DR. HOFFMAN: We now know that high levels of estrogen are associated with higher risks of breast cancer.
There are things that keep your estrogen levels up such as taking unnecessary hormone replacement therapy after menopause. That's a risk. Also, being overweight will increase your estrogen. Even drinking too much alcohol will increase your estrogen levels.
But how are you supposed to lower your estrogen levels to reduce your risk of breast cancer and uterine cancer?
Well, the answer is something I've been doing for a while and has been confirmed in this month's issue of the Journal of Clinical Oncology. You can follow an estrogen lowering diet to reduce your risk of breast cancer. And what does that diet entail?
Well, as reported in this month's Journal of Clinical Oncology, they looked at 291 women an average of two years after the diagnosis of breast cancer. So these women had a big stake in lowering levels of estrogen in their bloodstream to prevent recurrence of their cancer.
They divided the women into two groups. Those in the cancer prevention diet group were advised to have a high intake of vegetables and fruit and a low intake of fat. They attended cooking classes. They had nutritional counseling, and they were given relevant printed materials to help them implement this diet, and it made a difference.
After one year, the high-fiber low-fat group reported a significantly reduced intake of energy from fat. So they cut the fat. They also had some infinitely higher intake of fiber. There was no significant change in weight but even though these women didn't lose weight, in a high-fiber low-fat group there was a significant drop in estrogen.
But in the group that got no dietary instruction, there was actually a slight increase in estrogen putting these women at higher risk, potentially. And I would add one more caveat to this: there's another mechanism by which diet influences your risk of breast cancer, actually, a lot of mechanisms. But one important mechanism is insulin resistance.
If you take in a lot of sugar or starch, if you don't exercise, if you lack essential fatty acids, you will develop the metabolic syndrome, syndrome X, associated with higher risk of high blood pressure, diabetes heart disease but also higher risk of certain hormone related cancers.
So what it comes down to is diets like the Salad and Salmon Diet modified to reduce your intake of saturated fat. So the Salad and Salmon Diet emphasizes beneficial fats from olive oil and fish and nuts. Those fats are healthy and won't cause cancer. This dietary approach can make a difference if you're a breast cancer survivor and you want to improve the odds of reducing your risk of recurrence.
DR. HOFFMAN: The Prince of Wales is in an argument with an eminent British medical authority over the value of coffee enemas. This is dateline London, just last week. The heir to the British throne got a stern telling off by a leading physician this week over his support for alternative cancer therapies. In an open letter to the British Medical Journal, Michael Baum who is a professor emeritus of surgery told the Prince of Wales, with respect your highness, you got it wrong.
We all know that Prince Charles has been a long term advocate of complementary medicine. He believes in the use of homeopathy. He's very open minded about natural therapies. But to many high tech British physicians, he is a brainless twit for embracing these approaches. In fact, Prince Charles recently called for more research into the role of complementary medicines and cancer treatment at a conference in London hosted by five charities of which he is a patron.
And he made this offhanded comment which apparently enraged some members of the British cancer establishment. He said quote: I know of one patient who turned to Gerson therapy having been told that she was suffering from terminal cancer and would not survive another course of chemotherapy. Happily, several years later, she is still alive and well, the Prince said. So it's therefore vital that rather than dismissing such experiences we should further investigate the beneficial nature of these treatments.
Now, I thought this was a pretty benign statement. He's not saying, don't go for conventional therapy. He's just saying, hey, we ought to look into the potential benefits of complementary therapy. Having known about the Gerson therapy, Gerson therapy offered originally in the United States then had to go offshore down to Mexico. The Gerson clinic treating a lot of people especially in the 60s and 70s and there still are places using the Gerson therapy, which involves various forms of detoxification, raw foods, lots of coffee enemas for detoxification.
But this guy Dr. Michael Baum, not happy with the Prince's comments -- he says this rather haughtily: Over the past 20 years, I've treated thousands of patients with cancer. The power of my authority comes with a knowledge built on 40 years of study and 25 years of active involvement in cancer research. He says to the Prince, your power and authority rests on an accident of birth. I don't begrudge you that authority but I do beg you to exercise your power with extreme caution when advising patients with life threatening diseases to embrace unproven therapies.
I don't see why this guy is getting so haughty and bent out of shape by the mere suggestion by the Prince of Wales that the government and private institutions further investigate the benefit of natural therapies. I don't think it's going to do one single cancer patient any harm to at least investigate these approaches which are not failsafe but may indeed offer some benefits, especially wherein conventional therapies are so lacking being definitive cures for cancer.
DR. HOFFMAN: For those of you who are fishermen or boaters, you've heard of Sea-Bands. These are pressure point wrist bands designed on a principle of acupuncture to relieve motion sickness. Well, Sea-band, the company, has diversified they are about to market a new, anti-motion sickness, sea sickness herbal formula that features ginger.
The Sea-Band gum will be available at drug stores and supermarkets in 24-piece blister packs costing $4.99 per pack or it can be ordered from www.sea-band.com. Ginger really does work and it's safe.
DR. HOFFMAN: We spend a lot of money on over-the-counter cough syrups. When I was studying pediatrics two decades ago I remember having one of my professors tell us that over-the-counter cough syrups are only good for one thing. If you show up late for rounds and you haven't had a chance to polish your shoes you can put a little dab of over-the-counter cough syrup on your shoes and it will restore their shine, otherwise he opined they were of no value at all.
And we've probably all heard by now the now-famous comedy routine by Chris Rock about Robitussin. He recalls how when he was a kid Robitussin was the remedy for everything. If you break your arm, put some Robitussin on it and it will fix it all up.
This proposition was recently put to the test by researchers investigating this at Penn State College of Medicine. What they found was kind of disappointing.
Two active ingredients found in many over-the-counter cough medicines are no better than nonmedicated syrup for nighttime cough and sleep quality in children with upper respiratory tract infections. The ingredients are dextramathorphan or DM and diphenhydramine, which is an antihistamine.
You would think at least it would knock the little kiddies out but it was published this month in Pediatrics, the authoritative journal on kid's health problems. And what they did is they put kids in groups where they either received dextramathorphan, diphenhydramine or a placebo.
The parents didn't know what they were giving the kids; they were just giving the kids some medication. The kids were coughing and they would say, here, take this bottle X. And they went through that reassuring and parental ritual where the kids are given a little cough syrup to sip and they're put to bed.
What they discovered was that, interestingly, all three groups including the group receiving nonmedicated syrup showed dramatic improvement. There's nothing like having a concerned parent giving you a little cough syrup and tuck you in, and that's probably all placebo.
What they found is all the groups showed dramatic improvement but there was no difference between the groups in terms of cough frequency, bothersome nature of the coughs and severity of the coughs. And they also had an interesting new measurement that they applied in this study and that measurement was whether parent's sleep was significantly better when their child took a cough medication.
Well, the parents slept equally well no matter which of these cough formulas were used. And the suggestion is keep your kids safe. Don't bother to go for the heavy duty medicine.
Maybe use just a gentle herbal cough syrup, something natural, maybe a cherry bark or something like that, or some of the proven remedies, horehound, things that are from the realm of folklore and tradition for helping kids with coughs because the new medications --those things that we spend billions of dollars on-- don't make any sense.
And isn't kind of disingenuous that we're still going to see these cough syrups on our pharmacy shelves and people are going to consume them by the boxcar load. They're not going to be recalled, they're not going to be taken out of circulation. But if an herbal medicine is used, they'll say that's worthless, there's no proof, there's no science behind it. But the science here states that the commonly used over-the-counter medications that we rely upon for kids make no difference at all.
DR. HOFFMAN: According to the New York public interest research group, there's danger lurking in your kid's playground. This is a survey of playgrounds in the Long Island region close to New York City.
This is based on an article in the New York Times, Sunday, July 4th, and they go through a list of playground hazards. I just wish that we could go back to the days when kids would play, they would fall off the jungle gym and bonk their heads like I did so many times. We didn't think of it as some sort of peril, there were less cat scans and liability suits.
They talk about things like the risk of head entrapment, clothing entanglement, inadequate fall zones. It seems like we have to engineer playgrounds the way that we engineer airtight contracts to make sure that there's no potential for liability. But this is the concern: some playgrounds may be toxic.
Toxic risk, the research group said, means the potential exposure to wood treated with something called CCA which sounds innocuous enough. It's the stuff that makes the wood green. People used to brag, my deck is CCA treated so it's going to be a deck for the ages, so it's a sign of quality assurance.
But unfortunately, CCA stands for chromated copper arsenate, a form of arsenic used as a wood preservative. And a 2002 state law in New York barred new playgrounds from using wood treated with the substance.
You can no longer make your dock out of CCA or your breakwater in front of your waterfront property out of CCA. And that makes a lot of sense because who wants to dump a lot of arsenic into the water. Maybe that's why the fish and the lobsters and scallops are disappearing off the Long Island coast.
Well the paper cites playgrounds in the following communities as still having potential risk for arsenic exposure, the communities are: Bayshore, Freeport, Hicksville, Huntington, Massapequa, Oyster Bay, Port Washington and Smithtown.
And this doesn't mean that every single playground in those communities are laden with arsenic but there are concerns that because of continuous use of old playground equipment that there's risk of arsenic exposure to our kids. And that is a shame because kids should play in safe environments and this whole thing of using CCA is just dumb and misguided.
Put it in the water and you're going to put it in playground equipment and there's going to be trouble.
DR. HOFFMAN: I found an unusual study in the Archives of Internal Medicine. They don't usually do studies like this but this study evaluated an herbal hangover remedy. And you better believe they would have been very happy to demonstrate, in this conservative medical journal, that the stuff was bunk but it did help only partially to alleviate the effects of a hangover.
Now there are a variety of things that have been purported to help and some studies have shown that vitamin C is helpful. Things that build glutathione in the liver like N-acetyl cysteine have been shown to be helpful.
All of these things have plausible mechanisms to help people better metabolize what is essentially a toxic substance. Alcohol is treated by the body as a harmful chemical and is rapidly converted into harmless bi-products and excreted.
But this new research is on an herb called OFI which stands for Opuntia ficus indica. It's a member of the cactus family. It's also most commonly known as the prickly pear. People who've been to the Arizona desert know about the prickly pear plant. It's not really a pear or a fruit but it does contain an internal flesh which is actually a food and water source for certain desert creatures.
Native Americans actually used to use it for its water, its nutritional effects as a natural source of red dye and even as a face cream. Its fruit is edible and it's got some unique properties, it seems to have anti-inflammatory effects.
To test this theory, researchers at Tulane Health Science Center in New Orleans -- boy that's a good place to do a study on alcohol, New Orleans. They recruited 64 young adults essentially to go on a drinking binge. It's not a great idea.
They were challenged with the alcohol equivalent of five to ten drinks on an empty stomach -- I guess easy to obtain down there in New Orleans, maybe they were med students, maybe they were just convention goers. And half the group was given prickly pear extract. The other half just got a placebo pill five hours before tying one on.
The next morning, participants rated the severity of their hangover symptoms and what they found was that in general, people who took the prickly pear extract tended to experience less nausea, dry mouth and decreased appetite the day after heavy drinking when they took OFI, which is Opuntia ficus indica extract. But other hangover symptoms such as headache dizziness and diarrhea appeared unaffected by the supplement.
Interestingly, they measured a marker -- C-Reactive protein, we know that is a marker of inflammation in cardiac disease -- and they found that the levels of C-Reactive protein were lower if you took OFI or prickly pear prior to alcohol. Alcohol messes things up, creates inflammation and apparently, prickly pear might offset that effect.
So the suggestion is, don't go for this necessarily as a way of offsetting a hangover. It's sort of like if somebody came up with an herbal head banger prevention formula so you can go out and bang your head against the wall. And to ease the aftermath, the headache and pain associated with that, we can give you some sort of herbal extract and you would have half the headache pain after banging your head against the wall.
The principle solution is don't bang your head against the wall. Don't court disaster by drinking a lot on an empty stomach. But for those who imbibe and have certain symptoms, this offers a plausible alternative.
Just as a caveat, the study was funded by the company that makes OFI called Extracts Plus so I guess there may be some unintentional bias. But it was published in a respectable medical journal, the Archives of Internal Medicine last month.
DR. HOFFMAN: An interesting phenomenon is occurring, kids are going through puberty earlier and earlier. It was not uncommon during colonial times for girls to begin menstruating on the average of 17, 18 or 19.
But as nutrition has improved, kids are beginning to go through puberty earlier and earlier. Now, it's actually not unusual to see nine and ten-year-old girls beginning to have their first periods. What's going on here?
Well, some people speculate that it's simply about diet. It's that nutritional restriction such as occurred on the frontier during periods of hardship made kids develop less quickly. And really, there's something to that because kids eat an enormous amount of calories. Overweight kids are more prone to go through puberty early.
But there's another factor involved. Could that factor be Britney Spears and Christina Aguilera? Well, if I were 11 years old and I were watching these pop sirens gyrating across the screen of my TV, MTV and other programs, perhaps that would induce me to go through puberty earlier. But the explanation may have something to do with something called "melatonin." Melatonin is a substance that gets produced in darkness and it makes you sleep. You sleep better. In fact, melatonin has been proposed as a sleep aid, also as something that can be used to treat jet lag. But low levels of melatonin have been found to play an important role in promoting an early onset of puberty.
Now try and follow me here -- what's the connection between Britney Spears, Christina Aguilera, MTV, melatonin and early puberty? Well, think about it. TV is a big and potent light box that kids watch until all hours of the night.
When kids are not watching TV, they're busily playing computer games or working on their computer, instant messaging all their buddies. And as a result, instead of the natural cycle of light and dark, they're exposed to a lot more light in the 21st century than their forbearers in the 19th century and early 20th century.
And as a result, all that light may suppress production of melatonin. It also makes kids sleep less well because melatonin is the substance of sleep. And to test this hypothesis, they did a study in Italy. They studied 74 children between the age of 6 and 12 who normally watched an average of three hours of TV in the evening between eight o'clock and midnight.
These youngsters lived in the Tuscan town of Cavriglia. That's interesting. Over there the kids are watching lots of TV too, not just here. And then they did a seven-day experiment. The kids were not allowed to watch TV and their families were asked to reduce the other sources of artificial light.
At the end of the week, the children's melatonin levels had risen by an average of 30 percent and the effect was most pronounced in the youngest children. So it's starting to make sense. There's is a link between excessive TV watching, suppression of melatonin and hastening the onset of puberty.
And folks, what's the take home message -- I don't know -- what are you going to do about this? All around, it's a good idea for your kids to watch less TV because watching TV is also associated with higher incidence of obesity. The more hours the kids watch TV, the more likely they are to be flabby and out of shape and at risk for the diseases of adulthood.
And yet another consequence of this is early puberty. So big deal, kids go through puberty earlier. The big consequence of this is the longer kids are under the influence of hormones, particularly girls, the greater their risk of breast cancer because prolonged years of hormone exposure, an additional five or seven years of estrogen, can put these young people at risk for hormonal cancers.
CALLER: You've mentioned strontium a couple of times to strengthen bones. I understand that ipriflavone has interactions with certain drugs, does strontium have any?
DR. HOFFMAN: Let's talk about ipriflavone first. Ipriflavone sounds like the isoflavones that are present in soy and it is derived from soy but it does not have a hormonal effect.
Ipriflavone is actually a bone builder that's been used a lot in Japan and Europe for bone enhancement. It's part of a lot of products that seem to enhance bone density. And we include it in our own Osteosupport , a product which has got bio-available calcium in the right form and other cofactors for bone development.
Studies show that ipriflavone enhances bone without a hormonal effect. It doesn't raise your levels of estrogen or increase the risk of certain cancers. I don't know that ipriflavone really does have an influence on certain drugs. Do you know of any drugs that ipriflavone -
CALLER: Coumadin.
DR. HOFFMAN: Not that I've heard. Please correct me if I'm wrong. If you've got a scientific article or evidence that that's the case, let me know. But coumadin would be affected by vitamin K.
Vitamin K is also a bone enhancer but we're careful about giving high doses of vitamin K to individuals who are taking blood thinners. That's the relationship I know about, but are you sure you read this somewhere?
CALLER: Yes, the people at Willner told me that ipriflavone interacts with coumadin and if you have autoimmune diseases.
DR. HOFFMAN: With due respect to the people at Willner, I invite them to send some evidence that that's the case because I think they're shooting from the hip. I really think that that's the case.
But anyway, your question is actually about strontium. For those of you who haven't heard about it, strontium is probably the most significant new player in our arsenal against osteoporosis. It's a mineral that's related to calcium. It has a dramatic effect on bone strengthening.
In fact, it was recently evaluated in a big study in the New England Journal of Medicine with spectacular results reducing fractures by double digit percentage points and enhancing bone density dramatically in a very short period of time, two years.
The major interaction with strontium is with calcium. You need to take them separately. You can actually use strontium in tandem with drugs like Fosamax and Actonel, popular drugs that are used to enhance bone. It will just enhance their benefits. But the main interaction is don't take strontium with calcium. Not that it's dangerous or bad, it's just that it will neutralize the absorption of the strontium because calcium and strontium compete.
That's the big relationship. I'll be happy to review any new information that clarifies potential interactions with ipriflavone and certain medications but I'm not familiar with that data.
With due respect to my colleagues at Willner Chemists, a lady called up earlier saying that she had been given advice by the pharmacists at that excellent nutritional pharmacy to exert caution in regard to combining the bone-building nutrient ipriflavone with coumadin, which is a blood thinner.
And through the miracle of modern computers and the internet, I was able to check it out during the commercial break and, indeed, there was a relationship. But the relationship is not one which precludes using ipriflavone if you're using a blood thinner, it's simply a caution.
It's a caution similar to the caution that you would give to people about using grapefruit juice when taking many medications. Grapefruit juice, an innocuous beverage, has the tendency to slightly alter drug metabolism, usually favoring increased levels of certain medications.
Medications like statins get stronger under the influence of grapefruit juice and so does coumadin, a blood thinner. And ipriflavone apparently has a grapefruit-like effect which shouldn't be too troublesome in small doses. But people who take blood thinning medication would be well advised to make sure that they monitor their bleeding times. Get a test called a PT or Protime frequently, especially if they're newly embarking on ipriflavone therapy.
It doesn't mean you can't take ipriflavone if you're on coumadin but indeed, there is a slight potential interaction.
CALLER: I want to know your opinion of neurontin as a treatment for neuropathy.
DR. HOFFMAN: It works sometimes. It's a drug; it's actually an anti-seizure drug. And the idea is this pain is kind of like a form of a seizure and it helps some people. Some people hate it, feel really zonked from it and for a lot of others it doesn't work.
What type of pain are we talking about?
CALLER: Neuropathy of the feet.
DR. HOFFMAN: Okay, it's worth a try. Do you have diabetes?
CALLER: Yes.
DR. HOFFMAN: Well, neurontin can be helpful but here's another tip: There's a type of therapy that is all natural, that shouldn't cause any side effects that's really worth trying and it's alpha lipoic acid.
In Germany it's considered a medical therapy reimbursed by the government. Here, alpha lipoic acid is just a nutrient; it's an ultra potent antioxidant. It seems to have the ability to work its way into the nervous system and the nerves of the brain and it can be very helpful for neuropathy. The dosage that would be necessary to find out would be anywhere from 600 mg to 3,000 milligrams a day.
And you need to try it over a period of two or three months. Also B12 shots could be helpful for preventing neuropathy in diabetes. You want to be taking GLA from borage oil ,that has preventive effects. Also quercetin could also help to prevent this complication of diabetes. And of course, keeping your blood sugar as stable as possible will reduce your risk of this.
Capsaicin, which is an extract of cayenne, also offers pain relief to people with this condition. So give those approaches some investigation.
CALLER: I recently had two dental surgeries and the inside of my mouth is very dry and there is a bad taste. The symptoms disappear during the day. But they looked at the tongue and they said I had geographic tongue. Can you discuss that or suggest anything I can take to avoid it?
DR. HOFFMAN: Did you take antibiotics for the dental surgery?
CALLER: They gave me amoxicillin, 500 milligrams; it added up to 54 capsules.
DR. HOFFMAN: I think we hit it right on the head here. Geographic tongue often arises from imbalances that are created in your gastrointestinal tract.
One of the surest ways that you can create such an imbalance is by taking antibiotics. You kill off certain bacteria and then resistant or harmful bacteria proliferate. And think of the tongue as sort of the visual manifestation of your intestinal tract. You don't need an endoscope to go down there. You just stick your tongue out and it reflects the status of the remaining 32 feet of your intestinal tract that are inside you and some distress that has been caused by the use of antibiotics.
One of the surest ways to restore normalcy is to eat a diet that is low in sugar and junk and also take probiotics to restore normal bacteria population. I think that will help put things back in order for you.
Geographic tongue can also be a sign of some sort of immune problem, viral problem, some sort of infectious problem systematically and it's a mirror of your internal status. It's sort of a window into the interior to tell you that an imbalance exists. And I think you can turn this around by the methods that I suggest.
CALLER: I always have pain in my breast and I have had mammographies and I had a sonogram and it doesn't show anything.
DR. HOFFMAN: Is it one side?
CALLER: It's one side.
DR. HOFFMAN: Okay, so you're safe from the standpoint of having a problem. And actually, I will tell you that generally problems of greater concern are painless problems in the breast.
If you have a lump and there's no pain associated with that, that's generally more dangerous. But if you have a tender area in the breast, you have to pay attention to tender areas in the breast because sometimes that can be a sign of something dangerous.
How old are you?
CALLER: Sixty-two.
DR. HOFFMAN: So you're well past menopause, you're not on hormone therapy, right?
CALLER: No.
DR. HOFFMAN: Some women even past the age of menopause are still producing higher levels of estrogen. Estrogen will stimulate the breast tissue. It will make it tender. Generally, women after the age of menopause have less of these problems.
The familiar refrain for women who suffer from PMS, they have painful, enlarged breasts. They feel very swollen and uncomfortable. And that usually goes away every month and it comes back prior to your menstruation. It's the cyclical fluctuations in your levels of estrogen.
You may be producing moderately high levels of estrogen after menopause. One of the ways to reduce that is with diet. The diet that is really beneficial to this is something akin to the Salad and Salmon Diet , accentuating fat just from olive oil, nuts and from oily fish and avoiding saturated fat.
Generally, weight loss will also tend to reduce your levels of estrogen and so will high fiber foods. They will sort of whisk the estrogen out of your body. One of the foods I suggest to women who are overproducing estrogen is flax seed.
Ground flax seed will actually help not only lower excessive levels of estrogen but will block harmful forms of estrogen from affecting the breasts, perhaps preventing breast cancer and also preventing prostate cancer in men with the added benefit that they will reduce excessive levels of cholesterol.
So those are things that I would suggest. Exercise, too, helps to moderate excessive levels of estrogen. You may want to take something like chasteberry or agnus castus which tends to regulate excessive levels of hormones. This could be helpful.
Also for breast pain, borage oil or primrose oil is generally helpful along with vitamin E. vitamin E in doses of 800 to 1,000 international units per day has been helpful for women with breast tenderness. And another nutrient that is ignored in painful breasts is iodine. You have to be careful in taking iodine. I think iodine should be given under doctor supervision.
But for some women with breast tenderness, iodine tends to work like a charm to reduce the problem. Also, avoidance of coffee is very helpful because lumpy, painful breasts can be related to coffee, chocolate even the caffeine that's in tea.
So avoid caffeine and avoid related substances in chocolate that could make a difference in your problem.
CALLER: I just hit 50 and I have had some blood work. I'm a holistic, green tea, salad and salmon, vitamin guy and I got my blood test back and two things stood out. My LDL was 143 and there's a note here, a little high.
DR. HOFFMAN: That's just a little high. We generally like to see that under 130, that's the so called bad cholesterol.
One of the things that we do, say we get a guy like you, a guy comes in and wants to do an assessment at the age of 50. A reasonable thing to do. We will check lipids but we won't stop there. Say you have an intermediate LDL,that could be bad. It might not be so bad.
We could further fractionate the LDL because the L is generally considered the bad part of cholesterol. There's good and bad patterns of LDL. You could have most of your LDL in large, fluffy, benign cloud-like particles or you could have small, dense, bullet-like particles of LDL which literally attack the walls of the arteries.
So there's a test called "cholesterol subfractionation." That's a profile that can be done relatively economically and then we can determine more about your risk for heart disease.
CALLER: The second point was testosterone. He said it was okay but it's low, borderline. The range is 241-1200, I'm 314. Once it's over that low border, it's fine or is that something to think about?
DR. HOFFMAN: It's something not to think about but it's something to keep in mind if you're experiencing symptoms of fatigue, sleep problems, problems with maintaining muscle tone or low libido.
And I guess those are pretty common problems in the post-50 crowd but the thing to keep your eye on is your levels not of total testosterone but of free testosterone. But you do have perhaps lower than a 25-year-old's average testosterone that doesn't necessarily mean that you're in dire peril of premature ageing.
A lot of men do fine, in fact, with a relatively lower level of testosterone within the normal range you're at lower risk of prostate cancer so that's good. But if you're really having problems with quality of life, then you ought to get further investigation of your free testosterone and then you might be a candidate of testosterone replacement with the patch or cream.
And that might improve your energy and your psychological outlook and your sex life if that turns out to be an issue.
But the problem here is -- testing, one, two, three. We get information and sometimes that information can just be a source of worry and anxiety rather than a call to action in a positive way.
The other thing you might do is if you have an intermediate risk from the standpoint of cholesterol and HDL get yourself an ultra fast CT Scan. Use the EBT method because that's the low radiation method of scanning the interior of your arteries for the beginnings of calcification.
If the beginnings of calcification are found, you may want to be more aggressive about getting your cholesterol down. Sometimes doctors are quick to pull the trigger, you need to go on a statin. But before you do that, we need to investigate the whole picture and make sure that that's warranted or make sure that you tried all the natural approaches to optimizing your cholesterol and your LDL.
CALLER: I wonder whether you have any ideas on what to do with water on the knee. I have a lump there the size of a ping pong ball. The doctor drained it last year but, of course, it came back.
DR. HOFFMAN: I'm not big on draining those. I think I've actually studied this because at one point I was working out and I banged my elbow a little bit and all of a sudden, I had the elbow equivalent of what you have. The old fashioned term of what you have is "housemaid's knee." It's actually a form of bursitis.
I said, gee, what am I going to do here; maybe I should have this fluid pulled out. Doctors are aggressive, they want to get it done with. And I looked at the research on this and I found that the research showed that unless you're having lots of pain and there are signs of infection there, it could damage the joint.
You don't really want to pull out the fluid because it makes absolutely no difference in the course of the pain, and the fluid comes back.
What I did was interesting. I rested the area and I painstakingly iced it every time I was sitting, every time I was relaxing, and even times when I was reading. I put the ice on it and I also gave myself B12 shots and it made it go away.
It's fine now and I never had to have it drained and those are things I would suggest.
CALLER: I have glaucoma in one of my eyes. I have been treated for the past number of years for it and have recently lost almost 99 percent of the vision in that eye. I'm totally blind in the other eye since I was a child.
DR. HOFFMAN: You have something going on with your eyes to begin with. Something blinded you in one eye and now the other eye is deteriorating.
CALLER: Yes, a detached retina blinded me in the left eye when I was nine years old. It went undetected. I've had multiple detached retinas in the right eye since I was ten years old but I had always had vision.
I started with the elevated pressure a number of years ago and they treated it with various glaucoma eye drops, and recently with methazolamide and with cytophotocoagulation. But the pressure is still up and like I said, about three months ago, all of a sudden the vision basically went out.
DR. HOFFMAN: This is bad because if you told me that, well, I have the beginnings of glaucoma, I would like to take the nutritional protocol for avoidance of the problem. But you say you lost vision in one eye plus reduction of vision in the other eye.
It's impossible to control your glaucoma with medication. There is something very seriously wrong with your eyes, perhaps from a genetic standpoint something you've inherited. You sound like a pretty young guy. This is not the normal run-of-the-mill glaucoma that's associated with living in western developed countries eating a bad diet.
Glaucoma is a problem that is related to diet to some extent -- it's the leading cause of blindness in African Americans and in the elderly and it has to do with diet to some extent because people are insulin resist and have high blood pressure. They have susceptibility to diabetes, high cholesterol they also are more prone to glaucoma.
So getting people on the diet like the Salad and Salmon Diet , getting them to optimize their weight often helps, but there are certain types of glaucoma. It doesn't help if you have a fixed lesion in your eye, a real structural problem in your eye, it won't make much of a difference.
In the so-called closed angle glaucoma we find that fish oil helps people with glaucoma reducing alcohol and caffeine intake. Obviously, smoking is a problem and you can improve circulation with things like gingko biloba and magnesium is helpful.
There's a book that describes some of the measures that are helpful for glaucoma prevention. It's called The Eye Care Revolution, by Dr. Robert Abel. There's also a great website, www.eyeadvisory.com.
But for you, nutritional intervention is perhaps a tad late in arresting the progression of your very aggressive eye deterioration.
CALLER: You know the shoulder where the muscle is in the back of the neck? My doctor told me that I had arthritis in the muscle, is that possible?
DR. HOFFMAN: That's a simplification. You probably don't have arthritis in the muscle. Maybe that was the doctor's effort to explain to you that you have inflammation in the muscle causing you neck pain or shoulder pain.
But actually, studies show that for the most part muscle pain is not really arthritis of the joint. Muscle is poorly responsive to the medication that helps joint pain. The nonsteroidal anti-inflammatory drugs and aspirin don't do much for muscle pain. They certainly haven't done much for me with various muscle injuries and pain.
So other things seem to be helpful. And I came across an interesting study the other day and I'm going to start doing this more with my patients. Nitroglycerin, used for heart disease: it's also the principle behind the use of drugs like Viagra. It seems to have a good effect on people who have chronic muscle spasm and muscle pain because it's not really an inflammation. It may be a lack of nitric oxide in the tissue and that's what nitroglycerin does. It puts nitric oxide back in and that might help muscle metabolism and reduce stiffness and pain.
And so we're going to try a topical ointment made of that on people with these types of problems. Try it on yourself and see if it works.
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