HEALTHY AGING for WOMEN

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HEALTHY AGING for WOMEN

• John Pan, M.D.
• Director, Center for Integrative Medicine
• Clinical Professor, Dept. of Ob Gyn, GWUMC

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Menopause is not a disease- But it sure feels
like one

• Hot flashes, night sweats
• Insomnia, poor quality sleep
• Dry skin, brittle hair, feels cold
• Fatigue, tired of being tired
• Feeling down depression
• Weight gain changing shape
• Aches and pains muscle/joints
• Worries Cancer, Heart, Bone
• Libido not the same

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Menopause Web
Hormone Emotions Bone Heart Digestive Cancer Fitn
ess Skin
Life style Exercise Stress management Nutrition CA
M Pharmaceuticals
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Comprehensive Approach

• Evaluation
• Endocrine Hormone Thyroid Adrenal Pancreas
• Cardiac
• Bone
• Digestive
• Cancer risk
• Stress
• Fitness
• Management Strategy Plan

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Sex Hormones

• Sex Hormones
• Estrogen
• Progesterone
• Testosterone
• Bio-Identical vs Synthetic
• Delivery
• Tablet, cream, patch, gel, vaginal suppository
  film/ring

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Estrogen

• Non-Bio-Identical
• Premarin Pregnant mares urine
• Bio-Identical
• Estrone E1, Estradiol-E2, Estriol-E3
• Tri-Est 2.5 estriol 1mg, estrone 0.125,
  estradiol 0.125mg
• Estrace 100 Estradio
• Source Mexican wild yam soy
• Side effects Risk/Benefit
• Insulin - Fat

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Progesterone

• Non-Bio-Identical
• Medroxyprogesterone Provera
• Norethindrone acetate - BCP
• Bio-Identical
• Progesterone - Prometrium
• Source Wild Yam, Soy
• Bioactivity
• Side effects Risk/Benefit

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Testosterone

• Essential
• Libido
• Side effects
• Complexion, hair, voice
• Cardiac complications

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Herbs

• Vitex Chasteberry
• 4-10mg extract 500-1,000mg/day crude herb
• Black Cohosh - Remifemin
• 40mg bid
• Kava
• 100-200mg 1-3 times/day
• Dong Quai
• 1500mg/day
• Red Clover
• 40mg/day extract

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Phytoestrogens

• Isoflavones Genistein Daidzein
• Legumes
• Beans - Soy
• Lignans
• Flax seed
• Cereal, fruits and vegetables
• Berries, asparagus, green pepper, carrot,
  lettuce, broccoli
• Coumestans
• Soy bean sprout, alfalfa sprouts

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Soyfoods - Estimated Isoflavone Contents
Food Serving mg/serving Tempeh 4
oz 167.0 Soy flour 1/4 cup 43.8 Tofu -
uncooked 4 oz 38.3 Texturized soy protein,
dry 1/4 cup 27.8 Soy milk 1 cup 20.0 Isoflavo
ne content varies among bean varieties,
manufacturing process and source of soy protein.
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Endocrine glands

• Thyroid
• Adrenal
• Pancreas

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Thyroid

• Hypofunction
• Weight gain, fatigue, dry skin, brittle hair,
  intolerance to cold
• BBT
• Hypothyroid
• Blood TSH, Free T-3 T-4
• Replacement
• Thyroid support herbal/nutritional
• Organic Armour thyroid
• T-4, T-4/T-3

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Adrenal

• Adrenaline
• Cortisol
• DHEA
• Dehydroepiandosterone
• Source of all hormones
• Male hormone
• Dose 5 - 25 mg per day

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Pancreas - Glucose Regulation

• Carbohydrate Sugar - Insulin Fat/Hormone
• Glucose/Insulin challenge test
• Insulin Resistance Syndrome X
• Trunkal obesity
• Hypertriglyceridenemia
• Hypertension
• Type II diabetes
• Polycystic ovarian syndrome
• Diet Glycemic Index

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Cardiac Health

• Risk - 1 cause of death in PM women
• Assessment
• Homocysteine level
• C-Reactive Protein
• Total cholesterol/HDL ratio
• Stress ECG-Thalium Scan-Heart Scan
• Social Support Stress Management
• Moderate exercise 20-30 min., 4 times/week
• Nutrition - Diet Supplements
• Soy, Garlic
• Omega-3, CoQ-10, antioxidants, B6, B12 folic
  acid

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Bone Health

• Bone undergoes constant remodeling
• Osteoclast (resorbtion) - Osteoblast (formation)
• Menopause
• Resorption gtgt Formation
• Tests
• Dexa scan Sono Urinary Metabolic Products
• Treatments
• Nutrition Sardines (bones)-Dark green
  leafy-Soy-Dairy
• Supplements Calcium-Magnesium-Vit-D-Boron-Silicon
  e
• Exercise Weight bearing-muscle building
• Medication Estrogen-Fosomax-Evista

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Digestive Health

• Gastric Acid Digestive Enzymes
• Improper nutrient absorption, foul stool,
  bloating
• HCL, Pancreatic Enzymes
• Intestinal Flora The Good The Bad
• Good bacteria Proper balance, convert nutrients
• Bad bacteria Yeast overgrowth, reconvert
  estrogen
• Probiotics Lactobacilli, Bifidobacter,
  Sacchramyces
• Intestinal Function
• Food Sensitivity
• Mucosal permeability Leaky gut
• Waste Elimination - Fiber, Water

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Emotional Tranquility Mental Acuity

• Meditation/Guided Imagery
• Reiki
• Yoga/Tai Qi
• Acupuncture
• Herbs
• St. Johns wort, Kava, Ginkgo, Melatonin, Hops,
  Chamomile, etc.

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Feel Fit Look Vibrant

• Prescriptive exercise program
• Cardiac
• Back
• Muscle toning building
• Skin care
• Proper nutrients applied and ingested
• Protection from sun

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General Health

• Nutrition Diet Modification
• Plant based diet
• Colors Antioxidants
• High fiber Reduce hormone load
• Anti-inflammatory
• Whole/Fresh foods
• Limit the 3 Whites Dairy, Flour Sugar
• Supplements
• Omega-3 - EPA/DHA/ALA
• Fish Oil, Flax oil/meal
• Vitamins Minerals
• Phytonutrients - Antioxidants

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Reduce Breast Cancer Risk

• Proper selection of hormones
• Tri-Est 2.5mg, Bi-Est, Progesterone
• Control estrogen metabolic process
• 216 hydroxy-estrone ratio
• Glucose/Insulin regulation, Bowel flora
• Avoid xeno-estrogen
• Pesticides, drugs, plastics, beef/poultry
• Plant based diet
• Isoflavone, lignans, fiber
• Supplements
• Indole-3-carbinol cruciferous vegetables

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Disease Development

• Antecedent
• Triggers/Milieu
• Disregulation

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Antecedents

• Genetic make-up Hard wired
• Gene expression
• Emotional Heritage Soft wired
• Family Constellation
• Environmental Heritage
• Family health profile

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Triggers

• Toxins
• Environmental/ Pollutions Air/Water/Radiation
• Iatrogenic Drugs/Vaccines/Amalgam/others
• Food
• Contaminants Additives
• Nutrients
• Life events
• Stress
• Physical Injuries Illness

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Milieu

• Health Reserve
• Nutritional status
• Inflammation Antioxidative capacity
• Organ systems function
• Musculoskeletal balance
• Disease Vessel
• Disease burden
• Capacity to resist illness
• Different size and shape
• The Final Drop

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Disregulation

• Biochemical Mediator
• Inflammatory cytokines
• Bacterial toxins
• Neuro-chemicals
• Hormones
• Cellular
• Cancer Tumor
• Functional
• Type II Diabetes
• Obesity
• Pain Neuro-skeletal-muscular

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The Constellation of Healing Disease
Health Provider
PATIENT
Disregulation
Antecedent
Trigger / Milieu
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John Pan M.D. Barbara Boston RNC

• Center for Integrative Medicine
• 908 New Hampshire Ave. NW, Suite-200
• Washington, DC, 20037
• Tel [phone]
• Fax [phone]
• E-mails jpan_at_mfa.gwu.edu
• barbaraboston_at_earthlink.net
• Web www.IntegrativeMedicineDC.com