Unfortunately, most doctors know very little about properly balancing hormones with natural, safe products.

In this FREE 47 minute webinar, you will learn about…
* what hormones do in the body
* the basic hormones and their functions
* what happens when hormones decline
* the adrenal glands and adrenal fatigue
* the thyroid gland and hypothyroidism
* your estrogens (yes men, you have this)
* your testosterone (yes women, you have this)
* your progesterone
* PMS aka “estrogen dominance”
* Menopause
* Andropause
* DHEA
* Pregnenolone
* Growth Hormone
* Melatonin
* Sex Hormone Binding Globulin

This is a 42 minute coaching call I did with a gentleman named Wayne.  Wayne is 45 years old and he just wants to stay looking young.   He has a history of working out and wants information on supplements and how to increase his testosterone.  I go pretty fast in the beginning and give the names of several natural supplements that will help.

We also talk about diet, how to optimize your protein intake and sources of good, lean protein.  We discuss the pharmaceutical route of increasing testosterone with and without taking testosterone, which is considered an anabolic steroid and why you should not take your hormones by mouth.

I give him a bunch of good information during this coaching call about muscle soreness and what I do to help with that

…how I work around injuries

…some eating advice

…how to easily tell the low fat cuts of red meat

…the theory of the Adkins diet

…what happens to your body if you take too much testosterone for too long

…my stance on cholesterol and how it relates to your hormones

…what is spot reducing and why it is a myth

…and my little rant on performance enhancing drugs.

Click Here to Download

Transcripts…

West Conner:  From what I’ve read, learned, and experienced in my whole life, your diet is probably seventy-five percent of the way you look. Your exercise is probably fifteen percent of the way you look. Your supplementation that you take is probably less than ten percent of the way you look, but everybody wants to take a pill to look better.

This is Dr. West Conner, founder and owner of MedicineCoach.com. For over fifteen years I’ve been helping people save money on their medication, balance their hormones, and live better and healthier through proper eating, exercise, and supplementation. I’m a think-outside-the-box type of person, and I feel that the traditional healthcare model is not the best solution to everyone’s healthcare issues. My website MedicineCoach.com offers real solutions, real strategies, real answers, and the real inside information that you need to live better, stay healthy, live longer, and get more out of life.

Now, let’s get going.

This is a forty-two minute coaching call I did with a gentleman named Wayne. Wayne is forty-five years old, and he just wants to stay looking young. He has a history of working out and wants information on supplements and how to increase his testosterone. I go pretty fast in the beginning and give the names of several natural supplements that will help. We also talked about diet, how to optimize your protein intake, and sources of good, lean protein. We also discussed pharmaceutical route for increasing testosterone with and without taking testosterone – which is considered an anabolic steroid and why you should not take hormones by mouth.

I gave him a bunch of good information during this coaching call about muscle soreness and what I do to help with that. How I work around injuries, some eating advice, how to easily tell a low-fat cuts of red meat, the theory of the Atkins diet; what happens to your body if you take too much supplemental testosterone for too long; my stance on cholesterol and how it relates to your hormones; what is spot-reducing and why is it a myth; and my little rant on performance-enhancing drugs.

You’re first going to hear Wayne describe his issues and what information his looking to get from me. Then, we go right in to the call.

So, let’s get going.

Wayne: Okay. So, I’m a forty-five year old man who has exercised, basically, all of my life. I worked in the health plan industry for ten years. So, I’m very adept at training consistently over long periods of time. You know, I am forty-five years old. So, I have a next goal, the next decade goal, of just staying as hard possible. I mean, that I want to keep muscle mass. I want to maintain strength and flexibility – just lean, hard muscle mass – for as long as possible. So, I would go work it out for ten years. Then, I’ll do another one for ten years thereafter.

Aside from that, I also have, you know, just little injuries – nothing major –just little places that hurt all over; different things that I kind of work around on. I find that a body has more energy then the muscles have more strength, sometimes, than my connective tissue will allow for. So, I’m looking for supplements that will help me burn fat, stay lean, increase… I don’t need, necessarily more mass, but I just want lean, dense tissue that is strong, flexible, and reasonably injury-free so I can keep training for the next decade.

West:   So, pretty much the basis here is: as we get older as guys, testosterone starts to drop around age thirty, maybe age thirty-five depending on the guy; depending on how well he’s taking care of himself. So, yours has probably been dropping in the last ten or fifteen years. It drops, maybe one percent a year. So, you don’t really notice it until you get to your late forties. Then, suddenly, you wake up one morning and you’re old.

To increase testosterone naturally with supplements is real hard – almost impossible to do. Our sex hormones, which is our estrogen, testosterone, progesterone, and all of the other ones, they are bound to proteins in our blood – albumin and sex hormone binding globulin. Now, depending on the person, that binding can be anywhere from eighty-five to ninety-eight percent. When they’re bound, they’re useless. They cannot be used by the tissue.

That’s kind of how your body checks and balances everything – keeps it balanced. If one hormone is too high, it will increase the binding globulin, sort of bind it up, and it won’t work anymore. Now, you can’t really increase testosterone, but what you can do is you can decrease binding globulin – the sex hormone binding globulin. So, based on you: between eighty-five and ninety-eight percent bound to protein and binding globulin; if you were to decrease that binding globulin by just a couple of percentage points, your percentage of testosterone will go up greatly.

So, that’s a much better and easier way to do it than trying to increase the testosterone without resulting to supplementation.

Wayne:  Makes sense.

West:   As we age, as guys, our body gets better and better at converting testosterone to estrogen. In the scheme of how your hormones work, your body makes testosterone, and then from that, it makes estrogen. Women do it the same way. As we get older, we get better at doing that. As we do that, our estrogen level goes up – our body wants it balanced. So, it increases that sex hormone binding globulin, which in turn, binds more testosterone. So, our testosterone goes down even further as we shift towards the estrogen side. That’s why we see old man at the beach with the man-boobs and things like that, and the wider hips.

When you go to a traditional doctor, what they’re going to do is they’re going to take your blood, and they’re going to test your testosterone level. The testosterone level in your blood, the normal range, is roughly, depending on the lab, two hundred to twelve hundred is normal. What they do is they test your total testosterone level. They test all of it. Whereas, only two percent to fifteen percent is actually active, but we don’t know where you are in that two to fifteen percent. That’s why the latest way of testing your hormones is saliva. The saliva tests that two percent to fifteen percent – the active portion.

So, how can we lower down this sex hormone and binding globulin? Well, there are a couple of supplements to take. The first one – probably the best one – is Nettle Root or Stinging Nettle. That just binds to that sex hormone binding globulin so that it doesn’t bind to the testosterone, so you’ll increase the free testosterone. You’re not going to increase your total testosterone in your blood, but it’s going to increase the free and active testosterone that your body can use.

Wayne:  Okay, but what was that called again? You just said…

West:   Stinging Nettle or Nettle Root.

Wayne:  Okay.

West:  There’s another one. It’s the active ingredient in the Saw Palmetto – it’s the Beta Sitosterol. What that does is, it blocks an enzyme in your blood that converts testosterone in to a metabolite. In other words, everything in your body is checks, and balances, and ups, and down, and everything. Your body tries to keep everything at a normal level. So, if we lock these enzymes that convert the testosterone to other things, it’s like a traffic jam and your testosterone will increase – your free testosterone will increase.

Another thing that does that is Myricetin. Then, Progesterone which is a natural bio-identical hormone and you can get that over the counter at health food store. What that does is that also just blocks the conversion of testosterone by competitive binding. There’s another one that is sort of like an aromatase. Aromatase is the enzyme that converts testosterone to estrogen, and there are drugs that stop that really well – but those are prescription.

Like I said before, it sort of a traffic jam where your testosterone is coming along, it’s getting ready to get changed in to estrogen, but it can’t because the enzyme is being blocked. So, the testosterone is backing up and it’s increasing in level.  The natural product for that is called luteolin. It’s a natural product that does that – not nearly as well, but it does it on a small amount.

Wayne:  Okay.

West:   That’s really about it. The thing that was popular twenty years ago was the Yohimbine that really doesn’t do it. Tribulus Terrestris or something like that, that can often times have an opposite effect that will actually lower your testosterone.

So, there’s really nothing natural that you can take, as a pill or supplement that will increase your testosterone. What we’re trying to do is decrease the things that take testosterone away. We’re trying to shift our balance towards a higher testosterone.

Also, when we talk about a balance, it’s a balance with estrogen. So, there’s a natural product that you can take that will help your body metabolize estrogen. So, if you’re going to get rid of some of the excess estrogen, as a result, the balance of testosterone will increase. Does that make sense? It’s like a scale – you’ve got estrogen on one side, testosterone on the other. Your body wants that balance. We’re going to try and do all these little things to try and increase that ration of testosterone.

Wayne: Makes sense.

West:   There’s a product called DIM. It’s Di-Indoly Methane. It’s a food supplement, but it’s in cruciferous vegetables like broccoli, cauliflower, things like that. What does is, it helps your body to metabolize the estrogen properly and get rid of it a little better, so it doesn’t metabolize into a dangerous form of estrogen.

Another big thing is the DHEA – which is another supplement. That can help a little bit. It’s not a miracle that a lot of people think it is. It does increase your testosterone a little bit if you need it. If you’re low on DHEA, and you supplement with it, it’ll help. Guys would take twenty-five milligrams a day, women would take ten milligrams.

These other supplements, they’re most likely found in a combination product somewhere in a health food store. Taking them individually is not going to work nearly as well as taking a combination of the three, or four, or five products that I talked about. It’s a sort of a synergistic effect with these things. By taking them all together at one time, it’s like a one plus one equals three type of a thing with these.

Wayne:  Okay. That makes sense. So, I’m familiar that some things work well together, that’s why they join them together – they have a synergistic effect – rather than just buy them all individually and just stack them up and take a whole bunch of them.

West:   I’m not familiar with a product that contains all these. There maybe something out there on the Internet that I missed that’s new or something, but these are the ones that I’m familiar with and I know do have an effect, albeit small. It’s not a miracle. You’re not going to take them…

With any supplements, with any natural supplements, it really takes about a month to see or feel anything. You really get the full effects after about three months with anything over-the-counter like that. There’s not a prescription drug for the most part. There’s some stuff like coffee, obviously, works right away. Other stuff like that, it just takes longer to work.

Just by your question, I’m assuming that you’re eating right and exercising. That always helps with your testosterone, because in our fat cells – that’s where a large part of the testosterone is converted in to estrogen. So, we have a lot of excess body fat on us. A lot of the testosterone is going in to the body fat and being converted to estrogen. Well, if you have less body fat, there’s less conversion. So, keeping that excess body weight off of you is also going to help increase that balance towards the testosterone.

Exercising, weight lifting, weight-resistance lifting, whatever you want to call it is also good for increasing your testosterone. I’ve been in the gym twenty-five years as well. The body builders that I’ve talked with, the old timers in the gym, the gym rats, pretty much the general consensus is that, best overall exercise for increasing testosterone is the twenty-rep squat; which is getting under the bar old-school style on the squat rack and squatting twenty times, and taking a break, and doing five or six sets of the twenty-rep squat. The general consensus is that the greatest overall exercise for upping your growth hormone, upping your testosterone, and tilting that balance towards the testosterone.

Wayne:  Okay.

West:   You want to talk about supplementing with testosterone, or what we can do as far as prescription drugs go? Or did you want to stick strictly with the natural stuff.

Wayne:  I think, at this juncture, I’m after more natural stuff. At the same time, I’m interested in education.

West:   Okay. We’ll talk to you a little bit on it because that is really about it, in a nutshell, for natural testosterone therapy. There’s really not much else. I can go on and explain how everything works, but it’s pretty boring and basic. They just bind to the enzymes that break down testosterone, thereby increasing testosterone. It’s simple. Each one has a small effect, but combined, they have a greater effect.

From what I’ve read, learned, and experienced in my whole life, your diet is probably seventy-five percent of the way you look. Your exercise is probably fifteen percent of the way you look. Your supplementation that you take is probably less than ten percent of the way you look, but everybody wants to take a pill to look better. Yet, they’re only concentrating on that small ten percent.

Like I said before, diet and exercise is really the two major things as far as the body composition, and how you feel, and how hard your muscles are, and how flexible you are, and what not. In traveling that’s probably pretty difficult.

Wayne:  It can be, yeah. You mentioned too on e-mail that certain amount of protein per pound of lean muscle weight, was it?

West:   Yeah. The diet that I developed, which is the 511-Diet… If you want to get crazy and really get in to it, because I’m a nerd and a numbers guy, I figured out in talking with body builders, because I’m in to the hormones… Whether you want to believe it or not, when you look at a professional athlete, they’re doing everything they can to tilt the winning percentage in their favor. When I say everything they can – you know, the ones you get caught are the ones you hear about. The professional body builders are loaded up on this stuff.

So, when I speak with these guys, what I’ve come to a conclusion is that when you check your body fat percentage, you get your lean body weight. The ideal amount of protein to take if you’re weight lifting and training hard is 1.15 grams of protein per pound of lean body weight. So, if you weight two hundred pounds and you have twenty five percent body fats. You have a hundred and fifty pounds of lean body weight. So, you go a hundred and fifty times 1.15 which is around a hundred sixty five maybe, a hundred and seventy. That’s how much protein you eat during the day broken in to three major meals and two or three snacks. You know, you’re not going to high, and you’re keeping a consistent stream of protein flowing through your system. So, when your muscles do need something to grow, it’s there.

A lot of nutritionists, and scientists, and what not, they think that’s way too much and it’s just a waste. Well, they’re not body builders, and they’re not football players, and they don’t do this for a living. So, I tend to believe and follow guys who do this for a living. It’s like if I wanted to be a bowler; I would pay attention to the bowlers and what the bowlers are doing, and not what the soccer players are telling me to do to be the best bowler. If that makes sense to you.

Wayne:  Yeah.

West:   If I want to gain muscle and be strong, I’m going to listen to people who have more muscle than I do and who are strong, and do what they say rather than a scientist in a laboratory in a white coat that says, “No, they don’t know what they’re talking about,” as he goes through the drive-through at McDonald’s – that’s his nutrition. So, I tend to stick with guys who are doing it and believe what they say, and follow what they do.

Wayne:  Yeah. That’s logical.

West:   Just real quick, we’ll talk about the prescription drug part with the hormones. There are two prescription drugs that work really well for aromatase inhibitors. Aromatase is the enzyme that breaks testosterone down in to estrogen. It’s Arimidex and Femara. Those are the two brand names. Both are pretty expensive. Arimidex is going to be generic soon, so the price will drop significantly six or eight months after the generic becomes available.

Like I was saying before, the cascade of your hormones – it all starts with cholesterol, believe it or not, which is another good topic to talk about. It all starts with cholesterol, cascades through a series of enzymes, and products, and everything, and you end up with testosterone. From testosterone, your body makes the estrogen.

Guys, we need estrogen. Women need estrogen, and women also need testosterone as well as we do. So, if you can block that enzyme – aromatase – that changes testosterone to estrogen, your level of testosterone will go up. The Arimidex – that’s exactly what it does; and the Femara – that’s exactly what it does. For Arimidex, probably the best dose is about half a milligram or one milligram three times a week. That’s a prescription. The Femara, you take half a tablet every week or every other week. Femara is very powerful and very long-acting. Your testosterone level will go up. I have personal experience to tell you that it does work very well; half of a pill every other week. You know, I have personal information, since I’m a pharmacist; I have access to all this stuff.  I like to try things out to make sure that they work.

I see these guys who are taking it. I say, “Well, I’m going to get two tablets here, cut them in half. I’m going to take half a tablet every other week for two months and see what it does.” I did. I took a test, and my testosterone was right about ten times normal. My estrogen was perfectly normal – right down the middle – because your body wants that level of estrogen. It’s going to keep flowing testosterone that way until it can overcome the blockade to get that estrogen there. As it does, like a traffic jam, testosterone is backing up and increasing. It did work and it does work.

There’s actually another product that I didn’t mention. A natural product called Chrysin. That’s also an aromatase inhibitor. The problem is, that was a big whoop-dee-doo for a while until they found out that it doesn’t really work. It doesn’t work orally. It works in a cream, if you rub it on your skin – which is really the best way to get hormones in to your body. So, the Chrysin will work that way also, but it’s got to be in a cream.

Going back to hormones – they should not be taken orally; in other words, by mouth, in a pill. They’ve taken testosterone, and they’ve taken estrogen… Well, not so much estrogen, but they’ve taken testosterone. They’ve tweaked it a bit in the lab so that it will bypass the liver and get in to your system. The problem is natural hormones are not in our stomach. Our testosterone, estrogens, and progesterone are not in our stomach. So, there’s no reason to take it orally. When you take it orally, it goes in to your stomach, and the liver tears it up. It eliminates, virtually, a hundred percent, of any oral, natural, bio-identical hormones that you take.

I try and relay this to doctors, but they don’t seem to understand that. So, you can take it orally and your body will eliminate it. You can get an injectable pellet, which is a small – a little bigger than a piece of rice, maybe pencil eraser size – a little pellet that goes underneath the skin in your hip. That releases the hormones over the course of two to six months depending on the person. You can get suppositories, some vaginal suppositories for estrogen and testosterone, but the real, best way is the cream.

Well, since we’re doing testosterone, you would put a testosterone cream. This is the natural, bio-identical testosterone. It’s the same chemical structure that’s found in your bodies. So, your body recognizes it as own, as normal. It doesn’t fight against it. Just rub the cream on your body, and it gets absorbed like any other hand cream or hand lotion would. It goes directly in to your blood stream, and it gets used. Over the course of the week or two, you build yourself up to a level where you’re comfortable, and then you stay there. That’s going the prescription route and doing the doctor route. With testosterone, there are also the injections. The most popular one is the Testosterone Cypionate. That’s an injection that you do once a week or once every two weeks.

The little injuries that you were mentioning… When you mentioned it, the first thing that came in to my mind was growth hormone. Unfortunately, growth hormone is now pretty regulated and pretty strict. They won’t even allow us to import the chemicals to make growth hormones in the lab. As a compounding pharmacist, I used to make it. It used to be dirt cheap. It’s an excellent, wonderful hormone until it’s abused. Then you get in trouble.

When you go outside the range of normal, bad things start to happen to you. You can hit a lot of home runs, but then the teenagers get on it, and they get screwed up. So, it’s very expensive now. It’s not difficult to get, it’s just expensive. It makes everything younger – for the lack of a better term. As we get old, growth hormone goes down. It’s sort of the master hormone of our body that keeps us young. It’s an injection. You can’t take a pill. Makes you feel younger, more flexible, your skins holds more water, less wrinkles, just everything is better when the growth hormone is back to the level of twenty something. You don’t get gigantism. You don’t get bigger, because you’re keeping the level in the normal range. There’s nothing that significantly increases that that you can take naturally. There are some amino acids that you can take, some combinations, but it’s really a drop in the bucket as far as what you can do with the growth hormone.

The best way that you can increase your growth hormone is, like I said before with the testosterone, diet and exercise is really the best way to do it for the growth hormone. One product that we use, and its prescription, is called Sermorelin. What that does, its growth hormone releasing hormone. So, that tells your body to release growth hormone. It’s not growth hormone. You cannot overdose on it because your body is not going to give you more than you need. It’s telling your body to release all it can.

If for some reason your body is deficient in pumping out growth hormone, you take this. It’s a subcutaneous injection that you do at bed time every night. It’s just telling your body to release as much growth hormone as it can. Your body has checks and balances, and negative feedback loop systems. Your body is not going to secret more growth hormone than you can handle and cause an overdosing effect in growth hormone and give you side effects. It won’t do it. Your body won’t do that.

The old standby ten years ago – Glucosamine-Chondroitin. Some people say it works some people say it doesn’t. Now, they say that the Chondroitin is too big to be absorbed in the stomach. Who knows? I tried it for a while. I never really got any benefit from it personally. Other guys have tried and liked it and say it helps their joints feel better. That’s fine. Since I’m a pharmacist, I’m a Motrin guy and an Aleve guy. After particularly strenuous work out, you’re sore, I take Aleve. That’s not something that I take everyday. If I do a different exercise and I woke up just sort of stiff, and I’m getting worse and worse as the day goes on, Aleve is my drug of choice for that as far as stiffness.

I can understand the small aches and pains all over the body. I did a lot of martial arts, a lot of jujitsu – which is a lot of what you see in the mixed martial arts now in my twenties. Just getting picked up and slammed on my back over, and over, and over, over the course of time plus lifting heavy weights… You don’t think that you’re going to be staring at forty when you’re twenty-two/twenty-three years old and realize that every time that you land on the mat, in twenty years, you’re going to feel that again, but you do. You don’t think about that twenty years ago.

Wayne: Right.

West:   So, all those little stress in my body is catching up with me also. So, I can understand. As far as me training, I just try and train around all those little injuries in the gym and stuff.

Wayne:  Yup. Generally, what I’m doing is I’m trying, you know, just get some stretching. A little sometimes, the Advil before the work out, but I don’t want to do it every day. Just, you know, try to ease in to it and get the endorphins flowing and let the body warm-up. It takes a little longer now…

West:   The testosterone does help that aspect of it, if you get the testosterone back up in to the normal range. To be sure, what you could do, you could take saliva test to test your testosterone – either thirty dollars or less than thirty dollars to do it. That would just let you know where you’re at – either right down the middle in the normal range, or on the low end of normal, or who knows, sort of as a piece of mind to see where… Or if you take it and you have no testosterone whatsoever, the natural products aren’t going to do anything.

You can only do so much with natural stuff before you get in to drugs. If you’re feeling like this and you’re sort of in the middle, or maybe a little bit lower than the middle inside the normal range, taking these natural products – the Stinging Nettle and the Beta-Sitosterol – it could just give you just enough bump up to put you back over the edge to feel normal again and feel ten years younger when you’re in the gym and when you wake up.

Like I said, you’ve got checks and balances. So, your body’s going to fight back. It doesn’t want to be that young. It likes to be in the thirty/thirty-five year old range as far as your hormones go. By taking natural products, your body will not revert back to that young. It won’t go back to your early twenties. It won’t give you more than you need type of a thing like the Sermorelin. So, you really can’t hurt yourself by taking the natural products. It won’t be a big jump in testosterone. Probably won’t take it and a week later feel like Superman and all your lifts go up in the gym. Then, you’re suddenly running a minute faster in a mile – it doesn’t happen. It will happen very gradually, but it could just be enough to get you over the edge to feel good again and feel younger again.

Wayne:  Right. I’ll add something to this. I want to ask you really two things. The first is sources of high concentration of lean protein. Then, two is, I’ve just come off of a five-week vacation, a holiday on the Coast eating comfort food. So, right now, I’ve rounded the New Year part of my call with you, and said take your advice, and grab a hold of it.

I, generally, eat clean throughout the year. I want a little kick start right now over the next thirty/sixty days. Any recommendations along those, and with that, lead me more towards something higher dose such as a prescription. What thoughts do you have on that?

West: A jumpstart as far as your diet goes?

Wayne: Yeah, complete diet and supplementation. Yeah.

West:   Okay. From people that I’ve worked with, I find that if you jump both feet in to the deep end of a diet pool, you’ll fail in about a week. People buy these diet books, or jump on Atkins, or do a no-carb whether it’s Atkins, or do some crazy diet – you know, the old cabbage soup diet or something like that. They’ll go for up to a week before they say, “Screw this. This sucks,” but if you slowly make a change, you’re more apt to stick with it. In other words, I tell people, “Start first with breakfast.” Monday, Tuesday, Wednesday… For some reason I always start people on a Monday. Concentrate on having a good breakfast.

I like eggs. I take eggs, and egg whites are excellent sources of protein. I used to eat whole eggs with the yolk in the morning, and enjoyed it, and didn’t worry about the fat content. Then, the more body builders that I spoke with, they’re going more towards just eating the egg whites. So, that’s what I’ve been leaning towards lately. I think there are a lot of good substances in the yolk, but there’s also fat. I think the fat in the yolk is good fat. I say, maybe, for every three eggs, have one yolk. So, two egg whites and one whole egg – maybe. Egg whites are excellent. I just throw a little butter in the pan. The only fats that I think are good are butter, olive oil, and coconut oil. Thing is, you can’t really cook with olive oil. I mean, coconut oil is really expensive. So, I just tend to go with butter.

So, if you just concentrate on having a good breakfast for three, four, five days just to get that routine down. Then, add a good lunch for three, four, five days. So, you’re having a good breakfast and a good lunch for a few days. So, you get that routine down. Then, add a good dinner after four or five days. So, you slowly and gradually ease in to this diet. So, it’s not a big, giant lifestyle change that you’re going to go through, because, then, you’ll fail. It’s very difficult to suddenly switch from eating poorly to eating healthy.

Talking about the different foods: lean sources of protein. What I eat, like I said, egg whites, chicken breast. I get my chicken breast from Costco, you know, frozen chicken breast, fish, and red meat. The red meat that I, I guess, grew up on, what I always ate is shoulder steak – relatively inexpensive, fairly lean. That’s just the one that I like because, for twenty years, that’s the cut of meat that I ate. When I was training twenty years ago to get big, that was the cut of meat that the body builders ate and told me to eat, and that’s what I did. You can tell which cut of meat is leaner by the price. The cheaper the cut of steak, the less fat it’s going to have in it. So, that’s one way to tell. Then, its chicken, fish – you know a can of tuna every now and then – turkey breast is fine, and that’s it. Its meat is what you’re looking for for protein.

If you want to go crazy and figure out how much to eat, you get a body fat analyzer and figure that out mathematically, or pretty much look at the palm of your hand – that’s the portion size for lean meat. The palm, not your fingers and not your thumb, just that palm. Some people say a deck of cards, but everybody’s palm is basically the size of meat that you want to eat. If you have that size over the course of three meals, then half that size again over the course of two or three snacks, it will all wash out in the end and work out for you.

Eating clean – just vegetables, one piece of fruit a day at the most. Fruit is good for you, have a lot of vitamins in it, but it’s full of sugar. Sugar spikes your insulin, and insulin is what drives your fat in to your cells to be stored. That’s the main theory behind the Atkins diet. Your insulin stays low because you’re not eating carbs. If there’s no insulin, your body cannot store fat. So, you keep your insulin low, your body can’t store fat. It can’t do it. That’s how the Atkins works.

When you eat sugar and you eat simple carbs – cookies, candy, and stuff like that – spikes your insulin. That insulin is just going to drive the free fatty acids in your blood in to your body and store them as fat for later use. So, you want to keep your insulin consistently low is what we’re looking to do. You can do that with eating vegetables, eating protein with every meal – that slows your digestion – then complex carbs. The complex carbs that I eat are only brown rice, sweet potatoes, and oatmeal. That’s really better. I like sweet potatoes, and I’ll eat those.

Another excellent source of protein is whey protein. I get that from EAS – it’s the company – and they sell these big bags at Costco of it. So, I think I’ve got one bag at the pharmacy. I think I’ve got two or three bags here at the house. I just grab the closest one because they’re all open. Two scoops of that and a little shaker with some milk or some water will get you your protein. It’s very digestible, bio-available. A good source of protein is whey.

Let me mention this, I think you should stay away from soy products. I don’t know if you do that or not, but the fake protein stuff, the soy, your tofu, its very estrogen like. It’s a phytoestrogen. When you eat that, you’re going to increase your estrogen level – the balance of your estrogen is going to go up. The Asians do it and they’re fine because they’ve been doing that for generations. They have the enzymes that can handle it and break it down, and their bodies are used to that.

Where as, us Americans, when we do that, our bodies aren’t used to that. We don’t have generation upon generation that have done that, and have built up a tolerance to soy like the Asians do – Japanese. So, our bodies can’t handle it. A lot of soy is going to increase your estrogen and tilt that balance towards estrogen which is what we do not want.

Wayne:  That’s valuable stuff. Having worked in the health plan industry, there’s a point in my life where were lifting heavy and we were doing some cycles that some young man do to get big and strong.

West:   Gotcha.

Wayne:  So, I’m not against prescription health, and I’m also not against subcutaneous injection, or whatever makes sense to do. So, that’s part of what I’m asking you is kick start in that direction, or would you say… You know because I don’t have anything right now, maybe just try natural and then go from there.

West: Are you still consistently training now?

Wayne: Yeah.

West:   Okay. I don’t see a problem with going the pharmaceutical route. If you did, if you personally… I don’t know if you did or not, but a lot of guys did. In their twenties, when we were indestructible, they took a lot of cycles, like you said, stayed on them for a long period of time and didn’t give their body time to readjust back. So, what happens, like anything else, if you’re giving your body outside testosterone so that it doesn’t have to make testosterone on its own, it’s going to atrophy and it’s going to shrink. It’s like if you break your arm and you’re in a cast for six weeks. When the cast comes off your arm that’s broken, it’s going to be smaller than the arm that wasn’t broken. It wasn’t used, it’s going to atrophy. So, it’s to use it or lose it.

In guys, it’s the testicles. If our testicles are not producing testosterone for years, upon years, upon years because our body was getting it from an outside source, they’re going to atrophy. They’re going to shrink up and eventually – and there’s no set time period for this – eventually, they’re just going to stop working because they haven’t had to work for so long.

Wayne:  Yeah.

West:   That’s what happens to some body builders, some sports guys. I shouldn’t say some sports guys – a lot of sports guys – who are now feeling those effects, who are now retired and they’re ten years out. They realize, wow, my body doesn’t produce testosterone. That’s because during their career their body didn’t have to, so it atrophied.

So, if that was the case with anyone in their late thirties and forties… When they were in their twenties, if we did a lot of testosterone, our body just might not be producing at all. I think you would definitely feel that. There would be a definite problem in your life if you have very little or no testosterone at all. So, I don’t think that’s the case, specially, if you have the energy to go to the gym and work out.

Wayne:  I watched this… Going back to that time frame, I studied that, I thought about it, I deliberately studied physiology. I was reading and thinking about it. The times that I had done it – it was a twelve-week cycle going up gradually, coming down gradually, and getting off over a timeframe – and I could see some other guys that would just stay on it for a year. I have one friend that was on it, you know, a couple two/three years. That’s probably his the case today but I haven’t talked to him for a long time. That was only, you know… Having three cycles my whole life – maybe twelve weeks of these – and done in that way for the purpose of putting on lean muscle and then normalizing with additional weight. Now, it’s been twenty years since having done anything like that.

I’m just being a little older, caring a little more fat, and a little slower, you know, all of those things. I’m just like; I’d like to get an edge.

West:   Well, that’s true. Like I was saying before, the natural products will bump it up a little bit. They’re not miracles. If you really want to get heavy in to it, it’s really the prescription route that you’ve got to go. You’ve got to find a doctor who is in to this, and who knows what to do and how to do it. It’s really wonderful. If you get testosterone supplementation, you’ll have a significant increase in your general wellbeing and your over all quality of life. It’s really a significant difference when your levels come back to normal.

You don’t realize how much of your edge you have lost because it has gone down so gradually – and it’s called andropause for men. Now, women, you know, they go through menopause, and they lose a lot of their hormones pretty quickly over the course of a couple of years. So, they feel it. You know, they complain about the hot flashes, where as us, we start at thirty to thirty-five, and we gradually lose one or two percent a year until we pretty much don’t have any.

By the time we’re fifty-five; most guys have more estrogen than a fifty-five year old woman. So, a couple who’s married fifty-five years old, the man is going to have more estrogen than the woman on average. It’s just because we shift towards estrogen, and the women – they don’t. So, that’s a part of getting older, and the natural substances work to a small degree. If you really want to get that edge and jumpstart, it’s going the prescription route with an experienced physician or doctor who can do that. Being a traveler, that would be difficult to get.

Let me explain my issue with cholesterol lowering.

Wayne:  Okay.

West:   The whole sex hormone thing, testosterone, your estrogen, and your progesterone, it all starts with cholesterol. That’s the base molecule for all these hormones. That’s where it comes from. So, the thing now is everybody’s got to lower their cholesterol. Lower their cholesterol with all these statin drugs – Lipitor, and all these stuff that you see on T.V. Everybody has got to get their cholesterol lowered. Well, our body needs cholesterol. That’s the spackle that your body uses when you get an injury.

There’s injuries going on in our body all the time in our blood vessels because they are expanding and contracting with the force of the blood flow, and they get tiny tears in them – tiny tears, tiny rips, little holes. It’s cholesterol that patches those up. But if your cholesterol gets too high, it’s going to patch up that hole, and then it’s sticky. So, as more cholesterol comes along it’s going to stick to that patch because it’s sticky. Then, more cholesterol is going to come along. It’s going to stick to the cholesterol that’s stuck. Then, so on and so on until you get a blockage.

So, they just keep saying lower your cholesterol, lower your cholesterol. Well, when you lower your cholesterol, you’re stopping that whole cascade of your sex hormones. Your body is going to preferentially use the cholesterol for repair before it uses it to make hormones, because if it doesn’t repair itself you’re going to die. So, it’s going to take the cholesterol, the little bit that you have, because you’ve lowered it so low taking Lipitor, and use it to repair yourself with. You have nothing to make your sex hormones with. So, now everybody’s hormones are going down even further along with all the other stuff. That’s just my own rant on that.

Wayne:  Got it.

West:   At forty-five, everything’s going to slow down unless you get some testosterone supplementation, then jump back up to the higher than normal. Natural products may just put you over the edge to feel good again. They’re not miracles, like I said. The diet and exercise are going to help with the testosterone level.

Wayne:  That’s really… You know, that’s pretty good. The other part, for me, that’s beginning to be… I’m noticing some new developments in the actual exercises people are doing – combining exercises – just doing different movements than the old-style, basic movements that we were doing fifteen, twenty, twenty-five years ago. Curious if you have any information about that, what I mentioned, Sir…

West:   Yup. My personal theory on all these new innovations in exercise is its marketing. I, still on a regular basis, watch the old Pumping Iron movie. I see the guys, and they’re pretty big, and they’re lifting free weights, and they’re using chains, and old-school stuff. I think if these guys can get that big doing that, so can I. You’re not going to be able to rock your way to rock-hard abs in an ab-rocker.

Then, you’ve got all these different… You know, the P90X thing is big. I did that for about two weeks with my wife and said, “Honey, I hate this. I can’t stand this. I need my weights.” If you’re happy doing crazy exercises and everything, that’s fine. I remember when I was training hard and getting big, me and my training partner at the time; we would purposely make up crazy exercises to see how many guys will be doing it next week.

Wayne:  [Laughs]

West:   Yeah. Now, if you can come up with a contraption and market it well, you can sell it on an infomercial as the latest, greatest thing. So, I think that’s what a lot of these are. You need heavy, compound movements to get strong, get your connective tissue strong. Heavy, compound movements are exercises that involve more than one muscle group like squat, bench press, pull up, overhead press, things like that. These involve your whole body, your core, like they say. When you get in to these isolated exercises, you’re not encompassing your whole body. If you’re doing a concentration curl, that’s all your body’s working is just the bicep. So, yeah, the bicep is going to get strong, but to get your whole body strong and get a good, solid foundation, it’s those heavy, compound movements.

So, everybody’s got fat around the midsection, and ladies got the big butts and the big thighs. So, that’s what these contraptions are focusing on. I think you know, Wayne that you cannot spot reduce. In other words, if I’ve got fat around my stomach, it doesn’t matter how many sit-ups I do, the fat around my stomach is not going to go away faster by doing sit-ups, or if a lady does butt exercises the fat on her butt is not going to go away faster doing that than in the other exercise.

Wayne:  Right.

West:   You can’t spot reduce. You can’t take the fat off of one area preferentially by exercise. You can do it by liposuction and surgery, but the fat’s going to come off where it wants to come off, and it’s based on genetics.

Wayne:  Yeah. I think the point I read about that. It’ll come off last where it goes on first.

West:   That’s typically it. Us guys get it in the stomach. So, when we start to lose weight, the stomach is going to be the last thing to come off. Women gain it in their butts and in their thighs, so as they lose weight, that’s the last place it’s going to come off. It’s just frustrating, but that’s the way it is.

Wayne:  Well, that’s good stuff. I sure appreciate it, West.

West:   I wish I had some great, insider information for you to help you out, but there just isn’t any. The same thing with the body builder guys that I talked to. Yeah, they’re like, “Hey, I may not give you… I’ll tell you everything I know.” I talked to them and they’re not telling me anything that I don’t already know.

I’m like, “Man, I was really hoping for some great diet secrets and how you guys do it.” Then, no, “It’s chicken and broccoli.” “What do you guys have for breakfast?” “Egg whites and oatmeal.” Okay, “About three hours later, I had some chicken and some broccoli. All right cool. What’s next?” “All right about three hours after that, I had some chicken and broccoli. All right, what’s next?” “Chicken and broccoli.” “What’s next?” “Chicken and broccoli. Then, have a protein shake.” Like, “All right, what else?” “That’s it.” I’m like, “Come on, man! Tell me something.” “That’s it. That’s all I’ll let you know.” Chicken, broccoli, egg whites, oatmeal, sweet potato. I’m like, “Man!”

Of course, they’ve taken all the injections and stuff. Now, with the Internet, they’re importing a lot of stuff from other countries. Who knows if it’s real or not or where it’s coming from. They’re going to be in for a shock there. When they get older, they’ll realize that they’re not indestructible. It’s just… The money calls, and that’s what you’ve got to do to compete at that level. Same with the football players. We saw what happened with baseball, with Bonds and McGwire. If it’s not illegal, they’re going to go all out and do it. Performance enhancing drugs – they don’t make you hit the baseball any better, but they make you hit it harder and farther, and you can recover much better the next day to do it again.

I deal with some former Major League baseball players who played in the eighties. They said the difference between, nowadays, making ten million dollars a year and making the bare minimum, is one little hit a week, or one more strike out a week if you’re a pitcher. It’s nothing. It’s such a fine line. So, anything that can give these guys an edge, they’re going to do. So what if you get caught? You made ten million dollars. You never have to work again.

Wayne:  Yeah. Right.

West:   That’s my spiel.

Wayne:  I appreciate it. I guess I’ll watch for you on Face book.

West:   All right. Well, thank you, Wayne. Thanks for calling.

Wayne:  Okay. Thanks a lot.

West:  Bye.

That’s the end of this coaching call with Wayne. I hope you can use some of the things we discussed here to help you in your health goals. If you have any questions, please e-mail me at askwest@medicinecoach.com,

I get requests on a regular basis to help people get their thyroid hormones balanced. Most of them are women as they are generally more susceptible to hypothyroid. By far the most common complaint I hear is, “My doctor said my thyroid test came back normal but I don’t feel normal.” When they go back to their doctor to insist they are not “normal,” they are sometimes written a prescription for an antidepressant as the doctor quickly scurries out of the exam room.

So, you get your thyroid test back and the “doctor” says you are fine. You know you are not “fine” so what are you to do? Here are five reasons that you have hypothyroid even though the standard test says you are “fine.”

1. You could be producing enough hormone but your body cannot convert it into the active form. Your thyroid produces mainly T4. It is inactive and must be converted in the cell membranes into the active form, T3. This issue is usually caused by high cortisol and inflammation.

2. You could be producing enough hormone, your body is converting it to the active form, but too much is being bound to proteins making it inactive. The thyroid hormones are transported by a protein called thyroid binding globulin (TBG). When TBG levels are too high, the thyroid hormones cannot enter the cells. This is usually caused to too much estrogen. Clear out excess estrogen with cruciferous vegetables and DIM.

3. You could be producing enough hormone, your body is converting it to the active form, but you don’t have enough TBG. It sounds counterintuitive but too little TBG, meaning too much thyroid hormone, will actually cause your cells to become resistant to the hormones. Think about the heel of your foot building up a callous. The cells build up a callous to the thyroid hormones. This is usually caused by too much testosterone.

4. You thyroid works just fine, but the signaling gland, the pituitary, isn’t functioning properly. The pituitary “tells” the thyroid to produce thyroid hormones. If the pituitary is not functioning properly because of stress, high blood sugar, infection, or another reason, it will not send out enough signal for the thyroid. Therefore, the thyroid will not produce enough hormone.

5. The thyroid works fine, the pituitary works fine, but your cells are not taking in the hormones. All your lab test will come back normal in this case and there is no way to test whether or not your cells are resistant to your thyroid hormones. This issue is usually caused by chronic stress and high cortisol levels.

Maybe your doctor has listened to you and does write you a prescription. Ninety nine times out of a hundred, you will get Synthroid, which is 100% T4. When you return to say you still do not feel right, you will get an increase in dose. This pattern will continue until you begin to have side effects from the increasingly high dose of synthetic drug.

Unfortunately, most traditional doctors will not look deeper into the issue. They continue to increase the dose. If they would simply pick up a book, stop learning “medicine” from the cute little pharmaceutical sales rep pushing a drug, and actually learn something new that wasn’t standard practice in the 1970s that has been handed down from teacher to student for forty years maybe people can get some relief.

Many woman use the term PMS to refer to symptoms of bloating, breast tenderness, food cravings, headaches, irritability, mood swings, weight gain, and many others.  A term that was coined decades ago by Dr. John Lee is “estrogen dominance.”  This is what is going on inside that body when the term PMS is used.

Before we get deeper into the issue, we need to define a couple terms…

We have three types of estrogens that are natural to the human body, each with different functions.  Produced in the ovaries and fat calls, they are responsible for the development of sexual characteristics, fat storage, development of the follicle, inhibit bone absorption, improve insulin sensitivity, and many other functions.

Progesterone is made mostly in the ovaries with a small amount made in the adrenal glands.  Progesterone helps with sleep patterns, maintains fluid balance, helps use fat for energy, promotes the build-up of bone, maintains pregnancy, opposes the actions of estrogen, and a host of other functions.

Xenoestrogens are estrogen-like chemicals that have many of the bad effects of estrogen.  They are found in commercially raised meat, dairy products, pesticides, plastics, cosmetics, sunscreens, food preservatives, petroleum products, lotions, dyes, birth control pills, and just about everything surrounding you right now.  Our bodies absorb these chemicals and do not know exactly what to do with them.  Some stick around for years and can accumulate inside our body, acting like estrogen, but without the beneficial effects.

Estrogen dominance is when there is too much estrogen relative to the amount of progesterone.  Estrogen dominance can be caused by:

• very high estrogen with high progesterone
• high estrogen with normal progesterone
• normal estrogen with low progesterone
• low estrogen with very low progesterone

The only way to know for sure what is causing the estrogen dominance (PMS) is to test the hormone levels.  This is best done through saliva testing.

Perhaps the most common cause of estrogen dominance is the oral birth control pill.  When a woman does not ovulate, her progesterone drops slightly for the next cycle.  Since oral contraceptives are taken for several years in a row, a woman’s progesterone can be very low.  Estrogen dominance can also be caused by adrenal fatigue, insulin resistance, poor diet, or thyroid disorders.

So what is a woman to do?

The first step is lifestyle changes.  She needs to reduce her intake of alcohol, caffeine, salt, sugar, and refined carbohydrates.  Increase the amount of fruits, vegetables, legumes, nuts, seeds, and protein.  Regular exercise helps to metabolize estrogen and regulate the system.  Stress management will decrease cortisol that will, in turn, increase progesterone.  Diindolymethane (DIM) helps the body to metabolize estrogen and remove it from the body.

Supplements, especially a good multi-vitamin that contains the B vitamins, vitamin E, magnesium, and calcium is beneficial.  Alternatively, she can take these supplements individually.  Other helpful products include Vitax (Chaste Tree), black cohosh, and DIM.

The most common treatment for estrogen dominance is over the counter progesterone cream.  Low progesterone is the most common reason for these symptoms.

Start by using 10mg of progesterone cream twice a day.  Apply it to your inner forearms on days 14-28 of your cycle.  The first day of your period is day 1 of your cycle.  You can adjust the dose and days based on the response you have to this dose and schedule.

If you begin your period before day 28, stop the cream and that is day 1.  If you have an important event and you wish to delay your period for a couple days, you can continue the progesterone and it may delay your period for an amount of time.

Everyone can dramatically improve their health and well-being by:

• eating a diet of 1/3 carbohydrates, 1/3 protein, and 1/3 fat
• taking a quality multi-vitamin, omega-3, DHEA, vitamin D, digestive enzymes, whey protein
• getting regular weight training exercises
• balancing their hormones

As women age, the consistency of menstrual cycles become erratic. Bleeding that was once regular, has become heavier, then lighter, then absent, then spotting with no rhyme or reason as to which type of month the next will be. It is these unpredictable cycles that lead to the highs and lows of estrogen and progesterone.

Natural bio-identical hormone replacement (BHRT) has only come into popularity in the last dozen or so years. Prior to that, women were told to use the synthetic hormones to relieve their menopausal symptoms. Because of the gaining popularity of BHRT, several years ago I began studying and learning about this “new” approach to therapy. Coincidently, while investigating these hormones, the frequency of questions from patients about the therapy increased.

In these last dozen or so years; many doctors, with the help of pharmacists, have been prescribing these bio-identical hormones to tens of thousands of women, as well as men. The hormones can enter the body through the skin, oral capsules, implantable pellets, or sublingual delivery systems. The dosages are individualized to meet the needs of the individual patient. Men and women all over the world have taken and continue to take these bio-identical hormones with great success and virtually no drawbacks.

What not to do

In 2002, one arm of the Woman’s Health Initiative, or WHI, study was abruptly stopped because of side effects. The study was testing the efficacy of combining synthetic estrogen and synthetic progesterone (Prempro) versus nothing. The synthetic hormones increased the risk of breast cancer, heart disease, blood clots, and stroke. The study was stopped after just five years, three years early, because the risks of synthetic hormone replacement were too great.

The study looked at 16,000 women and determined that after five years of taking synthetic hormones, there was a 29% increased risk of breast cancer, 26% increased risk of heart disease, and 41% increased chance of stroke. In August 2003, the British medical journal, The Lancet, published a different study involving approximately one million women. The researchers concluded that in the United Kingdom, in ten years time, synthetic hormone use has caused 20,000 extra breast cancers.

Because of this, both patients and physicians have been inundated with conflicting information regarding hormone replacement. Many physicians are avoiding hormone replacement altogether because of the new findings. These findings after years of prescribing these medications, confused even the most experienced of doctors. Patients began looking into alternatives.

The synthetic hormones increase breast cancer risk because of “unchecked” estrogen in the breast tissue. You have to balance estrogen with progesterone. Taking oral synthetic hormones will also give you a better chance of blood clots due to metabolism in the liver. When the liver has to filter out these synthetics, it produces chemical metabolites that cause blood clots. These blood clots can increase your risk of a blood clot in the brain, also known as a stroke.

The goal of most physicians is to optimize their patients’ health while alleviating annoying symptoms that occur with hormonal changes. With the stoppage of the WHI, many physicians were left scratching their heads. They knew the hormones relieved their patients’ symptoms but, in the long term, did not optimize health. Also, there are no long term, large clinical trials to test the effectiveness of bio-identical hormones versus the synthetics.

Looking for clinical trials to show the effectiveness or ineffectiveness of bio-identical hormones proves difficult. Large, clinical studies are generally funded by big drug companies. They are trying to prove that their patented medication out performs other therapy. Since “Big Pharma” cannot profit from the sale of these bio-identical hormones, they are not going to pay for a study.

Or, as I see it, drug companies have plenty of money to study medication. If they are confident that their synthetic product is superior to the naturally occurring bio-identical hormone, why don’t they test them side-by-side in a long term study? The answer is, because they would lose. If you can’t win, don’t fight.

Some government agencies and colleges have performed studies with bio-identical hormones. While many studies are positive, other studies are inconclusive. This is partly due to the expertise required for proper individualized dosing. Getting the proper dose for the patient is critical when balancing the delicate hormone system.

Go natural or don’t go at all

These hormones are the exact chemical structure found inside our bodies. There is a constant on-going long term clinical trial called life. We, as humans, have had these hormones in our body since, well, since we were created. By simply replacing what our body can no longer produce or supplementing our lowered output is certainly a reasonable goal. Don’t we have enough sense to realize that we are not drugging ourselves but simply restoring our natural hormone levels?

Bio-identical hormone replacement has been sometimes regarded as a way to slow down or stop the aging process. This is untrue as the goal of BHRT is not to bring a 60-year old woman’s hormones to that of an 18-year old. The goal is to optimize the function of the body without causing harm in the form of overdosing the patient. How many 60-year old women would like to return to the menstrual cycle and fertility of an 18-year old? I think the number is very low. God does not want us having children at 60 years old.

Statistics show that nearly 50% of woman who begin synthetic hormone replacement stop within one year. They stop because of side effects like weight gain, spotting, moodiness, and breast tenderness. With the bio-identical hormones, the dose is based on the individual woman, not on a widely accepted “normal” range. The one year continuation rate with bio-identical hormones is reported to be over 90%.

This form of therapy works. It has absolutely no side effects, none, never had, never will. The only unwanted effects are from under dosing or over dosing.

Before we go any further, it is important to know the hormones that are currently flowing through your body. Both men and women should have a balanced level of the big three; progesterone, estrogen, and testosterone. These, along with dehydroepiandrosterone (DHEA) make up the majority of the hormones we’ll be discussing here.

In short, progesterone regulates the other hormones and preserves pregnancy. Estrogen makes a woman a woman, giving her wider hips, softer skin, breasts, and a higher-pitched voice. Testosterone makes a man a man, giving him a larger frame, body hair, and deeper voice. DHEA can be converted into these hormones. As we age, DHEA levels drop, therefore, our other hormone levels tend to drop.

Later, we will go into further explanation of each of these essential hormones.

What are bio-identical hormones?

Bio-identical hormones have the same, exact chemical structure as those found inside the human body. Bio-identical hormones will provide for you the exact same physiological response and action as those hormones manufactured in your own body. What the practitioner is attempting to do when administering bio-identical hormones is to bring you up to normal levels. This will achieve the same physiological response that would normally happen if your own body were producing the proper amounts of estrogen, progesterone, and testosterone.

These hormones should be administered in a similar manner in which your body excretes them. This provides a more natural and balanced approach. By doing this, we are attempting to duplicate what your body has done for years by itself. You had been running along on cruise control for 30 or 35 years with your hormones directing the show. Now, your hormones have diminished and your body wants its hormones back where they are supposed to be.

Although theoretically impossible to reproduce exactly how our bodies send out the hormones, we do our best to replicate it. Your body will release a small burst of hormones about every two hours, or 12 times a day. This gives an average level as well as high and low levels. Symptoms of hormone imbalance vary but the most common complaint from the menopausal woman is the hot flash.

The dreaded hot flash

It is reported that up to 75% of women go through the “experience” of hot flashes during menopause. A hot flash occurs when blood vessels in the upper torso area open more widely than normal. These blood vessels are generally located towards the surface of the skin and this opening brings more blood to the area. This increase in blood causes the heat and redness in the upper chest, neck, and face region.

Almost immediately the perspiration arrives and you become a soaking mess. Shortly after the hot flash is over you become a shivering wreck because of the cooling effect of the perspiration. Fortunately, this annoyance only lasts a few minutes but you know the next one is on the way.

Of course, there is never a convenient time for this phenomena. They seem to occur while sleeping, at an important meeting, during a speech, or at a job interview. It would be nice if there was a way of controlling these. Fortunately, we can relieve most of these symptoms.

Hot flashes are caused by a drop in hormones and a rise in another hormone called follicle stimulating hormone. The time before a burst of hormones is when the hot flashes occur. The estrogen level gets to a certain critical threshold causing the unpleasant effects. As soon as the hormones are released again, the hot flash is over. Without any treatment, hot flashes will slowly decrease and eventually go away on their own. This process can take up to three years after your last menses.

Are bio-identical hormones “natural”?

Yes, and no. To the general public, the term “natural” means coming from nature. The base chemical structure to the bio-identical hormones are found in the Mexican yam or soy plants. The base structure, called diosgenin, cannot be readily used by the body in the same form in which it is found in nature. So, yes the basic chemical structure is natural, as in found in nature. This structure must then be brought into a laboratory and altered to create the exact chemical found in our bodies. So, no the exact chemical is not natural, as in found in nature.

Well, then is Premarin natural? Yes, and no. Premarin comes from the urine of pregnant horses. The last time I checked, urine is natural. The urine is then brought into a laboratory where the estrogens are concentrated. This product is then pressed into a tablet. So, yes the basic chemical structure is natural. This estrogen from horses is natural to horses, not to humans. To the human body, they are foreign, and therefore not natural.

The term “natural” is more appropriately referred to the system that is using the natural product, not from where it came. In other words, the body “sees” these chemicals as natural because they are the exact same structure as the ones it has produced since before you were born. They are not synthetic as far as your body is concerned. The base could have originated anywhere. It could have begun in a tomato, a mouse, a tree, in ocean algae, it doesn’t matter where it started, it matters where it ends up.

What are phytoestrogens?

Phytoestrogens are very weak estrogen-like compounds. In fact, they are as much as 10,000 times weaker than your own natural estrogen. They can be found in various substances, over-the-counter products, and herbal supplements. What needs to be clear is that phytoestrogens are not hormones and they are not estrogen. They mimic, and very poorly at that, what estrogen does in the body.

There are three basic types of phytoestrogens; isoflavanoes, lignans, and coumestans. Isoflavones are the most popular and the most potent of the three types. Isoflavones can be found in legumes such as soy, chickpeas, red clover, lentils, and beans. Lignans are found in flaxseed, lentils, whole grains, beans, fruits, and vegetables. Coumestans are found in red clover, sunflower seeds, and sprouts.

It also takes a long time for the phytoestrogens to build up in the body in order to have any effect. The exact time for this action varies from person to person and is dose dependent. There has not been much in the way of clinical research on the subject of phytoestrogens, especially when it comes to long term effects.

Some scientists are discovering that, depending on where the phytoestrogen is located within the body, it can act as either an estrogen or an anti-estrogen. Studies have shown that soy acts as either an estrogen or anti-estrogen, depending upon where it resides in the body. If you have a normal estrogen level and eat soy products, the phytoestrogens can counteract the actions or your own estrogen, causing an anti-estrogen effect. It does this by attaching to the cell and blocking the normal estrogen hormone from attaching. This causes less estrogen affects. If your estrogen level is low and you eat soy foods, the phytoestrogens act like a weak estrogen. It will bind to the cell and have a slight effect on the cell. Crazy huh?

I’ve been asked many times about the subject of cancer with the phytoestrogens. The thinking is that if the synthetic estrogens cause cells to grow uncontrolled, will these weak estrogens cause cancer like the synthetic estrogens are known to cause. We aren’t sure.

We do know that the phytoestrogens in soy cause uncontrolled cell growth in breast tissue. This means that they can cause cancer. But the actual, real life, results show that women who eat a large amount of soy have lower amounts of breast cancer. Another study concluded that soy lowered your risk of breast cancer if you were premenopausal but not if you are postmenopausal. Other studies concerning endometrial cancer have come to similar conflicting results. While some show an increase in cancer, some show a protective effect.

Some women have begun taking the phytoestrogns before any menopausal symptoms have appeared. By doing this, they may prolong the beginning of the symptoms for a short period of time. This, so far, has not been fully proven nor is the therapy very effective. Remember, by taking these phytoestrogens, a woman may block the actions of her own hormones. This is explained by the phytoestrogens blocking the hormones at the receptor site. To put it another way, the doorway is being blocked by something you do not want to come inside.

A word of warning…
If you have a history of breast cancer, or a family history of breast cancer, I would recommend you avoid using phytoestrogens alltogether. If you include some of the phytoestrogen foods in your diet occasionally, there shouldn’t be a problem. But avoid the supplements containing isoflavanoes, lignans, or coumestans.

Is there a difference between commercially available
hormones and bio-identical hormones?

Yes, a big difference. The big drug manufacturers are now using the term “natural” to describe some of their products. This is in response to the large number of patients who are asking their doctors for natural alternatives to the synthetic hormones. Remember, Premarin could be considered natural because it is derived from natural horse urine. The chemical is natural but it is not a natural substance to the human body. The structure is different and therefore our bodies see it as a synthetic, foreign chemical.

The synthetic, commercially available, patented medicines are chemically different from those found in the human body. They are not the same chemical structure, and do not perform the same functions as the hormones produced by the human body. These drugs only mimic some the activity of our hormones. When you take them the response from the body is similar, but not exactly the same.

One of the main issues surrounding the bio-identical hormone movement is money; yes, money. The pharmaceutical drug manufacturers cannot patent a naturally occurring chemical. Therefore, they cannot make any money from the sales. The only way they can profit from hormone therapy is to alter the chemical structure and patent the new structure.

They can patent how a natural chemical is manufactured and a unique drug delivery system. In other words, a company can protect it’s intellectual knowledge in extracting a natural product from its source, but not the actual product. They can place this natural product in a patch or capsule, develop some unique technology for the drug to enter your body, and patent the delivery system. But they cannot make money from something that is not unique and not manufactured in a laboratory.

For example, you can get natural, bio-identical estradiol in the form of a prescription patch. The medication is not patentable, but getting the medication through your skin by way of a matrix delivery system is patentable. So the drug company took a natural product and impregnated a drug delivery system. They are protected by the patch’s drug delivery system.

Many in the medical community use the term HRT, or hormone replacement therapy, without properly defining the meaning. By using a synthetic product, like Premarin, the patient is substituting natural, human estrogen with a synthetic, horse urine product in the form of a drug. This drug simply mimics the action of estrogen, it does not replace it. The patient is not replacing estrogen with estrogen, she is substituting estrogen with a drug. This definition of the term HRT has led to confusion amongst the medical community.

Let’s use a little common sense. A hormone’s job is to get to a cell and fit into it’s unique receptor site. This fitting is like a lock and key, or two pieces of a puzzle. The hormone molecule fits perfectly into a receptor site located on the cell wall.

By studying chemicals that are structurally similar from our own hormones, we learn that the foreign chemicals act differently at the receptor site. Sometimes they act like our own hormones, sometimes they have no effect, sometimes they have a harmful effect, and sometimes they block the receptor so no other hormone can enter. These are not natural to our body.

The pharmaceutical companies know this and try to formulate a chemical that is similar to our own. It doesn’t matter how close they get, the effects at the receptor site on the cellular level are different from the exact chemical structure of our own hormones. Remember, they cannot patent a naturally occurring substance.

My grandmother once told me, “You can’t get any younger, but you sure can get old in a hurry.”  If you think about it, that statement is very true.  Have you ever noticed how certain stressful situations “age” a person?  A serious illness, like cancer, can make a person look much older, and feel much older, than they truly are.

Growing older is a fact of life, we cannot stop it.  We can, however, actually reverse the aging process to add quality years to our life.

You have two ages: your chronological age and your real age.

Your chronological age is how long you have been alive.  You cannot change your chronological age no matter what you do, it grows every second, every hour, every day, you cannot stop it or slow it down.  This is the age you tell someone who asks, “How old are you?”  Your chronological age is JUST a number.

Your real age is the age your body “thinks” it is.  You can be 30 years old in chronological years but your real age could be 25, 35, or 45.  The real age depends on how well, or how poorly, you take care of your body.  This age can be changed.  You can get much older or much younger depending on your own lifestyle choices.

Real age is an excellent indicator of your overall health.  Beginning at about age 25, unless we consciously change our habits, we begin to lose about 1% of all our body functions every 2 years.  So, by the time we are 45 years old, we’ve lost about 10% of the functioning ability of our heart, our liver, our kidneys, eyes, hearing, lung capacity, everything.  Fortunately, we can restore these processes through lifestyle changes.

Our cardiovascular system is the greatest measure of our real age.  Preventing aging of your heart and blood vessels is the single most important thing you can do to live a longer and higher quality life.  Fortunately, you can slow the aging process of your circulatory system in a measurable and reliable way.

Blood pressure is the most important gauge in determining the health of your heart and blood vessels.  Keeping your blood pressure below the magic numbers of 120/80 will keep this system functioning at youthful levels.  When pressure is high, small tears occur in the walls of blood vessels.  These tiny “cuts” are covered over by cholesterol.  When the pressure increases and the tears become deep, they can go down into the middle layer of the artery wall and cause inflammation in that area.  This causes swelling that further increases pressure.  Also, the cholesterol covering can form sort of a scab over the injury and could possibly break off.  This scab is now called a thrombus and if your body does not dissolve this before it reached the brain, it may lodge itself in the small blood vessels, becoming a clot and causing a stroke.

When blood pressure is high, you also have what is called “end organ” damage.  Your “end organs” are the organs in your body where blood flow goes to “feed” your organs.  Your kidneys are an excellent example.  As blood is pumped into your kidneys, the tiny, fragile, inner workings of the organ are doing their job.  When the pressure is too high, the tiny vessels inside the kidneys get damaged under the intense pressure.  The constant increased force damages the kidneys and they begin to malfunction.  This leads to an increase in fluid and waste products in the blood that would normally be filtered out of the body.  The increased fluid causes blood pressure to further increase and the waste products cause a constant, low-level inflammation.

Take care of your body and your body will take care of you.

Here are 20 quick ways to take up to 67 years off your real age:

1. Getting at least 10,000 steps a day can make your body 2 years younger after just six months.  Many people use the excuse, “I walk a lot at work.”  If that is the case, buy yourself a pedometer and see how many steps you take during your work day.  You can find a pedometer at just about any department or sports related store.  Just mark down your step number every time you get home from work over the course of a week.  If you averaged 10,000 steps per day, congratulations, you get enough walking at your job.  Anything below 10,000 steps per day, go get those magic 10,000 steps per day.

2. While you are outside walking, your body is absorbing sunlight and converting it into active vitamin D.  Thirty minutes of winter sunlight or fifteen minutes of summer sunlight in a short sleeved shirt is all most people need to keep their vitamin D levels adequate.  Darker skinned people need more sunlight while fairer skinned individuals will require less.  If you do not have any underlying medical conditions, like osteoporosis, multiple sclerosis, arthritis, etc., you should keep your vitamin D level at about 50.  If you do have a medical condition, depending on the severity, keeping your vitamin D levels over 80 can be very beneficial.  Taking 5000IU of Vitamin D3 can help in this area.  By keeping this level up, you will be one year younger.

3. If you are a smoker, stop.  If you live with a smoker, you will have to avoid second hand smoke in order to shave 7 years off your real age.  Sitting next to someone who is smoking for 15 minutes has been shown to have the same damaging effects as smoking one cigarette.  Keep your distance from smokers.  If your spouse smokes, give as much support as possible to get him or her to stop.

4. Your mother told you to brush and floss your teeth.  If you listened to mom and continue to do that today, you will take 6 years off your real age.  Researchers have concluded that the same bacteria found in the mouths of those with poor oral hygiene, causes aging of the blood vessels.  By keeping this bacteria from growing in your mouth, you will keep it from growing on your blood vessels.

5. Many doctors recommend taking a daily aspirin to keep your cardiovascular system in good working order.  By swallowing 162mg of aspirin a day, you can make yourself 2 years younger after three years.  Swallow your aspirin whole with a full glass of water.  Taking it with water prevents it from sticking to the side of your stomach or getting lodged in your esophagus (the tube leading from your mouth to your stomach) on the way down.  You also should not use a chewable form of aspirin.  Chewing aspirin will increase your risk of developing tooth decay.

6. Managing your finances is something that most people should do anyway but you normally wouldn’t associate this with a youthful body.  Financial worry is one of the most damaging forms of stress and by eliminating that excess tension, you will lower your real age roughly eight years.  That’s extra time to spend your children’s inheritance!

7. Continuing with the subject of stress, general stress reduction will give you another six years off your real age.  Even simple stress reducers like lying down and breathing deeply, scrunching your face and holding it for ten seconds, or calling friends on the phone can help lower body tension.  When you go for your daily 30 minute walk, take a cellular phone with you and call family or friends.  Here’s a tip for you guys out there; call your mother.  If you really want to impress a loved one, go for a walk and call your spouse.

8. Now that you have impressed your wife (or husband), having sex is an excellent way to stay young.  By having sex at least three times a week, you can lower your real age anywhere from two to eight years.  The difference in the age reduction has to do with the quality of sex.  The better satisfying for both you and your partner, the greater the age reduction.  It is not just the act of making love but the love in making the act that counts.

9. After all that love making, you are going to want to get a good night’s sleep.  Getting about seven hours of sleep every night will get you another three years.

10. Having fun makes you feel younger and playing mind games or thinking games will keep your body younger.  Reading, doing crossword puzzles, word searches, or anything that exercises your mind on a regular basis will do away with two and a half years.

11. What you put in your mouth significantly contributes to your real age.  Learning to read food labels and following a few simple rules can shave three and a half years off your real age.  Look on the labels and avoid saturated fat, trans fat, sugar, hydrogenated oils, corn syrup, and anything that says “enriched.”  Corn syrup is in most canned or bottled sauces and actually fools our brain into thinking we have not eaten as much food as we have.  Stay away from food that contains any of those substances listed above in the first five ingredients on the label.

12. Most people know that eating fish is good for you.  Unfortunately, many people put breading on it and fry it in oil.  This counteracts any benefit you will get from eating fish.  Eating non-fried fish at least three times a week will take off three years from your real age.  The oils in fish help to prevent those tiny tears in our blood vessels and decrease inflammation in the body.  If you cannot stomach fish, taking fish oil capsules at a dose of two grams a day is roughly the equivalent of eating three servings of fish per week.

13. Another important part of anyone’s diet should be fruits and vegetables.  Research shows that eating five servings of fruit and four servings of vegetables a day will take one and a half years from your real age.

14. More and more dieticians are recommending that we add nuts to our diets.  Nuts contain a great amount of healthy fats.  Eating an ounce of mixed nuts (peanuts don’t count in this case) every day can reduce real age by four years.  Walnuts have the highest concentration of beneficial fats, just twelve walnuts a day is all you need.

15. Have a fatty appetizer.  Eating a high fat food prior to your regular meal will make you feel fuller faster.  Avocado is probably the best choice here since it contains many beneficial substances along with being a great source of health fats.  Eating half an avocado a day or something equivalent, will take two years off your real age.

16. White food increases inflammation which means increased aging.  Avoid white foods like bread, flour, sugar, white rice, or white pasta.  The only acceptable white foods are fish, egg whites, and coconut.  Keeping all those processed, unhealthy, white foods from going into your body will eliminate three and a half years from your real age.  Cow’s milk is good for baby cows.  It has some good assets and some bad characteristics when consumed by humans.  Limit your cow’s milk consumption.

17. Calcium and magnesium work together in your body in many different areas.  By getting at least 1,200mg of calcium a day and 400mg of magnesium a day, you can do away with another one and a half years.  Your body can only absorb calcium when it has the proper amount of vitamin D (go back to tip #2 if you need more vitamin D).  Also, you can only absorb about 600mg of calcium every six hours.  So you will have to take your calcium two or three times a day to get the proper amount.  If you are a coffee or soda drinker, you will have to increase your supplemental calcium 50mg a day for every cup of coffee or can of soda you drink.

18. Any woman who has been pregnant knows the importance of folic acid.  When cells divide and grow, they need folic acid to properly duplicate the DNA inside the nucleus.  Not having enough folic acid increases the chances of a mutation that can lead to diseases like cancer.  A daily intake of 800mcg of folic acid lowers your real age by one year.

19. I am an advocate for strength training.  Resistance exercise, weight lifting, using resistance bands, pumping iron, whatever you want to call it, keeps you healthy.  This form of exercise will preserve bone strength and add muscle mass to your body.  The added muscle mass burns calories 24 hours a day and keeps your metabolism high.  Averaging just ten minutes a day takes off one and a half years from your real age.

20. Since I am a pharmacist, I have to mention prescription drugs.  Taking your medication correctly will make you another year younger.  About half of the people who are on prescription blood pressure medication do not take it correctly.  In my own experience, about 80% of patients do not even know why they are taking a certain medicine or even the name of their prescriptions.

Even if you can add just ten quality years to your life, what kind of a difference would that make to your grandchildren, or great-grandchildren?  You will carry decades of life experience with you to pass on to future generations.  What pieces of advice can you give to a loved one?  What insight can you give to a family member who is making a major decision?  Think about the future.  Think about your legacy.  Think about the memories your family will have of you when you are gone.  Think of the impact you will make in a child’s life.  Let’s stay on God’s Earth as long as we can.

What I need is a way to keep the mosquitoes off when I want to sit in my backyard patio.  They’re terrible this year! I’ve heard that the DEET in “Off” is really bad to rub on your skin, and while I can spray it on my clothes, the info on the can says not to wear the clothes again until washed.  The local pharmacist says there are no natural products that work, but in checking the Web I found that the CDC does recommend oil of lemon eucalyptus. Not something my local drug store carries, though.  Just thought I’d check with “the master.”  It seems that West Nile virus is a very serious threat, and every time a skeeter catches me, I worry.

Since you called me the master, I feel compelled to give you a great, groundbreaking, change-the-world answer.  There just isn’t one.  Let’s start with what attracts mosquitoes in the first place.  There is carbon dioxide.  This is what we give off when we exhale during breathing.  The faster you breathe, the more mosquitoes you attract.  A fire or a candle gives off carbon dioxide as it burns.

Lactic acid; when we exercise, our bodies create lactic acid as a waste product.  Sometimes, it can come through the skin, giving a slight odor that is detectable by the mosquitoes.

Some certain perfumes, flowery or fruity fragrances like those found in bath or body lotions have a tendency to bring on mosquitoes.  And moisture, mosquitoes reproduce in water so they are attracted to moisture in the air.  If you are sweating, even in the slightest, the mosquitoes will find you.  If you have been exercising, breathing rapidly, sweating, and try to cover the smell with a fruity perfume, just stay inside.

As far as your concern with DEET, I use it and I spray it on my kids.  I can hear the dirt people shouting already, “How dare you put that toxic, deadly chemical on your children.”  I don’t coat them from head to toe every day.  They are boys and, occasionally, they want to go walking around in the woods.  Here in Tennessee, we have ticks.  So, I spray their shoes, socks, and up their legs.  I’m comfortable with the occasional use but have no problem with someone who wants to use something else.

I found an old Consumer Reports article from June 2006 that said a product called Repel Lemon Eucalyptus was the best repellant that does not contain DEET.  The testers did say that the odor was pretty strong.  I checked epinions.com and it got 4 1/2 stars, so I guess it is pretty effective.  You can buy it just about anywhere.  If you can’t find it, just google Repel Lemon Eucalyptus and you’ll find it for sale somewhere.

I also found a comparison in the New England Journal of Medicine that gave the repellant times of various products…

Deep Woods Off at 23.8% DEET repelled mosquitoes for 301 minutes.  Second was Repel Lemon Eucalyptus at 120 minutes.  Then Off Skintastic for Kids which is 4.75% DEET at 88 minutes.  And Bite Blocker that contains geranium, soybean, and coconut oil repelled the mosquitoes for 88 minutes.

The studies that I read concerning citronella candles showed that they have very little effectiveness.  On average, they provided about 25% better protection than no candle at all.  So, instead of four mosquito bites, you’ll get three.

Also, a product that I have used, Skin So Soft was shown in other studies to give only about 10 minutes of protection.  I will say that my skin was nice and I didn’t get any mosquito bites as far as I can remember, but I rarely get bit anyway.

Have you noticed that some people rarely get bit while others seem to always be getting mosquito bites?  I rarely get bit and send the mosquitoes to someone else to have a feast.  Scientists are working on developing a natural repellant that is derived from the scent given off by people who rarely get bitten, like me.  They have discovered a few and are working on putting those odors into a product.  Since it is natural to the human body, it should have no perceivable odor and no skin reactions.

I’m not concerned about West Nile Virus.  If you are bitten by a mosquito that carries it, your chances of getting a serious infection are about 1%.  Your risk of death from West Nile is about the same as winning the lottery.  In the last 10 years, only about 500 people have died from the West Nile Virus and they were most likely in poor health to begin with.

I don’t fall for all these killer diseases that seem to spring up every year.  How come every summer, there is something new that is going to wipe out the human race?  Remember SARS?  We were all going to die from that.  We still have the deadly bird flu.  Why aren’t we dropping like dead pigeons?  I remember the “summer of the shark” when a half-dozen swimmers were bitten by sharks.  They had shark experts coming out of the woodwork saying that sharks were moving towards the shore because of over-fishing.  The fact was, there were the same amount of shark bites that year as any other year, it was just slow news at the time, they needed something sensational to talk about.  Oh, and Mad Cow disease, what happened there?  We just went through the MRSA, flesh eating bacteria.  That was just this year, we were supposed to bathe in antiseptic lotion so as not to succumb to the dreaded MRSA.

If you get a nail fungus, it is just tough to get rid of.  Medication really doesn’t penetrate the toenail and a lot of times you end up spreading it to your other toes.  When you cut your toenails, either cut the one with the fungus last or really wash the clippers in alcohol between cutting the toenails to clean off any fungus.  See, if you cut a toenail with fungus on it, the fungus can get stuck on the clippers.  Then when you go to cut another toenail, bingo, you get the fungus on another toe.  So don’t do that, that’s rule #1.  Oh, and you don’t want to clean the dirt out from under the nails because there is a good possibility of cross contamination, just like with the clippers.  If you do that, clean whatever you are using, clean it with alcohol.

Fungus looks like a discoloring or a thickening of the nail.  There normally isn’t any pain involved but it just looks ugly.  If it gets too bad, the nail could fall off because the fungus sort of detaches it from the nail bed.

Going to the podiatrist, the doctor may try to cut the nail short enough to get rid of the fungus, just kind of dig it out.  There are a few commercially available antifungals that can be prescribed but, really, they just don’t work all that well.  I’ve made some compounds with iodine, terbinafine, which is an antifungal tablet, some doctors like DMSO.  Honestly, I haven’t seen any prescription product work really well, or any over the counter antifungals either.

OK, here’s the deal.  I’ve recommended this a couple times since reading about it on the internet.  My customers, the ones who followed it, say that it works.  So what you need to do is go to the store, the grocery store, and buy a couple bags of Epsom salts, toenail clippers, and a nail file.  Cut the infected nail as short as possible and then file it down, on the top of the nail, making it thin over the fungus.  Make sure you don’t go too deep when you file, if you do, it hurts.

A minimum of once a day, two is better, and three is even better, soak your toes in hot water with a good amount of Epsom salts, maybe ½ cup or something in a shallow pan.  The water needs to be as hot as you can tolerate.  Soak them for at least 20 minutes, 30 is better.  So, try for three times a day for 30 minutes in hot water.  To make it even better, just pour that Epsom salt right on the toenail.  Get as much touching that infected toe as possible, bury it if you have to.

If you sit at a desk all day or do something where you can just soak your feet all day, that’s fine.  Keep them in the water as often as possible and just keep heating the water in the microwave or adding hot water.  Try putting a towel under one end of the pan so that the water is deeper towards the toes and your heal is out of the water.  It’s not necessary to do this but soaking the heal of your foot for a long time will have the tendency to soften the skin of your heal and that could cause pain when you walk, you want your heal to be tough.

When doing this treatment, you want to keep your feet out of shoes and socks as much as possible.  The fungus grows in a warm, moist environment so avoid that situation.  Wear sandals as much as you can and keep your toes dry between treatments.  Try to keep your feet out of shoes, put them on at the last minute before work, take them off at lunch, take them off while driving, things like that until the fungus if gone.

After you are done soaking, you don’t have to throw away the water with the Epsom salts in it.  You can use the same water for a few days, maybe even a week.  Just add some water as it evaporates.

You also want to file that nail down just about every day.  You want there to be as little room or as thin a nail possible between the water and the fungus.  That just makes it easier for the Epsom salts to do their work.  So file, cut, file, cut, keep it short and thin.

I’m not going to tell you that this is going to take care of the fungus overnight, or even in a week.  This is a tough one, this nail fungus.  I mean, it can take over a month for this to work.  Another thing that you may want to try is putting Vicks Vapor rub on your toes in the morning after your soak and before bed.  Some people say that the Vicks prevents the fungus from growing but I don’t really have any proof either way on that one.

Rich Sagall, MD is a graduate of the Medical College of Ohio at Toledo.  After completing his family practice residency at the Eastern Maine Medical Center, Bangor, ME, he practiced family medicine and occupational medicine there for nearly 20 years.  During that time he began NeedyMeds.  He and his wife moved to Philadelphia where he practiced occupational medicine and ran NeedyMeds.
Rich has written articles on assistance programs and occupational medicine topics for a number of publications.

He has given presentations on patient assistance programs and occupational medicine throughout the country.  In addition to directing NeedyMeds, he runs the Pediatrics for Parents website (www.pedsforparents.com), a website on children’s health, and publishes Pediatrics for Parents.  He now lives in Gloucester, MA.

In this short, 30 minute interview, you will learn:

- How and why Dr. Sagall started Needymeds.org

- The type of information available at Needymeds.org

- Why drug manufacturers have these programs

- What a patient assistance program is

- How to qualify for patient assistance programs

- How the medication gets to the patient

- How to get on to a patient assistance program

- How to gain access even if you don’t have a computer

- How to get help filling out the applications

- What to do if you are turned down by the assistance program

- How to get your doctor to help you fill out the forms

- Can you use a patient assistance program if you have Medicare Part D

- How to locate free or low cost clinics

Right-Click Here to Download the Interview

Download and print this card TODAY to begin saving at the pharmacy.

Transcripts…

Right-Click Here to Download the Transcripts

West Conner:  This is Dr. West Conner, founder and president of MedicineCoach.com. Being a pharmacist help provide a great life for me and my family. After practicing a short time, I realize the struggles people were having affording their medication. It was then that I began my quest to help those who were struggling in this area.

During this time, I developed several unique ways to both lower your prescription drug cost and greatly reduce the time, your precious time, that you spend actually acquiring your medication. I put these time-tested and proven ideas down in the workbook so anyone can get this information and begin to save.

Just because a doctor prescribes a medication for you, you’re not forced to take it. Most likely, there are other far less expensive medications out there that you can use and get the same result. I bring these and tons more information in the workbook: How To Save Money On Your Prescription Drugs.

During my personal coaching sessions, many clients were interested in remedies other than medication – herbal products, vitamins, and lifestyle changes can greatly reduce or eliminate your need for expensive prescription drugs. The shelves at your pharmacy or grocery store can be a minefield of one concoction after another. I, along with other researchers, sift through the confusion and bring you the real studied and science-based products that work for you.

In the MedicineCoach.com website, you’ll find articles, podcasts, special reports, and interviews – all dealing with your health, your medication, and your supplements. Keep checking back at the website for frequent updates.

This is an interview with Dr. Richard Sagall president of NeedyMeds.org. Rich is a graduate of the Medical College of Ohio at Toledo. After completing his family practice residency at the Eastern Maine Medical Center in Bangor, Maine, he practiced family medicine and occupational medicine there for nearly twenty years. During that time, he began NeedyMeds.

He and his wife moved to Philadelphia where he practiced occupational medicine and ran NeedyMeds. Rich has written articles on assistance programs and occupational medicine topics for a number of publications. He has given presentations on patient assistant programs and occupational medicine throughout the country. In addition to directing NeedyMeds, he runs the Pediatric for Patients website at www.pedsforpatients.com – a website on children’s health, and publishes Pediatric for Patients. He now lives in Gloucester, Massachusetts. You can learn more about Rich at NeedyMeds.org.

Before we learn about NeedyMeds, can you just tell me a little bit about of you and why you got in to assisting people with high medication costs?

Rich Sagall:     Sure. My background is in family medicine, and I was practicing in Bangor, Maine where I did my residency. I was practicing family medicine. Talking to a friend of mine who I had met in Bangor but she was living down in either Mississippi or Alabama. She’s a medical social worker. I thought I was pretty astute and up-to-date on how to help my patients and lots of patient information, etc. She told me about the patient assistance program, and I never heard of them. She said, after explaining them to me, she said that she put together a little database on her laptop because she would go out in to people’s homes.

At the time, I had just learned how to do websites. I’ve always been interested in computers, I just learned HTML, and I said, “This will be a good project for us to do.” So, combining her knowledge and my skills, we’ve put up NeedyMeds. That’s how it started, because we just wanted to get the information out. Since then, it’s grown quite a bit. She is no longer involved on an active, day to day basis with NeedyMeds, but we have grown quite a bit.

This last week for example, everyday of the week – every work day – we’ve got over eleven thousand unique visitors to the website. One day, over thirteen, almost fourteen thousand.

West:   Can you describe NeedyMeds and some of the information that people can get from the website?

Rich:    We started off with the pharmaceutical patient assistance programs. These are the programs run by the pharmaceutical manufacturers that give away billions of dollars of drugs every year to people that can’t afford their medications. These programs are primarily for the uninsured, or underinsured – what we often call the working poor. Many of these programs help people who may be at three hundred or even four hundred percent of the federal poverty level. We have information of over four hundred companies and programs offering over four thousand different drugs and formulations.

So, that’s what we started with. Then, we added what we call disease based assistance. These are programs that help people with specific diseases. To be listed on our website, they have to help financially one way or another. There are many what are called co-pay foundations. These are programs that help people with certain diseases that can’t afford a co-pay. So, these people have insurance, but their co-pay may be a couple of hundred dollars a month or more. So, these programs help people who can’t afford co-pays with certain diseases – not everybody.

We also added a database of state programs. There are many, many programs – some are well known, some are not very well known in every state. So, we have all of those listed.  Then, we recently added a list of free, low-cost and sliding scale clinics. We have close to thirty-three hundred on our database on the website in every state. These are clinics that will help people either at no cost, a very low rate, or on a sliding scale based upon income.

We’re adding to this every week. We’re probably adding close to a hundred every week of these types of clinics. Then the latest thing that we added is a list of discount coupons. These are coupons, usually offered by the manufacturer to give people a discount, or a rebate, or free medication as a trial of the drug. The last time I checked we had over two hundred seventy-five of those. That’s going everyday also.

West:   Why do drug manufacturers have these programs to help out patients?

Rich:    Depending upon who you ask, you’ll get different answers. Most of the companies say that they want people who can’t afford medications to get them. I think that this is a strong motivating factor. Drug companies have a reputation to maintain. Sometimes, it’s not been the most sterling of reputations. This is one way that they can help people who can’t afford their medications. I’ve also been told that they found the people who get their medications for free; many of them end up having insurance at some point and tend to stick with their medication.

So, I think that there’s always two sides to an issue, but they do have the programs, and they do help, last I heard, maybe fifteen million plus people a year get over six billion dollars worth of drugs wholesale value.

West:   Yeah. I tend to agree with you on that. When I think that the big pharma gets such a bad rap in the news, in the newspaper or whatnot that they kind of got to do something to help people and get themselves in a better light than what the news media portrays them. Similar to oil companies where they just profit, profit, profit. That’s the way people tend to see big pharma and the big drug companies. So, they can do this, they can help out some people and shed themselves in a better light than the way they’re normally seen. Also, like you said, if you get somebody on a drug for a while, and if they are responding well, and eventually do get insurance, they will continue on that same medication.

Rich:    Exactly. So, there are two sides to it, but the bottom line is they do help many millions of people who, otherwise, couldn’t afford their medications.

West:   So, can you just go over, in general, what is a Patient Assistance Program?

Rich:    Patient Assistance Program, as I mentioned, is a program that dispenses medications to people who can’t afford them. You can think of them as a pharmacy in some way because they do dispense medication. So, every program requires doctor involvement. The involvement varies from just a prescription to, some time, much more information about the patient, about the diagnosis, about the medication, etc.

So, the programs dispense the medication to people who need it. There are varying requirements. Some programs are very simple, others are very complex. All of them have some type of an application process, most have an application form, although some you call and go through a pre-screening process. Once you’re approved after submitting the application, whatever information you need from the doctor, perhaps income verification such as an income tax return, or a pay stub, or a denial letter for Medicaid, etc., then you can receive the medication anywhere from one prescription to [it's] endless.

Some of the programs will go on and on. You may have to reapply every three to six months, but they will keep people on it for as long as they can’t afford their medication. There are other requirements besides financial. Most of them have some type of residency requirement. Most of them will not help people that are not legal residents, or illegal aliens in this country. Most require that the doctor be located in this country, not in a foreign country. So, they vary. Some, as I said, are very simple. The applications are very simple; others are very complex.

Most, if not all of the programs require that the medication be used for what’s called an on-label indication – in other words, an indication for which a drug has an FDA approval. Many drugs are used for what’s called off-label purposes – purposes that have not been approved by the FDA, and yet the medications are very beneficial for that symptom or disease. Most of them require a diagnosis so it’s for on-label.

West:   When you say these programs “dispense” the medication, do they mail the medication to the individual patients, or do they give the patient a voucher to go to the pharmacy, how does that work?

Rich:    All of the above. The programs are all different. The only generalization you can make about the programs is that they’re all different in some way or another. Even two programs run by the same pharmaceutical company may have differences.

West:   For more interviews like this, visit MedicineCoach.com

Rich:    Most of the programs send the medication directly to the patient. Some send it to the physician’s office. Some will send it to a pharmacy. Some will issue a voucher. So, they go to a pharmacy of their choice and get it filled there, and then give the pharmacist the voucher. So, it varies from program to program.

West:   So, step one to get on a Patient Assistance Program – once the patient goes to NeedyMeds.com, how do they go from there to get on a patient assistance program?

Rich:    Part of the initial concept of NeedyMeds was to make it simple. So, to find the information one needs to get on a program there’s generally three or four clicks of the mouse. Just a couple of other of our basic concepts, before you to get in to the process we wanted it all to be free. So, we do not charge anything for access or use of our information and our information is updated regularly – almost daily – we’re making changes to the website. It’s confidential. We do not ask any information about the applicants – the people who come to the website.

So, now going back to the process, somebody is on a drug. They go to the website, on the left there’s a list of links. You see the brand name of the drug, and then click on the brand name list. If they know the generic, they click on the generic name list. Either brings up a list of drugs. It starts with the As. That’s what we call an Alphaby – A-B-C-D, etc. You click on the first letter of the drug, and that brings you to that section of the alphabet for the drugs. Some of them are broken up because the lists are too long. You find your drug. If it’s on the list, you click on the drug name, and that brings up the program page or program pages. There you have all the information you need to decide if you’re eligible for the program, how to apply.

We have PDFs for most of the applications. It’s the type of PDF that you can type right in and fill it out, then print out a completed application. So, you’ll look at the eligibility guidelines and notes to see if you qualify. If you do, then you complete the application. Then, you need to submit it to the drug company along with any supporting signatures such as the patient’s, or the doctor’s, or any supporting documentation that you’re required.

If it’s accepted the drugs are normally sent, as I said, most often to the patient’s home, but sometimes to the other places generally within three to four weeks. So, this is not a program for people that need drugs immediately. So, if someone needs an antibiotic, for example, immediately – this is not the program. These programs don’t work that fast. So, that’s the basic process. On the program page, we do list the refill process so you know how you apply for refills.

In addition to the PAPs, we list information on two, reliable, large, nationally certified, discount mail-order pharmacies because they offer a wide number of generics at a very low cost. We also list some programs that are more of a discount card, such as Together RX Access and a few others which have a discount. You don’t get it for free, but if you qualify, you can get a ten to fifteen percent discount on the medication that you need to get.

We list them in order of what we consider most beneficial. In other words, PAPs come first, then the discount pharmacies, then the discount cards.

West:   Yeah. Someone with a lower income level that would qualify for these assistance programs may not have a computer, but they can always go to the library – which is free for anyone – and sign up there right at the library.

Rich:    Right. We find… Although we don’t accept phone calls because we’re not set up to handle it, we do get some calls. We find that the vast majority – over ninety-percent of people that call – either have a computer at home, at work, they go to the library, a senior citizen center, or they have a friend or family member that can help them. The reason it’s on the web and not in a book is that it’s changing all the time. Between all of our programs, we’re probably making ten to fifteen changes everyday – in the drugs that are available, the program requirements, the applications, we load up new programs, or programs that are not taking new applicants, state programs, disease-based assistance, etc. So, it’s always changing.

So, anyone who try to publish a book… And we used to publish a manual. By the time it’s sent out, it’s out of date.

West:   Yes, I learned that.  When I was researching my book, if this information was available to me, it would have saved me months of work. I mean, I went to each and every manufacturer’s website and tried to find the Patients Assistance Programs. NeedyMeds probably was out there, I just didn’t know about it, and you’ve got it all in one place. So, how did you get all this information in one place, or where do you collaborate all this information?

Rich:    We have three employees who’s primary job is keeping the information current. So, depending upon the type, for example, the Patient Assistance Programs, we have a system set up so that we contact many of the programs on a regular basis depending on how active they are. Some of them it’s once a month or even more frequently. Others it’s very infrequently because either they don’t have a program, and they’re never going to have one, or they have one drug and it just doesn’t change.

We have many programs that just contact us whenever there’s a change because they know that we’re the most reliable source. We found that many of the companies… We have the experience where we’ll call the pharmaceutical company and say we just want to check on your PAP. Then, she’ll just look at NeedyMeds, they have all the information. We do it that way. We also have a system for some of our other databases where we send out letters or e-mails so that the organizations like the disease-based assistance and the free clinics, for example, will be able to go and actually make changes in the listing we have for them.

It’s a real task. We’re updating everything. We have our set schedule. For example, with the state programs, every six months we check every program on a rotation just to make sure what we have is accurate. Another way that we keep things accurate is through the help of our users. We know that there’s no way we can keep everything current ourselves. We could talk to a company this week, have it scheduled to talk in two months because things never change, and then in two weeks they change something. Our users will find that and let us know. So, it’s really a cooperative effort. We’re not foolish enough to think that we can keep everything current ourselves. It depends upon our users also, and they help us quite a bit.

West:   Some of these forms can be pretty daunting specially someone who has English as a second language. Is there a place that people can go that have help filling out these forms or a program that will help them fill out the complex forms?

Rich:    There are a couple of different ways. We’re not, again, set up to do that because we just don’t have the funding for the staffing.  We’d love to be, so if any of your listeners are feeling magnanimous, just go to NeedyMeds.org and make a big donation. We do have a list of what we call Application Assistance Programs. These are programs throughout the country that help people fill out the applications. To be included in our list, you either have to do it in no charge, or a very, very low charge and you have to be flexible in your charging, otherwise, we don’t put you on our list. So, there are those programs.

As you said, some applications are very simple, others are very daunting. There are companies out there that charge for this, and I look at them with mixed feelings. There are some that charge a reasonable amount – maybe a twenty-five dollar registration fee and five or ten dollars per application. Although, nobody has to use one, some people just do because they find it easier.

Then, there are companies that are rip-offs where they charge hundreds of dollars guaranteed to get you all their medications, and often do nothing. We’ve had people e-mail, or write, or call with these very sad stories of how much money they’ve lost because these companies never live up to their reputation. So, I’d be very careful in terms of paying for this service. If you can do it yourself, that’s what I recommend. If you’re going to go with any company make sure and check with the Better Business Bureau, perhaps the State Attorney General’s office, because a number of them have been sued by the Attorney General just because they have been ripping-off and making false promises.

West:   So, let’s say you’ve gone the route, you filled out the paperwork, and you’ve submitted it, then you’ve been turned down by the assistance program. Is there a place to go to plead your case?

Rich:    Each program has its own appeals process. You want to try to find out why you’ve been turned down. It goes, partially, back to the philosophy of the program. Some programs, although none will admit this, measure their success by how much drugs they give away. The more they give away, the better their program is and more successful it is up to whatever limits they set. Other programs I’m sure, although none will admit this, measure their success by how little drugs they give away. They want to have a program, but they really don’t want to give it away.

So, if your application gets denied, you want to find out why. Sometimes it’s something simple – about a piece of information, you didn’t sign it. Those are the two biggies right there. You may not qualify, but you may be very close. It’s very important for anyone who doesn’t think they qualify but are close to contact the PAP and plead your case. Some of them do have leeway. It depends upon what the issue is. If they say you have to be a two hundred and fifty percent or less of the federal poverty level – and we have that information on the website – and you’re in two hundred and sixty, they have some leeway. If you’re using the medicine for a non or an off-label purpose, most of the time they don’t have any leeway.

So, it depends but it never hurts to call, and just like with any helpline or service line that you call, if you don’t like the answer you get from the first person, you may want to try calling again and get somebody different. In a small program, it may only be one or two people; in a big program they may have ten or twenty advisers. So, you may want to talk to them and see if a different adviser can do a little bit more.

West:   You mentioned poverty level a couple of times. Right now, at the beginning of 2009, what is the poverty level?

Rich:    It depends on a number of factors – including family size, and also where you live. Now, as of today, I don’t have the 2009 poverty levels out there. I don’t know if they’ve been released yet, but for 2008, for a single person living in the United States – for the forty-eight contiguous states in DC, its ten thousand four hundred dollars. For Alaska, it’s thirteen thousand. For Hawaii, it’s eleven thousand nine hundred sixty. As the family size increases, obviously, the federal poverty level increases.

Now, we also have in the website the percentages. So, then if for example a family of four and it was three hundred percent of the federal poverty level, that’s sixty-three thousand six hundred dollars last year. We have it a little higher this year. It’s not wealthy, but it’s not a bad income. So, that’s why I always encourage people to check, because you never know what a program is going to have as their requirements.

I also recommend, while we’re talking about that, is be sure and check every drug you’re on.

West:   For more interviews like this, visit MedicineCoach.com.

Rich:    Many people only go and look for the expensive one and forget, maybe, the five other inexpensive ones they’re taking. Yet, they may all be programs or available through a generic pharmacy much cheaper – freeing up enough cash to hopefully be able to afford the expensive one.

Another thing to do is be sure and check the medications for everybody in the household. You may be looking at your child’s ADHD medicine and forgetting about your diabetes, and hypertension, and hypercholesterol medicines; where if you can get those for free, then you might be able to afford something else that is not on program.

West:   Some of these programs require doctor participation and have a doctor’s office fill out certain parts of the forms. Now, you’re a doctor and I’m a pharmacist, so we both know the time constraints that we deal with on the job. Doctors are most likely not going to fill out all these paperwork for the patient. So, what can a person do if that’s the case?

Rich:    A couple of suggestions: one is read the form carefully and completes everything possible that you can. Leave as little for the physician to do as you can. Number two, is to get those little sticky flags and flag exactly where the doctor needs to do something. Number three is including a self-addressed stamped envelope for the physician to send the application back to you. The reason I say that, is that you want to know that the physician did it. This way, the physician sends it to you, and then you send it to the pharmaceutical program. It cuts out any of this… You know, saying the doctor didn’t do it. You know if the doctor did it. I also suggest you keep copies of whatever you submit.

There was one study that looked at the cost to the physician’s office to completing an application – and this was minimal physician involvement. It was mostly a medical assistant doing all the work. It was twenty-five dollars per application. Now, some physician will charge a small amount for this, others don’t. If you can’t afford your medicines, I feel strongly that you need to be upfront with the doctor and say, “Look, I can’t afford this. Will you help me with the PAP? Will you prescribe something cheaper? Is there something else that we can do?”

There have been studies that show that a low percentage of patients bring this up to the doctor. This is why there’s many treatment failures, because the doctor thinks the patient is taking the medication and the patient doesn’t tell the doctor that they did not.

West:   That’s true. That’s something that I try and educate my clients too; it’s to learn about your disease state. Learn about the medications. So, that if you are taking an expensive drug and there’s a generic substitution available, you can go in to the doctor’s and say, “Hey, Doc, this is costing me an arm and leg. Is it possible that we can try this other medication that’s available in generic and see how I do after a couple of months?” If you can speak intelligently to your doctor about your disease state and your medication, the doctor’s more apt to listen to you rather than you just complaining about the cost.

Rich:    That’s true. One of the things that we’re going to be putting on the website – we haven’t told anybody yet, so this is a first – is we’re going to be setting up a system so you can look up a drug and if it’s not on the PAP, you’ll be able to generate a list that you can take to your doctor of drugs in the same family that are on a PAP so you can discuss that with the doctor. So, if for example the doctor prescribed a non-steroidal anti-inflammatory for your arthritis, and it was not on the PAP, you could generate a list of all the non-steroidal anti-inflammatory that are on the PAP, send that or take it to your doctor and say, “Look, these are drugs or programs that I’ve qualified for. Can I try one of these instead?”

West:   Yeah. I’ve got a similar chart to that in the back of the back. I always use Lipitor as the example because Lipitor is not available in generic right now. So, if someone’s taking Lipitor – it’s the most popular drug in the world, it’s so expensive – well heck, there’s a number of generic medications that are statins like Zocor or simvastatin which is on a number of big box stores four-dollar generic list. So, they’re cheap. So, instead of spending a hundred fifty dollars a month on Lipitor, it’s four dollars; but if you don’t know that, you don’t know to ask that.

Rich:    That’s right. Even if your doctor prefers Lipitor, you’re better off taking the Zocor than taking nothing. That’s often the choice you have.

West:   Now, do these Patient Assistance Programs also work with someone who’s currently on the Medicare Part D program?

Rich:    It varies depending on the program. Some of them say if you have any insurance that provides pharmaceutical coverage, we won’t help you. Others say, if you’re eligible for Medicare Part D you have to apply. Then, if it’s not covered we’ll help you. Others say when you’re in the donut hole, we’ll help you, etc.

If you’re in the donut hole and you get medications through a PAP, the value of those drugs does not help you get out of the donut hole because you did not pay for them. It’s not a true out-of-pocket expense.

West:   I wrote an article about the power of coupons for prescription drugs because it’s something that people don’t think about. You don’t need to be at a certain income level, or live in a certain state, nothing. Anyone can use them. You just print out the coupon or fill out a form and you can save hundreds of dollars. So, NeedyMeds has them all in one place. It’s great, a big time saver. I didn’t know it was there. I think you need to spread the word around more about using coupons.

Rich:    We’re trying to because, as you said, it is an important thing. Many people who don’t qualify for any PAPs still could take advantage of it – for example, my wife. The co-pay of one of her medications is a coupon. We offer two different ways to use your coupons. With some of the programs – it depends. On all of them we have a link where you can print out the coupon and take it to the pharmacy. Then, we also work with one mail-order pharmacy where you can fill out all the information online and they’ll take care of everything for you. So, you can do it either way. We’re always looking for more coupons. So, if any of your listeners who go to the website know of any, there’s a link there so you can e-mail us information.

One of the reasons that we added this list is we couldn’t find a good, single listing of all the coupons. It’s the same reason we had for the free clinics. If we could find a list of all the free clinics, we wouldn’t have done it, but we couldn’t find any single, comprehensive, national list of all the free clinics. So, we added it. We’re always looking for information to add. So, if any of your listeners have any other suggestions as to types of information we could put up there, we want to know about it.

When we started NeedyMeds, Libby and I, the social worker that helped me set it up, we came up with the PAPs and then we couldn’t think of anything else to add. We really had to wrack our brain, and it’s grown since then, but it took a while for these other sources of help. We want to be the one-stop place to go when you need help with the cost of medication or healthcare.

West:   With the Patient Assistance Programs, do any of them limit you to which pharmacy you can use?

Rich:    It depends on the program. Most of them send the medications to the patient or the physician. So, it’s not an issue. Usually they don’t. If they send you a voucher, you can take it to any pharmacy.

West:   Is there a way to search for the free or low-cost clinic by your zip code?

Rich:    We do not have it set up specifically by zip code. What we have is it’s set up by state. There’s a map and you click on your state. Then it lists all the programs by city. That does raise an interesting opportunity that we have which is we don’t have a system to do it within a certain range of zip, but we could easily switch it so that you can hit a button which sort them by zip code. That might be a useful feature.

We do have on there that when you click on a clinic, you can click on a Google Map, and it’ll bring up a map of where the clinic is located so you get an idea. You can also click on a number of clinics. Let’s suppose you live in Boston and you wanted to print out a list of five Boston clinics, you can check off a box, you hit print. It’ll print out those clinics.

We like to think of NeedyMeds as being similar to the Yellow Pages. We give people the information, and then they have to use it. So, if you’re looking up a plumber in the Yellow Pages, you might see half a dozen plumbers listed. You have to pick one and make a call. We give you the information about the programs then you’ll have to use it. We want to teach people how to use the programs so they can do it themselves – how to use our information. We even told many, many times our information is very easy to use, very easy to access and that’s what we want. We want it to be so people can come, find want they need, print it out and use the information.

I think that we’re succeeding. We’re approaching our twelfth millionth view of the homepage. As I said, we get eleven to thirteen thousand unique people to the website every workday. So, I think we’re getting the information out. We’d love to get more of it out. We’re always looking for links to be added to other people’s websites.

One new feature that we just recently started is what we’re calling Disease Resource Pages. These are special pages – we only have one up right now, but we have a couple more in the works. We’re planning to really expand this. Where somebody who has a certain disease – in this case the one that we have up is scleroderma – you go to the website or a certain webpage and there are links to information about the disease. There’s a list of all the drugs that are typically used to treat the disease that are available through Patient Assistance Program. There’s a link to the free clinics page, and there are links to the programs that help people who have scleroderma.

So, we’re trying to put everything together in one page. We’re doing this in cooperation and partnership with the Scleroderma Foundation, because we’re not in a position to vend all the information that’s available on scleroderma. That’s just not something we can do. Particularly, when we add another twenty, or fifty, or a hundred of these pages – which is what our goal is – we’re not in the position to sort out the information. So, we’re working with organizations that do that. So, hopefully we’ll have all these information or these links to information up shortly.

West:   So, you’re working with different organizations that help disease states, to help out their patients, similar to like if you were to help the American Diabetes Association. You would put links to all the diabetic medication in one certain area for diabetes.

Rich:    Right. We would have all the diabetes drugs and our PAPs one place. Then we would take from their websites. They would give us links to certain sections where people go to a lot like, “What is Diabetes?” “What’s the difference in Type-1 and Type-2 Diabetes?” “What are oral medications?” “Why would I need insulin?” Etc., etc., etc. So, they would give us those links so that people could come here who were diagnosed with diabetes, have links to all the information about diabetes. Have links to all the programs that offer medications to be used to treat diabetes. Have links to all the disease-based assistance programs that are specifically for people with diabetes – programs that may help with the cost of meters for example, that may help with artificial limbs if someone has an amputation because of diabetes, etc., etc. So, we’re trying to put it all together in one page.

West:   So, anybody who wants to get on Patient Assistance Programs, or coupons, or find out where low-cost or free clinics are in their area, how do they get to the website?

Rich:    The website is very easy. It’s www.needymeds.org. If you happen to go to com or net, you end up at the same place. So, that’s where all the information is. We like to think it’s laid out fairly simply. There are no graphics that are required to get any place. We do have a special section for first time visitors, first time users. Then, we have a commonly asked questions section which answers most of the questions that people have.

One important thing to remember is that NeedyMeds does not have a program. We have information. We’re an information source. So, you don’t apply to the NeedyMeds program, you have to apply to the individual programs that might help you.

West:   That concludes this interview with Dr. Rich Sagall from NeedyMeds.org. For more information visit NeedyMeds.org.

Tip #1 - Going for a 30 minute walk every day and getting a total of about 10,000 steps per day, can make your body 2 years younger after just six months.  Many people use the excuse, “I walk a lot at work.”  If that is the case, buy yourself a pedometer and see how many steps you take during your work day.  You can find a pedometer at just about any department or sports related store.  Just mark down your step number every time you get home from work over the course of a week.  If you averaged 10,000 steps per day, congratulations, you get enough walking at your job.  Anything below 10,000 steps per day, get out and get those magic 10,000 steps per day.

Tip #2 – While you are walking, your body is absorbing sunlight and converting it into active vitamin D.  Thirty minutes of winter sunlight or fifteen minutes of summer sunlight in a short sleeved shirt is all most people need to keep their vitamin D levels adequate.  Darker skinned people may need more sunlight while fairer skinned individuals will require less.  If you do not have any underlying medical conditions, like osteoporosis, multiple sclerosis, arthritis, etc., you should keep your vitamin D level above 40.  If you do have a medical condition, depending on the severity, keeping your vitamin D levels over 60 can be very beneficial.  Taking vitamin D2 supplements can help in this area.  By keeping this level up, you will be one year younger.

Tip #3 – If you are a smoker, stop.  If you live with a smoker, you will have to avoid second hand smoke in order to shave 7 years off your real age.  Sitting next to someone who is smoking for 15 minutes has been shown to have the same damaging effects as smoking one cigarette.  Keep your distance from smokers.  If your spouse smokes, give as much support as possible to get him or her to stop.

Tip #4 – Your mother told you to brush and floss your teeth.  If you listened to mom and continue to do that today, you will take 6 years off your real age.  Researchers have concluded that the same bacteria found in the mouths of those with poor oral hygiene, causes aging of the blood vessels.  By keeping this bacteria from growing in your mouth, you will keep it from growing on your blood vessels.  Remember, the most important measure of our real age is our heart and blood vessels.  Let’s keep them happy.

Tip #5 - Many doctors recommend taking a daily aspirin to keep your cardiovascular system in good working order.  By swallowing 162mg of aspirin a day, you can make yourself 2 years younger after three years.  Swallow your aspirin whole with a full glass of water.  Taking it with water prevents it from sticking to the side of your stomach or getting lodged in your esophagus (the tube leading from your mouth to your stomach) on the way down.  You also should not use a chewable form of aspirin.  Chewing aspirin will increase your risk of developing tooth decay.

Tip #6 – Managing your finances is something that most people should do anyway but you normally wouldn’t associate this with a youthful body.  Financial worry is one of the most damaging forms of stress and by eliminating that excess tension, you will lower your real age roughly eight years.  That’s extra time to spend your children’s inheritance!

Tip #7 – Continuing with the subject of stress, general stress reduction will give you another six years off your real age.  Even simple stress reducers like lying down and breathing deeply, scrunching your face and holding it for ten seconds, or calling friends on the phone can help lower body tension.  When you go for your daily 30 minute walk to satisfy tip #1 from the last email, take a cellular phone with you and call family or friends.  Here’s a tip for you guys out there; call your mother.  If you really want to impress someone, go for a walk and call our wife!  Then move on to tip #8…

Tip #8 – Now that you have impressed your wife (or husband), having sex is an excellent way to stay young.  By having sex at least three times a week, you can lower your real age anywhere from two to eight years.  The difference in the age reduction has to do with the quality of sex.  The better satisfying for both you and your partner, the greater the age reduction.  It is not just the act of making love but the love in making the act that counts.

Tip #9 – After all that love making, you are going to want to get a good night’s sleep.  Getting at least seven hours of sleep every night will get you another three years.

Tip #10 – Having fun makes you feel younger and playing mind games or thinking games will keep your body younger.  Reading, doing crossword puzzles, word searches, or anything that exercises your mind on a regular basis will do away with two and a half years.

Tip #11 – What you put in your mouth significantly contributes to your real age.  Learning to read food labels and following a few simple rules can shave three and a half years off your real age.  Look on the labels and avoid saturated fat, trans fat, sugar, hydrogenated oils, corn syrup, and anything that says “enriched.”  Corn syrup is in most canned or bottled sauces and actually fools our brain into thinking we have not eaten as much food as we have.  Stay away from food that contains any of those substances listed above in the first five ingredients on the label.

Tip #12 – Most people know that eating fish is good for you.  Unfortunately, many people put breading on it and fry it in oil.  This counteracts any benefit you will get from eating fish.  Eating non-fried fish at least three times a week will take off three years from your real age.  The oils in fish help to prevent those tiny tears in our blood vessels and decrease inflammation in the body.  If you cannot stomach fish, taking fish oil capsules at a dose of two grams a day is roughly the equivalent of eating three servings of fish per week.

Tip #13 – Another important part of anyone’s diet should be fruits and vegetables.  Research shows that eating five servings of fruit and four servings of vegetables a day will take one and a half years from your real age.

Tip #14 – More and more dieticians are recommending that we add nuts to our diets.  Nuts contain a great amount of healthy fats.  Eating an ounce of mixed nuts (peanuts don’t count in this case) every day can reduce real age by four years.  Walnuts have the highest concentration of beneficial fats, just twelve walnuts a day is all you need.

Tip #15 – Have a fatty appetizer.  Eating a high fat food prior to your regular meal will make you feel fuller faster.  Avocado is probably the best choice here since it contains many beneficial substances along with being a great source of health fats.  Eating half an avocado a day or something equivalent, will take two years off your real age.

Tip #16 – White food increases inflammation which means increased aging.  Avoid white foods like bread, flour, sugar, white rice, or white pasta.  The only acceptable white foods are fish, egg whites, and coconut.  Keeping all those processed, unhealthy, white foods from going into your body will eliminate three and a half years from your real age.

Tip #17 – Calcium and magnesium work together in your body in many different areas.  By getting at least 1,200mg of calcium a day and 400mg of magnesium a day, you can do away with another one and a half years.  Your body can only absorb calcium when it has the proper amount of vitamin D (go back to tip #2 if you need more vitamin D).  Also, you can only absorb about 600mg of calcium every six hours.  So you will have to take your calcium two or three times a day to get the proper amount.  If you are a coffee or soda drinker, you will have to increase your supplemental calcium 50mg a day for every cup of coffee or can of soda you drink.

Tip #18 – Any woman who has been pregnant knows the importance of folic acid.  When cells divide and grow, they need folic acid to properly duplicate the DNA inside the nucleus.  Not having enough folic acid increases the chances of a mutation that can lead to diseases like cancer.  A daily intake of 800mcg of folic acid lowers your real age by one year.

Tip #19 – I am an advocate for strength training.  Resistance exercise, weight lifting, using resistance bands, pumping iron, whatever you want to call it, keeps you healthy.  This form of exercise will preserve bone strength and add muscle mass to your body.  The added muscle mass burns calories 24 hours a day and keeps your metabolism high.  Averaging just ten minutes a day takes off one and a half years from your real age.

Tip #20 - Since I am a pharmacist, I have to mention prescription drugs.  Taking your medication correctly will make you another year younger.  About half of the people who are on prescription blood pressure medication do not take it correctly.  In my own experience, about 80% of patients do not even know why they are taking a certain medicine or even the name of their prescriptions.