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Some Personal Care Products May Raise Diabetes Risk

From Medical News Today:

Women may be at higher risk of developing diabetes because of phthalates that exist in such personal care products as soaps, hair sprays, moisturizers, nail polish, and even perfume. Researchers from Brigham and Women's Hospital published a report in Environmental Health Perspectives explaining that the higher concentrations of phthalate metabolites in the urine of females compared to males might mean that women have a higher risk of developing diabetes.

The researchers found that, overall, those with higher urine levels of phthalates had a higher risk of developing diabetes, compared to those with the lowest levels.

The authors say that the women in their study were a "representative sample" of America's female population. They factored in variables which could distort their findings, such as dietary habits, behavioral traits, and socio-demographic details.

Posted: 7/18/2012 3:50:00 PM

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Vitamin D, Miracle Drug: Is It Science, or Just Talk?

From The New York Times:

Imagine a treatment that could build bones, strengthen the immune system and lower the risks of illnesses like diabetes, heart and kidney disease, high blood pressure and cancer.

Some research suggests that such a wonder treatment already exists. It’s vitamin D, a nutrient that the body makes from sunlight and that is also found in fish and fortified milk.

Yet despite the health potential of vitamin D, as many as half of all adults and children are said to have less than optimum levels and as many as 10 percent of children are highly deficient, according to a 2008 report in The American Journal of Clinical Nutrition.

As a result, doctors are increasingly testing their patients’ vitamin D levels and prescribing daily supplements to raise them.

Although numerous studies have been promising, there are scant data from randomized clinical trials. Little is known about what the ideal level of vitamin D really is, whether raising it can improve health, and what potential side effects are caused by high doses.

And since most of the data on vitamin D comes from observational research, it may be that high doses of the nutrient don’t really make people healthier, but that healthy people simply do the sorts of things that happen to raise vitamin D.

Dr. JoAnn E. Manson, a Harvard professor who is chief of preventive medicine at Brigham and Women’s Hospital in Boston, is leading a major study over the next five years that should provide answers to these questions and more. The nationwide clinical trial is recruiting 20,000 older adults, including men 60 and older and women 65 and older, to study whether high doses of vitamin D and omega-3 fatty acids from fish-oil supplements will lower risk for heart disease and cancer.

Dr. Manson said fish-oil supplements were included in the study because they are another promising treatment that suffers from a dearth of clinical trial evidence. In addition, both vitamin D and fish oil are known to have an anti-inflammatory effect, but each works through a different pathway in the body, so there may be an added health benefit in combining them.

Study participants will take 2,000 I.U.’s of vitamin D3, believed to be the form most easily used by the body. The study will use one-gram supplements of omega-3 fish oil, about 5 to 10 times the average daily intake.

The vitamin D dose is far higher than what has been used in other studies. The well-known Women’s Health Initiative study, for instance, tracked women taking 400 units of vitamin D and 1,000 milligrams of calcium. The study found no overall benefit from the supplements, although women who consistently took their pills had a lower risk of hip fracture. Even so, many experts think 400 units is far too low for any additional health benefits.

Another study, of 1,200 women, looked at the effects of 1,500 milligrams of calcium and 1,000 units of vitamin D. Women who took both supplements showed a lower risk for breast cancer over the next four years, but the numbers of actual cases — seven breast cancers in the placebo group and four in the supplement group — were too small to draw meaningful conclusions.

Although consumers may be tempted to rush out and start taking 2,000 I.U.’s of vitamin D a day, doctors warn against it. Several recent studies of nutrients, including vitamins E and B, selenium and beta carotene, have proved disappointing — even suggesting that high doses do more harm than good, increasing risk for heart problems, diabetes and cancer, depending on the supplement.

Posted: 2/17/2010 2:07:00 PM

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Millions of Children In U.S. Found to Be Lacking Vitamin D

From The Washington Post:

Millions of U.S. children have disturbingly low Vitamin D levels, possibly increasing their risk for bone problems, heart disease, diabetes and other ailments, according to two new studies that provide the first national assessment of the crucial nutrient in young Americans.

About 9 percent of those ages 1 through 21 -- about 7.6 million children, adolescents and young adults -- have Vitamin D levels so low they could be considered deficient, while an additional 61 percent -- 50.8 million -- have higher levels, but still low enough to be insufficient, according to the analysis of federal data being released Monday.

Low Vitamin D levels are especially common among girls, adolescents and people with darker skin, according to the analysis of a nationally representative sample of more than 6,000 children. For example, 59 percent of African American teenage girls were Vitamin D deficient, Melamed's study found.

The researchers and others blamed the low levels on a combination of factors, including children spending more time watching television and playing video games instead of going outside, covering up and using sunscreen when they do go outdoors, and drinking more soda and other beverages instead of consuming milk and other foods fortified with Vitamin D.

The analysis and an accompanying federal study also found an association between low Vitamin D levels and increased risk for high blood pressure, high blood sugar, and a condition that increases the risk for heart disease and diabetes, known as the metabolic syndrome.

Taken together, the studies provide new evidence that low Vitamin D levels may be putting a generation of children at increased risk for heart disease and diabetes, two of the nation's biggest health problems that are also increased by the childhood obesity epidemic.

Posted: 8/3/2009 9:28:00 AM

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Supplements for Athletes Draw Alert From F.D.A.

From The New York Times:

Federal regulators warned consumers on Tuesday not to use body-building products that are sold as nutritional supplements but may contain steroids or steroidlike substances, citing reports of acute liver injury and kidney failure.

The Food and Drug Administration said it issued the warning because of increased reports of medical problems in men who had used such products.

But except for naming eight specific supplements sold by a single company, the Food and Drug Administration did not provide much clear guidance to consumers on what other products to avoid. The F.D.A. acknowledged that it did not know how many products its warning affects.

Generally, the F.D.A. said, buyers should beware of body-building products that claim to enhance or diminish the effects of hormones like testosterone, estrogen or progestin. In particular, the agency said consumers should not buy products labeled with code words like “anabolic” and “tren,” or phrases like “blocks estrogen,” and “minimizes gyno.” The references to estrogen and “gyno” are meant to indicate the products do not have a feminizing effect on the body, like swelling breasts or shrinking testicles, which can be unwanted side effects of steroid use in men.

The F.D.A. cited eight popular products from American Cellular Labs, including Mass Xtreme and Tren Xtreme, that the agency found to contain hidden and potentially hazardous steroids. The agency sent a letter on Monday warning the company to make the products comply with federal regulations. Last week, federal agents in San Francisco executed search warrants for the company and for a San Francisco outlet of Max Muscle, a chain of sports nutrition stores, some of which sold the products cited by the F.D.A.

“We think that there may be a number of firms that are marketing similar products, if not products that are exactly the same,” Michael Levy, director of the Division of New Drugs and Labeling at the agency’s Center for Drug Evaluation and Research, said in a conference call with reporters on Tuesday. The agency, he said, is considering taking action against those firms as well.

The warning is part of a larger investigation into body-building products that contain hidden steroids, according to court documents in the American Cellular Labs case. A spokesman for Joseph P. Russoniello, the United States attorney for the Northern District of California, said he could not comment on open investigations.

But Travis Tygart, the chief of the United States Anti-Doping Agency, which oversees the drug testing of Olympic athletes, estimated that there could be 50 or more other brands on the market that contain the same steroids as those in the American Cellular products. The F.D.A. warning follows the agency’s crackdown on more than 70 brands of weight-loss supplements that the agency found to illegally contain hidden and potentially dangerous active pharmaceutical ingredients.

But the federal regulations governing dietary supplements are inadequate to protect consumer health, according to some experts who have studied the safety of such products.

Unlike drug makers, which must demonstrate that a drug is safe and effective before the agency approves it for sale to the public, dietary supplements are a largely self-regulating industry. Manufacturers of such products are themselves responsible for the safety and effectiveness and marketing claims of their products, and for voluntarily recalling them if problems arise. The F.D.A. has authority to act only after it has received reports of serious health problems associated with products already on sale and it is able to prove a serious health hazard. If a company refuses to voluntarily recall problem products, the agency can then file an injunction and seize the products.

Such a reactive strategy puts consumers at risk, critics said.

Posted: 7/29/2009 10:56:00 AM

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ENDO: Chronic Opioid Therapy Risks Hypopituitarism

From MedPage Today:

Chronic opioid therapy significantly increases the risk of multiple hormonal deficiencies that warrant evaluation, according to data from small retrospective study.

Hypogonadotrophic hypogonadism topped the list, occurring in 16 of 25 patients, Murray Gordon, MD, of Allegheny General Hospital in Pittsburgh, reported at the Endocrine Society meeting.

Ten patients each had growth hormone deficiency and adrenal insufficiency. On average, the 25 patients had 1.68 disorders associated with hypopituitarism.

About half of the patients had combined deficiencies.

"Patients treated with chronic opioid therapy should be thoroughly evaluated for hypothalamic-pituitary dysfunction," said Dr. Gordon. "Larger prospective studies are required to confirm these findings. The effects of treatments need to be assessed in patients with hypopituitarism associated with chronic use of opioids."

Though infrequently documented in medical literature, isolated reports of adverse endocrine effects from chronic opioid use date back more than a century, said Dr. Gordon.

Opioids' known effects on endocrine pathways include suppression of gonadotropin-releasing hormone, suppression of adrenocorticotropic hormone, and suppression of growth hormone.

However, little information has accumulated regarding the effects of chronic opioid use on hypothalamic-pituitary function.

To examine the issue, Dr. Gordon and colleagues retrospectively reviewed medical records of chronic opioid users referred for assessment of hypothalamic-pituitary function.

The study population comprised 14 men and 11 women, all of whom had received opioids for more than six months.

The forms of chronic opioid therapy consisted of fentanyl patch for seven patients, hydrocodone for five, oxycodone (Oxycontin) for four, sustained-release morphine and methadone for three patients each, an intrathecal morphine pump for two, and hydromorphone for one.

All the patients underwent dynamic pituitary testing and measurement of baseline pituitary function.

Hypogonadotrophic hypogonadism was defined as low testosterone or estradiol with inappropriately nonelevated gonadotropins.

Ten men and six women met the criteria for the condition. All of the men had low testosterone levels and low gonadotropin levels.

All of the women had low estradiol levels and either low or low-normal gonadotropins. Three of the six were premenopausal, and all six were amenorrheic.

The investigators defined adrenal insufficiency as low levels of cortisol and adrenocorticotropic hormone (ACTH) or a low stimulated peak cortisol level.

The 10 patients with adrenal insufficiency had lower cortisol levels (P<0.007), basal ACTH levels (P<0.001), and stimulated peak cortisol levels (P<0.03) compared with patients who had normal adrenal function.

Growth hormone deficiency was defined as a low insulin-like growth factor-1 (IGF-1) or a low stimulated peak growth hormone level.

Patients with the deficiency had significantly lower IGF-1 levels (P<0.007) and a significantly lower peak stimulated growth hormone level (P<0.001).

All of the patients had either a peak hormone level <3 ng/mL or a peak stimulated hormone level <5 ng/mL in association with low IGF-1 and multiple pituitary deficiencies.

The investigators found no evidence of hypothyroidism in any patient.

MRI scans of 24 of the 25 patients revealed a normal pituitary in 15, six with heterogenous pituitaries, and three with partial empty sella.

There were 9 patients with single deficiencies, and 16 with combined deficiencies. 64% had hypogonadotrophic hypogonadism, 60% had adrenal insufficiency, and 64% had growth hormone deficiency.

Posted: 6/22/2009 12:12:00 PM

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BPA may cause heart disease in women, research shows

From EurekAlert!:

New research by a team of scientists at the University of Cincinnati (UC) shows that bisphenol A (BPA) may be harmful for the heart, particularly in women.

Results of several studies are being presented in Washington, D.C., at ENDO 09, the Endocrine Society's annual meeting, June 10-13.

A research team lead by Scott Belcher, PhD, Hong Sheng Wang, PhD, and Jo El Schultz, PhD, in the department of pharmacology and cell biophysics, found that exposure to BPA and/or estrogen causes abnormal activity in hearts of female rats and mice.

In addition, these researchers found that estrogen receptors are responsible for this affect in heart muscle cells.

BPA, an environmental pollutant with estrogen activity, is used to make hard, clear plastic and is common in many food product containers. It has been linked to neurological defects, diabetes and breast and prostate cancer.

Using live cultures of cells isolated from rat or mouse hearts, researchers briefly exposed the cardiac cells to BPA and/or estrogen. Both compounds caused striking changes in the activity of cardiac muscle cells from females but not males. Additional studies revealed that these cellular changes in activity caused improperly controlled beating in the female heart.

"Low doses of BPA markedly increased the frequency of arrhythmic events," Belcher says. "The effect of BPA on these cardiac arrhythmias was amplified when exposed to estradiol, the major estrogen hormone in humans."

The mechanism underlying this harmful effect was investigated using cellular imaging techniques.

"BPA and/or estrogen rapidly stimulated contraction by altering control of the concentrations of free calcium inside the heart cell but only in heart muscle cells from females, showing that these effects were sex-specific," Belcher says. "BPA's presence increased the frequency of calcium 'sparks' from the sarcoplasmic reticulum—the part of the cardiac muscle that stores and releases calcium ions—indicating spontaneous release or 'leak' that's likely causing the heart arrhythmias and may have other harmful actions, especially following heart attack."

Belcher and colleagues also investigated the nature of the mechanisms that mediated the responses of the cardiac muscle cells to estrogen and BPA.

"Pharmacological studies using selective estrogen receptor drugs and animal models lacking estrogen receptors were used to investigate the role of each estrogen receptor in mediating the rapid sex-specific function effects of E2 and BPA in cells," he says. "Our findings suggest that estrogen has opposing actions in cardiac cells.

"In female cardiac muscle cells, the blocking or genetic removal of estrogen receptor beta completely blocked the contractile effects of BPA and estrogen, while in males, blockade of the effects of estrogen receptor alpha caused the male heart to become more 'female-like' and become responsive to estrogen and BPA.

"These studies have identified new and important potential cardiac risks associated with BPA exposure that may be especially important for women's heart health," he says.

Posted: 6/10/2009 1:48:00 PM

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EPA Will Mandate Tests On Pesticide Chemicals

From The Washington Post:

The Environmental Protection Agency for the first time will require pesticide manufacturers to test 67 chemicals contained in their products to determine whether they disrupt the endocrine system, which regulates animals' and humans' growth, metabolism and reproduction, the agency said yesterday.

Researchers have raised concerns that chemicals released into the environment interfere with animals' hormone systems, citing problems such as male fish in the Potomac River that are bearing eggs. Known as endocrine disruptors, the chemicals may affect the hormones that humans and animals produce or secrete.

Testing will begin this summer and will focus on whether these chemicals affect estrogen, androgen and thyroid systems. The tests eventually will encompass all pesticide chemicals.

Pesticide industry officials said they had anticipated the move, which was set into motion in 1996 by the passage of the Food Quality Protection Act, and they planned to cooperate on the matter.

"It's been a long time coming," said Jay Vroom, president and chief executive of CropLife America, a major trade association. "For pesticides, we think the likelihood is extremely low we'll have any concerns come to the surface."

Linda Birnbaum, who directs the National Institute of Environmental Health Sciences and the National Toxicology Program, said the program represents "a more organized way to look at" how human exposure to pesticide chemicals could affect such things as bone growth and brain development.

"This is a good beginning," Birnbaum said, adding that scientists need to examine how different hormone disruptors might interact or accumulate in the human body. "It's very important to know: Can certain chemicals, especially chemicals that are out there that people are exposed to, impact our hormone system?"

Although researchers have observed the most visible effects of these chemicals in animals, Birnbaum said it is likely that some humans, depending on their particular sensitivity, could experience similar problems.

Linda Phillips, who manages the Endocrine Disruptor Screening Program, said that it will take about two years to obtain data from the two-tier program, and that it then could take the agency another year to make a final determination about the chemicals' effect on hormone disruption.

Vroom said pesticide manufacturers are "very confident our products will come through with flying colors." He added: "If we do learn something about our products that raises a cause for concern, our industry will be at the table, ready and willing to step forward and take action to mitigate risk."

Posted: 4/22/2009 9:14:00 AM

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Oral contraceptives linked to lupus risk

From the United Press International (UPI) :

Canadian researchers have linked initial use of oral contraceptives to an increased risk of lupus.

The study, published in Arthritis Care & Research, finds a significant increased risk of newly diagnosed systemic lupus erythematosus associated with the first three months of use of first- and second-generation contraceptives containing higher doses of estrogen.

Hormones are believed to play a role in systemic lupus erythematosus because the ratio of women to men with systemic lupus erythematosus -- an autoimmune disease -- is 9 to 1 and the incidence increases after puberty.

Study leader Dr. Samy Suissa of the Center for Clinical Epidemiology at Jewish General Hospital of McGill University in Montreal used data for 1.7 million women ages 18-45 taken from the United Kingdom General Practice Research Database of more than 6 million people.

The women, all of whom had been prescribed combined oral contraceptives containing estrogen and progestogen were followed for eight years. A first time systemic lupus erythematosus diagnosis was found in 786 women, usually in the first three months of combined oral contraceptives use.

Posted: 4/9/2009 11:19:00 AM

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Asperger Syndrome Tied to Low Cortisol Levels


Low levels of a stress hormone may be responsible for the obsession with routine and dislike for new experiences common in children with a certain type of autism.

U.K. researchers found that children with Asperger syndrome (AS) do not experience the normal twofold increase of cortisol upon waking up. Levels of the hormone in their bodies do continue to decrease throughout the day, though, just as they do in those without the syndrome.

The body produces cortisol, among other hormones, in stressful situations. Cortisol increases blood pressure and blood sugar levels, among other duties, to signal the body's need to adapt to changes occurring around it. It's thought that the increase shortly after waking helps jump-start the brain for the day ahead, the researchers said.

People with Asperger syndrome notably have very repetitive or narrow patterns of thought and behavior, such as being obsessed with either a single object or topic. Though tending to become experts in this limited domain, they have otherwise very limited social skills, according to the study.

"Although these are early days, we think this difference in stress hormone levels could be really significant in explaining why children with AS are less able to react and cope with unexpected change," study co-leader Mark Brosnan, from the psychology department at the University of Bath, said in a news release issued by the school.

If these Asperger symptoms are caused primarily by stress, caregivers could learn to steer children away from situations that would add to anxiety, the researchers said.

"This study suggests that children with AS may not adjust normally to the challenge of a new environment on waking," study researcher David Jessop, from the University of Bristol, said in the news release. "This may affect the way they subsequently engage with the world around them."

The researchers, whose findings were published in the journal Psychoneuroendocrinology, will next study if this lack of cortisol upon waking also occurs in children with other types of autism.

Posted: 4/3/2009 12:26:00 PM

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Hormonal imbalance: Steve Jobs can recover in six months


Steve Jobs recently announced that his obvious weight loss and weakened condition was a result of ’hormone imbalance’. This announcement was met with a barrage of medical opinions suggesting that no such entity exists. Research at the Roby Institute dealing with hormone imbalance and hormone allergy suggests Steve Jobs’ diagnosis may be dead on. If the diagnosis is correct, then Steve Jobs can expect a complete recovery within three to six months.

The imbalance causes the body to operate with the emergency hormone adrenalin. The chronic use of this major stress hormone leads to fatigue and all manner of stress-related disorders. They include chronic fatigue syndrome, weight disorders, pain, fibromyalgia, arthritis, shortness of breath and anxiety. The patients are easily identified…they feel serious symptoms…and their doctor insists there is nothing wrong with them. Often the patients are led to believe - it is all in your head.

A readily available blood test for hormones could measure for such an imbalance. Hormones tested include estradiol, testosterone, thyroid, cortisol and DHEA. An imbalance could be treated by hormone replacement therapy (HRT) or supplements. Lifestyle changes are often prescribed since stress is a common factor. The patients are usually intense individuals with increasing stress in their lives.

The disorder is rarely diagnosed because doctors are not trained to look for it. In 2006, Texas researchers at the Roby Institute and the University of Texas, Austin, published the first paper describing hormone imbalance (Hormone Allergy, AJRI). In 2008, Dr Roby of the Roby Institute published the book ’Maybe It IS All in Your Head…and You Are NOT Crazy!’.

Professor RH Richardson of The University of Texas, Austin is one of the authors of paper on hormone allergy. He points out that there is often a precipitating factor that pushes us into adrenalin hyper-drive. Dr Roby states that in Jobs’ case the precipitating event was probably the pancreatic cancer. It can be a divorce, job loss or a severe illness.

Once something like that occurs, the pattern of adrenalin driven behaviour and body responses become fairly common. He points out that these are very intense people, even as young children. The intensity results from having been born low in cortisol. If there are low levels of cortisol, the result can be high adrenaline. As kids they are described as ADHD. Children with these qualities are often called hyperactive.

Roby states, “All this energy is very useful…These people get a lot done. They are the professionals, the intense and highly productive people we see all around us. But, in their adult years the use of adrenalin increases and there is less balance. So, they begin to use adrenalin more and more.”

The consequences are all the disorders medicine lumps into the ’syndrome’ basket. Symptoms, often severe, with no disease detected, no known cause and no treatment available. So, physicians treat the symptoms of fatigue (antidepressants), or pain (narcotics as in fibromyalgia) or steroids for all the inflammatory disorders that seem to accompany this agitated condition.

So, to deal with this problem The Roby Institute suggests measuring the hormones and correcting any imbalance. This almost always requires supplementing DHEA and often testosterone (in men) or estradiol (in women). Researchers emphasise the importance of helping the patient become more aware of the adrenal effect and stress. Sometimes the patients are instructed to wear a pulse meter with a wristwatch alarm to warn them of up-ticks in their adrenalin. Dr Roby states, “We explain that without moderate movement designed to get rid of adrenalin…nothing will ever change. So, we introduce them to the concept of moderation. Particularly with respect to movement. The people with this disorder are always intense and their movement often is as well.”

Posted: 2/9/2009 11:01:00 AM

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