Implantable Cardioverter-Defibrillator Efficacy in Patients With Heart Failure and Left Ventricular Dysfunction (from the MADIT II Population) Wojciech Zareba, MD, PhD, Katarzyna Piotrowicz, MD, Scott McNitt, MS, and Arthur J. Moss, MD, for the MADIT II Investigators The Multicenter Automatic Defibrillator Implantation The Multicenter Automatic Defibrillator Trial II
Rocky Mountain Analytical
Changing lives, one test at a time Information for Patients Common Hormone Conditions
Interactions between the four hormones of the male panel (see right) are fundamental to health, which means that hormone imbalance may have a negative effect on • helps maintain muscle mass health. The following are examples of how hormone and bone, improves sense of imbalance can affect health: well-being, helps control blood sugar, is needed for heart Bone Loss
health, and improves sex drive. Testosterone and estradiol help build bone, while high cortisol tends to break • is responsible for male sex down bone. High cortisol is of particular concern because it breaks down bone characteristics like facial and and interferes with the bone-building action of testosterone.
body hair growth, deepening of voice, and development of male sex organs. Testosterone receptors are plentiful in the brain, so a lack of testosterone may result in decreased arousal response. Testosterone is also needed for muscle Estrogens
contraction, so low testosterone may result in poor erection quality. Low testosterone may also lead to increased ‘wait' times between erections.
estradiol, estrone, estriol• the testes produce Memory Loss
approximately 20% of a man's Because testosterone receptors are abundant in the brain, low testosterone estradiol, while the rest is levels often affect memory.
converted from testosterone via Apathy, Depression, Grumpiness
the enzyme aromatase (found Our laboratory data shows that approximately 3/5 of men with self-reported in fat cells). symptoms including aggression, apathy, depression, irritability and an inability • estrogens can compete with to cope have at least one out-of-range hormone result. This is not proof that testosterone for receptor sites, restoring hormone balance will lessen these mood symptoms, but many men which means that having too experience some relief from mood disorders when hormone balance is restored.
much estrogen may reduce the effect of testosterone. Breast Enlargement
Men who carry extra weight around the middle have more of the enzyme
aromatase, which converts testosterone to estrogen. Increased estrogen can lead to breast enlargement.
• is the major stress hormone released by the adrenal glands. Weight Gain
• high or low cortisol levels High levels of the stress hormone cortisol can cause unstable blood sugar levels may be an indication of poor and may increase sugar cravings.
adrenal function. Benign Prostatic Hyperplasia (BPH)
Most men over the age of 60 have signs of prostate enlargement, also known
as BPH. Some researchers have suggested that low testosterone and/or high • is the storage form of the estradiol may be contributing factors in prostate enlargement. adrenal hormone DHEA, used to make estrogens and Why Test Hormones in Saliva?
• DHEA and cortisol have opposite effects on immune function and blood glucose • Saliva hormone testing is excellent at uncovering hormone imbalance.
• Saliva measures hormone that actually made it into tissue, because hormones pass through saliva gland tissue before getting into saliva • Blood measures hormones that might eventually get to tissue. • Saliva collection is painless and easy to do at home. Blood collection requires a trip to the laboratory, and some hormones cannot be tested in blood (e.g. estriol).
• The stress of a needle puncture for blood collection tends to raise cortisol levels. Saliva collection is not known to raise cortisol levels.
Rocky Mountain Analytical Version Aug, 2012
Restoring Male Hormone Balance
Good health has a lot to do with maintaining balance: Low testosterone levels do not necessarily mean you need to supplement with the right balance of work testosterone. Your healthcare professional may want to investigate options and play, the right balance of like zinc supplementation, which can slow the conversion of testosterone nutrients in the diet, and the into estradiol. If these or other interventions do not relieve low testosterone right balance of hormones.
symptoms, likely only then will your healthcare professional consider supplementing with testosterone.
Hormone imbalance may be a result of illness, or may High testosterone is general y a consequence of supplementing with too much produce symptoms and testosterone. Although natural y high levels are rarely a problem, significantly biochemical changes that elevated testosterone may require a referral to a medical specialist.
eventually lead to illness. Rocky Mountain Analytical is committed to offering Low estrogen levels are not usual y a problem for men. However, if estrogen laboratory tests that identify levels are low and symptoms of low estrogen are present, there are some hormone imbalances and supplements that may help. For example, boron may help boost estrogen other conditions - so they production, and plant estrogens and progesterone may relieve symptoms of can be corrected before low estrogen.
disease develops! High estrogen levels in men general y occur as a result of conversion from testosterone. An enzyme cal ed aromatase causes testosterone to be changed into estradiol. Aromatase lives in the fat cel s, so men who carry extra weight around the middle tend to have more cortisol and consequently make more Rocky Mountain Analytical estradiol. Cortisol increases the activity of the aromatase enzyme, so high was founded in 2002 with cortisol levels can also lead more testosterone to be converted into estradiol. a mission to offer tests that Thus, weight loss and stress reduction are important steps in restoring the focus on early identification balance of hormones. and prevention of disease. Rocky Mountain Analytical Low cortisol in the morning may be indicative of adrenal issues, which may is an accredited medical require further testing or interventions by your healthcare professional.
laboratory located in Calgary, Alberta. Accreditation means High cortisol levels are associated with numerous symptoms and conditions tests performed by Rocky including: bone loss, high blood pressure, insulin resistance and diabetes, Mountain Analytical are weight gain, memory impairment and immune system suppression. High regularly reviewed for quality, cortisol levels also interfere with the action of other hormones. Therefore, when accuracy and reproducibility cortisol levels are high, the first step in restoring hormone balance should be by the College of Physicians & to reduce high cortisol levels. Your healthcare professional may recommend Surgeons of Alberta. lifestyle changes as well as supplements to help address high cortisol levels.
Ask your healthcare professional whether a test is right for you. Low DHEAs symptoms are not well-defined although low DHEAs is often associated with chronic illness. Some men benefit from supplementing with DHEA to bring saliva hormone levels back within range.
High DHEAs may be a consequence of supplementing with too much DHEA, in which case your health care provider may recommend reducing the dose.
Information is for educational purposes only. It is not meant as medical advice and any treatment decisions should be More information on male hormone balance can be found in Chapter 9 of the made with the knowledge or consent of book "You've Hit Menopause: Now What?" Visit www.rmalab.com to learn
your healthcare professional. more about this book and how you can get a free copy.
Rocky Mountain Analytical
Changing lives, one test at a time www.rmalab.com [email protected] 403.241.4513 an accredited medical laboratory
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