Real Fibromyalgia, Treatment & Emotions
A Pituitary Endocrinology Perspective. Effective natural therapies for Fibromyalgia
Hot flashes, memory loss, and a weird polyneuropathy, polymyalgia or polyarthropathy (i.e. adds up to fibromyalgia)?
What is fibromyalgia? The great magical mystery illness! Pituitary endocrinology research.
Fibromyalgia really is…• Simply pituitary damage. • Causing a lack of several key hormones.
Few pituitary endocrinologists out there. Out of 150 endocrinologists there will be 1 true Pituitary Endocrinologist.
Fibromyalgic syndromes: could growth hormone therapy be beneficial?
Diabetes, Lupus, Cancer, multiple sclerosis, gout, rheumatoid arthritis, arthritis, lymphoma, glucose, osteoarthritis, type 2 diabetes, fatigue, chronic fatigue syndrome, dizziness, autoimmune disease, adrenal fatigue, polymyalgia rheumatica, depression, why am I so tires
Actual Causes of Fibromyalgia?
The pituitary secretes hormones that are essential to growth and reproduction. Hormones and vasculature.
Problems that can cause stalk or pituitary damage:
• Whiplash or any MVA
• TBI – even mild (Australian Rules Football would qualify)
• Air Bag Deployment to face or head
• Any Mild to Moderate Blows To The Head – heading a soccer ball! Any concussion!
• Sexual abuse as a child
• Stroke
• Tumors – if you can’t find anything else!
• Sheehan’s Syndrome
• Snorting or huffing drugs (i.e. cocaine)
• Radiation exposure (i.e. MD/DO/DC/DDS)
• Prolonged High Stress (i.e. MD/DO/DC/DDS)
Pituitary Dysfunction = Fibromyalgia = Maybe Even Multiple Sclerosis (MS)
Fibromyalgia Really Occurs from a Lack of Healing Hormones
Occurrence of pituitary dysfunction following traumatic brain injury. “subjects with a history of TBI frequently develop pituitary dysfunction, especially GHD.” (GHD=Growth Hormone Deficiency)
Lack of Testosterone is a problem, too.
Sage (Salvia officinalis), fennel (Foeniculum vulgare), lavender (Lavandula angustifolia), myrtle (Myrtus communis), peppermint (Mentha piperita), and blue yarrow (Achillea millefolium), in a base of sesame seed oil.
Symptoms of Inadequate Progesterone Production?
• Hot Flashes
• Day and Night Sweats
• Migraine Headaches
• Severe PMS
• Endometriosis
• Demyelination Problems
• TMJ Problems (not usually the only cause)
• Libido Problems
For diagnoses related to hypothyroidism, typical problems include fatigue, weight gain, depression, lethargy, dry skin, cold intolerance, voice change, change in menses, muscle cramps, or treatment of a thyroid condition.
Here’s the emotional tie in
• Depression, lethargy, fatigue.
• Lack of HGH causes PTSD, depression, fatigue, confusion.
• Low testosterone causes decreased libido, fatigue, depression.
• Lack of progesterone causes depression, fatigue, PMS.
“Progesterone prevents menstrual migraine headaches in women.”
Lack of Thyroid Causes Hair Loss
3. Aesthetica -- my office in Lindon, Utah,
USA.
(By Salt Lake City and Near YLEO
Headquarters)
My name is Dan Purser, I’m an MD, and I work with
plastic, trauma, and neurosurgeons in my area dealing
with healing and pain issues
and proactive prevention .
It’s a new concept – ProActive Prevention…
7. Hang on – save your
questions!
This will be brisk…
(I will give Jim O’Reilly a copy of this PPT/pdf)
8. 28 year old mother of 2 is sitting across from you with hot flashes,
memory loss, and a weird polyneuropathy, polymyalgia or
polyarthropathy
(i.e. adds up to fibromyalgia)?
This girl isn’t suddenly old –
she doesn’t have some weird
aging disorder – but what does
she have to cause her to have
these unusual conditions?
13. No one out there really seems
to know, do they?
But I think some do…
14. Who?
• A few research
oriented doctors…
• And big
pharmaceutical
companies
15. I also do pituitary endocrinology research in
Los Angeles with my team from University of
Southern California.
USC Kleck Medical
Center and Norris
Library
But we hang out in Anaheim
on the weekends!
18. Few of the Right Kind of
Doctors
Few pituitary endocrinologists out
there. Out of 150 endocrinologists
there will be 1 true Pituitary
Endocrinologist.
(None in Utah and in
Australia???)
23. Pediatr Endocrinol Rev. 2009 Jun;6 Suppl 4:529-33.
Fibromyalgic syndromes: could growth hormone therapy be beneficial?
Cuatrecasas G.
Endocrinology Department, Centro Medico Teknon & C Sagrada Familia,
Barcelona, Spain. gcuatrecasas@cpen.cat
Abstract
Fibromyalgia is a chronic, idiopathic condition in which patients experience
pain, asthenia and fatigue. The pathogenesis of the condition is unknown,
and numerous mechanisms have been postulated, including neural
hypersensitivity and autoimmunity. Symptoms of fibromyalgia are broadly
similar to those of growth hormone deficiency (GHD), and there is evidence
of decreased GH secretion and functional GHD in a subset of patients with
fibromyalgia. Use of GH therapy in this patient population therefore
represents a rational treatment strategy. Preliminary placebo-controlled
trials have shown that GH therapy can significantly improve signs and
symptoms of fibromyalgia and quality of life in patients receiving the current
standard of care. Despite the use of relatively high doses of GH in these
patients, treatment is well tolerated. Several mechanisms of action for GH in
fibromyalgia have been suggested, including both central and peripheral
effects.
24. You Do NOT Have a Bunch of
Odd Separate and Rare
Medical Problems
So
29. Hormones and vasculature
The posterior
pituitary elutes
ACTH and
controls the
adrenals.
TSH
HGH
LH FSH
Notice the
fragile
vasculature!
30. Another view…
This is with a 1.5T MRI view of a macranomatous pituitary.
A little blurry…
31. REMEMBER!
The pituitary stalk is EXTREMELY
fragile and so is the pituitary
(especially past age 35).
Docs -- should have an extreme
level of suspicion!
Most MRIs have very poor resolution
at 0.5T, better at 1.5T, and the best and
newest are 3T (T means Tesla) – still
not very good.
32. Problems that can cause stalk or pituitary damage:
• Whiplash or any MVA
• TBI – even mild (Australian Rules Football would qualify)
• Air Bag Deployment to face or head
• Any Mild to Moderate Blows To The Head – heading a
soccer ball! Any concussion!
• Sexual abuse as a child
• Stroke
• Tumors – if you can’t find anything else!
• Sheehan’s Syndrome – most common in Utah
• Snorting or huffing drugs (i.e. cocaine)
• Radiation exposure (i.e. MD/DO/DC/DDS)
• Prolonged High Stress (i.e. MD/DO/DC/DDS)
• (Can you tell a LOT of my patients are docs?)
I ALWAYS LOOK FOR THESE IN YOUR HISTORY!
33. ALWAYS HAVE A HIGH LEVEL OF SUSPICION!
And remember – pituitary
dysfunction is the
great mimic!
But we’re finding, due to the fragile nature of the
pituitary (especially the stalk), damage appears to be a
LOT more common than was once thought.
36. Italian studies?
J Neurotrauma. 2004 Jun;21(6):685-96.
Occurrence of pituitary dysfunction following traumatic
brain injury.
Bondanelli M, De Marinis L, et al
Department of Biomedical Sciences and Advanced Therapies-Section of
Endocrinology, University of Ferrara, Ferrara, Italy.
“subjects with a history of TBI frequently
develop pituitary dysfunction, especially
GHD.”
(GHD=Growth Hormone Deficiency)
38. Is further evaluation for growth hormone (GH) deficiency necessary in
fibromyalgia patients with low serum insulin-like growth factor (IGF)-I
levels?
Growth Horm IGF Res. 2007 Feb;17(1):82-8. Yuen KC, Bennett RM, et al. Department of
Endocrinology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode
L607, Portland, OR USA.
OBJECTIVE: Fibromyalgia (FM) is characterized by diffuse pain, fatigue,
and sleep disturbances; symptoms that resemble the adult growth
hormone (GH) deficiency syndrome. Many FM patients have low serum
GH levels, with a hypothesized aetiology of dysregulated GH/insulin-like
growth factor (IGF)-I axis. CONCLUSION: Our data shows that a
subpopulation of FM patients with low serum IGF-I levels will fail the
GHRH-arginine test. We, thus, recommend that the GH reserve of these
patients should be evaluated further, as GH replacement may
potentially improve the symptomatology of those with true GH
deficiency. Additionally, the increased GH response rates to GHRH-
arginine stimulation in the majority of FM patients with low serum IGF-I
levels further supports the hypothesis of a dysregulated GH/IGF-I
axis in the pathophysiology of FM.
42. “Hyposecretion of androgens was
documented in FM. This was more
pronounced in obese patients. Low
serum androgen levels correlated
with poor health status in FM.”
Dessein PH, Shipton EA, et al. Hyposecretion of adrenal
androgens and the relation of serum adrenal steroids, serotonin
and insulin-like growth factor-1 to clinical features in women
with fibromyalgia. Pain. 1999 Nov;83(2):313-9.
43. What natural product can you
take to stimulate your own
production of testosterone?
46. Mister™ for men (women too?)
Contains:
Sage (Salvia officinalis),
fennel (Foeniculum vulgare),
lavender (Lavandula angustifolia),
myrtle (Myrtus communis),
peppermint (Mentha piperita), and
blue yarrow (Achillea millefolium),
in a base of sesame seed oil.
47. (Most but not all women with
fibromyalgia need progesterone,
but only if they have symptoms of
need.)
Lack of Progesterone is a BIG
problem for women with Fibro.
48. Symptoms of Inadequate
Progesterone Production?
• Hot Flashes
• Day and Night Sweats
• Migraine Headaches
• Severe PMS
• Endometriosis
• Demyelination Problems
• TMJ Problems (not usually the only cause)
• Libido Problems
More about
these later!
49. Progesterone (P4) for TMJ
pain
“P4 prevents and relieves TMJ inflammation.”
-- Kramer PR, Bellinger LL. The effects of cycling levels of 17beta-estradiol and
progesterone on the magnitude of temporomandibular joint-induced
nociception. Endocrinology. 2009 Aug;150(8):3680-9.Online at
www.nlm.nih.gov/medlineplus/ency/article/003714.htm.
51. Progesterone (P4) improves
libido!
Progesterone (P4) increases libido and
desire for women.
--Stuckey BG. Female sexual function and dysfunction in the
reproductive years: the influence of endogenous and exogenous sex
hormones. J Sex Med. 2008 Oct;5(10):2282-90.
53. Progessence Plus™
Natural Progesterone in
Vitamin E Oil Base
Has awesome Essential Oils To
Boost Absorption and Immune
System Function:
Frankincense
Sandal Wood
Copaiba
60. Benefits of each ingredient in Progessence Phyto-
Plus
• Vitex EO
– Vitex is used for female reproductive system conditions ranging from PMS and menstrual cycle irregularities,
to mastalgia, menopausal symptoms, and lactation complications.
• Vitamin E
– Antioxidant, skin health
• Wild Yam extract
– historically used for menstrual pain, rheumatoid arthritis, and colic (due to it having some anti-inflammatory
properties). Wild yam has anti-inflammatory, cholagogue, and antispasmodic effects. It is used for
rheumatic conditions, cramps, dysmenorrhea, and gallbladder colic. The diosgenin and glycoside saponins
found in wild yam are hormonal precursors to corticol steroids and are stated to reduce pain.
• Copaiba EO
– Anti-inflammatory
• Sacred Frankincense EO
– anti-inflammatory, anticancer, supports skin health, calming, promotes spiritual awareness
• Cedarwood EO
– calming, purifying, stimulates the pineal gland – which releases melatonin
• Bergamot EO
– calming, antibacterial, antidepressant, relieves anxiety
• Peppermint EO
– anti-inflammatory, antitumoral, antiparasitic, antibacterial, antiviral, antifungal, pain relieving, appetite
curbing, purifying, stimulating to mind
• Rosewood EO
– improves skin elasticity, antifungal, stimulant
• Clove EO
– antiaging, antitumoral, antimicrobial, analgesic/anesthetic, antioxidant, anti-inflammatory
• Coconut oil (FCO) –
– Skin smoother and softener, facilitates absorption of essential oils
62. Chaste Tree (Vitex agnus castus)
ž “Animal and human studies have shown that
extracts of chaste tree bind to dopamine2
receptors in the anterior pituitary and decrease
both basal- and thyrotropin-releasing-hormone
stimulated secretion of prolactin. This decrease
in prolactin leads to increased progesterone
production in the luteal phase of the
menstrual cycle, which reduces symptoms of
PMS. Consistent with this theory, PMS sufferers
have significantly higher rates of prolactin
throughout their cycles, especially in the second
and third weeks.” Vitex has been speculated to
correct hyperprolactinemia, thus allowing
normal corpus luteum development and
preventing PMS. (various authors, see Vitex
references)
63. Chaste Tree Reduces
inflammation
• “Vitex extract remarkably inhibited inflammation
and [inflammatory pain] and can be used for
treatment of inflammatory diseases.” (Ramezani et
al. 2010)
ž Moderate anti-inflammatory activity through
6a,11a-dihydro-6H-[1]benzofuro[3,2-c][1,3]
dioxolo[4,5-g]chromen-9-ol (Ahmad et al.
2010)
66. • Casticin
– “Casticin has potent analgesic and anti-
hyperprolactinaemia properties.” (Hu et al 2007)
– “…casticin, isolated from the aerial parts of the V.
agnus castus possess significant anti-
inflammatory activity.” (Ahmad et al 2010).
– “casticin has significant anti-inflammatory
effect on acute inflammation.” (Lin et al 2007)
– Significant anti-inflammatory activity from
casticin, p-hydroxybenzoic acid, and 3,4-
dihydroxybenzoic acid (Choudhary et al 2009)
– Casticin and artemetin have potent
lipoxygenase inhibition (Choudhary et al 2009)
– “casticin has the potential for use in the treatment
of allergic asthma.” (Koh et al. 2011)
67. • Vitexicarpin
– “showed moderate chymotrypsin urease
inhibitory and anti-inflammatory
activities.” (Ahmad et al 2010)
– “potential therapeutic agent involved in
inflammatory/immunoregulatory
disorders such as rheumatoid arthritis
and lymphomas.” (You et al. 1998)
– “Vitexicarpin significantly reduced
vascular inflammation” (Lee et al 2011)
73. References1. Hu, Y et al. 2007. Anti-nociceptive and anti-hyperprolactinemia activities of Fructus viticis and its effective fractions and chemical constituents.
Phytomedicine 14:668-674.
2. Ahmad, B et al. 2010. Biological activities of a new compound isolated from the aerial parts of Vitex agnus castus L. African Journal of Biotechnology 9
(53):9063-9069.
3. Lin, S et al. 2007. In vivo effect of casticin on acute inflammation. Zhong Xi Yi Jie He Xue Bao (5):573-576.
4. Choudhary, MI et al. 2009. Antiinflammatory and lipoxygenase inhibitory compounds from Vitex agnus-castus. Phytother. Res. 23:1336-1339.
5. Koh, DJ et al. 2011. Inhibitory effects of casticin on migration of eosinophil and expression of chemokines and adhesion molecules in A549 lung epithelial
cells via NF-κB inactivation. J. Ethnopharmacol. 136(3):399-405.
6. You, KM et al. 1998. Vitexicarpin, a flavonoid from the fruits of vitex rotundifolia, inhibits mouse lymphocyte proliferation and growth of cell lines in vitro.
Planta Med. 64(6):546-550.
7. Lee, SM et al. 2012. Vascular protective role of vitexicarpin isolated from Vitex rotundifolia in human umbilibal vein endothelial cells. Inflammation 35(2):
584-593.
8. Ramezani, M. et al. 2010. Antinociceptive and anti-inflammatory effects of hydroalcohol extract of Vitex agnus castus fruit. Proceedings of World
Academy of Science, Engineering and Technology 64: 619-621.
Vitex agnus-castus References
9. Kuruüzüm-Uz, A., et al. 2003. Glucosides from Vitex agnus-castus. Phytochemistry 63: 959-964.
10. Bruno, M., et al. 2010. Extraction, separation and isolation of volatiles from Vitex agnus-castus L. (Verbenaceae) wild species of Sardinia, Italy, by
supercritical CO2. Natural Product Research, 24(6):569-579.
11. Gardiner, P. 2000. Chasteberry (Vitex agnus castus). Http://www.mcp.edu/herbal/default.htm. The Longwood Herbal Taskforce.
12. Lucks, B. C., J. Sørensen, and L. Veal. 2002. Vitex agnus-castus essential oil and menopausal balance: a self-care survey. Complementary Therapies
in Nursing & Midwifery 8:148-154.
13. Lucks, B. C. 2003. Vitex agnus castus essential oil and menopausal balance: a research update. The International Journal of Aromatherapy 13(4):
169-172.
14. Hardy, M. L. 2000. Herbs of special interest to women. Journal of American Pharmaceutical Assoc. 40(2):234-242. http://tgmeds.org.uk/herba.html
15. Berger, D., et al. 2000. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet
264:150-153.
16. Schellenberg, R. 2001. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomized, placebo controlled study.
British Medical Journal 322:134-137.
Wild Yam References
17. PDR for Herbal Medicines. 1998. Montvale, NJ: Medical Economics Company, Inc.
18. Swain, Liz. 2005. Mexican Yam. Gale Encyclopedia of Alternative Medicine. The Gale Group, Inc.
http://www.encyclopedia.com/doc/1G2-3435100530.html
19. Hooker, Eric. 2004. Final Report of the Amended Safety Assessment of Dioscorea villosa (Wild Yam) Root Extract. International Journal of Toxicology
23:49-54.
20. Rosenberg Zand, R. S., D. J. A. Jenkins, and E. P. Diamandis. 2001. Effects of natural products and nutraceuticals on steroid hormone-regulated gene
expression. Clinica Chimica Acta 312:213-219.
21. Wojcikowski, K. et al. 2008. Dioscorea villosa (wild yam) induces chronic kidney injury via pro-fibrotic pathways. Food and Chemical Toxicology
46:3122-3131.
22. Komesaroff, P. A., et al. 2001. Effects of wild yam extract on menopausal symptoms, lipids and sex hormones in healthy menopausal women.
Climacteric 4:144-150.
23. Abascal, K. and E. Yarnell. 2005. Combining Herbs in a Formula for Irritable Bowel Syndrome. Alternative & Complementary Therapies 11:17-23.
24. Mazzio, E. A. and K. F. A. Soliman. 2009. In Vitro Screening for the Tumoricidal Properties of International Medicinal Herbs. Phytotherapy Research
23:385-398.
25. Wu,W. et al. 2005. Estrogenic Effect of Yam Ingestion in Healthy Menopausal Women. Journal of the American College of Nutrition 24:235-243.
26. Hu, C. et al. 2007. A Spirostanol Glycoside from Wild Yam (Dioscorea villosa) Extract and Its Cytostatic Activity on Three Cancer Cells. Journal of
Food and Drug Analysis 15:310-315.
74. Lack of Estradiol
is a problem, too!!
THIS IS WHY FIBRO GETS
WORSE WITH MENOPAUSE!!!
(Not all women with fibromyalgia
need estradiol.)
75. “E2 (estradiol) significantly
increased wound healing.”
Florian M, Florianova L., et al. Interaction of estrogen and tumor
necrosis factor alpha in endothelial cell migration and early stage of
angiogenesis. Endothelium. 2008 Sep-Oct;15(5-6):265-75.
79. “Patients with FMS had
significantly lower cortisol
levels during the day, most
pronounced in the morning.”
Riva R, Mork PJ, et al. Fibromyalgia syndrome is associated
with hypocortisolism. Int J Behav Med. 2010 Sep;17(3):
223-33.
83. Chronic Fatigue Syndrome
• If it’s not anemia and not a viral
condition then it’s pituitary (remember
the STALK is VERY FRAGILE)…(This
is NOT magical)
• Think about it – low thyroid, low tes, low
GH can and do all cause fatigue.
• So does low progesterone.
• “When you hear hoofbeats – think of
horses!”
84. Fatigue after TBI: association
with neuroendocrine abnormalities.
Brain Inj. 2007 Jun;21(6):559-66. Bushnik T, Englander J, Katznelson L.
Rehabilitation Research Center, San Jose, CA 95128, USA. tamara@tbi-sci.org
OBJECTIVE: Evaluate the association between neuroendocrine findings and fatigue
after traumatic brain injury (TBI)
“Given the high prevalence of pituitary
abnormalities, screening for
hypopituitarism after TBI is a
reasonable recommendation.”
86. Low Thyroid is a Cause of
Fatigue
“For diagnoses related to
hypothyroidism, typical problems
include fatigue, weight gain, depression,
lethargy, dry skin, cold intolerance, voice
change, change in menses, muscle
cramps, or treatment of a thyroid
condition.”
-- Melish JS. Thyroid Disease. In: Walker HK, Hall WD, Hurst JW, editors.
Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd
edition. Boston: Butterworths; 1990. Chapter 135.
87. "the hypocortisolism found in
chronic fatigue syndrome may be
secondary to reduced adrenal
gland output."
Cleare AJ, Miell J, et al. Hypothalamo-pituitary-adrenal axis
dysfunction in chronic fatigue syndrome, and the effects of
low-dose hydrocortisone therapy. J Clin Endocrinol Metab.
2001 Aug;86(8):3545-54.
92. Low Thyroid is a Cause of
Fatigue
“For diagnoses related to
hypothyroidism, typical problems
include fatigue, weight gain, depression,
lethargy, dry skin, cold intolerance, voice
change, change in menses, muscle
cramps, or treatment of a thyroid
condition.”
-- Melish JS. Thyroid Disease. In: Walker HK, Hall WD, Hurst JW, editors.
Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd
edition. Boston: Butterworths; 1990. Chapter 135.
93. What YLEO oil can you get in
Australia that helps with
hypothyroidism?
(Can Improve Low Thyroid)
45min
96. Here’s the emotional tie in
• Depression, lethargy, fatigue.
• Lack of HGH causes PTSD, depression,
fatigue, confusion.
• Low tes causes decreased libido,
fatigue, depression.
• Lack of progesterone causes
depression, fatigue, PMS.
• FIBRO IS 50% EMOTIONAL!!!
97. What oil helps you deal with
hard past adversity?
Trauma Life™
QUIZ TIME!!
98. What oil helps you deal with
adversity and pull good things
unto you?
Abundance™
99. What oil blend makes you feel
your pain and happiness in
your life again?
Sensation™
100. Why does fibro get worse with
menopause?
Because you quit producing
estradiol, and
progesterone, and
testosterone
which are ALL very healing to
women.
101. Do you know who the
7 Menopausal Dwarves are?
• Sweaty
• Bloaty
• Sleepy
• Forgetful
• Itchy
• Witchy (with a B??!?!)
• and Psycho!
If you don’t want to be one of these
dwarves then let’s look at the
literature…
102. PMS/Early Menopause/Migraines
These are often thought by most physicians to be
caused by low estradiol (estrogen).
Most physicians are wrong.
Most medical articles are wrong.
A decline in progesterone usually is the cause.
There are good articles that are correct.
Joel Hargrove, MD’s work at Vanderbilt is correct
and good.
Europeans make fun of American doctors because
we don’t get it. (Do Australians??)
103. PMS/Early Menopause/Migraines
Low progesterone causes these problems.
Low progesterone is caused by lack of FSH,
usually.
FSH comes from the front of the pituitary –
remember?
Lack of FSH occurs with pituitary damage or
with real and timely (age 51) menopause from
failure of the ovaries.
104. Hormones and vasculature
The posterior
pituitary elutes
ACTH and
controls the
adrenals.
TSH
HGH
LH FSH
Notice the
fragile
vasculature!
105. How does FSH work in women?
FSH Stimulates
ovaries
Out
comes
P4
P4 is
human
progester
one!
106. The majority of so-called medical experts
say you should go quietly into the dark…
• “Don’t treat those symptoms – those meds
cause breast cancer.”
• “Grow up! Hot flashes won’t hurt you!”
• “Night sweats eventually go away – just turn on
a fan.”
• “Wear a wig – that’s what they’re for.”
• “We’ll just cut out that nasty uterus – you don’t
need it anyway!”
• Don’t sweat the petty things and NEVER pet
the sweaty things!
107. Human P4!
What’s that answer again?
Though human estrogen (17β-estradiol) has a
thousand benefits, too but my time tonight is
limited so…
108. Human Progesterone (P4)
Progesterone (4-pregnene-3,20-dione or P4 in this case[i])
is the “feel good” hormone of pregnancy. We are strictly
talking about naturally occurring biologically identical human
progesterone – not synthetic progestational agents such as
progestin, medroxyprogesterone acetate, or norethisterone –
these are not the natural progesterone and are very
problematic and side effect intensive (they have almost exactly
the opposite of the side effects to the benefits of natural
progesterone).
[i] Hargrove, JT; Osteen, KC. An Alternative Method of Hormone Replacement Therpay Using the Natural
Sex Steroids. Infertility and Reproductive Medicine Clinics of North America. Volume 6, Number 4, October
1995.
109. Known Side Effects From Taking
Medroxyprogesterone (Provera® or MPA)
• MPA is a teratogen and cannot be used in pregnancy
• MPA increases cholesterol and increases risk of heart disease
• MPA increases foam cell formation, endothelial inflammation,
plaque formation, strokes and heart attacks.
• MPA is carcinogenic and causes breast cancer[i] (see PEPI[ii]
trial).
• MPA has no effect on osteoporosis (i.e. does not help)
• MPA is associated with side effects of increased bleeding,
bloating, depression
• MPA provides a serum progesterone level of zero.
[i] Campagnoli C, Clavel-Chapelon F, Kaaks R, Peris C, Berrino F. Progestins and progesterone in hormone
replacement therapy and the risk of breast cancer. J Steroid Biochem Mol Biol. 2005 Jul;96(2):95-108.
[ii] Cushman M, Legault C, Barrett-Connor E, et al. Effect of postmenopausal hormones on inflammation-sensitive
proteins: the Postmenopausal Estrogen/Progestin Interventions (PEPI) Study. Circulation. 1999;100:717-722.
111. Benefits of Biologically Identical Human Progesterone (P4)
Increases bone density preventing osteoporosis and related fractures[i].
Prevents and treats endometrial hyperplasia (use triple or quadruple the usual
dose)[ii].
If you give enough progesterone almost always halts uterine bleeding (cyclical
bleeding)[iii].
Can act as a hypersomniac (sleep aid) if you give 100 mgm at night orally for
sleep[iv] problems. Orally administered progesterone may have advantages
over other routes of administration in the treatment of premenstrual
syndrome (PMS) because of substantially higher levels of the anxiolytic
metabolites 5 alpha and 5 beta pregnanolone[v] which also cause
drowsinesss[vi].
[i] Lydeking-Olsen E, Beck-Jensen JE, Setchell KD, Holm-Jensen T.
Soymilk or progesterone for prevention of bone loss--a 2 year randomized, placebo-controlled trial. Eur J Nutr. 2004 Aug;43(4):246-57.
[ii] Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol 1997;90:434-40.
[iii] Fraser IS. Regulating menstrual bleeding. A prime function of progesterone. J Reprod Med 1999;44(2 suppl):158-64.
[iv] Arafat ES, Hargrove JT, Maxson WS, Desiderio DM, Wentz AC, Andersen RN. Sedative and hypnotic effects of oral administration of micronized progesterone may be mediated
through its metabolites. Am J Obstet Gynecol. 1988 Nov;159(5):1203-9.
[v] Vanselow W, Dennerstein L, Greenwood KM, de Lignieres B. Effect of progesterone and its 5 alpha and 5 beta metabolites on symptoms of premenstrual syndrome according to
route of administration. J Psychosom Obstet Gynaecol. 1996 Mar;17(1):29-38.
[vi] Maxson WS. The use of progesterone in the treatment of PMS. Clin Obstet Gynecol. 1987:30:465-477
112. Benefits of Biologically Identical Human Progesterone (P4)
Improves
(along with testosterone)[i].
Synthetic progestins, on the other hand, often cause androgenic side
effects (acne, body and facial hair), depression, and weight gain.
Micronized progesterone is devoid of the androgenic effects on
the lipid profile seen with MPA and other synthetic progestational
agents; for that reason, it may be preferable in HRT protocols for
perimenopausal and postmenopausal women[ii].
Men should not take progesterone unless they are a sex offender in jail
[iii].
[i] Davis SR, Guay AT, Shifren JL, Mazer NA. Endocrine aspects of female sexual dysfunction. J Sex
Med. 2004 Jul;1(1):82-6.
[ii] Hargrove JT, Maxson WS, Wentz AC, Burnett LS. Menopausal hormone replacement therapy with
continuous daily oral micronized estradiol and progesterone. Obstet Gynecol. 1989:73:
606-612.
[iii] Zumpe D, Clancy AN, Michael RP. Progesterone decreases mating and estradiol uptake in
preoptic areas of male monkeys. Physiol Behav. 2001 Nov-Dec;74(4-5):603-12.
116. Benefits of Biologically Identical Human Progesterone (P4)
Oral P4 for also treats PMS in the same manner (give double or triple
the usual dose for about a week)[i].
Remember -- an oral micronized progesterone given sublingually
preparation has improved bioavailability and much fewer reported
side effects compared with synthetic progestins[ii].
P4, when given with estradiol, improves the quality of life according to a
Mayo Clinic report[iii]
[i] Ahlgrimm, M. (May 2003). Managing pms and perimenopause symptoms The role of compounded
medications, Advance for Nurse Practitioners, (11)5, p. 53.
[ii] APGAR, B.S., GREENBERG, G. Practical Therapeutics Using Progestins in Clinical Practice. AFP
- October 15, 2000.
[iii] Fitzpatrick, LA; Pace, C; Wiita, B. Comparison of Regimens Containing Oral Micronized
Progesterone or Medroxyprogesterone Acetate on Quality of Life in Postmenopausal Women:
A Cross-Sectional Survey. Journal of Women's Health & Gender-Based Medicine. May 2000,
Vol. 9, No. 4 :381 -387.
117. Hargrove, JT et al from
Infertility and Reproductive Clinics of North America
1. Titrate progesterone to pre-menopausal levels. Progesterone is
protective!
2. Treat menopause as a deficiency state.
3. Correct all hormone levels that are deficient (remember: it’s the hormonal
milieu!).
4. Use human micronized bio-identical hormones[i].
5. Metabolized by normal metabolic pathways.
6. This approach avoids problem causing metabolites.
7. There is absolutely NO reason to not give progesterone to ALL
postmenopausal women – hysterectomy or not.
8. There is no good reason NOT to give these bio-identical estrogens and
progesterone every day[ii]. Do not cycle – give them all every day.
[i] Hargrove JT, Maxson WS, Wentz AC, Burnett LS. Menopausal hormone replacement therapy with
continuous daily oral micronized estradiol and progesterone. Obstet Gynecol. 1989 Apr;73(4):606-12.
[ii] Hargrove JT, Maxson WS, Wentz AC, Burnett LS. Menopausal hormone replacement therapy with
continuous daily oral micronized estradiol and progesterone. Obstet Gynecol. 1989 Apr;73(4):606-12.
118. Why the hot flashes and night
sweats?
98% Due to Lack of Progesterone!
2% Due to Lack of Estradiol
120. Progesterone (P4) for PMS
Benefits or halts symptoms of premenstrual
syndrome (PMS).
-- Vanselow W, Dennerstein L, Greenwood KM, de Lignieres B. Effect of
progesterone and its 5 alpha and 5 beta metabolites on symptoms of
premenstrual syndrome according to route of administration. J Psychosom
Obstet Gynaecol. 1996 Mar;17(1):29-38.
122. Progesterone (P4) for Endometriosis
There is a current belief among researchers that
endometriosis occurs secondary to endometrial
resistance to progesterone in some women. The only
way known to overcome this resistance is it to take larger
doses of progesterone (it’s better than narcotics and
hysterectomies).
--Young SL, Lessey BA. Progesterone function in human endometrium: clinical
perspectives. Semin Reprod Med. 2010 Jan;28(1):5-16.
124. Progesterone (P4) for
Migraine Headaches
“Progesterone prevents
menstrual migraine headaches in
women.”
-- Somerville BW. The role of progesterone in menstrual migraine. Neurology. 1971
Aug;21(8):853-9.
WIDELY KNOWN
SINCE 1971 -- DO
YOU KNOW HOW
IMPORTANT THIS
IS?
126. “Insomnia is mostly due to low GH. Low
HGH is associated with the inability to
enter REM and Stage IV sleep – the
lightest level of sleep and the deepest
and most restful respectfully.”
-Hayashi M, Shimohira M, Saisho S, Shimozawa K, Iwakawa Y. Sleep
disturbance in children with growth hormone deficiency. Brain Dev. 1992 May;
14(3):170-4.
-Guilhaume A, Benoit O, Gourmelen M, Richardet JM. Relationship between
sleep stage IV deficit and reversible HGH deficiency in psychosocial dwarfism.
Pediatr Res. 1982 Apr;16(4 Pt 1):299-303.
135. Why the weird numbness and
tingling in your extremities?
(Or all over for that matter!)
Lack of various hormones
cause demyelination of nerves
– especially in the extremity
and the Vagal Nerve!
136. So What is myelin?
And what is demyelination”?
138. The Vagal Nerve Often Demyelinates First!
• Vagal Nerve controls the sympathetic
nervous system
• It runs from your head to bladder
• It controls swallowing and stomach
• It controls your small bowels and
digestion
• It controls your heart rate
• It controls your colon
• It controls your bladder
139. MS is also a demyelinating disease.
Neurology. 2003 Sep 23;61(6):851-3.
Fatigue in MS is related to sympathetic vasomotor dysfunction.
Flachenecker P, Rufer A, Bihler I, Hippel C, Reiners K, Toyka KV, Kesselring J.
Department of Neurology, Julius-Maximilians-Universität, Würzburg, Germany.
peter.flachenecker@surfeu.de
Abstract
The authors studied standard autonomic function tests and measures
of heart rate variability in 60 patients with multiple sclerosis (MS) and
correlated results with the Fatigue Severity Scale and the Modified
Fatigue Impact Scale. The authors found that autonomic
responses correlated with fatigue resembling a
hypoadrenergic orthostatic response, possibly due to
a sympathetic vasomotor lesion with intact vagal heart
control. Treatments to control sympathetic dysfunction for MS-
associated fatigue deserve further study
140. Progesterone (P4) for nerve
healing (remyelination)
P4 assists in myelination of nerves – so women
with low P4 levels often have tingling or burning
or a gross neuropathy – and normalizing P4 can
reverse this demyelination.
-- De Nicola AF, Labombarda F, et al. Progesterone neuroprotection in traumatic CNS
injury and motoneuron degeneration. Front Neuroendocrinol. 2009 Jul;30(2):173-87.
142. Tes is a Neuroactive Steroid
Peripheral neuropathy, either inherited or acquired, represents a very
common disorder for which effective clinical treatments are not available
yet. Observations here summarized indicate that neuroactive steroids,
such as progesterone, testosterone and their reduced metabolites,
might represent a promising therapeutic option. Neuroactive steroids
modulate the expression of key transcription factors for Schwann cell
function, regulate Schwann cell proliferation and promote the
expression of myelin proteins involved in the maintenance of myelin
multilamellar structure, such as myelin protein zero and peripheral
myelin protein 22.
Roglio I, Giatti S, et al. Neuroactive steroids and peripheral neuropathy. Brain Res Rev.
2008 Mar;57(2):460-9.
Department of Endocrinology and Center of Excellence on Neurodegenerative Diseases,
University of Milan, Via Balzaretti 9, 20133, Milan, Italy.
143. Arch Neurol. 2007 May;64(5):683-8.
Sicotte NL, Giesser BS, Tandon V, Klutch R, Steiner B, Drain AE, Shattuck DW, Hull L, Wang HJ, Elashoff RM, Swerdloff RS,
Voskuhl RR.
Division of Brain Mapping, Department of Neurology, The David Geffen School of Medicine at UCLA, Los Angeles, California,
USA.
OBJECTIVE: To study the effect of testosterone supplementation on men with multiple
sclerosis (MS). RESULTS: One year of treatment with
testosterone gel was associated with improvement in
cognitive performance (P = .008) and a slowing of brain
atrophy (P <.001). There was no significant effect of testosterone treatment on gadolinium-
enhancing lesion numbers (P = .31) or volumes (P = .94). Lean body mass (muscle mass) was
increased (P = .02). CONCLUSION: These exploratory findings
suggest that testosterone treatment is safe and well
tolerated and has potential neuroprotective effects in men
with relapsing-remitting MS.
Testosterone treatment in multiple sclerosis: a pilot study.
145. Glia. 2009 Aug 1;57(10):1062-71.
Adult-onset deficiency in growth hormone and insulin-like growth
factor-I alters oligodendrocyte turnover in the corpus callosum.
Hua K, Forbes ME, et al.
“adult-onset GH/IGF-I
deficiency decreased cell
proliferation in the white
matter and decreased the
survival of newborn
oligodendrocytes”
146. ScientificWorldJournal. 2006 Jan 18;6:53-80.
Aspects of growth hormone and insulin-like growth factor-I related to
neuroprotection, regeneration, and functional plasticity in the adult
brain.
Aberg ND, Brywe KG, Isgaard J.
“accumulating evidence suggests that the
growth hormone (GH)/insulin-like
growth factor-I (IGF-I) axis is involved in
the regulation of brain growth,
development, and myelination. In
addition, both GH and IGF-I affect
cognition and biochemistry in the adult
brain”
151. Lack of Thyroid Causes Hair
Loss
Clinical observations of hair conditions involving hormones beyond the
androgen horizon have determined their role in regulation of hair growth:
estrogens, prolactin, thyroid hormone, cortisone, growth hormone (GH),
and melatonin. Primary GH resistance is characterized by thin hair, while
acromegaly may cause hypertrichosis. Hyperprolactinemia may cause
hair loss and hirsutism. Partial synchronization of the hair cycle in anagen
during late pregnancy points to an estrogen effect, while aromatase
inhibitors cause hair loss. Hair loss in a causal relationship to
thyroid disorders is well documented.
Trüeb RM.[Hormones and hair growth]. [Article in German] Hautarzt. 2010
Jun;61(6):487-95.
152. Lack of HGH Causes hair loss
Clinical observations of hair conditions involving hormones beyond the
androgen horizon have determined their role in regulation of hair growth:
estrogens, prolactin, thyroid hormone, cortisone, growth hormone (GH), and
melatonin. Primary GH resistance is characterized by thin hair, while
acromegaly may cause hypertrichosis. Hyperprolactinemia may cause hair
loss and hirsutism. Partial synchronization of the hair cycle in anagen during
late pregnancy points to an estrogen effect, while aromatase inhibitors
cause hair loss. Hair loss in a causal relationship to thyroid disorders is well
documented.
Trüeb RM.[Hormones and hair growth]. [Article in German] Hautarzt. 2010 Jun;61(6):487-95.
153. Lack of Estradiol causes hair
loss, too!
This hypoestrogenemia may be spontaneously attenuated
by local synthesis of oestradiol in peripheral target tissues
according to the intracrine process. This new hormonal
pattern is associated with skin atrophy, hyperseborrhea,
increased pilosity on the cheeks and upper lip, loss of
scalp hair, increase in degeneration of elastic tissue,
atrophy and dryness of the vaginal mucosa. Estrogen
treatment in post menopausal women has been shown to
increase collagen content, dermal thickness and elasticity.
Bensaleh H, Belgnaoui FZ, et al. [Skin and menopause]. [Article in French] Ann
Endocrinol (Paris). 2006 Dec;67(6):575-80.
154. Why the cold hands and feet?
(It’s DEFINITELY NOT Raynaud’s
– even though your doctor told
you so.)
155. HYPOTHYROIDISM!!!
“For diagnoses related to hypothyroidism,
typical problems include fatigue, weight
gain, depression, lethargy, dry skin, cold
intolerance, voice change, change in
menses, muscle cramps, or treatment of a
thyroid condition.”
-- Melish JS. Thyroid Disease. In: Walker HK, Hall WD, Hurst JW, editors. Clinical
Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston:
Butterworths; 1990. Chapter 135.
156. Hypothyroidism causes
brutally cold extremities
Eighteen patients had ongoing or intermittent ongoing distal pain in
their limbs. Of these, 8 reported evoked and 10 reported paroxysmal
pain. Fifteen patients had only diffuse musculoskeletal pain. A total of
16 patients had "hyperphenomena" (brush-evoked allodynia, punctate
hyperalgesia, or cold allodynia or a combination of these, in their feet
or hands or both). Eight patients were classified as having large fiber
neuropathy, whereas 20 had "hypophenomena" (34 out of 38
total had problems with cold extremities)
Ørstavik K, Norheim I, Jørum E. Pain and small-fiber neuropathy in patients with hypothyroidism.
Neurology. 2006 Sep 12;67(5):786-91.
157. Why are you often told you
have
Raynaud’s Phenomenon?
158. It’s really hypothyroidism!
"Raynaud's Phenomenon is often
mistakenly diagnosed when the signs
and symptoms are really felt to be the
initial manifestation of hypothyroidism."
Coleman CE, Sessoms SL. Raynaud's Phenomenon as the Initial Manifestation of
Hypothyroidism. J Clin Rheumatol. 1998 Oct;4(5):270-3.
161. Demyelination Occurs
Rheumatology (Oxford). 2008 Feb;47(2):208-11.
A subset of fibromyalgia patients have findings
suggestive of chronic inflammatory
demyelinating polyneuropathy and appear to
respond to IVIg.
Caro XJ, Winter EF, Dumas AJ.
Division of Rheumatology, David Geffen School of Medicine at UCLA,
Los Angeles, CA, USA
163. Vagal Nerve supplies the Small Bowels
Am J Physiol. 1998 Mar;274(3 Pt 1):G552-60.
Vagal involvement in dietary regulation of nutrient transport.
Bates SL, Sharkey KA, Meddings JB.
“a role for the vagus nerve in regulating
intestinal transport function”
So if the Vagal Nerve demyelinates, nutrients cannot be
absorbed!
165. ICS Starts as Bladder
Problems
• Frequency and Urgency.
• Check for low tes or low GH.
• Remember bladder problems are often
caused by demyelination of the Vagal
Nerve.
• Be patient – can take 9-12 months to
resolve.
166. Interstitial cystitis (IC)
• Especially bad IC – this is a SEVERE bladder problem.
These women are in AGONY.
• Low GH rather than low testosterone. Usually both
though.
• Horribly worse after menopause starts (double whammy
again).
• These patients often present with fibromyalgia and
sarcopenia.
• Get a good history and labs.
• Start low and go slow.
• Some are on IC diets so just start them on an injectable
tiny dose (.05) GH and topical tes.
• Be patient! Can take months to improve or resolve.
• Remember – you cannot undo the damage that other
doctors (though well meaning) have done to them with
DMSO flushes, etc.
167. Comorbidity of interstitial cystitis with other
unexplained clinical conditions.
Urol. 2004 Oct;172(4 Pt 1):1242-8. Buffington CA. Department of Veterinary Clinical Sciences, College of
Veterinary Medicine, Ohio State University, Columbus, Ohio, USA.
RESULTS: A significant overlap of symptoms exists
among a number of unexplained clinical conditions
and a common stress response pattern of increased
sympathetic nervous system function in the
absence of comparable activation of the
hypothalamic-pituitary-adrenal axis occurs in a
subset of patients with many of these conditions.
169. Ann Neurol. 1987 May;21(5):419-30.
Disorders of the autonomic nervous system: Part 1.
Pathophysiology and clinical features.
McLeod JG, Tuck RR.
The peripheral neuropathies most likely to cause severe
autonomic disturbance are those in which small
myelinated and unmyelinated fibers are damaged in the
baroreflex afferents, the vagal efferents to the heart, and
the sympathetic efferent pathways to the mesenteric
vascular bed. Acute demyelination of the sympathetic
and parasympathetic nerves in the Guillain-Barré
syndrome may also cause acute autonomic dysfunction.
171. Osteoarthritis
• Especially in a younger patient (late 20s),
especially male.
• Don’t let them get that knee or hip replaced!
• Protect their heart/brain -- give them other options!
• Beware – orthopods will hate you!
• Properly diagnose them!
• Read them the somatropin package insert (FDA
approved).
172. Effects of chronic growth hormone and insulin-like growth
factor 1 deficiency on osteoarthritis severity in rat knee
joints.
Ekenstedt KJ, Sonntag WE, Loeser RF, Lindgren BR, Carlson CS. Arthritis Rheum. 2006 Dec;54
(12):3850-8. Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN 55108,
USA.
OBJECTIVE: To determine the effects of chronic deficiency of growth hormone
(GH) and insulin-like growth factor 1 (IGF-1) on osteoarthritis (OA) severity.
CONCLUSION: These results indicate that chronic GH/
IGF-1 deficiency causes an increased severity of
articular cartilage lesions of OA without the bony
lesions normally seen in this disease.
173. What is the Proper Testing for
Fibromyalgia?
• Starts with Proper Lab Testing
• Next is a really detailed history – in search of
the “sentinel” event.
• Then a physical exam with EKG if necessary.
• 3T MRI of pituitary with contrast (if necessary)
• Then maybe a stress echo – why?
• Mammogram too.
• FOBT if old enough.
175. My Lab Rules
• Fasting at least 12-24 hours.
• Water is okay.
• No nuts, peanut butter or oil for 72 hrs before.
• Off anti-depressants 2-3 days at least before.
• Off Provigil or Nuvigil 2-3 days at least before.
• No melatonin or cantaloupe day/night before.
• No exercise 24 hrs before blood draw.
• Have blood drawn at 8 a.m. – BE THERE!
176. Treatment?
(But only if testing shows you’re
levels are low. And the natural
options have not worked.)
177. Remember – you can’t fix your pituitary but feel you can
live a mostly normal life.
• I think, given tincture of time, I can get rid
of 95-98% of their symptoms.
• Treatment, however, is permanent and
continuous unless they want to go back to
the pain. (Like being a diabetic.)
• Some of them pray for our continued
health and safety.
• Remember the “double whammy” patients!
179. • Very good if compliant.
• Approx. 40% improvement at 6 months
• Approx. 90% improvement at 12 months
• Approx. 95-8% improvement at 18
months
• If REALLY ill –24 months to 98%
• Be patient.
• Start low go slow.
Efficacy?
180. Prognosis?
• Good.
• It’s like being a diabetic – if you’re compliant
you can live a mostly normal life. (I do.)
• There is no cure – this is just replacement
(again like being a diabetic).
• Normal life if treated early enough.
• I have few patient (none?) who are on pain
or neuro meds or anti-depressants past 9
months of compliance.
181. Vitamins That REALLY Help
• Fish Oil – try Omega Blues™
• You must be on a natural and good
Multi-vitamin -- best is Young Living
Master His or Master Hers™
183. Pituitary Endocrinologists?
• Very difficult for you in Utah or Colorado
• Not any true pituitary endocrinologists
available here or in any Rocky Mountain
states. (--Surgeon General’s Office)
• 1/150 are. 149/150 are “below the
neck”
• What do you do in Australia? Ugh…not
sure.
• Treat yourself naturally?
190. FASTING 48-72 hours every month
• Drink lots of water!
• Cancer cells have a VERY HIGH metabolism!
• Fasting starves cancer cells.
• Fasting can kill cancer cells!
• If you are diagnosed with cancer (and about to
start chemo), always fast 48 hours before each
chemo episode – can improve complete
remission rates dramatically (by up to 80+%)!
• Works even in Stage 4 cancers!
• **Prevents cancer formation, too!**
191. This is a GREAT time to drink
Slique Tea™!
Helps the appetite and and clears
the brain!
193. 48 hours prior to surgery of
the cancer
(if you choose that route)
ask your doctor to prescribe
some PROPANOLOL!
194. Why?
• People get stressed and nervous before
this very important surgery! (EMOTIONS!)
• That emotional stress is deadly!
• It depresses immune function via adrenal
suppression!
• β – blockers such as PROPANOLOL help
alleviate that stress.
• Pay for it out of pocket (cheap) if needed.
• This trick can dramatically decrease
metastases (70-80%). WOW!
195. This would be a great time to
take CortiStop™!
(Just 48 hours before and after
the surgery!)
197. Along this same line of
stressfulness of surgery
Pain, even while unconscious, is a
big cause of stress!
198. Ask your doctor if, during
surgery, you could have
one dose of IV ketorolac
(a NSAID non-narcotic cheap
pain med)
(You could also try Deep Relief™
before surgery!!)
199. Again…
• Ketorolac when given IV to help alleviate
intraoperative pain
• Seems to dramatically decrease metastases
and survival of the cancer cells
• (Probably reduces stress again.)
• Dramatically increasing Complete Remission
rates!
• Who would have thought?
201. Ask your doctor to prescribe
some inexpensive
Metformin
Only 500 mg a day – cheap
enough to buy out of pocket!
202. Metformin is diabetic medicine
• But diabetes IS NOT why you are taking it.
• Same as the fasting 48-72 hours
• Metformin starves the cancer cell dramatically
• Improves cancer cure rates and survival!
• Take for 30-90 days or longer while you are
undergoing treatments.
• Won’t make you sick or nauseate you.
• Again in even Stage 4 cancers!
• Again supported by the literature.
203. This trick alone –
Triples Complete Remission
rate in Stage 2 & 3 Breast
Cancers
WOW!
204. All these are cutting edge
concepts now being espoused
in the USA by top experts at
Harvard and elsewhere…
All very easy and inexpensive.
(All supported by the literature!)
205. But can increase your survival
rates 70-98%
When added together!
206. You might feel terrible doing it.
But the cancer cells will feel
horrible (enough to die!)!
207. Go to this website for more
info!
www.global-cures.org
A non-profit started by a Harvard
professor of nephrology – support
Global Cures!
(I have no affiliation with Global
Cures)
(A more thoughtful approach to cheaper,
more natural, and more effective treatments
of cancer that improve survival and cure!)