Category Archives for Health & Wellness

Putting the Brakes on Testosterone Prescriptions

Published in Pawtucket Times on March 30, 2015

Sophisticated mass marketing pitching testosterone to combat age-related complaints combined with lax medical guidelines for testosterone prescribing can be hazardous to your physical health, even leading to strokes and death, warns an editorial in this month’s Journal of the American Geriatrics Society.
The March 2015 editorial coauthored by Dr. Thomas Perls, MD, MPH, Geriatrics Section, Department of Medicine, Boston Medical Center in Boston, and Dr. David Handelsman, MBBS, Ph.D., ANZAC Research Institute, in New South Wales, Australia, expressed concern over commercial-driven sales of testosterone, effectively increasing from “$324 million in 2002 to a whopping $2 billion in 2012, and the number of testosterone doses prescribed climbing from “100 million in 2007 to half a billion in 2012.”

Pitting Patients Against Patients

The editorial authors see the “40 fold” increase of testosterone sales as the result of “disease mongering,” the practice of widening the diagnostic boundaries of an illness and aggressively promoting the disease and its treatment in order to expand the markets for the drug. Glitzy medical terms, like “low T” and “andropause,” showcased in direct-to-consumer product advertising pit aging baby boomers against their physicians, who demand the prescriptions, say the authors.

“Clearly, previous attempts to warn doctors and the public of this disease mongering that is potentially medically harmful and costly have not been effective, says co-author Dr. Perls.

The epidemic of testosterone prescribing over the last decade has been primarily the proposing of testosterone as a tonic for sexual dysfunction and/or reduced energy in middle-aged men, neither of which are genuine testosterone deficiency states,” observes Dr. Handelsman.

According to the National Institutes on Aging (NIA), the nation’s media has increasingly reported about “male menopause,” a condition supposedly caused by diminishing testosterone levels in aging men. “There is very little scientific evidence that this condition, also called andropause or viropause, exists. The likelihood that an aging man will experience a major shutdown of testosterone production similar to a woman’s menopause is very remote.”

The authors agree with the NIA’s assessment, but go further. They point out in their editorial that for many men, testosterone does not decline with age among men retaining excellent general health, and if it does, the decline is often due to common underlying problems such as obesity and poor fitness. Those who hawk testosterone have developed advertising that focus on common complaints among older men such as decreased energy, feeling sad, sleep problems, decreased physical performance or increased fat.

But, many times a testosterone level won’t even be obtained and the patient is told that, simply based on these common symptoms alone or with minor reductions in serum testosterone, they have “late onset hypogonadism” or that their erectile dysfunction may be improved with testosterone treatment, say the authors. But the authors also point out the true hypogonadism is the cause in fewer than 10% of men with erectile dysfunction.

FDA Enters Debate

The U.S. Food and Drug Administration’s (FDA) recent dual commission findings concluded that testosterone treatment (marketed as ‘low T’) is not indicated for age-associated decline. The benefits of this “deceptive practice” remain unproven with the risks far outweighing the perceived benefits,” says the agency. Pharmaceutical companies are now required to include warning information about the possibility of an increased risk of heart attacks and stroke on all testosterone product labels.

Health Canada, Canada’s FDA, recently echoed the FDA’s committee findings that age-related hypogonadism has not been proven to be a disease-justifying treatment with testosterone. Both agencies warn of an increased risk of blood clots in the legs and lungs and the possibility of increased risk for heart attack associated with testosterone use.

In a statement, James McDonald, the chief administration officer for the Board of Medical Licensure and Discipline, says: “There is a concern in healthcare regarding direct-to-consumer prescribing of medication. At times, the prescription is not evidence-based, and can lead to misuse. There is concern with Testosterone, a schedule 3 controlled substance,that can be used as a performance-enhancing drug. The Rhode Island Board of Medical Licensure (BMLD) investigates complaints regarding all types of misuse of prescription medications as well as complaints regarding over-prescribing.”

Drs. Handelsman and Perls also warn about another drug commonly hawked for anti-aging, growth hormone. The FDA requires that doctors perform a test to demonstrate that the body does not produce enough growth hormone. “Those who market and sell HGH for these common symptoms nearly never perform the test because if they did a properly performed test, it would almost never be positive because the diseases that cause growth hormone deficiency in adults, such as pituitary gland tumors, are very rare,” said Perls. Growth hormone is well known for its side effects, including joint swelling and pain and diabetes. Ironically, opposite of anti-aging claims, growth hormone accelerates aging, increases cancer risk and shortens life span in animal studies.

In the editorial, Perls and Handelsman call upon professional medical societies and governmental agencies to take definitive steps to stop disease mongering of growth hormone and testosterone for conjured-up deficiencies.
“These steps include the banning of ‘educational’ and product advertising of testosterone for these contrived indications,” said Perls. “Furthermore, the FDA and Health Canada should require a physician’s demonstration of a disease process proven to benefit from testosterone administration in order to fill a lawful prescription for testosterone.”

Tightening Up Prescription Guidelines

The issue of prescribing testosterone is firmly on the medical profession’s radar screen with the FDA’s recent committee’s findings and Perls and Handelsman’s pointed editorial calling for the medical profession to seriously tighten up the lax consensus guidelines in order to stop the medically inappropriate prescribing of testosterone.
Rather than pushing testosterone, wouldn’t it be a “mitzvah – a good deed- if the nation’s pharmaceutical companies ran public service commercials stressing the importance of losing weight, exercising and eating nutritious meals as a way to effectively combat age-related problems, like low libido. But, this won’t happen because it is not a revenue generator or good for the company’s bottom line.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Experts Offer Some Advice on How to Age Successfully

Published in Pawtucket Times, February 21, 2014

            As an aging baby boomer, the pains and aches of old age and my noticeable gray hair are obvious signs of getting closer to age 60.

            Amazing, being given a free donut with my large cup of coffee at Dunkin Donuts, an AARP member benefit, is a clear reminder to me of how people may perceive my chronological age.  When I pulled out my wallet to get my membership card, the employee said, “Don’t worry, your covered.”  Simply put, by having gray hair it was obvious to the young woman that I was eligible to get the free donut.

            The aches and pains of getting older happen more often, too.   After spraining my ankle from a fall on a sheet of ice, while taking out my garbage, it took much longer for this injury to heal.  Most recently, a sharp pain in my hip makes me wonder if hip replacement surgery could be in my future.

            Even like me, President Barack Obama has shown his age by his gray hair and is even beginning to publicly complain about his aches and pains, because of living over five decades.

            The 52- year- old President told retired National Basketball Association star Charles Barkley in a recent interview that he was limiting his trip to the basketball court to once a month because “things happen.”

             “One is, you just get a little older and creakier. The second thing is, you’ve got to start thinking about elbows and you break your nose right before a State of the Union address,” said the 52-year-old president in the interview on the TNT network before the NBA All-Star Game.

             Discussing the aging process during an exchange about his signature healthcare reform law, Obama said that being past 50, “you wake up and something hurts and you don’t know exactly what happened, right?”

 Taking Control of the Aging Process

             Of course, President Obama’s complaints about getting old went viral. Approaching two Rhode Island gerontologists and a geriatric physician, this columnist gives the middle aged President tips on easing into his old age.

            Phillip G. Clark, ScD,  Director, URI Program in Gerontology and Rhode Island Geriatric Education Center and Professor, Department of Human Development and Family Studies, notes that some research has indicated that the decade between 50 and 60 is when many people start getting “messages” that they are getting older. These can be physical, psychological, familial, and social.

             “A lot are based on the messages that they receive from those around them, including the media (“if you’re older than 50, you should be taking Centrum Silver, or you qualify for this special type of life insurance policy,” adds Clark. “These messages may not reflect an accurate picture of what normal aging really is, but rather a biased and stereotypical portrait,” he says, for example, supposed bodily reminders of aging, such as aches and pains, may be due more to lack of exercise rather than actual aging itself.

             To successfully age, “stay physically active” says Clark, suggesting that you get an assessment from your physician.  This helps both your body and your brain. A moderately brisk, 30-minute walk a day is all you need, he notes.  “It’s more important that you build physical activity into your daily routine and do something that you enjoy and can stick with, than spend a lot of money on a gym membership that you seldom use,” he says.  Eating a diet that is high in fruits and vegetables is also important as part of a healthy lifestyle at any age.

             Clark also recommends that aging baby boomers stay engaged with settings and activities that keep them involved in life through their faith community, family and friends. Even having a sense of purpose in life that gets you outside of yourself, through volunteering, can help you age more gracefully, he adds, stressing that having a social network and people who care about and support you are essential elements of successful aging at any age.

             But don’t forget to “have a positive attitude and keep a sense of humor,” warns Clark. According to the gerontologist, this can get you over the challenges and hurdles you may encounter.  “Being resilient in the face of the challenges of life and getting older demands that we see the positive side of situations and not get bogged down in focusing on what we no longer have. We need to emphasize what we can do to keep the enjoyment in our lives.”

             Successful aging may not be swimming the English Channel at age 80, noted Brown University Professor of Medicine and of Health Services, Richard Bresdine, Director of Brown’s Center for Gerontology and Healthcare Research and Director of the Division of Geriatrics in the Department of Medicine.  However, for the general population, successful aging, that is “optimum physical cognitive functioning, rests on your genes, education and life experiences,” he says, not accomplishing great feats like swimming the English Channel.

            While the Brown University geriatrician agrees with Clark about the impact of exercise and social networks on improving your health and longevity, he also sees other ways to increase the quality of your aging.

 Strategies to an Improved Life Style

             According to Besdine, a majority of people with high blood pressure don’t take medication to control it.  This chronic condition can cause strokes.  Smoking does not just cause lung cancer, “but every type of cancer and chronic lung disease, “one of the worst ways to die on this planet.”

             Driving safely can increase your lifespan and quality of aging.  As one ages your eyesight may change, glare becomes a problem, and you lose flexibility to turn.  Retraining programs, offered by AARP and AAA, can reduce the probability of having an accident, says Besdine.

             Don’t forget your pneumonia or influenza vaccination, warns Besdine.  Having repeated occurrences of the flu can lead to heart disease and other health issues, he says.

             A good nutritional diet is key to enhancing the quality of health in your later years, notes Besdine, but people living on fixed incomes may not be able to afford eating fruits, vegetables and lean meats.  Cooking for yourself may even lead to a decision to not make nutritional meals.  Besdine is also a big advocate of the Mediterranean diet, a heart-healthy eating plan that emphasizes fruits, vegetables, whole grains, beans, nuts and seeds, and healthy fats.  He notes that this diet reduces your chances of getting heart disease and diabetes.

             Besdine also notes that there are simple things that you can do at home to increase your longevity and quality of life.  Make sure your home is safe, equipped with fire and carbon monoxide detectors.  Rid your kitchen of toxic substances.  He urges a “gun free” home. “This is not a political statement. Research shows us that a person is much more likely of being shot by a gun that is kept at home,” he says.

             Screening for cancers (by scheduling a mammogram and/or colonoscopy) and depression, along with moderate drinking, good oral health care, and preventing osteoporosis by taking calcium and Vitamin D, even reducing adverse drug reactions and improving mobility, are simple ways to increase the chances of your successful aging, Besdine says.

 Unraveling Research Findings

             Rachel Filinson, Ph.D., Professor of Sociology/Gerontology Coordinator at Rhode Island College, says the “devil may well be in the details,” as older persons try to unravel research findings that might provide them with a clear road maps to achieve successful aging.

             For instance, Filinson notes that while some gerontologist have long regarded “under nutrition,” that is the consuming relatively few calories to sustain oneself,” as a way to increase one’s longevity, others disagree with the theory.

             Meanwhile, mental stimulation is believed by many to deter cognitive decline, Filinson says, but brain teasers and games have not been adequately proven by research findings, she adds, while reading and writing may be helpful.

             Although a large social network and recreational pursuits have been lauded as essential to enhance the quality of aging, some investigations have found that solitary activities like gardening are just as effective, observes Filinson.

             In that science can be a work in progress, Filinson believes that older adults can take charge of their lives by optimizing the positives and minimizing the negatives–how we age.  “It’s about the choices we make in life rather than the genes we were born with,” she quips.

             President Obama might well listen to Clarke, Besdine, and Filinson’s sage advice as to how he can cope with the aging process. Even small changes in his daily,  mundane routines, like using the stairs rather than taking an elevator in the White House or even taking Bo, the first family’s dog, for a brief walk around the grounds, can result in his living longer, even reduce his noticeable aches and pains.

              Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.

Some Simple Resolutions Can Better Your Life

Published in Pawtucket Times, January 4, 2014

Every year we see the Times Square ball swiftly drop as a million or so revelers loudly count down to one at the stroke of midnight. Also, we traditionally make New Year Resolutions to accomplish in the coming year to perform acts of kindness and for self-improvement.

Making a resolution for positive change goes back for eons. According to Wikipedia, the act of making a resolution can be documented in Mesopotamia (the territory of modern-day Iraq). Babylonians made promises to their stone deities to start off a new year by returning borrowed goods and paying off debts.

The free internet encyclopedia also notes that the Romans even carried out this tradition by making promises to Janus, the God of beginnings and transitions (for whom the month January is named). Knights during the Medieval era, from the 5th to 15th century, took a “peacock vow” after the Christmas season to re-affirm their commitment to knightly virtues of honor, courtesy love and courtesy.

Wikipedia also reports that even “watch services” held late on New Year’s Eve, also provided an opportunity for Christian parishioners to review the past year and make confessions and prepare for the New Year by prayer. Even Judaism’s High Holidays, from Rosh Hashanah ending with Yom Kipper, the Day of Atonement, gives worshipers an opportunity to reflect on their wrongdoings over the year to seek forgiveness and to prepare for the upcoming year, adds the internet website.

Memorable New Year Resolutions

Zoe Mintz, of the International Business Times, posted her thoughts about New Year Resolutions just hours before 2014, on the New York-based digital global publication’s web. Like clockwork, many of the nation’s newspapers and magazines, including Mintz, printed articles detailing interesting, inspirational and unusual resolutions from prominent people, from movies stars (they usually tweet) artists, politicians, writers, and corporate leaders.

Mintz details some well-thought out New Year Resolutions from people who you may well know.

“Let our New Year’s resolution be this: We will be there for one another as fellow members of humanity, in the finest sense of the word.” — Goran Persson, served as Prime Minister of Sweden from 1996 to 2006

“New Year’s resolution: To tolerate fools more gladly, provided this does not encourage them to take up more of my time.” — James Agate, British diarist and critic.

“I made no resolutions for the new year. The habit of making plans, of criticizing, sanctioning and molding my life, is too much of a daily event for me.” — Anaïs Nin, an American author, ‘

“One resolution I have made, and try always to keep, is this: to rise above the little things.” — John Burroughs, an American naturalist and essayist important in the evolution of the U.S conservation movement.

“I think in terms of the day’s resolutions, not the years.” — Henry Moore, an English sculptor and artist. He was best known for his semi-abstract monumental bronze sculptures which are located around the world as public works of art

“What the New Year brings to you will depend a great deal on what you bring to the New Year.” — Vern McLellan, author of Wise Words and Quote.

“Follow your passions, believe in karma, and you won’t have to chase your dreams; they will come to you.” — Randy Pausch, American professor of computer science and human-computer interaction and design at Carnegie Mellon University in Pittsburgh, Pennsylvania. He is author of the “Last Lecture.”

Yesterday is gone. Tomorrow has not yet come. We have only today. Let us begin.” — Mother Teresa, an Albanian-born, Indian Roman Catholic Religious Sister who founded the Missionaries of Charity which in 2012 consisted of over 4,500 sisters in 133 countries.

“If you asked me for my New Year resolution, it would be to find out who I am.” — Cyril Cusack, an Irish actor, who appeared in numerous films and television productions in a career lasting more than 70 years.

Everyday Resolutions

Resolutions may inspire or be a little bit ethereal, as detailed in the above listing compiled by Mintz. Simply put, our personal New Year’s resolutions help us cope with daily challenges to improve health, personal finances and relationships, that is to enhance our quality of life.

Many of your family and friends will be making their 2014 New Year’s resolutions to improve their health by eating healthy foods, losing weight or ratcheting up their exercise regimen. Everyone knows someone whose has made a resolution to either drink or smoke less, or not at all.

As the New Year approaches a person may say “Life’s too short,” when they begin to craft their personal resolutions. Attitude adjustments may well occur, when the person resolves to see “a glass half full rather than half empty,” making a commitment for the coming year to become a more positive person, one who looks forward to living life to the fullest. Even some may explore ways to reduce the stress in their lives.

A 2014 New Year resolution for others may just be to dig themselves out of credit card debt (cut those cards in half), regularly put money away for retirement, invest in the stock market or even to find a more satisfying job that pays better than their current one.

You might even see college students making their 2014 resolution to study harder to get that “A.” Some baby boomers and seniors may even chose to make this year the time to enroll at a local College or University to get a bachelor’s or graduate degree, or go to just learn new or sharpen up their existing skills.

For many, life may have become too routine and predictable, pushing them to schedule a trip to exotic places in the New Year. Some may choose to watch less television, committing to put their leisure time to a better use in 2014. One might resolve to become a volunteer at the local food kitchen, or helping the homeless, or even joining civic groups, like the Pawtucket Rotary Club or Lions club, or the Masons, to reach out to their community. Spending time helping those in need can also be a benefit for those volunteering – learning new skills, meeting new friends, advancing your career, or even improving mental and physical health.

New Year’s resolutions even help a person focus where their time, money and energy is directed. Everyone knows someone who is resolving to spend quality time in 2014 with family members. Some may even make resolutions to get engaged or married their long-time partner or to even begin a family.

With Christmas becoming so commercial, some may well make New Year resolutions that will push them away from materialistic pleasures, to exploring their spirituality.

Using Technology to Keep Resolutions

New technology can help keep us on track with keeping our 2014 New Year’s Resolutions. With the growing popularity of cell phones (iPhone and Android) thousands of self-help apps are now becoming available on app stores for IOS and Android cell phones, reports Business Reporter Victor Luckerson, in an article published on New Year’s Day on Time.com.

Luckerson details apps that will keep you on track with keeping your 2014 New Years resolutions. Here is a small sampling:

For learning the basics of a foreign language to prepare for a vacation, Duolingo helps you to quickly learn the basics. Users can easily review lessons in vocabulary, pronunciation, and basic grammar. Currently Duolingo offers lessons in English, Spanish, French, Portuguese, German and Italian. Available for iPhone and Android.

MyQuitCoach was created to help you keep cigarettes at arms length. The app uses data to help people curb their bad habit by allowing users to input how often they smoke and when they have their cravings. This information allows short and long-term goals to be set, enabling the smoker to reduce their daily cigarette use. Tying results to both Facebook and Twitter can increase support from social media friends. Available for iPhone.

For those who require motivation to go to their neighborhood gym, MapMyFitness is just the app for you. The app tracks 600 different fitness activities, from running, to ballroom dancing, to even walking the dog. With this app you can even map out effective jogging routes. It even offers a social component that allows your friends to motivate you to exercise from within the app. Available for iPhone, Android, and BlackBerry.

For resolutions to tighten your belt to improve your personal finances, check out DailyCost. The app easily allows you to closely check in going and outgoing money in all you bank accounts. Moreover, you can easily log in all your daily expenses, too, categorizing them within seconds. Weekly and monthly spending charts allow you to closely review where you spend your money. Available for iPhone.

Finally here’s an app to help you accomplish your resolution goals. Simply put, Lift helps you track how often you complete your tasks that you resolve to complete and rewards you with virtual check marks for achieving. Tasks can be drinking more water, praying, and other habits you want to change. App users who pursue the same goals can support each other via discussion groups. Available for iPhone and Android.

For this columnist, my 2014 New Year’s Resolutions (like many) revolve around health, financial and family. I resolve to become healthier by losing weight, eating healthier foods, and increasing my visits to the local YMCA; to get my financial house in order; and to spend more time with family and good friends. Maybe I might even write a book. As to my success, I will keep my fingers crossed.

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.