Koshland Pharm: Custom Compounding Pharmacy is Open for Business!

We finally opened our doors!  Thanks to everybody for their support.

Please don’t forget to come to our grand opening party on Nov. 5th from 5:30 to 7:30pm.  Check out the details at www.koshlandpharm.com.

Live well!

Do you have adrenal fatigue?

I’ve been talking a lot about chronic stress and adrenal fatigue (see my earlier posts Chronic Stress – The 300 Pound Gorilla in the Room and More on Chronic Stress).  I have good reason to be bringing it up – it seems like everywhere I go I find people who suffer from it.  In fact, adrenal fatigue is rampant, maybe even epidemic.  The surprising thing is that, for the most part, the medical community doesn’t see it (good thing we have compounding pharmacists around to help rectify that).

So this begs the question: How do I know if I have adrenal fatigue?  Here are some tell-tale signs:

• difficulty getting up in the morning, feel terrible in the morning
• needing coffee to get going or keep going during the day
• mid-morning energy low
• afternoon energy low between 2-5pm
• second burst of energy at around 11pm lasting until 1-2am
• best sleep comes between 7-9pm
• craving salt and foods high in salt (potato chips, pretzels, etc.)
• low blood sugar under stress
• low blood pressure
• craving sweets
• intolerance to foods high in potassium (i.e. bananas)
• generally don’t feel well throughout the day

If this sounds like you, you most definitely have adrenal fatigue and need treatment.  In a future post, I’ll talk about the basic principles in treating adrenal fatigue.

By the way, this information was taken from a lecture by James Wilson, ND who wrote the excellent book, “Adrenal Fatigue: the 21st Century Stress Syndrome”.  I highly recommend this book if you are interested in this subject.

In the mean time, live well!

Peter Koshland, Pharm.D

www.koshlandpharm.com

More on Chronic Stress

In today’s modern times, being “stessed-out” is almost a cliche.  But what is rarely talked about are the real, quantifiable health effects of continuous stress on the body.  Even doctors often miss the boat when it comes to identifying the consequences of chronic stress and doing something to help alleviate it.

The bottom line is that humans are not physiologically equipped to experience continuous stress for months or years.  In his excellent book, “Why Zebras Don’t Get Ulcers,” Dr. Robert Sapolsky explains that our body is designed to deal with stress in ways similar to a Zebra.  In other words, we are built to have short bursts of intense stress (i.e. when we are being chased by a lion that wants to eat us) followed by long periods of relaxation (i.e. laying in the grass taking a nap).

Our reality is obviously much different.  With the varying demands placed on us by our jobs, families, and environment, we often experience prolonged moderate levels of stress with very little rest.  Over months and years, this can result in very real symptoms that can dramatically affect our quality of life.  Some of these symptoms include:

• depression
• insomnia
• ulcers
• low morning energy
• mid-day energy “crash”
• chronic fatigue
• fibromyalgia
• allergies
• constant infections and colds
• coronary heart disease
• and many more

Our society has already adapted itself to this reality.  Why do you think there is a Starbucks on every corner?  Caffeine helps us cope with low level of morning cortisol that result from the fatigue our adrenal glands experience after having to produce ongoing levels of stress hormones.

Stress and its consequence on our adrenal glands absolutely affects our hormonal balance.  If our adrenal output of cortisol is abnormal, the activity of all the other hormones in the body are effected.

The bottom line is that hormonal balancing begins with addressing the effects of chronic stress.  I’ll talk about how to do that in a future post.

In the mean time, live well! (and relax!)

Mail Order Pharmacies Come Up Lacking

Having always worked in a face-to-face pharmacy setting, I’ve heard many anecdotal stories about problems with mail order pharmacies, but results from  this patient survey just out from the National Community Pharmacists Association (NCPA), proves that problems with mail order are widespread. 

The study interviewed over 400 mail order pharmacy users.  Here’s what the study found:

• 48% had to go without medication at some time because of late delivery.
• If a patient was required to use a mail order pharmacy, that number jumped to 63%
• 85% of patients had to at least once pay for a medication twice because it didn’t arrive in the mail in time and they had to purchase it from a local pharmacy

Unfortunately, some health plans require patient’s to get their prescriptions from mail order only, so I guess for them these problems are unavoidable.  For those that have a choice, it looks like the costs of mail order are more than just not being able to see your friendly pharmacist’s face.  Something to consider.

Live well!

Chronic Stress – The 300 Pound Gorilla in the Room

I went to an excellent seminar a few years ago where the lecturer, Dr. Eldred Taylor, listed the top 10 best selling pharmaceuticals of that year.  They included Lipitor, for cholesterol; some asthma medications; Ambien, for sleep; drugs for heart disease; and some antidepressants.  Then Dr. Taylor went on to say that every disease that these drugs are used to treat can be caused by chronic stress.

Well, that really got my attention since I had not heard a word about this in my 4 years of pharmacy school (although I did learn a lot about those top 10 drugs).  As I began talking to some of my patients about this topic, I realized that chronic stress is the 300 pound gorilla in the room.  The more I talked to people, the more it seemed like everyone had it.  Chronic stress and the subsequent adrenal fatigue that it causes, may be the single most important medical condition of our times, and no one has heard of it – not even most doctors!

What happens when we experience chronic stress over months and years is that it slowly alters the way our adrenal gland functions, ultimately depleting it of its ability to produce hormones necessary for our body to function properly. 

The adrenal gland is an important organ that sits on top of our kidneys.  Among other things, it is responsible for secreting the hormone cortisol, with is the hormone that allows us to cope with stress.  All cells in the body need cortisol.  It regulates glucose metabolism, it mediates inflammation, it regulates blood pressure, it affects the contractions of the heart, it affects the functioning of our immune system, it regulates the functioning of other hormones (like thyroid and the sex hormones), and much more. 

Interestingly, although our adrenal glands are the organs in our body that are designed to respond to stress, they are also the glands that are most easily damaged by stress.  Some people who have suffered from post-tramatic stress disorder (PTSD), have such a massive shock to their system, that their adrenal functioning is instantly altered.  For most of us, the damage is slow and incremental.

The good news is that there are things we can do to restore the functioning of our adrenal glands and reverse the negative effects of all this stress.  I’ll talk about that more in a future post.

In the mean time, live well!

Good Discussion on Andropause (… that’s male menopause)

View From the Bay, a local Bay Area television talk show, recently had this informative discussion with Dr. Kent Holtorf about the often misunderstood subject of andropause or male menopause.  Believe it or not, as men age, they can suffer from many of the same hormone imbalance symptoms as women – yes, they can even get even hot flashes!  Also, recent trials have related testosterone levels (which tend to drop as men age) with cardiovascular health and longevity (higher testosterone = greater longevity).

I would be remiss if I didn’t also put a link to my own appearance on View from the Bay from back in January, where I discussed bioidentical hormones.

Live well!

Progesterone Trial Shows Multiple Benefits

A clinical trial published in last month’s International Journal of Pharmaceutical Compounding showed strong symptom relief and minimal side effects with progesterone treatment.  This study is in line with numerous others conducted throughout the years reinforcing the benefits of bioidentical progesterone.

Participating women showed relief in menopausal related symptoms like migraine, painful breasts, mood swings, bloating, and hot flashes but also described other unexpected improvements in irregular and painful periods, cystitis pain and libido.

The women in the study also described difficulty in obtaining information about progesterone as their doctors often didn’t know much about it and often learned about progesterone through social interactions and by doing their own research rather than a formal doctor/patient relationship.

Women who understood the difference between synthetic progestins and progesterone unanimously chose progesterone for their self-treatment.

Although this trial is limited by a small sample size and the self-selection of the participants, the findings seem to fit with the experience of many of my patients.

Please share your own, I’d love to hear about them (as would many who read this blog, I’m sure).

For more information on progesterone and bioidentical hormones, see my earlier blog posts.

Live well!

Can Meditation Help Balance Your Hormones?

Yes.

Numerous clinical trials have proven the stress reducing properties of meditation.  When stress is reduced, the adrenal glands are happy.  When the adrenal glands are happy, they release the proper amount of the hormone cortisol.  When the proper amount of cortisol is released, the body’s cells utilize all other hormones more efficiently (including thyroid).

So, therefore, meditation can help balance your hormones.  It’s also good for cardiovascular health and mental well-being.  Interestingly, a few clinical trials showed that having a religious experience during meditation was not necessary for it to be effective.

Here are a few clinical trials that showed the beneficial effects of meditation on stress:

1. Oman D, Shapiro SL, Thorensen CE, et al. Meditation lowers stress and supports forgiveness among college students: a randomized controlled trial. J Am Coll Health 2008;56:569-78.

• This trial (performed at UC Berkeley) showed significant reductions in stress and increased forgiveness in students after two 90 minute training sessions in one of two types of meditation.

1. Tang YY, Ma Y, Wang J, et al. Short-term meditation training improves attention and self-regulation.  Proc Natl Acad Sci U S 2008;56:569-78

• This trial showed significantly improved attention and control of stress with 5 days of a 20 minute long meditation practice.

1. Jain S, Shapiro SL, Swanick S, et al. A randomized controlled trial of mindfulness meditation versus relaxation training: effects on distress, positive states of mind, rumination, and distraction. Ann Behav Med 2007;33:11-21.

• This trial showed significant improvement in stress and positive mood states with 1 month of meditation practice.
• There was no difference in stress reduction between people who did and did not have a spiritual experience through the meditation practice.

1. Lane JD, Seskevich JE, Piper CF. Brief meditation training can improve perceived stress and negative mood. Altern Ther Health Med 2007;13:38-44.

• This trial showed significant improvement in stress after learning a simple meditation practice in 4 – 1 hour small group sessions with instructions to practice for 15-20 minutes twice daily.
• Increased frequency of meditation improved the stress reduction.
• Those most likely to experience negative emotions benefitted most from the intervention.

Live well!

Excellent Radio Program on Bioidentical Hormones

I came across this excellent radio program on Bioidentical Hormone Replacement – Beyond 50 hosted by Daniel Davis (click here the for link).  The guest is Jim Paoletti, the Director of Provider Education for, ZRT Labs, a highly respected saliva testing company.  LOTS of straight talk here.  Check it out and live well!

Pharmaceutical Ads – Reinforcing Stereotypes?

I came across this article about how the pharmaceutical industy reinforces or even creates stereotypes about women.  I was struck by this quote from the article:

‘In every society,’ writes Ivan Illich, ‘medicine, like law and religion, defines what is normal, proper or desirable. Medicine has the authority to label one man’s (or woman’s) complaint a legitimate illness, to declare a second man (or woman) sick though s/he themselves do not complain, and to refuse a third social recognition of his/her pain.’

Here are some ads from the past pulled from this article plus a few more:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Live well!