Part 6 Flashcards
Estrone basic facts
E1
Postmenopausal estrogen
Mid potency (1/8 binding of E2)
Should hormone replacement therapy in women be started earlier or later?
The benefit ratio improves the earlier replacement therapy it started
Estradiol facts
E2
Premenopausal estrogen
Most potent
Estriol facts
E3
Pregnancy estrogen
Least potent (1/80th binding of E2)
Name two selective estrogen receptor modulators
Tamoxifen (nolvadex) and Evista (raloxifene)
Do SERMs have any positive effects on the brain?
No. Natural hormone replacement does
What affects do SERMs have on cholesterol and LDL?
Decreased total cholesterol by 5% and decrease LDL by 10%. They don’t have any effect on triglycerides or HDL
Pregnenolone can proceed into what two hormones?
DHEA or progesterone
Where is pregnenolone produced?
In the mitochondria in the brain and adrenal glands
Pregnenolone replacement has what effect on sleep?
It improves REM sleep
What effect does pregnenolone replacement have on brain and memory?
It improves memory and improves the survival of hippocampal neurons
True or false. Pregnenolone replacement improves mood, decreases fatigue and helps patients deal with stress
True
Why could pregnenolone help with multiple sclerosis?
It has a role in repairing the myelin sheath
What two effects does estrogen have on dopamine in the brain?
It enhances dopamine transmission and it decreases dopamine receptor sensitivity (modulates stimulation)
What effects does estrogen have on norepinephrine and serotonin?
It modulates norepinephrine transmission and increases serotonin availability
What are 10 common causes for low progesterone?
1) menopause
2) low LH
3) increased prolactin production
4) stress
5) antidepressants
6) sugar consumption
7) saturated fat
8) excessive arginine consumption
9) decreased vitamins A, B, C and zinc
10) low thyroid hormone
What are 14 symptoms of low progesterone?
Anxiety, depression, irritability, mood swings, insomnia, pain and inflammation, osteopenia/osteoporosis, low HDL, excessive menstruation, hypersensitivity, nervousness, migraine headaches before cycles, weight gain and low libido
What are 6 potential side effects of synthetic progestins?
Increased LDL, decreased HDL, increased blood pressure, coronary artery spasm, increase breast cancer risk and increased venous thromboembolism risk
Name 4 beneficial effects of DHEA replacement
Decrease insulin resistance, enhanced immune function, improved ability to deal with emotional stress, improved sleep
Where is DHEA made in the body?
Adrenals, gonads and brain
Low levels of DHEA are commonly associated with what?
Hypothyroidism
What is the only hormone increases with age?
Cortisol
True or false. Low levels of cortisol are associated with Alzheimer’s disease and generalized memory loss
False. Chronically elevated levels of cortisol are associated with Alzheimer’s disease and generalized memory loss. It causes deterioration of the hippocampus.
Chronically elevated cortisol is associated with what nutritional abnormalities?
Decreased magnesium, potassium, B vitamins, vitamin C and zinc
True or False. Chronically elevated cortisol causes the body to increase production of free radicals
True
Clinically elevated cortisol levels are associated with what 19 conditions?
Decreased immune function, fatigue, irritability, sugar cravings, shakiness between meals, confusion, poor sleep, decreased energy, night sweats, binge eating, hypertension, hypercholesterolemia, hypertriglyceridemia, elevated glucose, insulin resistance, increased risk of infections, thin-skin, easy bruising, muscle weakness and abdominal fat
Is vitamin D a vitamin?
No. It is a steroid hormone
What’s seven effects does vitamin D have on the immune system?
1) immune modulation
2) stimulates macrophages to produce antimicrobial peptides
3) it decreases inflammatory cytokine levels
4) it improves phagocytosis
5) it decreases dendritic cell presentation
6) it inhibits Th1 cell proliferation
7) it decreases TNF alpha
Living north of what area is the body unable to produce adequate amounts of vitamin D from the winter sun?
35° latitude (bottom of Tennessee and North Carolina)
Elevated vitamin D levels may decrease the risk for what three diseases?
Breast-cancer, multiple sclerosis and type one diabetes
What is the biochemical pathway to Melatonin production?
Tryptophan —> 5HTP —> Serotonin —> Melatonin
What effect does melatonin have on body temperature and blood pressure?
It lowers both
What does melatonin do to growth hormone?
Promotes it’s release
How does melatonin affect free radicals?
It is the most effective scavenger of the hydroxyl radical and stimulates production of other endogenous antioxidant enzymes.
How does melatonin affect inflammation?
Is inhibits cox2 and NF Kappa Beta
How does melatonin protect cells and DNA?
It protects against cellular DNA damage from ionizing radiation and ischemia/reperfusion injury
What are the symptoms of temporal arteritis?
The temporal artery is nodular, tender and non-compressible. Spread to the central retinal artery can result in visual loss.
What is the antiaging treatment for temporal arteritis?
Steroids, omega 3 FAs, curcumin and ALA
What are the causes of subarachnoid hemorrhage?
Aneurysm rupture =75 to 80%
AVM = 5%
Vasculitis, carotid dissection and perimesencephalic SAH = the rest
What is the 30 day mortality of subarachnoid hemorrhage?
Greater than 46%
What percentage of patients with subarachnoid hemorrhage had a sentinel bleed 2 to 3 weeks prior?
50%
What are the risk factors for subarachnoid hemorrhage?
Hypertension, smoking, oral contraceptive pills and stimulant abuse
True or false. Most cervical radiculitis patients will have headache as a complaint as well as neck pain?
True
