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We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
Enrique Saguil, M.D.
The First Health Approach
We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
Your Team
Ric Saguil, MD
Jason Gruss, MD
Joe Musolino, DC
Jennifer Green, ND
Katrina Christie, LCPC
Tom Jordan, RD
Aimee Weber, EP
Emery Paredes, PT
Lori Szczupaj, MA
Yu Zhu, MD China
Paul Kolaski, DC
Cheryl Broderick
You
We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
-DrRic
The Change
• 45-55years old
• Last 3 months up to 5 years
• Irregular periods
• Vaginal dryness
• Hot flashes/Flushing
• Weight gain
• Mood disturbance
• Sleep disturbance
DIY Heat Regulation - Home
DIY Heat Regulation - Body
Messages in the Hormones
Other Triggers
DX 1,2 and 3
Endocrine Disruptors
• BPA (clear hard plastics/epoxy/drink cans) 7+9
• Poly Vinyl Chlorates (solvents) Easyoff, Lysol
• Phthalates (soft flexible plastics pvc/water)
• DDT/fungicides (pesticides/baby food pears)
• Dioxans (CAFO fat styrofoam)
• Flame retardants (PJ’s memory foam trees)
• Mercury (fish fillings)
www.ewg.org
Women’s Health Study 2001 WHI
• 26% increase in breast cancer with
undetermined benefits since study stopped
early (estrogen + progestin)
• Double risk of venous thrombosis
• Increased risk for stroke, heart ds, gyne
cancer, dementia, blood clot, colon ca
• Did help decrease hip and vert fractures
Personalized dose
HRT/BHRT
• Estrogen
• Progesterone
• Testosterone
• Estrogen
• Progesterone (for mood not for bone)
• Testosterone
(ie-Prometrium from peanut oil, oral/topicals from soy or yams)
Standard dose
DrRic’s Variables
• Nutrition
• Depletion
• Maintenance Medication
• Maintenance Meditation
• BMI
• Level of Fitness
• Breast Cancer
(Food Insecure, ETOH, Caffeine, PhD)
(from intake or meds)
(diagnosis 1 2 and 3)
(relaxation response)
Bottom line with hormones
• In theory, everyone needs the same/In
practice everyone should get a personal plan
(variables…)
• Plan on Exit Schedule for when to get off
hormones
• Make changes while getting rescue
meds/herb/supplement
Testing hormones
• Blood testing is a snapshot of dynamic process
• Salivary testing has improved and can be done
with ease but still can be variable
• Urine testing good also but can be variable
• (bottom line- if you are rich, take the saliva
- if deep into the age, take blood
-if on fringe, good history, +/- test
-be on the look out for early CA
Estrogen deficiency symptoms
• Hot flashes
• Sleep disturbance
• Dry skin
• Heart palp
• Painful intercourse
• Low libido,
• Night sweats
• Vaginal dryness/atrophy
• Headaches
• Memory lapses
• Yeast infection
• Depresion
• Bone loss
Estrogen excess symptoms
• Water retention
• Breast swelling and tender
• Craving for sweets
• Fibrocystic breasts
• Uterine fibroid
• Nervousness/anxiety/irritability
• Heavy irreg mense
• Fatigue
• Weight gain
• Mood swings
• Low thyroid symptoms
Progesterone deficiency symptoms
• Many symptoms of estrogen excess +
• Swollen breasts
• Headache
• Anxiety
• Irregular mense
• Cramping
• Infertility
• Acne
• Weight gain
• Low libido
• Mood swings
• PMS
• Fuzzy thinking
Progesterone excess symptoms
• Many symptoms of estrogen deficiency +
• Somnolence
• Mild depression
• Candida exacerbations
• Gastrointestinal bloating
• Breast swelling
Testosterone deficiency symptoms
• Fatigue prolonged
• Memory problems
• Decreased libido
• Muscle weakness,
• Heart palpitation
• Bone loss
• Incontinence
• Fibromyalgia
• Mental fuzziness
• Depression
• Blunted motivation
• Diminished feeling of well being
• Thinning skin
• Vaginal dryness
• General aches/pains
Testosterone excess symptoms
• Acne
• Deepening voice
• Irritability moodiness
• Loss of scalp hair
• Male pattern hair
• Clitoral enlargement
• Insomnia
Other hormones to consider
• Adrenals (cortisol am or 4x throughout 1day)
• Thyroid (TSH, FreeT3, Free T4)
Other Rx’s
• SSRI -reduce severity, help moodiness
• Antidepressants –reduce severity like SSRI’s
• Clonidine –reduce number of flashes
• Gabapentin -to reduce number of flashes
• IUD with levo –reduce mense
• Estrogen cream low dose –vaginal dryness
• HRT –pill, patch, cream, foam, ring
• Soy (need the gut flora) –mixed results (+ or -)
• Flax seed -2tblsp am/pm (small study +)
• Black cohosh -40-160mg/day (liver damage?)
• SJW –ramp up 3xdaily (watch interactions)
• Kava kava -
• Wild yams –otc topical (adequate skin
conversion?)
We didn’t invent the practice of medicine….
we’re just changing the way it’s provided.
Herbal/Botanical (phytoestrogens or isoflavones)
Alternative Approaches
• Ayurveda (yoga)
Breath work
Movement
Meditation
• TCM (acupuncture)
+ Acupuncture
• Homeopathy
Naturopathic or Homeopathic
physician
Environmental control
• Decrease spicy food, alcohol and caffeine
• Textiles (clothes, bedding, hiking collars)
• Lose weight –BMI target setting
• Reduce stress or increase relaxation training
Mind – Body Medicine
• Relaxation therapy to slow the reaction
• Hypnosis decrease frequency/severity flashes
• Relaxation response decreases markers of
inflammation
Healing Injury with
Supplements and Food
Saturday, July 10th
3-4pm
Whole Foods Market Schaumburg
Call to reserve a place
847 585 5800

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Hot flashes in hot times

  • 1. Hot Flashes in Hot Times We didn’t invent the practice of medicine…. we’re just changing the way it’s provided. Enrique Saguil, M.D.
  • 2. The First Health Approach We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 3. Your Team Ric Saguil, MD Jason Gruss, MD Joe Musolino, DC Jennifer Green, ND Katrina Christie, LCPC Tom Jordan, RD Aimee Weber, EP Emery Paredes, PT Lori Szczupaj, MA Yu Zhu, MD China Paul Kolaski, DC Cheryl Broderick You
  • 4. We didn’t invent the practice of medicine…. we’re just changing the way it’s provided. -DrRic
  • 5. The Change • 45-55years old • Last 3 months up to 5 years • Irregular periods • Vaginal dryness • Hot flashes/Flushing • Weight gain • Mood disturbance • Sleep disturbance
  • 8. Messages in the Hormones
  • 10. Endocrine Disruptors • BPA (clear hard plastics/epoxy/drink cans) 7+9 • Poly Vinyl Chlorates (solvents) Easyoff, Lysol • Phthalates (soft flexible plastics pvc/water) • DDT/fungicides (pesticides/baby food pears) • Dioxans (CAFO fat styrofoam) • Flame retardants (PJ’s memory foam trees) • Mercury (fish fillings)
  • 12. Women’s Health Study 2001 WHI • 26% increase in breast cancer with undetermined benefits since study stopped early (estrogen + progestin) • Double risk of venous thrombosis • Increased risk for stroke, heart ds, gyne cancer, dementia, blood clot, colon ca • Did help decrease hip and vert fractures
  • 13. Personalized dose HRT/BHRT • Estrogen • Progesterone • Testosterone • Estrogen • Progesterone (for mood not for bone) • Testosterone (ie-Prometrium from peanut oil, oral/topicals from soy or yams) Standard dose
  • 14. DrRic’s Variables • Nutrition • Depletion • Maintenance Medication • Maintenance Meditation • BMI • Level of Fitness • Breast Cancer (Food Insecure, ETOH, Caffeine, PhD) (from intake or meds) (diagnosis 1 2 and 3) (relaxation response)
  • 15. Bottom line with hormones • In theory, everyone needs the same/In practice everyone should get a personal plan (variables…) • Plan on Exit Schedule for when to get off hormones • Make changes while getting rescue meds/herb/supplement
  • 16. Testing hormones • Blood testing is a snapshot of dynamic process • Salivary testing has improved and can be done with ease but still can be variable • Urine testing good also but can be variable • (bottom line- if you are rich, take the saliva - if deep into the age, take blood -if on fringe, good history, +/- test -be on the look out for early CA
  • 17. Estrogen deficiency symptoms • Hot flashes • Sleep disturbance • Dry skin • Heart palp • Painful intercourse • Low libido, • Night sweats • Vaginal dryness/atrophy • Headaches • Memory lapses • Yeast infection • Depresion • Bone loss
  • 18. Estrogen excess symptoms • Water retention • Breast swelling and tender • Craving for sweets • Fibrocystic breasts • Uterine fibroid • Nervousness/anxiety/irritability • Heavy irreg mense • Fatigue • Weight gain • Mood swings • Low thyroid symptoms
  • 19. Progesterone deficiency symptoms • Many symptoms of estrogen excess + • Swollen breasts • Headache • Anxiety • Irregular mense • Cramping • Infertility • Acne • Weight gain • Low libido • Mood swings • PMS • Fuzzy thinking
  • 20. Progesterone excess symptoms • Many symptoms of estrogen deficiency + • Somnolence • Mild depression • Candida exacerbations • Gastrointestinal bloating • Breast swelling
  • 21. Testosterone deficiency symptoms • Fatigue prolonged • Memory problems • Decreased libido • Muscle weakness, • Heart palpitation • Bone loss • Incontinence • Fibromyalgia • Mental fuzziness • Depression • Blunted motivation • Diminished feeling of well being • Thinning skin • Vaginal dryness • General aches/pains
  • 22. Testosterone excess symptoms • Acne • Deepening voice • Irritability moodiness • Loss of scalp hair • Male pattern hair • Clitoral enlargement • Insomnia
  • 23. Other hormones to consider • Adrenals (cortisol am or 4x throughout 1day) • Thyroid (TSH, FreeT3, Free T4)
  • 24. Other Rx’s • SSRI -reduce severity, help moodiness • Antidepressants –reduce severity like SSRI’s • Clonidine –reduce number of flashes • Gabapentin -to reduce number of flashes • IUD with levo –reduce mense • Estrogen cream low dose –vaginal dryness • HRT –pill, patch, cream, foam, ring
  • 25. • Soy (need the gut flora) –mixed results (+ or -) • Flax seed -2tblsp am/pm (small study +) • Black cohosh -40-160mg/day (liver damage?) • SJW –ramp up 3xdaily (watch interactions) • Kava kava - • Wild yams –otc topical (adequate skin conversion?) We didn’t invent the practice of medicine…. we’re just changing the way it’s provided. Herbal/Botanical (phytoestrogens or isoflavones)
  • 26. Alternative Approaches • Ayurveda (yoga) Breath work Movement Meditation • TCM (acupuncture) + Acupuncture • Homeopathy Naturopathic or Homeopathic physician
  • 27. Environmental control • Decrease spicy food, alcohol and caffeine • Textiles (clothes, bedding, hiking collars) • Lose weight –BMI target setting • Reduce stress or increase relaxation training
  • 28. Mind – Body Medicine • Relaxation therapy to slow the reaction • Hypnosis decrease frequency/severity flashes • Relaxation response decreases markers of inflammation
  • 29. Healing Injury with Supplements and Food Saturday, July 10th 3-4pm Whole Foods Market Schaumburg Call to reserve a place 847 585 5800

Notes de l'éditeur

  1. 0.3mg conjugated equine estrogen or 1mg estradiolmedroxy progesterone