our lives and most of the time we don’t think about them causing problems or side effects, but many types of relatively safe medications can cause you to have heat stroke when the other folks around you are completely normal. My Experience with Heat Stroke I was playing golf in August in St. Louis, when the starting temperature at 8:30 am was 88 degrees F, and the humidity was 65%.  Being me, I thought to myself,” Well I’m in good shape because I have minimal body fat and good muscles, I should be able to golf with 3 other women even in this heat.” That day the humidity increased to 80% and the temp was over 90. Then the Pro announced that we had to stay on the cart path.  Well that makes golf a lot harder…,it takes twice as many steps  during a round and it requires even more exertion than walking the course and dragging a bag behind you….but I’m not a quitter (but clearly I was not thinking about being sick and taking my life in my hands)…which means I was stupid! I want all of you to be smarter than I was! Right away I started sweating profusely so much so that I had to change my golf glove three times in 6 holes. I still felt ok, but I couldn’t hit the ball as far as usual, and I continued to sweat.  Despite 7 bottles of water, 2 with electrolytes, I started getting a headache, and then I couldn’t make contact with the golf ball. My balance was off….” Uh-oh,” I thought, “it’s happening”….At that point I knew I had to go inside but was far away from the club house.  I continued one more hole and I was dizzy and had poor balance….so I quit, and I drove the cart back to the club house not finishing the 9 holes. I sat inside, drank water took another packet of electrolytes and put ice packs under my arms and laid down in the women’s locker room until my headache was bearable, but I knew I was not going to be productive the rest of the day. It took 24 hours of lying down in a cool room, drinking quarts of water and taking electrolytes, putting ice around my neck and head, and doing nothing else! I kept thinking “why did the heat and humidity affect me and not the other 3 women?” We are all in good shape for our ages 60-70, and we all exercise and lift weights as well as play golf a few times a week, so I thought about what my risk factors were. Finally, I checked out all the medications and supplements I am on and found that  some of them  put me at risk!  This incident made me look up the all the meds that can impact people and increase their risk of getting heat stroke. Medications That Increase Risk of Heat Stroke Diuretics- Spironolactone is a diuretic given to all women who take T pellets to prevent facial hair and acne. It can cause dehydration in hot weather unless enough water, and electrolytes are taken to replenish body fluids. Other reasons for taking a diuretic is hypertension, heart disease, swelling, and poor circulation.  eg Hydrochlorothiazide (HCTZ) and Maxide are diuretics. Beta Blockers- such as Metoprolol, Propranolol slow down the heartbeat and reduce blood pressure.  The actions of Beta blockers slow the cooling mechanism of the body. Antidepressants- There ae many types of antidepressants but the “Serotonin-reuptake-inhibitors” such as Lexapro, and Wellbutrin can increase the risk of Heat Stroke, but the mechanism is not known. Amphetamines like ADD medicine, Sleep Apnea drugs, and old-fashioned weight loss pills speed up the heart rate, increase baseline body temperature and decrease the body’s ability to cool itself. Thyroid Replacement-Thyroid replacement increases the heat produced by muscle tissue therefore it increases body temperature. This causes a patient on thyroid to have fewer degrees to get to a critical body temperature. I will leave you with the warning that hot weather can kill you and knowing the signs and symptoms of Heat Stroke is the first step toward helping yourself and others avoid the worst consequences. If you have medical conditions or take medications that increase your risk of developing heat stroke you should spend most of your time indoors staying cool when heat and humidity is highest. I will leave you with the warning that hot weather can kill you and knowing the signs and symptoms of Heat Stroke is the first step toward helping yourself and others avoid the worst consequences. If you have medical conditions or take medications that increase your risk of developing heat stroke you should spend most of your time indoors staying cool.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog As the founder and Medical Director of BioBalance® Health, an anti-aging longevity practice for 23 years, I have long sought a blood test that serves as a reliable indicator of aging and disease risk. Identifying those at highest risk allows me to better motivate patients to follow my treatment plan and pursue a longer, healthier life. For people who test negative, I would reassure them they are doing well and encourage them to maintain healthy habits. Over time, I assessed common medical tests that many doctors use to steer patients toward certain treatments that do not reduce pain and may shorten life. I examined the actual risk of death and illness through clinical evaluations and credible, though less publicized, research studies. Here is what I found: Elevated blood lipids are not reliably predictive of vascular plaque. In my experience, both high and low cholesterol patients show similar rates of plaque in Cardiac Calcium Scans. Despite this, primary care physicians often prescribe statins, which may be unnecessary for many. Statins were not initially tested on women, who tend to experience more severe side effects such as cognitive impairment, muscle breakdown, and fatigue, likely because these drugs impact mitochondrial function—the cell’s energy source. BMI has long been used to assess whether someone is at a healthy or risky weight, but it is often inaccurate. It overlooks individuals with low muscle and high fat, while labeling muscular people as overweight. As a result, BMI is being replaced by body composition measurements.   Recently, body composition analysis using InBody has become more common than BMI for evaluating patient health, frailty, and muscle mass. Measurements of visceral fat and body composition are considered indicators of current health status. BMI is a straightforward calculation that only uses height and weight, whereas body composition includes assessments of visceral fat and percent body fat. Only one weight- and height-based test directly relates to health status. High muscle mass indicates health, while excess visceral fat signals risk, and normal body fat percentage reflects current—but not future—health. Since body composition can shift over time, it is a useful measure of present health but does not reliably predict longevity and is just one aspect of overall health. Several blood tests can indicate current health, such as fasting blood sugar, HbA1c, IGF-1, and fasting insulin. For assessing future health risks and existing damage, HS-CRP (high-sensitivity C-reactive protein) is crucial, as it measures inflammation—a major factor in unhealthy aging and reduced longevity, especially when levels exceed 3.0. An article in Life Extension (July 2025) refers to persistently high CRP as “inflammaging.”   The Truth About Aging and Inflammation? Temporary spikes in HS-CRP from infections or surgeries usually do not cause lasting issues unless inflammation persists. Chronically high HS-CRP levels (>3) are linked to various age-related diseases, such as obesity, arteriosclerosis, autoimmune disorders, poor dental hygiene, and other conditions that reduce health and lifespan. We now can measure “inflammaging” with HS-CRP blood test.  This test indicates increased risk of heart disease, cancer, stroke, dementia, autoimmune disease, and other degenerative diseases.” A review of studies with more than 400,000 participants revealed that people with a High HS-CRP had 75% increased risk of all-cause mortality compared to people with a low HS-CRP. These studies found that HS-CRP may be a more reliable predictor of heart attack and stroke, than LDL cholesterol! HS-CRP may predict age-related diseases because chronic inflammation leads to issues such as arterial plaque and Alzheimer’s. Although white blood cells fight infection, their persistent activity can damage healthy tissue and accelerate age-related conditions. The changes that you can make to decrease inflammation, Inflammaging, include: Fat loss to ideal weight Low inflammatory mediterranean diet Omega 3 oil supplements or in food Daily exercise Probiotics Quercetin supplement Treat joints that are damaged (inflammation is increased with injured joints) At least 3 cups of coffee per day Less than 4 oz of alcohol a day No sugar in the diet ***Replacing hormones to the levels of a young man or women with non-oral hormones, pellet testosterone for men and both testosterone and estradiol for women.   BioBalance® Health assesses new information through medical studies and bases treatments on knowledge of human physiology and the aging processes. No single test can determine if you are aging well, but HS-CRP is a better indicator than cholesterol or BMI. At BioBalance®, we’ve tested HS-CRP for 20 years and developed treatments to address inflammaging. Citation: Life Extension –July 2025

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you are female who is menopausal and you have experienced your OBGYN or internist drawing your blood to check your hormone levels, (Estradiol, and LH and FSH) to see if you are menopausal or to see what your estradiol level is while on HRT, you may have heard your doctor tell you that your estradiol level is too high. That is what I would like to talk about today….. This often occurs when my patients take the blood work I order to another doctor who doesn’t know anything about estrogen and just looks at the reference range on the lab sheet. Most of you have heard me talk about the fact that lab reports must be interpreted by the treating physician, because what is written on the lab sheet isn’t tailored to your situation. The lab reference ranges for menopausal women are based on women who don’t take any hormones, very low estradiol and high LH and FSH, which is not healthy and is the level that causes women overwhelming hot flashes and painful periods. Estradiol blood tests have a list of numbers that don’t reflect the healthy estradiol level, but a level that makes women miserable. After I replace a woman’s estradiol, their tests show blood levels of a young healthy woman who is pre-menopausal, and that brings them back to feeling like themselves. “I have my life back!  Estradiol and Testosterone Pellets have cured all my symptoms (low libido, hot flashes, poor interrupted sleep, bladder spasms, depression, and I feel like myself again!” No other hormone replacement brings estradiol blood levels to (60-250ng/ml), patches, creams and gels just stop one symptom, hot flashes.  There is a reason that your doctor doesn’t know about hormones. The education that OBGYNs get in residency effects what they recommend to their patients for life, and they have very little training about hormones which means that no one is taking care of the hormones for women, and bioidentical estradiol is never discussed because it is not approved by the FDA which is why I DO!  I have made it my business to know everything about women’s hormones and have prescribed them to women for over 45 years.  Therefore, when I am told that the primary care or internal medicine doctor told one of my patients that their estradiol and estrone are “too high”, I am dismayed.    Women must think about the fact that when they feel normal after menopause treatment, then that is the best treatment for them.  My patients become better, healthier, and their relationships are more fulfilling with Estradiol replacement, and I know the range the Estradiol should be within (60-250), the same as when we were fertile and young. Estradiol taken non-orally (patch, cream or pellet) is safe and does not cause breast cancer or liver cancer or cause blood clots. What Should I Tell My Doctor about my estrogen replacement? Therefore, If your doctor tells you to stop estradiol, you can tell him that estradiol replacement decreases all causes of death in Menopausal women, it decreases heart disease, bladder disease, bladder infections, osteoporosis, and dementia/Alazheimer’s Disease! Tell him or her that, they can stop worrying about your Estrogen because you are being prescribed it by a doctor who knows how to manage hormones. Breast Cancer Patients There is another type of patient who I often see in my office. Breast Cancer patients with estradiol receptors are taken off their estrogen, and they are given an estrogen blocker like Tamoxifen® (oral) or Anastrazole (Arimidex®) to get rid of the estrogen in their body which is to “starve” breast cancer cell that may have seeded other tissues in the body. These patients are miserable. I treat them with Testosterone pellets only and monitor their Estrogens. That works until their doctor sees an Estradiol level that is in the premenopausal range in a patient who hasn’t had an estradiol pellet in a year.  E2 pellets are tiny and friable, and they can’t last longer than 6 months. What happens when the oncologist freaks them out saying it is the Estradiol pellet causing the E2, E1 levels. They are upset but this is estradiol from other sources (not the ovaries). Here are the facts: Estradiol pellets are 2-3 mm in size. They dissolve by blood flowing around the pellet located in the fat. Estradiol pellets dissolve completely over 3-4 months in most women. We cannot see them by ultrasound at 4 months. Therefore, a year later a woman who has estradiol over 60 The oncologist is not a hormone specialist and doesn’t know the other sources of estradiol and estrone in the body. a prescribed amount of Estradiol (E2) is given every 4 months. The medium dose of E2 is 25mg and it lasts 120 – 180 days The size of an estradiol pellet = 2×2 mm Causes Of Continuing High Estrogen In a Woman Long After She Stops E2 Pellets: Tamoxifen given for Breast Cancer is an Estrogen and also an Estrogen Receptor modulator, but is really an Estrogen, which turns off the receiving end for E2 (the cellular receptors) so the breast cancer cannot be stimulated by circulating estrogens, but the rest of the body is. When on Tamoxifen it is not the pellets that are raising the blood level of E2, E1, it is the Medication. When someone is on Tomoxifen all their other organs are stimulated by estrogens from Tamoxifen, but the Breasts are not. That means that the estrogen in the blood is from the medication Tamoxifen and not the previous pellets. Obesity increases body fat and E2 is made in the fat and the less fat the lower the Estrone and estradiol. Other Medications and supplements can increase the E2 and E1 in the circulation but rarely help with menopausal symptoms. Your doctor should know what medications you can’t take if you are trying to get rid of estradiol and estrone usually prior to Breast Cancer therapy. Drinking alcohol can prevent the liver from processing the estrogen that is meant to be removed normally so it builds up in the circulation. Liver disease causes an increase in E1 as well. Some medications increase estrogens in the body, but do not relieve symptoms of menopause, so have you doctor review your other medications you take. High intake of soy, edamame, soy nuts, soy in nut milk, Tofu, and other vegan (fake meat) is made of soy and soy is a phytoestrogen which can cause uterine bleeding but doesn’t help the symptoms of menopause. Soy is in everything so read the labels. Genetic Diseases can cause high estrogen in menopausal women who are not taking estradiol for their symptoms.   Some women have an aromatase defect, which is genetic and can’t be cured but can be treated with anastrazole or Arimidex, the same medication. This means that they convert Testosterone into estradiol and estrone. Even before menopause women have very low testosterone, so this is not obvious when they come to my office. The test for the gene defect is very expensive and this is not a common occurrence.  We diagnose this when a woman’s estrogen is too high for the dose she is taking, AND her testosterone ran out too fast! We treat that condition with a testosterone + anastrazole pellet in the normal dose of T, and it corrects the conversion of T into E2, E1. Oral anastrazole also called Arimidex blocks that conversion too and is tolerated better by men but women get arthritis symptoms. DIM can treat this genetic conversion by blocking the enzyme at a different place than Arimidex. Fat Loss through dieting releases the estradiol stored in the body fat   Obesity and weight loss can cause estradiol and estrone to be high in the blood. Estrogen is made and stored in fat tissue.  The more you have, the more E1 and E2 you have in your fat.  Obesity can store the hormone and slowly release it which fools us and makes us think we are seeing pellet E2 nd E1. The more fat you have the more estrogens you make! When people lose fat under the supervision of a doctor, they usually have somewhat rapid weight loss.  This floods the blood with both estradiol, estrone, and triglycerides.  It takes longer to clear the estrogens because the liver is also processing fat. PubMed https://pubmed.ncbi.nlm.nih.gov Does reducing body fat reduce estrogen? Making some lifestyle changes may help lower your estrogen levels. Your provider may recommend that you: Decrease your percentage of body fat. Decreasing your body fat can reduce the amount of estrogen that your fat cells secrete. Feb 9, 2022 Above is what your doctor should think about when diagnosing you for high estradiol long after a pellet is gone.  There are some ovarian and adrenal specific problems that are also possible to be the reason E2, E1 are increased. I hope this gives you ammunition to discuss with the doctors who don’t know anything about hormones, estradiol and menopausal women.  Tell them what you know to be true and stop blaming a 2mmx2mm pellet that can’t physically last more than 120 day.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog You have all heard about smoking and the risks of lung and mouth cancer as the biggest dangers associated with it. However, since the ban on smoking indoors, many people have switched from cigarettes to other forms of nicotine, such as cigars, e-cigarettes, pipes, hookahs, or Nicorette gum. Most of my patients believe these alternatives to be safer and think they are not at risk for cancer. They haven’t even considered that nicotine is a drug that, when taken internally, increases the incidence of other deadly diseases. Today, I’ll inform you about the risks you are taking by using nicotine in any form. I guess I should back up a bit. The act of smoking cigarettes not only provides the smoker with nicotine but also presents many other concerns. The average cigarette, cigar, pipe tobacco, and hookah contain these chemicals along with 69 others that have been linked to cancer: Acetone – the poisonous ingredient in nail polish remover. Benzene – the ingredient in gas and fuels that causes cancer. Arsenic – in murder mystery movies as the poison of choice. Formaldehyde – the chemical used to embalm dead bodies that causes cancer. Ammonia – the active ingredient in window cleaner. Lead is a toxic chemical that we avoid by treating our drinking water, so it doesn’t contain it. It causes neurological damage and can lead to dementia. No adult in their right mind would willingly put any of these chemicals into their body. Yet, the addiction to tobacco and nicotine leads millions to contaminate their bodies with these poisons. We haven’t even begun to discuss the effects of nicotine. If you are listening to motivate someone you love to stop smoking, you might want to memorize these chemicals and see if understanding this fact affects their ability to quit smoking. If not, I have some more motivating yet unfavorable news for you. The drug nicotine is highly addictive, and it is indeed a drug. It falls into the category of stimulant drugs. Most individuals with anxiety issues tend to choose nicotine as their drug of choice.   Nicotine functions like any other stimulant; it causes the arteries to contract, reducing blood and oxygen flow. Over time, this results in elevated blood pressure, arterial stiffness, and an impaired ability to dilate when increased blood flow is necessary in a particular area. The next stage in this progression is arteriosclerosis, which may be followed by a heart attack or stroke. Many people addicted to nicotine in cigarettes try other forms of the drug, generally derived from tobacco, introducing numerous other chemicals into their bodies. Attempting to reduce nicotine by changing the method of ingestion still exposes you to another form of tobacco. In medicine, we refer to smoking as “pack years” to describe the amount of cigarette smoking in the patient’s history. A Pack Year is equal to one pack a day multiplied by the number of years the patient has been exposed to the poisons and nicotine from cigarettes. Even though other forms of nicotine carry the same risks, we haven’t developed a shorthand for exposure to these forms. However, we do understand the amount of nicotine present in each type of tobacco. Cigarettes contain an average of 10 to 12 mg of nicotine each, but only about 1.5 mg is actually inhaled. A pack of cigarettes delivers approximately 28 mg of nicotine. You can compare that to other forms of nicotine: Product Amount of nicotine Cigar 13.3–15.4 mg (large cigars) E-cigarette 0.5–15.4 mg (15 puffs) Pipe (tobacco) 30.08–50.89 mg  Chewing tobacco 144 mg (whole can) Hookah 1.04 mg (per puff)   Now, the alternatives for stopping this addiction include replacing nicotine with something else that doesn’t contain the chemicals responsible for cancer. Nicorette gum or lozenges are the most popular options, but they should not be used for extended periods. They serve as short-term solutions to an addiction, as they can still cause vascular damage. The dose in one piece of Nicorette gum is 2 mg, which is equivalent to 1.5 cigarettes. This is not a permanent solution; other methods, such as acupuncture, hypnosis, and antidepressants, should be used to stop the addiction. A professional counselor or psychiatrist is the best choice for helping a smoker quit. Like any addiction, specialists are available to help and guide you throughout the process.