Seasonal Affective Disorder Sees Brighter Days

Dr. Lori Horan

“I feel like I’m swimming under water lately, like I’m in slow motion. I’m depressed, tired and unmotivated,” Doreen explained. She had moved here from Arizona 10 years ago, and had never experienced seasonal depression before moving to Portland. “I think I have to leave the state every winter unless I can get help for it.”

Doreen is experiencing Seasonal Affective Disorder (SAD), also known as winter depression. Most SAD sufferers experience normal mental health throughout most of the year, but experience depressive symptoms in the winter. Some people are not depressed but may lack energy to perform daily activities. There are various theories about how SAD develops: possibly a lack of serotonin, or melatonin under-production in dim light.

We undertook an aggressive strategy to combat Doreen’s SAD.  If you have ever experienced symptoms of depression in winter, the following program is known to give a body the best chance possible at balancing the neurotransmitters that support well-being:

Exercise.

One of the best ways to combat depression is by exercising regularly. It is even more important for SAD winters, even though outdoor activities are restricted. The key is to find an exercise you enjoy doing, and do it daily. It could be a good time to explore new forms of exercise by taking classes. Give yourself permission to leave  and try a different one if after a few times you feel it doesn’t work for you. Try yoga, tai chi, dance, kung fu, swimming, anything. The best kind of exercise is the kind you will DO. Be adventuresome.

Diet.

Caffeine and sugar might seem like a good idea for a quick fix when you’re feeling a little down, but these can make things worse in the long run. It is especially important to eat balanced meals, which include good quality protein and complex carbohydrates in order to balance our insulin levels, as swings in blood sugar levels can contribute to depression.  A diet rich in whole foods like fruits, vegetables, grains, beans, seeds and nuts are best.

The quality of your nutrition plays a big role in the quality of your mental function and mood. Feed your brain by eating well. Take a good quality multivitamin, and 3000 mg. of fish oil per day. We recommend Multigenics and EPA/DHA enteric-coated fish oil.

NeuroFocus Test.

The NeuroFocus test measures the most active neurotransmitters associated with feelings of well-being. It is a urine-collection test which measures the neurotransmitters serotonin, dopamine, epinephrine, norepinephrine, GABA, and their precursors. If the test detects a low neurotransmitter, it can be treated by supplementing with amino acids to restore neurotransmitter balance.

Treat any underlying physical conditions.

Certain diseases can contribute to depression, as can the drugs used to treat them. Get yourself tested to rule out thyroid or adrenal insufficiency, hypoglycemia, food allergies, yeast overgrowth, or heavy metal toxicity.

Five Element Acupuncture.

When we are not being true to ourselves or our soul needs, depression can result. Lack of acceptance can trap intense emotions and lead to energy blocks in the body. Five Element acupuncture can help to dissolve the blocks to knowing or honoring ourselves and allow us full access to our vital emotions.

Full-Spectrum Lighting.

SAD is often known to respond to full-spectrum lighting. If you have fluorescent lights in your house or office, change the bulbs to full spectrum. Also, consider investing in a full-spectrum light box specifically designed for SAD sufferers. For the best effect you must sit under or near the light for 30 minutes per day.

Doreen’s NeuroFocus test showed she had normal serotonin, but low norepinephrine and low GABA. We supplemented her with an amino acid formula, made diet and exercise changes, and performed a course of four acupuncture treatments. As a result, she had the best winter she had ever experienced in Portland, followed by another successful winter last year where she felt well and optimistic that she didn’t need to leave the state after all.

If you suspect you are suffering from SAD, consider evaluation and treatment with Dr. Horan.

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Drugs for Heartburn and Osteoporosis May
Increase Risk of Spontaneous Hip Fracture

Dr. Noel Peterson

Drugs commonly prescribed for heartburn include Proton pump inhibitors, or PPIs, such as Prilosec, Nexium and Prevacid are often taken for years. Now studies show that patients who used proton pump inhibitors for more than a year had a 44 percent higher risk of hip fracture than nonusers. The longer they took the drugs, the higher their risk.

The biggest risk is seen in people who take high doses of the drugs for more than a year. That group has a 2 1/2 times greater risk of hip fractures than nonusers.

“Doctors should make sure patients have good reason to stay on heartburn drugs long term”, Dr. Yu-Xiao Yang of the University of Pennsylvania School of Medicine where the drugs were studied.
“The general perception is they are relatively harmless,” Yang said. “They often are used without a clear or justified indication for the treatment.” Men in the study had a higher drug-associated risk of hip fracture than women, possibly because women may be more aware of osteoporosis and may get more calcium in their diets, Yang said.

Questions have also emerged about the roll of popular drugs used to treat osteoporosis, linking them to spontaneous fractures of the hip. Because bisphosphonate drugs like Fosamax and Actonel inhibit bone remodeling, the microscopic bone cracks that appear with normal wear and tear are not repaired. These microscopic injuries are allowed to accumulate when on the drugs. Bones get denser but not stronger while taking the drugs. Bone scans and x-rays are not sensitive enough to show this accumulated damage and studies show an increase incidence of fracture after 5 years of use.

Another rare side effect is osteonecrosis of the jaw, in which a patient ’s jawbone rots and dies. Dentists report this drug complication among patients given intravenous bisphosphonates during cancer treatment, but oral bisphosphonate users are vulnerable too. For alternatives in the treatment of osteoporosis, contact the Center.

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Acupuncture Works for Migraines

Dr. Lori Horan

Twenty-eight million Americans (approximately 1 in 10) suffer from migraines. Fortunately, research proves Chinese medicine helps stop migraines. In the March 2008 issue of the journal Headache, the results of a study were published that involved 160 migraine patients.

Researchers divided study participants into different groups, each of which received one of the following treatment protocols: real acupuncture plus migraine medication, mock acupuncture with migraine medication, and medication alone. Patients were evaluated three and six months after starting treatment. For patients receiving true acupuncture, each was treated twice a week for a total of twenty acupuncture treatments.

In patients receiving mock acupuncture, the protocol was the same as in the actual acupuncture group, but the needles were not inserted. Needles with blunted tips were pressed against but did not penetrate the skin. This allowed the patient to feel a superficial, light pricking-like sensation, thus simulating needle insertion. This procedure was used in order to check possible placebo effects.

Researchers found that of all the groups studied, only the group that received real acupuncture showed a significant improvement both in terms of migraine disability and reduced medication use, both at the three- and six-month follow-ups. If you suffer from migraines, consider putting this research to work for you with Dr. Horan.

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Childhood Knee Injuries Occurring
at an Alarming Rate

Dr. Noel Peterson

With the increased intensity and demands of childhood athletics these days, orthopedists at leading medical centers are seeing soaring rates of childhood knee tears in younger and younger children. And contrary to the old belief that boys are more prone to the injury than girls, as many as eight times more girls than boys are suffering tears to their knee ligaments.

An ACL injury is extreme stretching or tearing of the anterior cruciate ligament (ACL) in the knee, while meniscus injuries involve the shock absorbing cartilage that cushions and helps the knee track smoothly. Tears to either may be partial or complete. Both injuries cause the knee to track abnormally, and can lead to further damage to the cartilage and eventual arthritis.

Doctors have also learned that contact injuries are not the most common cause of A.C.L. and meniscus tears. It turns out tears occur more often from twisting and jumping. A child can be running and step in a hole, twisting a leg. Other times, a young athlete can tear an ACL or meniscus by coming down from a rebound in basketball or when accelerating and decelerating in a game. It seems that the best athletes are constantly at risk because of the intensity of play.

With an injured meniscus or overstretched or torn ACL, even everyday activities can injure the smooth, shock-absorbing cartilage that caps the knee joint, triggering arthritis. Parents often give in to their child’s attitude of being “indestructible”, or worse, encourage their child to play through the pain, increasing the risk of further injury.

Even the standard A.C.L. repair operation, with its drilling into the growth plate to re-attach a replacement ligament, may cause permanent damage to the still-growing bones of young children. That happened recently to a 14-year-old boy who was referred to Dr. Freddie H. Fu, an orthopedic surgeon at the University of Pittsburgh. A year after the operation, Dr. Fu said, the leg with the repair was bowed 20 degrees on one side and was shorter than the other leg.

Even when everything goes right, surgery and its aftermath can be more difficult than the child or parents anticipate. Children often are in intense pain after the operation and then spend much of the next six weeks lying down with their leg in a machine that moves the knee slowly through a range of motions. This is followed by six months of physical therapy, which is often painful and physically and emotionally difficult.

What can be done? Listen to your child and do not let them play through the pain. No game or tournament is worth permanent injury and a lifetime of knee arthritis. And don’t let minor injuries go untreated.

While physical therapy can strengthen the muscles that stabilize the knee, prolotherapy is the only therapy shown to turn on the body’s repair of cartilage and ligaments. Over the years I have treated many child athletes with prolotherapy, and have found that anything short of a full thickness ACL or meniscus tear can heal. Children are especially responsive to the natural growth and repair that prolotherapy provides.

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Dr. Peterson’s 5 Health Habits for Men
(and the Women Who Love Them)

Dr. Noel Peterson

#1 Stay Strong with smart exercise. Of all the lifestyle factors affecting longevity, exercise continues to lead the pack. In fact, researchers with the Veterans Affairs recently completed a study of 15,860 men, and found that after 7 ½ years, those who were “highly fit” had an all-cause 50% reduction in mortality, and “very highly fit” men had a 70% reduced all-cause mortality when compared to men of “low fitness”. That’s right, exercise fitness confers a 50%-70% reduction in the risk of dying from any cause!

#2 Don’t let pain interfere with your ability to stay fit. Whatever you do, don’t ignore pain by dosing yourself with ibuprofen, as that will only serve to inhibit your body’s natural repair cycle. If rest and exercise hasn’t helped relieve pain, then it may be time for regenerative injections with prolotherapy. If your neck, back, knees, shoulders, fingers, and feet are in pain, treat them with prolotherapy. You don’t have to let cumulative injuries limit your activities.

#3 Eat less, live longer! Roy Walford, MD of UCLA has studied low calorie, high nutrient diets for over 35 years. He has proven that “systematic under-eating” (the practice of eating nutrient–dense low calorie whole foods) and keeping your weight just below your set point can add 20-30 % to your disease-free life expectancy. This means avoiding nutrient deficient high calorie refined foods, fast foods, sugars, and trans fats, while eating a Mediterranean style diet rich in vegetables, fresh fruit, legumes, olive oil, nuts, seeds, lean meats, and fish.

#4 When it comes to prostate cancer, prevention is the best medicine. About 80% of men will get prostate cancer before the age of 80. That’s the bad news. The good news is that more is known about the effect of diet on the risk of prostate cancer than on any other cancer. So what can you do to lower your risk? Eating just a 4 oz. daily serving of lycopene rich watermelon or pink grapefruit can lower prostate cancer risk by a whopping 50%. Other lycopene rich foods include apricots and cooked tomato products (marinara sauce, juice, catsup). Eating flax seeds can increase your intake of cancer fighting lignans more than any other food. Flax lignans are known to inhibit the enzyme aromatase, thereby preventing testosterone from being converted to estrogen. Other powerful anti-prostate cancer foods include pomegranate juice, green tea, vitamin D3 (sunlight, supplements) and soy products (tofu, tempeh, soy beans, soy milk), all of which inhibit prostate cancer growth.

#5 Manage your male hormones: Testosterone levels gradually decline as a man ages, decreasing approximately 1.5 percent per year after age 30. The effects of low testosterone include decreased muscle mass and bone density, insulin resistance, decreasing sex drive, less energy, irritability and feelings of depression.

In recent research by Molly M. Shores, M.D., and colleagues at the VA Puget Sound Health Care System and University of Washington, Seattle, men with low testosterone levels had an 88% increase in risk of all-cause mortality compared with those who had normal levels.

They studied the relationship between hormone levels and death rate in a total of 858 male veterans older than age 40 years. All participants received care in the VA Puget Sound Health Care System and were followed for an average of 4.3 years to a maximum of eight years. When the researchers considered other variables that may influence risk of death, such as age, other illnesses and body mass index, men with low testosterone levels were still 68 percent more likely to have died, and if they had other risk factors, low testosterone increased their risk of dying even more.

Other studies, including those by Farid Saad, PhD, of Berlin-headquartered Bayer Schering Pharma, have found that restoring testosterone to normal levels in testosterone-deficient men lowers these risks, and leads to major and progressive improvements in features of the metabolic syndrome. He found that testosterone treatment significantly reduced waist circumference, total cholesterol, LDL (“bad”) cholesterol, triglycerides, and body mass index (a measure of body fat), while increasing “good” HDL cholesterol.

And it turns out that frequent sex can lower prostate cancer risk by effectively “cleaning the pipes”, preventing the buildup of cancer causing hormones in the prostate.

At CTM, we have several options available for testosterone treatment. Gels are convenient, while hormone pellet implants have the advantage of lower doses providing greater benefits and preventing the conversion of supplemental testosterone into estrogen through induced aromatase activity. For more information on male hormone testing and replacement therapy with transdermal gels vs. pellet implants, contact Dr. Peterson.

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