Friday, November 28, 2008

IVF and Birth Defects? Ugh!

"The CDC reports that certain birth defects -- including heart wall problems and cleft lip/palate -- may be two to four times more common among babies conceived with assisted reproductive technology (ART) than babies conceived naturally. Those findings -- published in the advance online edition of Human Reproduction -- focus on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)."

"The following types of birth defects were more common among babies conceived through ART:

*Septal heart defects: Twice as common among babies conceived by ART

*Cleft lip and/or cleft palate: 2.4 times as common among babies conceived by ART

*Esophageal atresia (birth defect of the esophagus): 4.5 times more common among babies conceived by ART

*Anorectal atresia (birth defect in the anal/rectal area): 3.7 times more common among babies conceived by ART

Those findings, which take into account other risk factors, only applied to single births, not to twins, triplets, or other multiple births.

But the CDC points out that multiple births are associated with ART and with birth defects."
Article pulled from, WebMDHealth, November 17, 2008

The researchers are unsure if assisted reproduction in itself is to blame for the increase in birth defects. In fact, new studies looking at men and women with sub-optimal fertility are being considered.

It is very important that men and women looking for fertility help really examine every angle of their health before doing IVF or ICSI. I say this not to divert you from these procedures but to make sure your egg and sperm are at their healthiest when you proceed.

Remember it takes about 3 months for an egg and 72-ish days for a sperm to fully mature. Plan about this far in advance for the healthiest chances!

Smoking and Hot Flashes

"Cigarette smoking is associated with hot flashes, higher androstenedione levels, a higher total androgen-to-total estrogen ratio, and lower progesterone levels in women who are not postmenopausal, according to the results of a cross-sectional study reported in the November issue of Obstetrics & Gynecology."

This means that smoking increases your hot flashes, increases your DHEA and testosterone, screws with the hormonal balance and lowers your precious progesterone levels. Not good ladies! Please keep this in mind when deciding to quit in the new year.

Tuesday, November 18, 2008

Food Allergy vs. Food Intolerance: Which are you?

A common question I ask my patients is, “Are there any foods that you avoid?” The answers range anywhere from “absolutely not” to a very long list. I ask this question because I find the things you put in your mouth may be affecting all of those symptoms you just described.

Fatigue? Gas and Bloating? Headaches? Constipation? Rashes? Acne? Joint pain? PMS?
Yes – they can all be food related.

As the commercials on television will tell you (and it is true) 70%-80% of your immune system lives right around your intestines. It is a smart maneuver in human design because anything you eat, breathe, swallow, and drink goes right into your gastrointestinal tract. Therefore the cereal you had for breakfast is evaluated just the same as the flu-bug you inhaled while waiting in line for coffee…then your immune system has to decide - friend or foe?

Many of us would assume the flu-bug must be destroyed and the cereal can live to see another day, right? Well, what if you put milk in your cereal and you shouldn’t have milk? What if your cereal is made up of wheat flour and you’re sensitive to wheat? What if your cereal also has soy crunchies for extra protein and soy is the enemy?
What if you didn’t know?

There are two main types of responses that can occur. One is the typical ‘food allergy.’ Most common examples are the people who eat nuts and have an anaphylactic reaction, drinking citrus juice causes their lips to swell up and dairy sends them running for the bathroom. It is an immediate response and governed by an immune antibody called, IgE.

The second type of response is non-IgE-mediated or known as IgG. This is a delayed response and may not produce a symptom for 2 hours to 48 or even 72 hours. This means if you drink a glass of milk on Monday, you may not notice any symptoms until Tuesday or Wednesday. What if you drink a glass of milk all the time? Then these symptoms could be a problem everyday because you are stringing along your delayed responses.

Remember that not all food related symptoms are intestinal problems. I commonly hear patients report no gas and bloating, no constipation and no diarrhea. Then they complain of being tired all the time, mild headaches that come and go, dry skin, bad PMS, hot flashes, chronic stuffy nose or constantly clearing their throat….this can be food related too.

A quick peak in the research shows overwhelmingly that the most common allergies (IgE) are Peanuts, Tree Nuts (cashews, almonds…etc.), Seafood, Wheat, Dairy, Egg and Soy. Interestingly enough, these are also the most common intolerances (IgG) just a slightly different order: Wheat, Dairy, Soy, Egg, Seafood, Tree Nuts, and Peanuts.

In my experience, I see smaller odd-ball foods too that produce large ‘Ah-ha!’ moments when discovered on testing. “Dr. Jones – I eat that everyday!” “Dr. Jones, I grew up on those.” “Dr. Jones, I take that as a supplement.”

So what do you do? First consider getting tested for both IgE and IgG food categories. Many doctors are familiar with the IgE testing but not with IgG testing so you may have to do some research. If you can not test then the easiest and cheapest is straight forward elimination. I recommend taking the top two, wheat and dairy, and get them out of your diet. I am not kidding. Go on a wheat-free, dairy-free diet for a full month and see how you feel. There are several resources on-line and many grocery stores now that offer a variety of options. You will not starve – I promise.

Of course the food you eat is probably not responsible for ALL of your symptoms but it could be perpetuating an unhealthy cycle. For example, allergies and intolerances might not be the only reason for your joint pain but the inflammations they produce make your pain that much worse.

If you are going to eat three meals a day anyway, then you might as well make them worth your while. Say good-bye to foods that are not benefiting your health and take note of the changes in your symptoms. You just might have an “Ah-ha” moment too.

Tuesday, November 11, 2008

The HPV Vaccine – What do you need to Know?

By now most everyone has seen the commercials on television about the most common HPV vaccine called Gardasil. HPV stands for the Human Papillomavirus and is responsible for both genital warts and abnormal changes on your pap test including cervical cancer. Even though there are hundreds of different strains, HPV-16 and HPV-18 account for 70% of cervical cancer while HPV-6 and HPV-11 cause 90% of genital warts. Therefore, these four strains are the basis for Gardasil’s protection.

The vaccine is not a live-virus but a “virus-like” particle that will still stimulate a woman’s immunity against these four strains of HPV. The company, Merk, reports girls between 9-26 years old can receive it. Lately, there are reports that women up to 45 years old are also seeing benefits.

The vaccine does not protect everyone – especially if you already have these most common strains of HPV or if you have a different, less common strain. Also, it is not meant as a treatment should you acquire genital warts or an abnormal pap. Currently, the vaccine is not recommended for pregnant women and is still being studied on men. Additionally, those who have yeast sensitivities should not receive Gardasil as it is a component of the vaccine.

The company states that girls, ideally between the ages of 11 and 12, who are not yet sexually active should start the first of the three rounds of vaccinations. The schedule of injection should occur over the next 6 months and costs about $125 per dose. A woman can still receive the vaccination up to 26 years old even if she is sexually active and has one of the common HPV strains because she could develop protection against the other three.

Once a woman has been vaccinated, it is not yet known how long the effects will last or if she will need a booster shot. Also, it is not a replacement for her yearly pap test.
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The most common side effects at the site of injection are pain, swelling, and redness. Systemically, women frequently experience fever, nausea, itching, dizziness, vomiting, headache and fainting. Additionally, when you look on the ‘Vaccine Adverse Events Reporting System,’ also known as VAERS, there are many reports of more serious effects such as anaphylaxis, neurological problems, autoimmune disease, seizures, heart problems and even death.

The ingredients in Gardasil are as reported: 225mcg of aluminum, 9.56mcg of sodium chloride, 0.78 mg of L-histidine, 50 mcg of polysorbate 80, 35 mcg of sodium borate, <7mcg yeast protein per dose, and water for injection. The product does not contain a preservative or antibiotics. It is mercury free.

Please review each ingredient and assess if they could trigger an adverse reaction in you before signing-up for the vaccine. A quick search for sodium borate, aluminum and polysorbate 80 did not bring up the healthiest information and may contribute to the reported side effects. For example, there is only 35mcg of sodium borate however the government still has it listed as ‘hazardous’ on the Material Safety Data Sheet webpage.

Before deciding on any vaccine, I urge you to do your due diligence and research what you can. Go directly to the company site and read the fine print available as product or prescribing information. Go to the VAERS website and read the adverse events reports that are made available and talk with your doctor about whether the vaccine is right for you or your daughter. Ultimately, it is your decision because it is your health.


References:
www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm
www.gardasil.com
www.vaers.hhs.gov
www.sefsc.noaa.gov/HTMLdocs/SodiumBorate.htm

Saturday, November 8, 2008

HPV: The Basic FAQs You Need to Know.

HPV stands for the Human Papillomavirus and is currently the most common sexually transmitted infection worldwide.

The Centers for Disease Control estimates that nearly 20 million Americans between age 15 and 24 years old have HPV. This is the virus that causes genital warts as well as those abnormal changes on your pap test that can lead to cervical cancer.

There are many strains of HPV with some remaining dormant, not doing anything (that we know of), and others causing problems.

When you go for your pap test, you can have your healthcare practitioner include a ‘high-risk HPV test’ for greater accuracy about whether you have HPV in your cervical area. It’s the ‘high-risk’ HPV that causes abnormal cells to occur on your cervix and can lead to cervical cancer.

How likely are you to acquire HPV?
Well, the lifetime risk in sexually active people is about 80-85%...which is a lot.

Does this mean you will automatically develop cervical cancer? Absolutely not!

The prevalence of HPV infections is greatest in young, sexually active women between the ages of 20 – 24 years old with the next highest rate being 15-19 years old.

The kicker though is figuring out exactly where your HPV infection came from if you’ve had 2 or more sexual partners. The virus can lay dormant for many years before causing an abnormal pap test. Because men are often asymptomatic, you could be well into your 30’s, 40’s and even 50’s before something comes up and it may be from a sexual encounter during your teen years.

Here’s the great thing – 80% of HPV infections are transient, asymptomatic and resolve without any treatment. In fact, the average length of infection is about 4-6 months. However, there are many risk factors that promote HPV you can prevent.

1)Stop smoking!! Research shows that the link between smoking and HPV is extensive. The number of cigarettes per day and number of years smoking correlates with the severity of your HPV infection.

2)Re-think your hormonal contraception. The estrogen in your pill, ring or patch is contributing to your HPV infection.

3)Having sex at an early age (before 16) exposes your cervix to HPV sooner.

4)Multiple sexual partners increase your risk of HPV exposure. Even if your numbers are low, what are the numbers of your partner?

5)Watch your waistline – some studies are linking obesity with increased chances of cervical adenocarcinoma – a type of cancer.

6)HPV is a contact sport – it is spread when skin touches skin. If you use condoms 100% of the time you are 70% less likely to acquire HPV.

7)Get other testing – having HIV or Chlamydia greatly increases your chance of a more invasive HPV infection.

8)Get your pap test! Have your healthcare provider include the high-risk test for HPV.

To see more visit: www.empowerher.com

References:
1 .www.cdc.gov/std/hpv/.htm
2. J Midwifery Womens Health 49(1):4-13,2004 © 2004 Elsevier Science, Inc
3. Tolstrup J, Munk C, Thomsen BL, et al. The Role of Smoking and Alcohol Intaqke in the Development of High Grade Squamous Intraepithelial Lesions Among High Risk HPV Positive Women. Acta Obstet Gynecol Scand 2006;85(9):1114-9.
Cancer. (Medscape Ob/Gyn & Snyder U. A Look at Cervical Women’s Health 2003;8(1).
4. Montero JA, Larkin JA, Houston SH, Toney J. Examining the Complex Relationship of Human Papilloma Virus to Cervical Dysplasia and Carcinoma. Medscape General Medicine 1(2). 1999.
5. Santelli JS, Brener ND, Lowry R, Bhatt A, Zabin LS. Multiple Sexual Partners Among U.S. Adolescents and Young Adults. Family Planning Perspectives 1998, 30(6):271-275.
6. Winer RL, Hughes JP, Feng Q, et al. Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women. N Engl J Med 2006;354(25):2645-54.
7.Lacey JV, Swanson CA, Brinton LA, et al. Obesity as a Potential Risk Factor for Adenocarcinomas and Squamous Cell Carcinomas of the Uterine Cervix. Cancer 2003; 98(4):814-21.
5) Windstar, K, Jones, C. Risk Factors potentiating HPV Pathogenesis; and Evidence of Natural Treatment Options. Lecture August 2008, American Association of Naturopathic Physicians.