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PRP Therapy - Non Surgical Hair Loss Treatment for Men and Women - 0 views

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    PRP Therapy or Platelet Rich Plasma Therapy is an effective non-surgical hair loss treatment for men and women. PRP Therapy makes efficient utilization of a growth enhancing blood constituent called platelets, which when combined together with plasma, results in an unprecedented increase in the hair follicles across the treated areas.
Nathan Goodyear

A comparison of saliva, plasma unconjugated and plasma total oestriol levels throughout... - 0 views

  • It seems probable that measurement of salivary E3 could adequately replace that of plasma unconjugated E3 in the assessment of fetoplacental function.
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    salivary testing of estriol in pregnancy validated
Nathan Goodyear

TESTOSTERONE AND Δ4-ANDROSTENEDIONE IN THE SALIVA OF PATIENTS WITH KLINEFELTE... - 0 views

  • measurement of salivary steroids, by reflecting their free hormone concentration in plasma, may be useful in evaluating endocrine function in both health and disease
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    salivary testing of testosterone and androstenedione reflects free hormone concentration in plasma, proving to be very useful in evaluating endocrine function and disease 
Nathan Goodyear

Plasma Homocysteine as a Risk Factor for Dementia and Alzheimer's Disease - NEJM - 0 views

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    An increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer's disease.
Nathan Goodyear

Plasma Homocysteine as a Risk Factor for Vascular Disease, June 11, 1997, Graham et al.... - 0 views

  • An increased plasma total homocysteine level confers an independent risk of vascular disease similar to that of smoking or hyperlipidemia. It powerfully increases the risk associated with smoking and hypertension. It is time to undertake randomized controlled trials of the effect of vitamins that reduce plasma homocysteine levels on vascular disease risk.
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    homocysteine levels increase vascular disease risk.
Nathan Goodyear

Normal Fasting Plasma Glucose and Risk of Type 2 Diabetes Diagnosis - 0 views

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    Normal Fasting Plasma Glucose and Risk of Type 2 Diabetes Diagnosis
Nathan Goodyear

Intravenous Fluid Use in Athletes - 0 views

  • The current data suggest that IV rehydration is faster than oral
  • There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route
  • Muscle damage during exercise in the heat was assessed by myoglobin and creatine kinase
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  • Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase
  • IV administration of fluids can rapidly replace plasma volume
  • The rapid increase in plasma volume is transient, and no measureable difference between IV and oral prehydration exists after 15 minutes of exercise
  • The use of IV fluid may be beneficial for a subset of fluid sensitive athletes
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    IV nutrition pre-event, intra-event, and post-event for recovery.
Nathan Goodyear

Specific 3,3′,5′-Triiodothyronine (Reverse T3) Binding Sites on Rat Liver Pla... - 0 views

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    rat model finds T4 and rT3 receptors at plasma membrane.  T3 was found to bind with lower affinity than rT3 and T4 at the same receptor binding site.
Nathan Goodyear

Original Articles: Comparison of Insulin Action on Glucose versus Potassium Uptake in H... - 0 views

  • When treating hyperkalemia, insulin remains efficacious in diabetics and nondiabetics and one does not need to resort to b-agonists, and diabetics do not require different doses of insulin to shift potassium
  • the commonly encountered “insulin-resistant” patients actually have preserved insulin-induced potassium disposal, one wonders why their high insulin levels are not causing hypokalemia
  • insulin independently regulates glucose and potassium uptake into cells and this independence explains why in noninsulin-dependent diabetic insulin resistance leads to impaired insulin uptake into cells but has no effect on the cell's potassium disposal
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  • insulin suppresses glycogenolysis, gluconeogenesis, lipolysis and fatty acid release, and protein catabolism and is the principal hormone that stimulates glucose uptake into mainly skeletal muscle and to a certain extent adipocytes
  • Plasma [K+] is a major determinant of the resting potential of all cells
  • Hyperkalemia and hypokalemia are silent yet fatal disturbances because of their arrhythmogenic potentials
  • Basal insulin maintains fasting plasma [K+] within the normal range
  • When insulin levels are suppressed, plasma [K+] rises and pronounced hyperkalemia develops after a potassium load
  • Potassium is a well proven insulin secretagogue
  • Insulin is a key defender against exogenous potassium load by using intracellular buffering to minimize hyperkalemia before renal excretion
  • Hyperkalemia is often encountered in patients with diabetes
  • The insulin-deficient state in type 1 diabetes predisposes to hyperkalemia because of an impaired ability of potassium to enter cells. During hyperglycemic hypertonic states in type 1 and type 2 diabetics, potassium is carried out of cells by convective flux as the most abundant intracellular cation
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    good review of the potassium, glucose, insulin relationship mostly in diabetes.  In diabetes, hyperkalemia is present due to the hyperglycemia and the associated exchange.  Inuslin independantly regulates potassium and glucose intake into the cell.  INterestingly, in IR found in diabetes, the hyperkalemia is the norm, which should cause hypokalemia--the authors were perplexed by this finding.
Nathan Goodyear

Vitamin C Research - IVC Protocol | The Riordan Clinic - 0 views

  • therapeutic goal of reaching a peak-plasma concentration of ~20 mM (350- 400 mg/dL) is most efficacious
  • The first post IVC plasma level following the 15 gram IVC has been shown to be clinically instructive: levels below 100 mg/dL correlate with higher levels of existent oxidative stress, presumably from higher tumor burden, chemo/radiation damage, hidden infection, or other oxidative insult, such as smoking.
  • If after four infusions the post IVC dosage remains sub-therapeutic, the patient may have an occult infection, may be secretly smoking, or may have tumor progression
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    IV vitamin C protocol and review of experience from the Riordan Clinic.
Nathan Goodyear

Endocrinology of the Aging Male - 0 views

  • All steps beyond the formation of pregnenolone take place in the smooth endoplasmic reticulum
  • Cytochrome P450 enzyme, CYP11A is located on the inner mitochondrial membrane and catalyses the rate limiting step of pregnenolone synthesis
  • Estrogen and related steroids, thyroid hormone and insulin increase SHBG levels.
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  • SHBG decreases in response to androgens, and in the presence of hypothyroidism, and insulin resistance.
  • Plasma SHBG levels tend to increase with increasing age
  • The apparent metabolic clearance rate of testosterone is decreased in elderly as compared to younger men
  • Testosterone circulates predominantly bound to the plasma proteins SHBG and albumin, with high and low affinity respectively
  • Testosterone is secreted in a pulsatile fashion
  • Current clinical guidelines suggest at least two measurements
  • In adult men, there is a well-documented diurnal variation (particularly in younger subjects) in testosterone levels, which are highest in the early morning and progressively decline throughout the day to a nadir in the evening
  • In older men, the diurnal variation is blunted
  • it is standard practice for samples to be obtained between 0800 and 1100 h.
  • Testosterone and DHEA decline, whereas LH, FSH, and SHBG rise
  • DHT remains constant despite the decline of its precursor testosterone
  • Longitudinal studies show an average annual decline of 1–2% total testosterone levels, with decline in free testosterone more rapid because of increases in SHBG with aging
  • Massachusetts Male Aging Study (MMAS) data show DHEA, DHEAS, and Ae declining at 2–3% per year
  • DHT showed no cross-sectional age trend
  • Androstanediol glucuronide (AAG) declined cross-sectionally with age in the MMAS sample, at 0.6% per year
  • The EMAS data show that, consistent with the longitudinal findings of MMAS (Figure 1), the core hormonal pattern with increasing age is suggestive of incipient primary testicular dysfunction with maintained total testosterone and progressively blunted free testosterone associated with higher LH
    • Nathan Goodyear
       
      This author proves the point in the review of these two studies, that TT may remain constant in aging men, however, FT drops.
  • obesity impairs hypothalamic/pituitary function
  • Androgen deprivation in men with prostate cancer has been associated with increased insulin resistance, worse glycemic control, and a significant increase in risk of incident diabetes
  • Low serum testosterone is associated with the development of metabolic syndrome 116, 117 and type 2 diabetes. 118 SHBG has been inversely correlated with type 2 diabetes
  • Improvement in insulin sensitivity with testosterone treatment has been reported in healthy 121 and diabetic 122 adult men
  • In studies conducted in men with central adiposity, testosterone has been shown to inhibit lipoprotein lipase activity in abdominal adipose tissue leading to decreased triglyceride uptake in central fat depots. 123
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    great review of hormone changes associated with aging in men.
Nathan Goodyear

Steroids in Saliva for Assessing Endocrine Function - 0 views

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    Another study validates saliva as a reliable method for hormone testing.  The author concludes: "steroid concentrations in saliva are independent of flow rate and reflect those in the free fraction in plasma".  This study also discuss potential collection problems and means to resolve them.
Nathan Goodyear

SALIVARY CORTISOL ASSAYS FOR ASSESSING PITUITARY-ADRENAL RESERVE - PETERS - 2008 - Clin... - 0 views

  • Since salivary cortisol concentrations were shown to reflect the free, biologically active fraction in plasma, salivary assay may, in selected cases, provide results of greater diagnostic significance than plasma total concentrations.
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    salivary cortisol found to be superior to total serum cortisol levels.
Nathan Goodyear

Effects of Smoking on Plasma Testosterone Level and Erectile Function in Rats - Park - ... - 0 views

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    smoking reduces serum testosterone in rats.  The real question is what does it do to the salivary levels (tissue) and the metabolism of testosterone.
Nathan Goodyear

Adrenocortical dysregulation as a major player in insulin resistance and onset of obesity - 0 views

  • acute GC secretion during stress mobilizes peripheral amino acids from muscle as well as fatty acids and glycerol from peripheral fat stores to provide substrates for glucose synthesis by the liver
  • chronically elevated GC levels alter body fat distribution and increase visceral adiposity as well as metabolic abnormalities in a fashion reminiscent of metabolic syndrome
  • This local production may play an important role in the onset of obesity and insulin resistance.
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  • In adipocytes, cortisol inhibits lipid mobilization in the presence of insulin, thus leading to triglyceride accumulation and retention.
  • Since the density of GC receptors is higher in intra-abdominal (visceral) fat than in other fat depots, the activity of cortisol leading to accumulation of fat is accentuated in visceral adipose tissue (24, 158), providing a mechanism by which excessive endogenous or exogenous GC lead to abdominal obesity and IR
  • obese patients generally have normal or subnormal plasma cortisol concentrations
  • This may be explained by an increased intratissular/cellular concentration of cortisol in adipose tissues
  • Intracellular GC may be produced from recycling of GC metabolites such as cortisone in adipose tissues
  • Local GC recycling metabolism is mediated by 11β-hydroxysteroid dehydrogenase enzymes (11β-HSD1 and 11β-HSD2
  • Cortisol also increases 11β-HSD1 expression in human adipocytes
  • In humans, elevated 11β-HSD1 expression in visceral adipose tissue is also associated with obesity
  • even if obese patients generally have normal or subnormal plasma cortisol concentrations (131, 158), triglyceride accumulation in visceral adipose tissue may be due, at least in part, to the local production of GC in insulin- and GC-responsive organs such as adipose tissue, liver, and skeletal muscle
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    another nice article on the dysregulation of cortisol and its role in insulin resistance, metabolic syndrome, and obesity.
Nathan Goodyear

Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men - NEJM - 0 views

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    Fasting glucose levels >90 require treatment.  Don't wait until they increase above 100, damage is actively occurring in the kidneys at levels above 90.  institute dietary/lifestyle changes at any point above 84.
Nathan Goodyear

Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use - 0 views

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    only vitamin C IV shown to raise plasma and urine levels when compared to oral intake in cancer patients
Nathan Goodyear

Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use - 0 views

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    only high dose IV vitamin C shown to produce high plasma vitamin C concentrations compared to oral vitamin c.
Nathan Goodyear

Transdermal testosterone replacement therapy in men - 0 views

  • a recent study has suggested that it may sometimes be inaccurate because of abnormal fluctuation of other circulating androgens
    • Nathan Goodyear
       
      The authors are referencing the increase in the suggestions to use other testing techniques i.e. saliva.
  • Testosterone therapy can inhibit hepcidin transcription and is associated with increased iron incorporation into red blood cells and increased erythropoietin concentrations
  • Transdermal TRT has a more favorable adverse effect profile when compared to buccal testosterone formulations
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  • Approximately 0.3% of testosterone is converted into estradiol by aromatase (CYP19A1)
  • the recommendation for injectable testosterone esters is to check the serum concentration midway between injections
  • it is recommended for serum testosterone to be evaluated 3 to 12 hours after application of the transdermal patch
  • testosterone concentrations should be checked 2–3 months after initiation of therapy and after adjusting the dose
  • a study from 1989 utilizing testosterone transdermally containing 5, 10, or 15 mg of testosterone showed that peak concentrations of testosterone were achieved 3 to 8 hours after scrotal application in hypogonadal men
  • It is used for many medications and has the advantage of high bioavailability, absence of hepatic first pass metabolism, increased therapeutic efficacy, and steadiness of plasma concentrations of the drug
  • evaluate serum testosterone at the end of the dosing interval for testosterone pellets
  • increased amount of fat leads to increased extragonadal aromatase activity, resulting in increased concentrations of estradiol. High circulating concentrations of estradiol down regulate the HPG axis and decrease the amount of circulating testosterone
  • Up to 80% of plasma estradiol originates from aromatization of testosterone and less than 20% of estradiol in the circulation is secreted by the testes
  • A PSA concentration, digital rectal examination, and hematocrit should be performed at baseline and at 3 months, 6 months, then yearly after TRT is initiated.
  • measure serum testosterone any time after the patient has been on treatment with gel for at least 1 week
  • If the hematocrit rises above 54%, treatment should be discontinued
  • elderly men having higher estradiol serum concentrations than postmenopausal women
Nathan Goodyear

The adipose tissue metabolism: role of testosterone and dehydroepiandrosterone. - PubMe... - 0 views

  • T inhibits lipid uptake and lipoprotein-lipase (LDL) activity in adipocytes, and stimulates lipolysis
  • T inhibits differentiation of adipocyte precursor cells
  • DHEA stimulates resting metabolic rate (RMR) and lipid oxidation, and enhances glucose disposal, by increasing the expression of GLUT-1 and GLUT-4 on fat cell plasma membrane
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  • The insulin-like effect of DHEA would be associated to a decrease of plasma insulin concentrations and, thus, to an increase of the molar ratio between lipolytic hormones and insulin
  • the fat-reducing effect of both T and DHEA seems to be more evident at the level of visceral adipose tissue
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    Testosterone inhibits lipid uptake into adipocytes.  Testosterone inhibits lipoprotein lipase.  Testosterone stimulated lipolysis.  Testosterone inhibits adipocyte differentiation of proginator cells. DHEAs effects are through different mechanisms.   Both have a preference for activity with visceral adipose tissue.
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