Nibble on This – Happy New Year edition

Valerie Costanza, RD

by Valerie Costanza, RD

Can you believe it? 2009 is almost over and the new year is just about here. It is time to start making your 2010 New Year’s resolutions.

Make this year a healthy one. Set your goals to be realistic, measurable and time sensitive. Don’t make goals that will be impossible for you to reach. This will only set you up for failure. Make goals measurable by applying specific numbers to your goals. Give yourself a time frame to work within.

If weight loss is on your mind, set a long-term goal by applying a realistic number to reach by a certain date. Then set small, short term goals to work toward each week or month. An example would be you will lose 15 pounds by April 1st. You will accomplish this by setting small, short-term goals:

• Decrease sodas to no more than 2 sodas per week for 2 weeks
• Decrease sugar by having no more than 1 dessert per week
• Increase water intake by 1 glass per day for 1 week
• Increase vegetables by eating at least 3 servings per day for 1 month

Making your goals attainable is the first step in keeping your 2010 New Year’s resolutions. Start the New Year off right with this healthy alternative to the traditional New Year’s meal.

Try this recipe for Collard Green and Black-Eyed Pea Soup.

Seasons Spotlight: Anna Stephens, Nurse Practitioner

My name is Anna Stephens, and I am an RNC, BSN, MSN, WHNP-C. What in the world do all those letters mean?

It all began with a Bachelor of Science Degree in Nursing from Northwestern State University (BSN).  I worked in Labor and Delivery for seven years and absolutely LOVED it!  After 1½ years working in the hospital, I decided that I could do more for women’s health with a higher degree.

I then earned my Master of Science in Nursing (MSN), also from Northwestern State University.  After four years of part-time school and part-time work, I became a Certified Registered Nurse (RNC) and a Certified Women’s Health Nurse Practitioner (WHNP-C).

So now that you know what all the letters mean, let me explain how that helps me to help you at Seasons.

Some of you may see me for a medical visit — hormone evaluation, annual exam, female problems. Some of you may see me for “fun” visits — Botox, Juvederm, Radiesse, microdermabrasions, IPL treatments, or even skin evaluations. My goal is to see all of you for everything!  How much fun would we have?! I love what I am doing at Seasons.  It is so much fun to see women feel better and then be able to help them look better as well.  The two truly go hand-in-hand!

In addition to my nursing education, I have had many trainings for medical aesthetics services. I am a certified injector for both Botox and Juvederm.  Since becoming certified, I furthered my training with one-on-one advanced training from Allergan, the makers of Botox and Juvederm, and am now a certified advanced injector.

I also have one-on-one training every four months with an expert trainer from Bioform Medical, the makers of Radiesse.  By having an expert train me, I am able to stay up-to-date on the latest injection techniques, thus offering my clients the most current treatments!  It is so much fun to see the immediate improvements on the faces of my patients following a Botox, Juvederm or Radiesse treatment.

In the area of skin care, I have attended Obagi Medical training workshops and have been educated on the Obagi Medical Skin care line. Healthy skin is so important and with Obagi the skin becomes healthy from the inside out. These are truly amazing products that offer truly amazing results!

I also have trained with Guinot, another pharmaceutical- grade skin care line available at Seasons. Guinot is manufactured in Paris and uses natural fruit acids and enzymes to give you a more gentle skin care than Obagi but with the same fabulous results!

The face is the first thing people see when they meet us…what better reason to offer them the healthiest, most beautiful, youthful, radiant face we can? I look forward to meeting you. Let’s work together to achieve your beauty, skin care and health needs!

Confession #5: Evidence and Crazy Talk. Part 2 of 3.

This is the second of three posts in response to a Newsweek headline, “Crazy Talk,” and the accompanying article “Best Life or Risky Advice?” which blasted talk-show host Oprah Winfrey for many things, including her support and use of bioidentical hormones.

A quick recap. First, read the Newsweek article for yourself. Second, make medical decisions based on medical research and evidence.

Bioidentical hormones are not the “solution of the week.” They are not a trend. Many out there are claiming bioidentical hormones are the cure for all that ails you. Seasons doesn’t make that claim. They are, however, a great solution for many women.

The Seasons Approach to Bioidentical Hormones is Balance.

The key to weathering the hormonal storms of womanhood is balance: balance between what we eat and how much exercise we get; balance between work and play; balance between rest and activity.

We also need balance on the inside. Balance between estrogen, progesterone, testosterone, DHEA, cortisol, thyroid, and melatonin. When these hormones became imbalanced (as mine did), we develop symptoms: hot flashes, fatigue, mood swings, irritability, mental fog, weight gain, just to name a few. This may or may not have anything at all to do with menopause (mine was stress and pregnancy related). But once these hormones are back in balance, the symptoms diminish or disappear.

And, oh, the bliss when the symptoms disappear! Don’t underestimate the value of just plain old “feeling good.” (Ladies, feel free to chime in with an Amen here!)

There Is No Blanket Prescription for Womanhood.

We can’t just take three pills and feel better (and if that doesn’t work, just do a hysterectomy). But that seems to be how modern medicine treats us. Think about it. We all have different bodies, different levels of hormones. These hormones are affected by environment, genetics, stress, pregnancy, etc. There’s no way my hormones and yours could be the same. Our lives are different. Our genetics are different. It just doesn’t make sense that our solutions should be the same.

So why is it that many physicians want to prescribe the same treatment for all of us? Birth control pills and anti-depressants are the prescription du jour for women between 30 and menopause. And for the those approaching/in/completing the BIG change of seasons (menopause), the prescription du jour is synthetic hormones and (yes) anti-depressants. Don’t get me wrong, here. There are some who need an anti-depressant for true symptoms of depression. But as a blanket prescription for womanhood, anti-depressants are a bad idea.

In fact, my husband told me a few years ago that I was the only wife he knew who wasn’t taking an anti-depressant – he and his friends actually had this conversation. That’s not to say I wasn’t having mood-swings. I just flat-out refused to take an anti-depressant even though my physician at the time offered it as an option. I knew depression was not my issue. It was something else. I just couldn’t quite put my finger on it.

You know, when the solutions you are offered in life just don’t work, you have to keep searching, especially when you just don’t feel good and you want your life back. I did keep searching. And I found a solution that worked. In my next post, I’ll complete my comments and share with you my solution.

See you there.

All Estrogens Are Not Created Equal

There is a lot of confusion in the medical and non-medical communities regarding estrogens. Many today think there is only one estrogen. Many today think bioidentical estrogens and synthetic estrogens are identical in structure and function. Many today think estrogen production stops after menopause or after a total hysterectomy. However, this couldn’t be further from the truth.

The body never stops producing estrogens. The body, in fact, produces 3 types of estrogens: estradiol, estrone, and estriol. These are the natural estrogens native to the body and the foundation of bioidentical hormone replacement of estrogen.

A woman’s body produces estrogens in various places. Most people knows that ovaries produce estrogens. But did you know that the adrenal glands and fat cells produce estrogens, too? Think about that for a minute. This explains why women of all ages continue produce estrogen. Our adrenal glands don’t disappear at menopause. And fat cells certainly don’t. So how do we know if a woman needs estrogen?

Let’s look more closely at the 3 main estrogens produced in the body.

• estradiol
• estrone
• estriol

Estriol is a good place to start. Estriol is the weakest of all Estrogens. A woman’s placenta produces very large amounts of estriol during pregnancy. However, estriol is not confined to pregnancy. The liver produces small amounts, too. Estriol primarily affects a woman’s hair, nails, skin, and her vaginal lining. Studies also suggest estriol has potential in breast cancer prevention because estriol binds to specific receptors (beta-receptors) in the breast that inhibit breast cell growth. All other estrogens would be expected to increase breast cell growth (which can lead to cancer) through activity with alpha-receptors.

Estrone is the second most potent estrogen. Estrone is predominately produced in fat cells after menopause. Overweight women have high circulating estrone levels. Unfortunately, 63% of American women are overweight or obese, so many women have high estrone levels. Estrone levels rise even more after menopause, and estrone has been implicated in breast tumors in animal studies. (Scientists say this because estrone has a 5:1 affinity for alpha breast receptors, but that’s pretty technical.) Just remember that alpha-receptors increase breast cell growth. You could say estrone encourages breast cell growth, and that can lead to uncontrolled breast cell growth. We call that breast cancer.

Estradiol is the most potent estrogen. Estradiol is produced predominately from the ovaries. This means a woman will have less estriadiol after menopause because her ovaries are producing less. Estradiol is the main stimulus for growth of the lining of the uterus in the first 2 weeks of the monthly cycle, and it helps in triggering ovulation. Like estrone, estradiol has been implicated in breast tumors. It has a 3:1 affinity for alpha-receptors in the breasts, which promote breast cell growth and can lead to cancer.

That’s a lot of information for one blog post, I know. But remember the overall point. Bioidentical hormone therapy is much more than the use of bioidentical estrogen. It is about which estrogens your body needs to maximize efficacy, reduce side effects, and prevent disease.

Related articles by Zemanta

• Bioidentical Hormones: A User’s Guide (health.usnews.com)
• Bioidentical Hormones: Safer For Hot Flashes Than HRT? (health.usnews.com)
• Marcia Stefanick: Continue Hormone Replacement Therapy? (health.usnews.com)
• Should I take hormones or not? (cnn.com)

Can I Feel Good Again?

Am I destined to a life of feeling sub-par? Can I feel good again? Or am I forever limited to my health as it is right now? The answer is an emphatic no. In this video, Dr. Nathan Goodyear answers these questions and discusses our revolutionary approach to women’s healthcare.

open source video, online video platform, video solution

What Is Seasons?

At Seasons, our focus is wellness, not just treatment of disease. In this video, Dr. Nathan Goodyear talks about his vision for Seasons and our revolutionary approach to women’s health care.

open source video, online video platform, video solution

From the Doctor’s Desk: What’s All The Fuss About Saliva Testing?

Confused about saliva testing? Don’t worry, your physician may be just as confused.

I don’t mean to suggest that the science of saliva testing is new. In fact, the clinical use of saliva testing of hormones has been validated over the past 25+ years, and it is well documented in journal publications such as Gynecology Endocrinology, Journal of Clinical Endocrinology, and Menopause. I know, you’re probably not going to run out and subscribe to those now, but these journals are important to doctors. They range from hard-core bench research to more clinical research.

So why use saliva testing for hormones? The short answer is accuracy.

This is going to get technical, so stick with me. See, hormones in the blood stream are mostly bound to carrier proteins (95-99%) for transportation to target tissues. In this transportation form, hormones are inactivated and not available for use. Only when the hormone is released inside the cells of the target tissue does it begin to have an effect. Saliva testing allows us to see your hormone levels inside the cells at the tissue level. That is where these free hormones can cause symptoms like hot flashes, irritability, breast tenderness, and dry skin.

You’re probably wondering, “Then why isn’t every doctor checking my hormones with a saliva test?” Or even worse, you may have been told that saliva testing is dangerous or inaccurate. Unfortunately, physicians are slow to apply new evidence into practice. History has shown this before. The medical community knew vitamin C replacement prevented scurvy on long sea journeys for 193 years before action was taken.

Hopefully, we will not wait that long this go around.

Spa Treatments Can Restore Confidence

A lot of my patients want to look better. So naturally, I want to help them with that. At our spas, Seasons Medical Aesthetics and It’s Permanent, we help restore a woman’s youthful appearance and so restore her confidence.

We are a full service medical spa with a wide range of offerings: facials, microdermabrasion, chemical peels, acne treatment, hair treatment, hair removal, treatments for hyper-pigmented areas of the face, even a natural lift of the face without any kind of surgery. We address wrinkles with botox and dermal fillers.

We’re a visual society. There’s nothing wrong with wanting to change elements of your physical appearance. For many women, looking better means having more self-confidence.

A visit to a spa can also be a kind of a spiritual renewal for many women. They walk away with confidence. They’re able to say, “I feel good about who I am.”

Who needs Hormones?

Who needs hormones? The answer is: not everyone. Some need hormones, and some don’t. Additionally, a need for hormone therapy is not unique to women. Men can benefit from hormone therapy as well.

If you have symptoms of hormone imbalances, then hormone replacement therapy may be right for you. However, a “one size fits all approach” is never appropriate. Each individual’s hormone needs are as unique as his or her thumb print.

Hormone testing will help determine the specific hormone imbalances and direct treatment.

What symptoms indicate hormone imbalance?

The symptoms of low estrogen include…

• hot flashes
• night sweats
• vaginal dryness
• urinary frequency
• depressed feeling
• sleeping difficulty
• no interest in sex
• no periods

The symptoms of low testosterone include…

• fatigue
• lack of drive
• lack of initiative
• less assertive
• decline in sense of well being
• general depressed moods
• irritable
• lack of self-confidence
• difficulty in setting goals
• decline in mental sharpness
• no stamina/endurance
• loss of muscle mass, strength, or tone
• increased body fat around waist
• elevated cholesterol
• decreased libido
• decreased sexual ability
• sleep apnea

The symptoms of low thyroid include…

• general fatigue or afternoon fatigue
• elevated cholesterol
• difficulty losing weight
• cold hands and feet
• sensitivity to cold
• difficulty thinking clearly
• difficulty concentrating
• poor short term memory
• depressed moods
• hair loss
• constipation
• dry, itchy skin
• fluid retention
• recurrent headaches
• restless sleep
• tingling or numbness in hands and feet
• decreased sweating
• infertility or recurrent miscarriages
• recurrent infections
• muscles aches
• joint pain
• thinning of eyebrows and eyelashes
• enlargement of tongue and teeth indentations
• decreased body hair
• hoarse voice
• slow heart rate
• low blood pressure
• low body temperature
• sleep apnea

The symptoms of high estrogen/low progesterone include…

• premenstrual breast tenderness
• premenstrual mood swings
• premenstrual fluid retention and/or weight gain
• migraine headaches
• severe menstrual cramps
• heavy periods with clotting
• irregular menstrual cycles
• uterine fibroids
• fibrocystic breasts
• endometriosis
• history of infertility
• history of miscarriages
• joint pain
• muscle pain
• decreased libido
• anxiety and/or panic attacks

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