Joe Langer long-term safety

posted July 17, 2008 - 8:19am

Joe Langer long-term safety

BACKGROUND: Results from prospective investigations of the relation between vitamin C intake and risk of CHD have been inconsistent. The lack of clear evidence for a protective association despite a plausible mechanism indicates the need to evaluate further the association between vitamin C intake and risk of CHD. METHODS: In 1980, 85,118 female nurses completed a detailed semiquantitative food-frequency questionnaire that assessed their consumption of vitamin C and other nutrients.( Joe Langer laboratory findings)

Joe Langer conducting clinical trials
Joe Langer => This is where marketing and medical science may part ways. Pharmaceutical companies often obtain F.D.A. approval of a new product for a niche population with a relatively rare disease, hoping to expand later to a larger and more profitable market. Once a drug is approved for sale, a physician can legally prescribe it for any clinical condition he thinks would benefit from it.

Nurses were followed up for 16 years for the development of incident CHD (nonfatal myocardial infarction and fatal CHD). RESULTS: During 16 years of follow-up (1,240,566 person-years), we identified 1,356 incident cases of CHD. After adjustment for age, smoking, and a variety of other coronary risk factors, we observed a modest significant inverse association between total intake of vitamin C and risk of CHD (relative risk [RR] = 0.73; 95% confidence interval [CI] 0.57 to 0.94).

Joe Langer thorough evaluation
Prostate cancer. No direct evidence has linked testosterone replacement with increased risk of prostate cancer. But prostate cancers that were not detectable by prostate-specific antigen (PSA) level or digital rectal exam were found by biopsy in 14% with low testosterone levels (JAMA 276[23]:1904-06, 1996).

Physicians have been targeted with similar ads. One that appeared in a recent issue of a primary-care journal calls on them to "identify the men in your practice with low testosterone who may benefit from clinical performance in a packet." The photographs are eye-catching: there's a well-built fellow in his middle years beside the words "improved sexual function"; a smiling man in shorts and a T-shirt who is standing next to a mountain bike ("improved mood"); a policeman directing traffic ("increased bone mineral density").

Joe Langer diagnosis and treatment
Patch testing can be used to identify susceptibility. Women who use topical estrogen and typically have close contact with children should be aware that gynecomastia, rapid growth, and advanced bone age can result when prepubescent children are indirectly exposed to excessive amounts of topical estrogen (Pediatrics 105[4]:E55, 2000). It should be noted that the Food and Drug Administration does not regulate custom-compounded topical estrogen formulations, which can contain high levels of estrogen.

"Get rid of the problem with orgasm." "Well, I believe we have a very good chance of helping you." Morgentaler wrote out a prescription for AndroGel. "We'll check your P.S.A. today, but we don't need to do biopsies of your prostate gland until after the age of fifty. So you can get started right away."

United Medical Network - AndroGel
Joe Langer Endocrinology => Estrogen also has been shown to regulate the anagen-telogen cycle (Proc. Natl. Acad. Sci. USA 93[22]:12,525-30, 1996). The higher levels of estrogen during pregnancy cause the hair to grow by increasing the amount of hair in the anagen phase. The hair loss often seen in postmenopausal women is likely the result, at least partially, of the increased amount of hair in the telogen phase.

Estrogel became available 4 years ago as the first estrogen gel to treat natural or surgically induced estrogen deficiency or menopausal symptoms such as hot flashes, vaginal atrophy, mood swings, and sleep disturbances. This ERT is a transdermal preparation combining a hydroalcoholic gel and 0.06% 17--estradiol derived from yam. Estrogel has a low side effect profile and is associated with a lower incidence of skin irritation, compared with transdermal estrogen patches, and has a 20-year track record of safe, effective use in Europe.( Joe Langer benefits)

United Medical Network genetic studies
The percentage of patients reporting full erections improved from 60%-65% to 70%-75%, with no apparent difference between dosage groups. That improvement was maintained over the rest of the follow-up. Lean body mass and total body mass changed similarly for all the dosage groups. For the group given the 10-g dosage, lean body mass rose by an average 3.5 kg at 30 months. Fat mass dropped by about 2.5 kg at 30 months.

?Lots of physicians don't delve into the matter too deeply, either for lack of time or because of the level of discomfort,? he said. A thorough evaluation is important because hypogonadism may arise from problems with the testes, pituitary, or hypothalamus, or by a genetic disorder. The AACE guidelines are aimed at three target populations: Men with primary testicular failure who require hormone replacement.

United Medical Network recent studies
"Another possibility could be a decrease of sensitivity in the [head of the penis]," Juza says. Arnold Melman, MD, head of the urology department at the Montefiore Medical Center in New York City, says he doubts that has anything to do with it. "What evidence is there?" he says. "Do you think when you have a hard erection you're less sensitive?"

There are also several generic forms of estradiol available. In all cases, they're made from plant sources (phytoestrogens) and micronized. With an increasing number of women from the baby boom generation entering menopause, it is safe to assume that pharmaceutical manufacturers with an already significant stake in hormone and estrogen replacement therapies are expanding research efforts to find safer, more effective estrogen therapies. It is likely that the positive effects that topical estrogens may confer on facial skin will achieve greater prominence in the coming years.

Joe Langer therapy
Joe Langer cardiovascular disease => Full remission of depression as documented by a reduction in the Montgomery-Asberg Depression Rating Scale to below 10 was achieved in 17 of 25 women (68%) on transdermal estradiol, compared with just 5 (20%) on placebo. The estradiol patch appeared to be equally effective regardless of which DSM-IV depressive diagnosis a woman carried.

Klinefelter's syndrome is a congenital disorder in which men have an extra X chromosome and underdeveloped testes. Other suitable candidates for therapy are men whose testes have been scarred by viral inflammation. Still others have had a tumor that damaged the hypothalamus or the pituitary gland, so the brain no longer sends activating signals to the testes. In such men, muscle strength, libido, and bone density are diminished, and testosterone replacement is an effective treatment.

Joe Langer hormone replacement
No studies have clearly indicated that a particular testosterone level is associated with pituitary tumors. But a total testosterone level of less than 150 ng/dL should trigger a pituitary imaging study, even in the absence of other symptoms, the guidelines state. The treatment goal is the same in each target population?to restore sexual function (including fertility, if desired and possible), libido, behavior, and physical well-being.

The basis for topical estrogen study stems from the findings of a correlation between natural estrogen depletion and chronologic aging, especially aging of the skin. Estrogen is a dynamic hormone that is matched with an equally impressive array of exogenous replacement products. The family of estrogen products includes estrogens in conjugated or esterified forms, ethinyl estradiols, estradiols, estradiol derivatives such as estradiol valerate and estradiol cypionate, estriols, and estrones.( United Medical Network - AndroGel)

United Medical Network pituitary imaging
The halt earlier this year of the HRT arm of the National Institutes of Health?sponsored Women's Health Initiative because of increased rates of breast cancer, acute MI, and stroke has for now squelched interest in identifying new indications for estrogen therapy in any form. That is particularly the case for conditions such as depression, for which numerous therapeutic options already exist.

The pharmaceutical industry is, of course, in the business of inventing treatments. Some people wonder whether it may help invent diseases, too. To be treated for andropause, you first need physicians who can confidently make the diagnosis. One of them is Dr. Abraham Morgentaler, the director of Men's Health Boston. He is forty-six years old, with thick black hair and deep-set eyes. Trained as a urologist, he specializes in male sexual dysfunction and infertility.

Joe Langer research
Joe Langer laboratory findings => Health experts are increasingly worried that most American adults do not consume healthy amounts of vitamins in their diet, although they may be getting enough to ward off such vitamin-deficiency disorders as scurvy, beriberi and pellagra. Almost 80 percent of Americans do not eat at least five helpings of fruits and vegetables a day, the recommended minimum amount believed to provide sufficient essential nutrients. Humans do not make their own vitamins, except for some vitamin D, and they must get them from an outside source to prevent metabolic disorders.

Testosterone also raises the level of circulating red blood cells; if this level is excessive, the blood becomes viscous, which can lead to congestive heart failure or stroke. And among men who received a 100-milligram daily dose of AndroGel over a year, nearly twenty per cent developed some sort of prostate disorder, such as prostatic hyperplasia.

Joe Langer hormone levels
Klinefelter's syndrome is a congenital disorder in which men have an extra X chromosome and underdeveloped testes. Other suitable candidates for therapy are men whose testes have been scarred by viral inflammation. Still others have had a tumor that damaged the hypothalamus or the pituitary gland, so the brain no longer sends activating signals to the testes. In such men, muscle strength, libido, and bone density are diminished, and testosterone replacement is an effective treatment.

The percentage of patients reporting full erections improved from 60%-65% to 70%-75%, with no apparent difference between dosage groups. That improvement was maintained over the rest of the follow-up. Lean body mass and total body mass changed similarly for all the dosage groups. For the group given the 10-g dosage, lean body mass rose by an average 3.5 kg at 30 months. Fat mass dropped by about 2.5 kg at 30 months.

Joe Langer perform a full evaluation
Among women who did not use vitamin C supplements or multivitamins, the association between intake of vitamin C from diet alone and incidence of CHD was weak and not significant (RR = 0.86; 95% CI 0.59 to 1.26). In multivariate models adjusting for age, smoking, and a variety of other coronary risk factors, vitamin C supplement use was associated with a significantly lower risk of CHD (RR = 0.72; 95% CI 0.61 to 0.86). CONCLUSIONS: Users of vitamin C supplements appear to be at lower risk for CHD.OBJECTIVE: To review the importance of antioxidant nutrients in the maintenance of health and the prevention and treatment of disease, with a focus on data pertaining to vitamin C, vitamin E, selenium, and carotenoids.

?Concern about long-term safety and efficacy remains an issue,? said Dr. Steven M. Petak, chair of the guidelines revision committee. ?Perhaps these new guidelines will stimulate some additional research into these issues,? said Dr. Petak, an endocrinologist at the Texas Institute for Reproductive Medicine and Endocrinology, Houston.( Joe Langer physical assessment)

Joe Langer cardiovascular disease
Joe Langer the symptoms of hypogonadism => Until then, the attempt to reverse the gradual decline in testosterone levels in aging men can't be considered the treatment of a disorder: it amounts to a vast, uncontrolled experiment, whose consequences remain uncertain. As Hayes says, "It would be a shame to make the same mistakes again."Once again, Viagra comes to the rescue. A new study shows that Viagra in combination with Paxil helps premature ejaculators who have not improved with standard treatment.

In prospective studies, the intake of vitamins A, C, and E has been correlated with lower mortality rates. When recent clinical trials and oxidation studies are analyzed, the weight of evidence suggests that 100-400 IU of daily vitamin E over 2 years or more may be most efficacious in reducing low-density lipoprotein oxidation and positively influencing mortality rates from CVD in primary care. Research also supports vitamin E supplementation in patients with known CAD or a history of transient ischemic attacks. Persons with diabetes or hypertension as well as smokers may benefit from supplemental vitamin C intake.

Joe Langer genetic disorders
A recent study showed that HRT in postmenopausal women limited the number and depth of wrinkles, measured by optical profilometry and computerized image analysis (J. Am. Geriatr. Soc. 45[2]:220-22, 1997). Research also shows that topical estradiol (17--estradiol and 17--estradiol) can promote the development of new connective repair areas in photodamaged skin as effectively as all-trans-retinoic acid (Arch. Dermatol. Res. 294[5]:231-36, 2002).

Drug interactions, too, might alter testosterone levels in unpredictable ways. And much of the variation simply eludes explanation. Crowley studied several young men whose initial test results showed testosterone levels ranging from 150 to 200?well below the 300 cutoff?over twenty-four hours. "They had a perfectly normal testosterone profile," Crowley says. "There can be a funny disconnect between one measurement and a later one"?which means that testosterone deficiency may be easily overdiagnosed.

Joe Langer laboratory findings
And there are those who don't want to wait for scientific validation. Last year, a panel organized by the National Institutes of Health?maybe the closest thing we have to a voice of independent scientific consensus?released a paper concluding that the andropause hypothesis is unproved. The report that Swerdloff's group released at the Endocrine Society meeting in June contains references to sixty-two relevant publications, but omits any reference to the N.I.H. report.

Data Sources and Study Selection We searched MEDLINE for English-language articles about vitamins in relation to chronic diseases and their references published from 1966 through January 11, 2002. Data Extraction We reviewed articles jointly for the most clinically important information, emphasizing randomized trials where available.

United Medical Network testosterone-replacement therapy
Joe Langer genetic disorders => The pharmaceutical industry is, of course, in the business of inventing treatments. Some people wonder whether it may help invent diseases, too. To be treated for andropause, you first need physicians who can confidently make the diagnosis. One of them is Dr. Abraham Morgentaler, the director of Men's Health Boston. He is forty-six years old, with thick black hair and deep-set eyes. Trained as a urologist, he specializes in male sexual dysfunction and infertility.

A recent study showed that HRT in postmenopausal women limited the number and depth of wrinkles, measured by optical profilometry and computerized image analysis (J. Am. Geriatr. Soc. 45[2]:220-22, 1997). Research also shows that topical estradiol (17--estradiol and 17--estradiol) can promote the development of new connective repair areas in photodamaged skin as effectively as all-trans-retinoic acid (Arch. Dermatol. Res. 294[5]:231-36, 2002).( Joe Langer diagnosis and treatment)

Joe Langer long-term safety
In a laboratory crowded with centrifuges, chemical hoods, and spectrophotometers, they and their team spend hours double-checking sensitive chemical assays for hormones produced by the hypothalamus and the testes, as well as the pituitary and adrenal glands. In an adjoining clinical-research center, volunteer human subjects are hooked up to I.V.s and insulin clamps.

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