DARE TO BARE: Sun Safety Tips for Healthier Skin

Summer is in full swing and with the warm weather luring us outdoors we often forget how much time we're spending in the sun and for us Californians, that's most of the year.

The summer season is a great time to enjoy outdoor activities and build up your levels of Vitamin D but before you head out the door to soak up the sun, make sure you're following the right steps to keep your skin healthy all summer long.

Whether you're biking, swimming, running, gardening or even driving your car, you are putting yourself at risk for the most common type of cancer in the United States. Over 1 million cases of non-melanoma skin cancer (squamous cell or basal cell carcinoma) are diagnosed each year. UV radiation is the most important factor in the development of skin cancer with more than 90% of skin lesions (non-melanoma type) occurring in sun-exposed areas.

The amount of sun exposure a person receives is dependent not only on how much time they spend in the sun but also on the time of day, geographical location, and weather conditions.
UV radiation that reaches the earth's surface is most intense at the equator due to the angle of the sun's rays. It is not surprising then that the incidence of skin cancer is higher near the equator. How close you are in proximity to the equator determines how strong of an exposure you have to UV radiation. Therefore, Southern California residents have greater overall exposure to UV radiation.

Be Sun Smart - follow the guidelines below to protect your skin from sunburn, wrinkles and skin cancer:

Slather on the sunscreen
Sunscreen is a great first line of defense against the sun's damaging effects on your skin. But how do you know how much protection you are getting from your sunscreen and what does SPF mean anyway?

SPF stands for Sun Protection Factor and measures a sunscreen's protection against Ultraviolet B (UVB) rays. Keep in mind that both UVA and UVB rays cause skin damage so you want to choose a broad spectrum sunscreen that protects against both types of UV radiation. The Centers for Disease Control and Prevention (CDC) as well as the American Academy of Dermatology recommends an SPF of 15 or higher. The higher the SPF, the greater the protection from sunburn caused by UVB rays. A higher SPF does not mean you can stay in the sun longer. For instance, an SPF of 15 filters out about 93% of the UVB rays and an SPF of 30 filters out 97% of the UVB rays. After several hours the protective effects of sunscreen begin to wear off so it should be reapplied about every 2 hours especially if you are sweating, engaged in water activities, in a humid climate, and drying or rubbing your skin with a towel.

Since no sunscreen can completely block UV rays, it is important to follow other methods of sun protection:

• Avoid the sun during peak hours (10am-4pm) when UV rays are strongest and therefore most damaging.
• Cover up your skin with a long-sleeved shirt, pants, wide-brimmed hat and sunglasses

Know Your ABCDEs
How to tell if that suspicious looking skin lesion is worth making a trip to the dermatologist:
4 square pic
A = Asymmetry: cancerous lesions are typically irregular in shape
B = Border irregularity: cancerous lesions tend to have uneven borders rather than smooth and round
C = Color: cancerous lesions usually have multiple shades of brown or black
D = Diameter equal to or greater than 1/4 inch or 6mm: benign moles are usually less than 6mm in diameter
E = Elevated: cancerous lesions often grow in size or change in height rapidly

For more information on skin cancer prevention, visit http://www.emilysfoundation.org.a/skincancer_abcde.php

To find out about the health plans offered at Ocean Pacific Integrative Health Center, please call our office at 760-944-9300 or visit our website at http://opintegrativecenter.com.

Managing Menopause Naturally

Without warning, a sensation of intense warmth spreads from your head to your neck and chest. Beads of sweat begin to form on your face and you feel a little dizzy. This brief episode is over in minutes and leaves you flushed (reddened), perspiring, hot and craving a cold glass of water. Like many women, you are experiencing a hot flash and would like some symptom relief.

In your search for managing your symptoms you may have come across Hormone Replacement Therapy (HRT), but not sure if it is right for you. You have read the testimonial of many women through different media resources who have successfully managed their menopausal symptoms using bioidentical hormones and would like to find out more about the treatment and its risks. You have also heard about nonhormonal ways of dealing with menopause. Whatever your questions, finding the right treatment can be just as overwhelming as the menopause transition itself.

A short history on Hormone Replacement Therapy (HRT)
For many years Premarin or Prempro were the prescription of choice for millions of women in America entering menopause. Premarin, a mixture of estrogens derived from the urine of a pregnant horse, and Prempro, a combination of horse estrogens and synthetic progesterone, serve to replace the hormones that the body is no longer producing in sufficient quantities in the perimenopausal and menopausal stages of a women’s life. These synthetic hormones are prescribed not only to alleviate menopausal symptoms, but also to protect women against heart disease, reduce fracture risk, and as an anti-aging regimen.

In 1991, the effects of hormone replacement therapy were tested in a large clinical trial called the Women’s Health Initiative. More than 16,000 healthy post-menopausal women participated in the study. They were given a placebo or a combination of conjugated equine estrogen and synthetic progesterone in 1 tablet daily for an average of 5.2 years. An important objective of the trial was to examine the effect of estrogen plus progestin on the prevention of heart disease and hip fractures, and any associated change in risk for breast and colon cancer. The study did not address the short-term risks and benefits of hormones for the treatment of menopausal symptoms.

In 2002 the study was stopped short because the health risks (increased risk of heart disease, breast cancer, stroke and pulmonary embolism) to participants outweighed the possible benefits.

While the study found that HRT does reduce the risk for fractures and colorectal cancer, the researchers concluded that the balance of harm versus benefit does not justify any woman beginning or continuing to take estrogen plus progestin exclusively for this purpose. Therefore, non-hormonal therapies and strategies for treatment of osteoporosis and prevention of colorectal cancer should be considered, respectively.

Recently, the 2008 reanalysis of the study concluded that hormone therapy is associated with increased risk of stroke regardless of age at which HRT started.

Although the associated risks were only reported for conjugated equine estrogens and synthetic progestin, many practitioners refrained from prescribing bio-identical and natural forms of the hormones as well.

Bio-identical Hormones
Bioidentical hormones share the exact same molecular structure as the hormones in our body. Since bioidentical hormones are not as profitable as their synthetic counterparts, there have been few large, well-designed studies to evaluate the risks and benefits of bio-HRT. More studies like the Women’s Health Initiative are needed to evaluate the safety and possible risks of bio-HRT. Although the exact risks for every woman using natural hormones are not known, the results of studies that have looked at bio-HRT thus far does not appear to show the same side effect profile as conventional HRT — particularly transdermal forms. HRT either conventional or bioidentical is not for everyone. Women who are interested in hormone therapy should discuss their individual risks for breast cancer, heart disease and stroke with their health care provider.

Natural Alternatives
The goals of treating menopause with an alternative approach are to provide symptomatic relief from common menopausal complaints and to prevent conditions such as heart disease and osteoporosis that increase in prevalence as a woman ages. A natural approach to treatment involves the following:

• Dietary recommendations: to help the body adequately metabolize estrogen.
• Exercise regimen (Aerobic and Resistance-Training): The risk of coronary artery disease rises dramatically in postmenopausal women.
• Aerobic exercise provides cardiovascular benefits and reduces menopausal symptoms.
• Resistance-Training protects against osteoporosis and fractures by increasing muscle strength and building bone.
• Stress Management: To help balance the hormone regulating system of the body (hypothalamic-pituitary-adrenal axis).
• Nutritional supplementation: To provide the body with adequate nutrition for prevention of developing heart disease, osteoporosis and cofactors needed for better mental function.
• Botanical therapies: Herbal preparations to help alleviate menopausal symptoms and provide active components for improved hormonal regulation.

Bio-identical hormone therapy should be the last step in the treatment of menopausal symptoms. When diet and lifestyle changes, nutritional supplements and botanical medicine are not enough to significantly effect menopausal symptoms, natural hormone therapy can be utilized. The dose and form of hormones should be determined based on the risk factors and unique needs of each menopausal woman.

It is important to recognize that each individual woman has a unique set of risk factors based on her family history, diet and lifestyle, past medical history, gynecological history, and other current medical conditions for which she is undergoing treatment. The most optimal treatment and prevention plan should be based on a comprehensive health history, physical examination, laboratory testing and assessment of risk factors, as well as a discussion with your healthcare provider about all the options (conventional and alternative) available and which ones are most likely to provide you the most benefit.

To find out about the health plans offered at Ocean Pacific Integrative Health Center, please call our office at 760-944-9300 or visit our website at http://opintegrativecenter.com.

Reference (detailed information available upon request)
NIH; JAMA (Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women); JAMA ( Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin) ; Women’s Encyclopedia of Natural Medicine. (Tori Hudson).

Heart disease is more than high cholesterol

Heart disease is more than high Cholesterol

A new national study published in the January issue of American Heart Journal has shown that nearly 50 percent of patients hospitalized for a heart attack had “normal” cholesterol levels. Evaluating your risk for heart disease measured by routine cholesterol test may not be enough.

You may be at risk for heart disease if you have:

o Triglycerides greater than 150
o HDL lower than 40
o LDL greater than 130
o Total Cholesterol greater than 200
o A family history of heart disease or cardiac events
o Diabetes or family history of diabetes
o High blood pressure
o Thyroid problems
o Abdominal obesity

The routine cholesterol test only reports 4 lipid components. However, a more comprehensive test called the VAP® (Vertical Auto Profile) panel that more accurately measures LDL (Bad Cholesterol) and provides measurements for 15 lipid components should be used. VAP® Tests also help identify early detection of the metabolic syndrome which leads to diabetes and heart disease.

Comparison of the VAP test and Routine cholesterol test is summarized below:

Cholesterol Measurements VAP Test Routine Test
LDL Direct Measurement Calculated
HDL included included
Triglycerides included included
Total Cholesterol included included
VLDL included
Non-HDL included
apB100 included
Lp(a) included
IDL included
LDL-R included
LDL-R Subclass Pattern included
Remnant Lipoproteins included
Metabolic Syndrome included
HDL2 included
HDL1 included

The VAP test breaks down cholesterol beyond HDL (high-density lipoprotein, the "good" cholesterol), LDL (low-density lipoprotein, the "bad" cholesterol), and triglycerides and provides new information that can help better assess and treat your heart disease risk. Risks of both Heart Disease and Diabetes can be reduced with the right preventative treatments, which is why more accurate diagnosis is critical.

In addition to The VAP® Test, other diagnostic tests that aid in the early identification and treatment of heart disease include:

• hsCRP: High sensitivity C-Reactive Protein (hsCRP) is a general marker of inflammation and has been recognized for its ability to predict future coronary events in apparently healthy individuals.

• Homocysteine: Homocysteine is an amino acid needed for normal health. However, at high levels homocysteine is a major risk factor for cardiovascular disease.

Once your risk factor(s) has been identified based on your VAP results and other risk factors according to National Cholesterol Education Program Adult Treament Panel- III Report (ATP-III), natural and/or pharmaceutical treatments can be used to lower your risk factors. Therapeutic Lifestyle Changes (TLC) that includes diet, weight management, and increased physical activity is the first therapeutic modality list in the ATP-III guideline for the proper management of cholesterol and cholesterol components. TLC and other natural treatments to reduce cholesterol and other risk factors associated for developing hear disease are summarized below:

• Lifestyle changes that focus on stress reduction, smoking cessation and weight management.
• Exercise: At a minimum 45-50 minutes of Cardio with Target Heart rate of 60% to 80% of maximum heart rate.
• Diet:
• Adopt a Mediterranean Style diet
• Decrease consumption of saturated and trans-fats to <7% style="color: rgb(204, 102, 0); font-weight: bold;" href="http://opintegrativecenter.com/">http://opintegrativecenter.com.

Links of Interest:
1- www.nhlbi.nih.gov/guidelines/cholesterol/index.htm
2- www.atherotech.com
3- www.thevaptest.com