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Nathan Goodyear

Early long-term L-T3 replacement rescues mitochondria and prevents ischemic cardiac rem... - 0 views

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    T3 in the post MI individual decreases the MI infarct size and the progression to heart failure. What is really  interesting about this study is that the T3 induced mitochondrial biogenesis and activity which is a great thing in recovery of MI and also in disease i.e. cancer.  However, it appears to increase HIF-1alpha and angiogenesis which is stimulated by retrograde signaling.  There is a muddied picture here.  Because T3 stimulates oxidative phosphorylation and mitochondria biogenesis which is favorable for health.  However, in this study of rats, it induced HIF-1alpha and angiogenesis in post MI, which is favorable to recovery, yet this is unfavorable for cancer.    Yet oxidative phosphorylation is favorable to cancer prevention/elimination and MI recovery.
Nathan Goodyear

Normalization of testosterone level is associated with reduced incidence of myocardial ... - 0 views

  • Normalized-TRT group had significantly fewer deaths than no-TRT
  • Mortality was also significantly lower in the non-normalized-TRT group compared with those in no-TRT group
  • the normalized-TRT group was associated with significantly increased all-cause mortality-free survival (log-rank, P < 0.05) compared with the non-normalized-TRT or no-TRT groups
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  • normalized-TRT group showed lower risk of MI than non-normalized-TRT (HR: 0.82, CI 0.71–0.95, P = 0.008) and no-TRT
  • normalized-TRT group had significantly lower stroke events compared with non-normalized-TRT (HR: 0.70, CI 0.51–0.96, P = 0.028) and no-TRT
  • study of men with low TT levels and without prior MI or stroke, normalization of TT levels using TRT is associated with lower all-cause mortality, fewer MIs, and ischaemic strokes
  • retrospective study
  • the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalize the TT levels
  • Patients who failed to achieve the therapeutic range after TRT did not see a reduction in MI or stroke and had significantly less benefit on mortality
  • selected patients without any previous history of MI or stroke prior to initiation of TRT to reduce bias related to CV outcomes
  • currently only half of the men on TRT had been diagnosed with hypogonadism.
  • 25% of users did not have their T concentrations tested prior to initiating therapy, and 21% of those prescribed TRT did not have their levels tested at any time during treatment.
  • men without a history of previous MI or stroke who have low TT levels, TRT might be associated with decreased risks of MI, ischaemic stroke, and all-cause mortality in long-term follow-up
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    Testosterone therapy in men with low T found to reduce all cause mortality, stroke and MI.
Nathan Goodyear

Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy - 0 views

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    Testosterone therapy in older men found to provide no increase in MI risk.  In fact, those men with high MI risk, Testosterone provided protection against MI.
Nathan Goodyear

Normalization of testosterone level is associated with reduced incidence of myocardial ... - 0 views

  • In this study of men with low TT levels and without prior MI or stroke, normalization of TT levels using TRT is associated with lower all-cause mortality, fewer MIs, and ischaemic strokes.
  • retrospective study
  • significant benefit is observed only if the dose is adequate to normalize the TT levels
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  • the mechanisms for these effects remain speculative
  • It can be postulated that the beneficial effect of normal T levels on adipose tissue, insulin sensitivity, and lipid profiles or by its anti-inflammatory and anticoagulant properties, as reported by other investigators, might have contributed to our findings
  • off-label use of TRT remains a concern
  • Recent FDA analyses suggest that currently only half of the men on TRT had been diagnosed with hypogonadism
  • 25% of users did not have their T concentrations tested prior to initiating therapy
  • 21% of those prescribed TRT did not have their levels tested at any time during treatment
  • two very recent meta-analyses suggested a lack of convincing evidence posed by TRT.
  • men without a history of previous MI or stroke who have low TT levels, TRT might be associated with decreased risks of MI, ischaemic stroke, and all-cause mortality in long-term follow-up
  • TRT should aim for doses resulting in normalization of TT level as this was shown to be associated with reduction in adverse CV events
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    Testosterone therapy in men with low T to restore physiologic Testosterone levels found to reduce mortality, MI, and stroke risk.
Nathan Goodyear

Rebuilding the post-infarcted myocardium by a... [Heart Fail Rev. 2010] - PubMed - NCBI - 0 views

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    Wow, thyroid hormones play a significant role in cardiac remodeling post MI.  Thyroid hormones, "promotes tissue growth and differentiation and favorably remodels cardiac cell while increases cellular survival..."  How many people post-MI are having their thyroid evaluated, let alone correctly evaluated?
Nathan Goodyear

Thyroid Replacement Therapy and Heart Failure - 0 views

  • A good biomarker of intracardiac TH signaling would be helpful but has not been identified. In the absence of such a marker, a rational, cautious therapeutic approach might be to restore and maintain over time biochemical euthyroidism as documented by normal circulating levels of TSH, FT4, and FT3.
  • a low-T3 state resulting from altered peripheral TH metabolism secondary to caloric restriction is associated with impaired cardiac contractility
  • Low-T3 syndrome is the central finding and defines the illness in a variety of acute and chronic severe nonthyroidal illnesses with cardiac origin, including MI, HF, and surgically treated cardiac disease.1 Low circulating levels of T3 in the absence of primary thyroid hypofunction have been found in 20% to 30% of patients with dilated cardiomyopathy.
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  • FT3 levels were inversely correlated to coronary artery disease
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    Great review of the current understanding of thyroid hormone metabolism in cardiac tissue.  Low T3 and increased rT3 (via increased D3 activity) is CLEARLY associated with poor cardiac performance and post MI and CHF is associated with poor outcomes.  T3 is critical in cardiac remodeling and recovery post MI.  T3 is actually a vasodilatory in the coronary arteries.   Why a endocrinologist would call rT3 useless only points to their ignorance of the literature.
Nathan Goodyear

Estradiol Enhances Recovery After Myocardial Infarction by Augmenting Incorporation of ... - 0 views

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    Estradiol shown to increase EPC activity post MI in female MI rat model
Nathan Goodyear

Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy - 0 views

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    This study appears to fly in the face of the recent studies on the dangers of Testosterone therapy in those with comorbidities.  This study was a retrospective cohort.  The study found that men in the highest risk for MI, had a reduced MI risk with Testosterone therapy.  Men in the lower risk quartiles had no such benefit.  Of note, the frequency of injections suggests inadequate dosing i.e. 4.4 in first year and 8.2 in follow up.  Most injection regimens will require at least monthly injections, though Testosterone pellets were used.  Of special note, no mention of level testing of Testosterone prior to study and/or during study and follow up.
Nathan Goodyear

Thyroid Hormone and Cardiac Disease: From Basic Concepts to Clinical Application - 0 views

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    Low T3 post MI is associated with increased CHF, morbidity and mortality.  Article discusses thyroid hormones and cardiac function/remodeling post infarct.  The article also lays the ground work for a new study of T3 in patients post MI to be followed for 6 months.
Nathan Goodyear

ScienceDirect - American Heart Journal : Plasma total cysteine and total homocysteine a... - 0 views

  • Fasting homocysteine was positively associated with MI risk
  • Fasting plasma concentration of total homocysteine, but not total cysteine, was positively associated with MI risk.
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    homocysteine associated with MI risk
Nathan Goodyear

PLOS ONE: Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Ther... - 0 views

  • For all TT prescription subjects combined, the post/pre prescription rate ratio for MI (RR)was 1.36
  • In men aged 65 years and older the RR was 2.19 (1.27, 3.77), while in men under age 65 years the RR was 1.17
  • increasing RR with increasing age.
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  • The RRs were 0.95 (0.54, 1.67) under 55 years
  • 1.35 (0.77, 2.38) at 55–59
  • 1.29 (0.71, 2.35) at 60–64,
  • 1.35 (0.44, 4.18) at 65–69, 1.62
  • 3.43 (1.54, 7.66) at 75 years and older
  • The adjusted post/pre RR for PDE5I across all ages was 1.08
  • For TT prescription, in men under age 65 years, the RR was 2.90 (1.49, 5.62) for those with a history of heart disease and 0.90 (0.61, 1.34) for those without
  • In men aged 65 year and older, the RR was 2.16 (0.92, 5.10) for those with a history of heart disease and 2.21 (1.09, 4.45) for those without.
  • Among men aged 65 years and older, we observed a two-fold increase in the risk of MI in the 90 days after filling an initial TT prescription
  • Among younger men with a history of heart disease, we observed a two to three-fold increased risk of MI in the 90 days following an initial TT prescription and no excess risk in younger men without such a history
  • Among older men, the two-fold increased risk was associated with TT prescription regardless of cardiovascular disease history
  • our own findings appear consistent with a higher frequency of thrombotic events following TT prescription among men with more extensive coronary vascular disease.
  • Our findings are consistent with a recent meta-analysis of placebo-controlled randomized trials of testosterone therapy lasting 12 or more weeks among mainly older men, which reported that testosterone therapy increased the risk of adverse cardiovascular-related events (OR = 1.54, 95%CI:1.09, 2.18), as well as serious adverse cardiovascular-related events (OR = 1.61, 95%CI:1.01, 2.56) which included myocardial infarction along with other conditions
  • This association appeared unrelated to average baseline testosterone level (p = 0.70) but varied by source of funding (p = 0.03), with a stronger summary effect in a meta-analysis of studies not funded by the pharmaceutical industry (OR = 2.06, 95%CI:1.34, 3.17) compared with studies funded by the pharmaceutical industry
    • Nathan Goodyear
       
      This supports prior analysis that studies done by pharmaceutical corps will be more favorable to their product(s) than those independently funded.  This is called bias.
  • the evidence supports an association between testosterone therapy and risk of serious, adverse cardiovascular-related events–including non-fatal myocardial infarction–in men
  • there is some evidence that low endogenous testosterone levels may also be positively associated with cardiovascular events
  • effects of endogenous and exogenous testosterone may differ. Exogenous testosterone (TT) is associated with physiologic changes that predispose to clotting and thrombotic disorders including increased blood pressure [18], polycythemia [19], reductions in HDL cholesterol [18], [20], and hyperviscosity of the blood and platelet aggregation. [20]–[23]; TT also increases circulating estrogens [24], [25] which may play a role in the observed excess of adverse cardiovascular-related events, given that estrogen therapy has been associated with this excess in both men and women
  • did not include information on the serologic or diagnostic indications for treatment.
  • no association between PDE5I prescriptions and the risk of MI
  • Recently TT has been increasing extraordinarily rapidly, including among younger men and among those without hormone measurement
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    New cohort study finds increased risk of Testosterone in men > 65 and those : these are based in marketing-based medicine not evidence based medicine.
star yu

BUN y la Creatinina 424.2 en la Etapa 3 de la Enferemad Renal - 0 views

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    Mi enfermedad renal se ha mantenido en la etapa 2 durante 8 años,pero la ultima prueba de sangre maestra mi sangre nitrogeno de urea es de 42 mg / dl y el nivel de creatinina en suero es de 4,2 mg / dl.
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    Mi enfermedad renal se ha mantenido en la etapa 2 durante 8 años,pero la ultima prueba de sangre maestra mi sangre nitrogeno de urea es de 42 mg / dl y el nivel de creatinina en suero es de 4,2 mg / dl.
star yu

Si Mi Nivel de Creatinina Baja desde 8.6 hasta 5.4 Despúes de la Diálisis ,¿S... - 0 views

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    Mi nivel de creatinina baja desde 8.6 a 5.4 después de la diálisis, significa eso mi enfermedad va bien? Diálisis como uno de los tratamiento común de insuficiencia renal, puede disminuir el alto nivel de creatinina mediante la descarga de las toxinas adicionales de la sangre.
star yu

La Medicina China es Mejor que la Diálisis para los Pacientes de Insuficienci... - 0 views

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    Soy un paciente de insuficiencia renal ,y recientemente mi GFR baja en 8 rápidamente ,mi nivel de creatinina aumenta a 13.Por cierto,yo todavía tengo buena producción de orina. Soy un paciente de insuficiencia renal ,y recientemente mi GFR baja en 8 rápidamente ,mi nivel de creatinina aumenta a 13.Por cierto,yo todavía tengo buena producción de orina.
Nathan Goodyear

ESC | Congresses | HEART FAILURE 2013 | Scientific Programme - 0 views

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    CoQ10 in those with prior MIs, found to have reduced hospital readmission, less heart failure, and lower cardiovascular death.  Enough said.
Nathan Goodyear

JAMA Network | JAMA | Effect of Disodium EDTA Chelation Regimen on Cardiovascular Event... - 0 views

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    This study looked at those with previous MIs.  This study found a reduction in recurrent events in those receiving EDTA chelation versus placebo.  The authors of this study looked at the Hazard ratio, which was reduced in every end point that this study was designed to evaluate.
Nathan Goodyear

Myocardial infarction is inversely associate... [Int J Epidemiol. 1990] - PubMed - NCBI - 0 views

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    Vitamin D (25 OH) below 34 ng/ml associated with double risk of MI.
Nathan Goodyear

Thyroid Hormone Treatment to Mend a Broken Heart - 0 views

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    free T3 is critical in the heart healing post MI.  Hypothyroidism and CHF share many hemodynamic and cardiovascular similarities.
Nathan Goodyear

Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction - NEJM - 0 views

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    NORVIT trial showed that vitamin B12, B6, and folic acid reduced homocysteine levels by 27%, however it did not lower MI, stroke,or mortality rate.  ONe variable to consider is the polypharmacy of the study group ie.  they were taking statins, beta blockers, diuretics, coumadin... so was the lack of change in mortality the result of polypharmacy?  And was the polypharmacy blocking the increased CVD risks associated with elevated homocysteine that would have been treatable with vitamin B12, B6, and folic acid.
Nathan Goodyear

Oestradiol levels in diabetic men with and without a... [Q J Med. 1987] - PubMed - NCBI - 0 views

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    High Estradiol is reproducible finding in men with Diabetes.  Link to MI not able to be determined.
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