Dr. Goodyear

The increased weight with tamoxifen is seen premenopausal women, but less with postmenopausal women.

Study finds that leptin, PAI-1, and hsCRP are positively associated with increasing metabolic syndrome components.  Adiponectin was negative associated with increasing MetS.  Not a lot of new info here.

Metabolic Syndrome is associated with CAD.  No surprise here, but increase in # of metabolic syndrome parameters was associated with increasing % of Triple vessel disease.   No surprise that MetS was associated with TNF-alpha, IL-6, IR, and hsCRP.

I really love biochemistry.  This is a pathway diagram of ERK signaling.  ERK is a subdivision of MAPK, which plays a very important role in regulating cell growth.  Dysfunction in the ERK pathway as well as in JNK and others are implicated in malignant transformation.

Study finds no improvement in sexual desire and/or ED in older, obese men with Type II diabetes by Testosterone therapy over 40 weeks.   There is so much wrong with this study.  The authors, by design, assume that Testosterone is all there is.  No assessment of Testosterone metabolism and or its effects on inflammation was designed into this study.  These men are known to have increased inflammatory cytokine production and likely are aromatase dominant.  Given these men Testosterone may just be throwing fuel on the biochemical fire.

This is an important study.  Study found that Estradiol increased the transcription of pyruvate kinase M (PKM2)production in endometrial stromal cells.  This increase in PKM2 shifted metabolism to a aerobic glycolysis pattern similar to the Warburg effect described in cancer.  Additionally, increased PKM2 via Estradiol increased ER alpha transcription and functioned as a ER alpha coactivator.

Cholecalciferol (vitamin D3) was found to increase male Testosterone production in cell culture model.  This fits with other data that low vitamin D and low T often go hand in hand.  This study actually shows improved D levels increase Testicular Testosterone production, though in cell culture.

Review of the data points to poor quality of evidence dealing with DHEA in post-menopausal women with normal adrenal function.  Yet if DHEA is low, which is >95% produced by adrenals in women, then how can the adrenal function be "normal".   The meta-analysis found no improvement in libido and/or sexual function, and no improvement in lipids, glucose, weight... was noted.  Essentially not positive or negative effects were noted.  Abstract only available here, so dosage is a question.

data on androgen therapy in women is sparse at best.  The conclusion here is suspect: "evidence supports the short-term efficacy and safety of high physiological doses of T" for women with with hypoactive sexual desire, yet the same authors recommend against long-term therapy.  How do those 2 go together???  They don't.  Support with physiologic Testosterone when appropriate testing reveals low T and symptoms support the same.  This is a practice guideline that lacks evidence to strongly back it up because so little evidence exists.  Practice guidelines are for lazy physicians.

After school fitness/exercise improved focus, attention, and cognition of children.

JNK pathway plays important role in inflammation signaling.  In this article, JNK activation plays role in insulin resistance, obesity, and metabolic dysfunction.

This population study finds increased risk, significantly more for women vs men, of type II Diabetes with gout.  This should come as no surprise as the underlying pathophysiology is the same.  Fructose increases Uric acid.  Uric acid is a biomarker of MetS.  Fructose increases abdominal adiposity and eventually inflammation which leads to diabetes.  

Men with Low T often have low vitamin D levels.  This study found better results with calcidiol versus cholecalciferol in raising 25-hydroxyvitamin D.

Interesting abstract of study of DHEA metabolites.  In vivo study finds some DHEA metabolites inhibit 5-alpha-reductase activity.  The opening sentence implies that 5alpha-reductase and conversion of T to DHT promotes androgen dependent disease.  The inference here is cancer, however, what they fail to mention is that this activity is via the estrogen receptors.

10 year Cochrane review finds low T associated with aging, obesity, MetS, and poor health.  The authors suggest that low T "may be linked to earlier all-cause and cardiovascular related mortality among men".  This is supported by other studies.  Only abstract available here.

So this is what passes as science these days.  The study looked at whether pre-therapy Testosterone evaluation was beneficial in men prescribed Testosterone therapy.  What?!

Previous Testosterone therapy did not effect Gonadotropin therapy for azoospermia in men with hypogonadotropic hypogonadism.  Gonadotropin therapy was quite successful in generating spermatogenesis in this meta-analysis.

Review of data of Testosterone in post-menopausal women is seriously lacking--especially long-term safety data and this is worrisome as other data points to increased CVD and cancer with increasing Testosterone levels in women.

lavender improves post cesarean postoperative pain.  This was via the aroma use of lavender.

Lavender effective in healing episiotomy pain and discomfort compared to traditional therapies.