Low Testosterone, another Man-Made Risky Fix?

22 01 2012
To have longevity and healty active lifestyle is dependent on understanding the natural environment.

To have longevity and active lifestyle is dependent on understanding the natural environment

I’m sure most of you out there have noticed the “is it low-T” commercial ads.  The “T” is for Testosterone and defined as the male hormone that develops during puberty and maintains masculine characteristics throughout a man’s life. As men age testosterone levels tend to decline (hence “low”).  We’ll first cover testosterone therapy and then the herbs that are known to increase, or influence testosterone production.

The questions most men ask, is one type of treatment better than the other, how safe is it and is it right for me?

I recall about a year ago seeing a commercial on one of the big 3 networks stations that promoted, “is it low-T” asking questions like, “feel like something’s missing, don’t have enough energy, or want more romance in your life?”  “Seems harmless enough right?  Could fixing a low-T condition be that simple?  And is it for everyone?

Don’t be deceived by a great advertising spot that promotes a therapy and/or herb that offers a quick “safe” fix for your male symptomatic problems.  Androgen (steroid hormone) therapy has been around for a long time.  Whether or not this type of treatment is right for you can only be answered by a physician.  And the doctors that your primary care physician should refer you to that specialize in hormone replacement therapy are known as an endocrine physician.  An endocrinologist is a specially trained doctor that specialize in diagnosing glandular disease.

I’ve often cited though my writings, “there is no way man could ever make a chemical product that “wouldn’t” have a health risk associated with it.  And just like weight loss diet formulas that promote fast results… when repeated too often will eventually ruin the body’s ability to lose weight naturally.  Raising testosterone levels “when not needed” presents similar types of metabolic challenges and other health risks associated with its use if not supervised and applied correctly.

Let’s first understand why testosterone in a man’s body is important and what happens to its production during the aging process.  Testosterone is produced by the testes and important for balanced metabolic body function, to build muscle, bone, lowering the voice and activates the sex drive and sperm production during puberty.

Science has confirmed that as a man age’s testosterone levels continue to drop after the age of 40, about 1-2% a year thereafter.  These numbers appear to vary slightly depending on the study.  As you age you should expect that your body will provide a proportionate amount of testosterone to maintain “healthy” male characteristics relative to age and throughout your life.  This is part of the “healthy” aging process, or aging gracefully.  There is no scientific evidence that shows by increasing testosterone levels for those that are “not low-T” or does not have an androgen deficiency that there will be a significant benefit.

There are a very “low” percentage of men that have lower than average low-T relative to age.  For those that do have unusual low levels of testosterone, this is the demographic that often receive a “quality of life” benefit from hormone therapy treatment says Karen Herbst, PhD., M.D., (an endocrinologist with the University of CA).

Little is known about the long-term effects of low testosterone and increasing those levels to normal range.  Science clearly understands that this hormone has an important connection to body weight and possibly cardiovascular health.  In other words, increasing testosterone levels may or may not be of health benefit for those that suffer with the following medical conditions:  osteoporosis – “thinning of bone,” diabetes, obesity, depression, heart health.  Andre Araujo, PhD, epidemiologist and researcher says illness that causes high blood pressure and diabetes for example “could” be the cause of low testosterone.  So for those that are diagnosed with low testosterone, some other illness, or disease may need to be treated first before the body can naturally elevate hormone levels.

Normal levels relative to age is important because a man’s overall health is dependent on these levels.  If testosterone levels fall below 300 nanograms per deciliter of blood than the general recommendation is to regulate toward mid-normal range.  This treatment can be accomplished through skin absorption patches, tablets, or injections.  This therapy provides those with below average testosterone production a quality of life benefit, as opposed to those that didn’t receive treatment.

If you are diagnosed with androgen deficiency (no other illness, or disease is the cause of your low-T condition), you “may need” testosterone therapy for life to correct the condition.  But if you start hormone therapy your testes will stop producing its own hormone.  This occurs once you influence hormone production with an enhancer because your body self regulates to maintain normal hormone balances.  Your body will gradually begin producing its own testosterone once you stop therapy to its previous levels.

There is no scientific evidence to suggest that testosterone therapy will be of benefit when not androgen deficient.  As a matter of fact, medical science indicates many types of health problems may occur if one participates in hormone therapy without a screening and not under a doctor’s supervision.  Also, you need to know that not all scientific data is in on the safety results of testosterone therapy.

However, Herbst states, “about 10% of men don’t get much of a response from therapy, while 90% see some sort of symptom improvement and 1 in 10 are ecstatic.  It is also stated that most of the men in clinical studies state improvement to erectile dysfunction and sex drive.  Primarily what these low-T marketers are selling is a quick fix for erectile dysfunction and sex drive.

Men diagnosed with the following conditions should absolutely not self administer, or participate “without supervision” in any type of testosterone enhancer program/product: men with metastatic prostate, or breast cancer.  This is because too much testosterone can cause these cancers to grow.  Other conditions that can be made worse when participating in testosterone therapy:  if you suffer from sleep apnea, severe congestive heart failure, severe benign prostatic hypertrophy, or high red blood cell count (erythrocytosis).

Outside of clinical testosterone therapy there are many herbs marketed as treatment to improve libido and muscle strength as advertised by marketers.  Beware, science tells us there are no known herbals that can be used to treat androgen deficiency.  Only that the herbals mentioned below and many more like them can “influence” higher levels of testosterone production.  These levels vary for each individual and relative to age.  And even if you use these products there is no guarantee that you’ll receive a benefit and in fact may be predisposing yourself to illness and disease with similar findings related to androgen therapy health risks.

If you’re thinking about a low-T product, it is recommended you discuss suspected low-T symptoms with a doctor who specializes in anti-aging and hormone therapy to address your concerns.  In this way you’ll ensure you’re not just trying various products that promise to:  improve sexual performance, improve mood or memory, increase energy, lower cholesterol, build muscle, lose body fat, and/or reduce high blood pressure (and anything else these marketers promise you).  If you know nothing about balancing hormones and you become sold on a product for which you now feel you are receiving a benefit; be suspicious and concerned and inquire about long-term use and health risks.  Herbs seem harmless enough to many consumers, but it’s what you don’t know that can cause internal metabolic harm.

The most popular herbs sold in the market boast claims that their products influence testosterone production naturally and perceived to be safe.  Four popular herbal enhancer products mixed into blends, or sold individually in high dose concentrations:   Horny Goat Weed, Mucuna Pruriens, Tongkat Ali and Ginseng.  If you want to know more about these herbal products, simply type the word into your Internet browser.

If you do not have a testosterone deficiency problem, it is not recommended you engage in influencing testosterone production without medical advisement and supervision.  Simply put, it is wise to consult with your physician before you engage in any hormone therapy/enhancer program regardless of whether it’s chemically synthesized or a marketed herbal product.

Just from the shear fact each one of the herbs listed, including those that are not, stimulate the release of testosterone by influencing the pituitary gland and testes should raise concern.  These hormonal metabolic functionalities within the body also have a huge influence on many other regulatory metabolic mechanisms.  For example, to increase testosterone production without understanding the risks, especially if you have an undiagnosed medical condition could manifest itself into a chronic medical condition.  However, as stated, it is also true that men need to be within a specific “safe” testosterone range to stay healthy.  Being too low or too high appears to create unhealthy medical conditions and then disease risk for men.

The most common types of illness and disease may occur if testosterone levels are too high, or too low:  rapid heartbeat and rhythm disturbances, anxiety, fatigue, overstimulation, irritability, restlessness, impatience, easily angered, increased blood pressure and body temperature.  Additionally, some herbs can have adverse effects on those suffering from breast and prostate cancer; heart, kidney, diabetes mellitus, sleep apnea and liver disease and also weaken the immune system.  Other side effects:  nausea, diarrhea, nose bleeds, low blood pressure, breast pain, depressive mania when mixing product with antidepressants.  Gross overdose: Seizures, convulsions and delirium.

Another question you should ask yourself; if you self administer how do you know you’re not too high in blood testosterone?  Or low when you stop dosing, because the natural production of testosterone shuts down between starting and stopping doses?  Manipulating the start and stop of self administering and producing natural body testosterone is hard on the metabolic mechanisms and overall health if not supervised correctly.

I stand by the statement I made at the beginning of this article.  There is no way man could ever manipulate nature and create a quick results product that would not have some adverse health risk.  To manipulate the physiology through “quick results” products is to potentially break the metabolism, thereby causing other ill-health conditions.

There is only one caveat to low-T therapy treatment for the sake of good health.  That unless supervised by a medical doctor, I don’t believe the benefit of self treating would out weigh the potential health risks that may occur if not monitored.  This is an important observation in caution since a “very low” percentage of men are actually diagnosed with androgen deficiency.  Also, science simply doesn’t understand what damage will occur through long-term dosing especially “if not” androgen deficient because long-term statistics don’t yet exist.

Here is a simple example and something to think about if you’re administering low-T supplementation to enhance your sexual performance.  If you acquire and use low-T enhancing products to fix a sexual dysfunction through a local distributor, or mail order, are you sure that some other ill-health problem is not the cause of your dysfunction and you’re not masking a circulatory/organ disease, or the dysfunction is not caused by another possible chemical reaction from diet, bad food, drug, etc., habit or prescription?

By administering an overriding circulatory enhancer to correct erectile dysfunction for example… How do you know you’re not masking a serious prostate, urethra, testicular disease?  Unless you’re a specialist in hormone replacement therapy (endocrist), or an urologist (one who specializes in male/female urinary tracts), how can you be sure?  The answer is you can’t.  Millions of men will continue to put their health at risk because the market manipulators will not error on the side of caution.  Instead, they’ll promote the benefits and down play the risks.  Why’s that? Because it is a lucrative business model and is not illegal!  Read “41 drugs to die for” and then you’ll be able to see the marketer “method-to-the-madness” for the sake of a buck.

If you do choose to self administer low-T products to resolve a problem, at a minimum pay attention to the side effects listed and get monitored by a doctor.  If you or your loved ones note aggressive personality changes, or any of the listed side effects, immediately consult your doctor.

References,

Woodard, M.T. 41 Drugs to Die for.  Mirror Athlete Fitness Secrets. Oct 24, 2010. http://mirrorathlete.com/blog/2010/10/24/41-drugs-to-die-for/

Woodard, M.T. Aging Gracefully is it Possible? Mirror Athlete Fitness Secrets. Oct 25, 2008. http://mirrorathlete.com/blog/2008/10/25/mirror-athlete-enterprises-health-blog-aging-gracefully/

Ezinearticles.  Low Testosterone Levels – A Combination of 4 Herbs to Increase Levels Naturally and Quickly.  http://ezinearticles.com/?Low-Testosterone-Levels—A-Combination-of-4-Herbs-to-Increase-Levels-Naturally-and-Quickly&id=1509055

Andrology Australia.  Australian Centre of Excellence in Male Reproductive Health.  http://www.andrologyaustralia.org/pageContent.asp?pageCode=LOWTESTREPLACE

Hoffman, M., MD.  Low Testosterone Explained: How Do You Know When Levels are Too Low? WebMD.  http://men.webmd.com/features/low-testosterone-explained-how-do-you-know-when-levels-are-too-low

Mayo Clinic. Testosterone therapy: Key to Male Vitality.  http://www.mayoclinic.com/health/testosterone-therapy/MC00030

Blackman MR, Sorkin JD, Munzer T, et al. Growth hormone and sex steroid administration in healthy aged women and men: a randomized controlled trial.  JAMA 2002; 288:2282-2292

HormoneTherapyNetwork.  A Nationwide Network.  http://www.hormonetherapynetwork.com/?k=testosterone

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2012 Copyright, All rights reserved, MirrorAthlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter.

 





Fentanyl Pain Patches Safe?

21 12 2011

Memories in Life are Precious

For those of you that have severe chronic pain and are considering the use of Fentanyl patches there are some considerations you may, or may not be aware.

Fentanyl was first synthesized and labeled by Janssen Parmaceutica in 1959.  The first intravenous anesthetic trade name of Fentanyl was Sublimaze.  Then following a series of mid-1990’s clinical trials a product was produced and marketed as a Duragesic alcohol gel infused patches.  These patches then were made available to patients with varing prescription dosages of fentanyl; time released to relieve chronic pain.  The patch is designed to release a specified dosage of the drug continuously for 48-72hours for chronic pain patients.

Thereafter, other pain relief products followed that included flavored lollipops with citrate mixed inert fillers under the name of Actiq (fentanyl oral transmucosal devices) and Onsolis (fentanyl buccal soluble film).  Also dosing is different if switching back and forth from Fentora to Onsolis.  For example, Fentora and Onsolis are given at lower levels than Actiq.

How does the patch work?  When the patch is adhered to the surface of the skin, the pain killer is absorbed where the opiate enters the blood stream.  Who gets the prescription?  Those that have painful cancerous condition, postoperative pain, or chronic pain conditions, such as constant low back pain are patients that use these patches.

How should you use fentanyl?  Never use more than what is prescribed in dose and frequency.  To use outside of the prescription can be extremely harmful to your health.  This pain medication when used correctly is very effective in controlling pain, but when used incorrectly can produce fatal results.

A huge problem now exists with abuse and addiction regarding fentanyl products.  These patches are entering the marketplace where illicit use of the patch is having deadly consequences due to the highly euphoric and addictive drug properties.  When the time released gel is removed from its blister pack and the gel material is consumed, or users double up on patches adhered to the skins surface, the health effects can be very serious.    For example, in 2005 Florida’s Dept. of Law Enforcement statistics show the patch resulted in 115 deaths.  And throughout the nation in recent years these numbers are up.

Since this pain killer can be 100 times more potent than morphine, drug dealers seek this stuff to provide their customers a quick high.  Inappropriate use of these patches combined with other drugs has also created a patient addiction, or street demand to turn a slow-release form of powerful pain killer into a dangerous high that can produce deadly results.

Tablets, sprays and popsicles were produced to treat and quickly alleviate sudden (breakthrough) cancer pain in patients that already had a high tolerance to strong narcotic pain medications, such as morphine.  If those on the street obtain fentanyl for a euphoric high and don’t understand the use, they can experience respiratory failure and death.

To date there are 12 different analogous (similar structure and in function to fentanyl) with various strengths under different labels ranging from 10 – 10,000 times more powerful than morphine.  For example, Carfentanil (Wildnil) has an analgesic potency 10,000 times that of morphine and is used to sedate very large animals.  Where Sufentanil (Sufenta) has an analgesic effect that is 5 to 10 times more potent than fentanyl and is used for specific surgeries on patients that are opioid tolerant.

These drugs because of potency have become ever more attractive to drug dealers because of the small volume it takes to produce a drug high.  This is a huge problem on the street because it is very hard to approximate the dosages to a point that will not cause the user to overdose.  For example, the fentanyl mixes sold on the streets are very difficult to dilute, especially the gel packs, tablets, films and popsicles because of the unknown potency multiplier within various fentanyl products.  And even if one known’s the various product strengths, proper dilution, or cutting of the product is another issue.

And to complicate illicit use is the mixing of fentanyl with other illegal drugs with one of many analogous clandestine products, e.g., heroin, methamphetamine, cocaine, or morphine, etc.  And these hybrid drugs cut with fentanyl on the street is known as “China White.”  For the unsuspecting, your heroin purchase may not be what you think it is.  Now drug dealers acquire fentanyl to upgrade their product if they’ve purchased a low-grade heroin for example.  That’s right, now your drug dealer has a new specialty on his/her resume, “pharmaceutical chemist.”  A drug dealing chemist with no ideal about the medical implications of opiate intolerant users, potency of product, let alone understand the combined drug mix incompatibilities and risk to health and life.

Although fentanyl is commonly ingested; like heroin, it can also be smoked, snorted, or injected.  And if a drug dealer sells fentanyl as heroin to an unknowing user, overdosing symptoms can cause a quick depressing effect on the respiratory system because of its fast acting anesthetic effects.  How does the fentanyl end up on the streets?  Although it is not always clear on how someone got their hand on the drug, it has also been reported by patients that their medicine has been stolen, or law enforcement has tracked the drug source as manufactured and distributed from Mexico.

It is clear the patch, tables and other ingested forms of fentanyl when used according to a doctor and manufactures recommendations is safe.  However, law enforcement agencies say the problems are when patients have addictive disorders that cause them to use “any” drug in a way that it was not met to be used.

Patients that are prescribed these patches must also be aware of the following precautions, especially if they are using other medications.  Do not use these patches unless you are already opiate and morphine tolerant, or know you don’t have bad reactions to the following types of pain killers:  Kadian, MS Contin, and others).  Hydrocodone (Lortab, Vicodin), oxycodone (Oxycontin), and Hydromorphone (Dilaudid)

Only a doctor can determine through patient consultation whether or not you are intolerant.  Also if you use a MAOI (Monoamine Oxidase inhibitor, “antidepressant drugs”) in the last 14 days, a dangerous drug interaction using fentanyl could lead toward serious side effects.  MAOI drugs to be aware of: furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate).

Also, if you have the following medical conditions and before using the patch, tell your doctor if you suffer from any of the following:  COPD (Cardio Obstructive Pulmonary Disease), irregular heart rhythm, epilepsy/seizures, depression, hallucinations, kidney/liver disease, low blood pressure, head injury/brain tumor, or a history of alcohol/drug abuse (addiction).  You also must be aware that the medications you use to regulate these conditions may also adversely react to the patch.  Instead of attempting to list all of the possible medications that may cause an adverse reaction with the use of fentanyl, your pain management specialist and medical doctors would be your best source of information and prior to prescription use advisement regarding these matters.

Handling fentanyl and use: do not freeze, or store this medication in warm or humid room conditions.  Use only dry fingers when handling tablets or film.  And do not use a tablet that has been left outside of its blister pack for more than a few minutes.  Simply flush down the toilet.  The FDA working with the manufacturer had determined this method to be the best for disposal to prevent accidental death.  And this type of disposal is only recommended with very few types of prescription drugs due to the lethality if it should be accidentally swallowed by a child.  The human safety aspect outweighs this drugs disposition recommendations compared to disposition instructions of other pharmaceuticals.

And only use 1 tablet or film should be consumed at a time.  When consuming, allow the film, or tablet to dissolve slowly in the mouth, do not chew, suck or swallow it.  Simply allow it to dissolve between your cheek and gum.  To ingest immediately may cause a severe health reaction.  If you feel dizzy, nauseated or bad in general spit the medicine out of your mouth.  Rinse your mouth out well with water and call your doctor.  On the flip side, if your pain doesn’t go away after the first tablet or film and if approved by your pain management specialist when break through pain occurs, wait 2 hours before applying another fentanyl buccal film, and at least 4 hours to treat a new pain episode with fentanyl buccal tablets.

Ensure, if you have pets, children, and you don’t finish a Popsicle type fentanyl pain killer to run hot water over it until completely dissolved.  And if you have extra buccal tablets lock them up.  To not secure these types of medications could potentially kill those that might consume them intentionally or accidentally.  Speak to your doctor if breakthrough pain is occurring more than four times a day while using this medication.  Also do not abruptly stop using this medication as it can have some serious withdraw side effects.  Never share fentanyl with anyone. There is no way you could know the effect the strength of this type of pain killer could have on another individual.  Also, it is not known if fentanyl will harm an unborn baby.

What are the overdose symptoms? Pinpoint pupils, extreme dizziness and weakness, shallow and slow breathing, weak pulse and clammy cold skin.  The side effects of an allergic reaction: hives, and swelling of throat, lips, face and tongue to include difficult breathing.  And the most serious side effects: heavy sweating, hot and dry skin, weak or shallow breathing, rapid heart rate, pale skin and extreme thirst to include concentration difficulties.  If you need medical attention call 911, or the Poison Help line at 1-800-222-1222.  An overdose using fentanyl can be fatal.

Less serious effects that you should call your doctor and you may report to the FDA at 1-800-FDA-1088, or your primary care physician, or pain specialist:  swelling hand and feet, mouth sores at spots of medicine placement, headache, vomiting, nausea, constipation, dizziness and drowsiness.

References,

Novella, Steven.  Does Acupuncture Work or Not?  Neurologica blog.  Sep 25, 2007.  http://theness.com/neurologicablog/index.php/does-acupuncture-work-or-not/

MedicineNet.com. Fentanyl Tablet (Cancer Pain Only) – Buccal, Fentora.http://www.medicinenet.com/fentanyl_tablet_-_buccal/article.htm

Answers.com.  Fentanyl Citrate Oral Lozenge.  http://www.answers.com/topic/fentanyl

Drugs.com.  What is Fentanyl.  http://www.drugs.com/fentanyl.html

University of Florida.  Fentanyl Pain Patch Abuse Can Be Deadly.  July 7, 2005.  http://alcoholism.about.com/od/prescription/a/bluf050706.htm

Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2011 Copyright, All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter.

 





Ineffective Pain Killers and Opioid Addiction

22 01 2011

    In many pain patients experience and now scientific studies prove, pain relief (Analgesic) decreases while pain sensitivity increases from excess use of opioids.  The opposite effect of pain relief is experienced when addiction and/or tolerance of morphine like drugs is established. 

    In other words, if you stub your toe and you’ve been using opioids for long periods of time, greater sensitivity to pain can/does occur.  So you ask yourself, how could this be?  I thought pain killers were supposed to lessen the pain experience.   This is true if you are following the manufacturer’s dose and frequency prescribed by your doctor.  Many do not realize excess opioid use can build the bodies tolerance to a point where pain relief is minimized.  In fact, you get the opposite results, increased pain sensitivity.   And the medical term is referred to as Opioid-Induced Hyperalgesia (OIH). 

      Simply stated, OIH is “pain intolerance,” meaning more sensitive to any pain stimulus.  And for many of you that suffer chronic pain, you’ve probably experienced a pain management program that didn’t go according to plan.  Recall, the doctor prescribes, but it is up to the patient to take the recommended prescriptions.  And unfortunately, all too often, patients that should be pulled off of certain pain medications are not.  And others simply do not use the prescribed dosages and create more pain for themselves than necessary because of misinformation and understanding of a pain management program. 

        First of all, how does analgesic tolerance to pain killers occur?  The best way to describe this characteristic is that, your body produces your own morphine like substance (via spinal cord secretions) known as endorphins to alleviate pain when you stub a toe, or slam your finger in a car door.  This substance lessons the painful stimuli experience.  If a person takes “too much and for too long” morphine like drugs, then the spinal cord no longer secrets the body’s natural pain relief agent.  So when your body hurts really bad (chronic) you no longer have that supplemental “natural” pain killing agent in your body.  Instead, you solely rely on your prescriptions.  The pharmaceutical prescription at this point is not enough to provide adequate pain relief.   Taking “too many” pain killers results in an overall increase in pain sensitivity because the pain patient now blocks the body’s ability to dose/mask pain naturally for lack of the body’s natural morphine like defense.  Hence, taking high dosages of pain relief medication for too long and the spinal cords natural pain relief secretion process shuts down.  This is also when addictions to morphine like prescriptions occur. 

      Last year the FDA (Food and Drug Administration) introduced REMS (Risk Evaluation and Mitigation Strategies) guidelines to help manage the known risks for pain medication use.  This is a program intended to improve upon patient safety, education and compliance to mitigate risk of abuse, addiction and serious side effects through smart physician to patient consults. 

      Once these guidelines became known to the pain patience, there was fear (amongst some) REMS would result in limiting their access to needed prescriptions.  This is simply “not” the goal of the FDA REMS guideline program.  In fact, I see a lot of positives in the right direction that I wished were in place when I began my pain management program many years ago.  For example, I didn’t understand the benefits of pain prescription used correctly.  I was mostly aware of the risks of taking pain medications.  So when I noted a secondary risk, I reduced or quit taking the prescription for fear of another secondary ill-health condition.  The lack of “not” understanding the benefits brought on more pain experiences than needed to occur.  And for others, taking too much created addiction. 

          REMS brought with it, concern that pain patients would now have limited access to needed medications.  Why would they fear such a thing?  Think about it, if your addicted to pain killers and you have a risk evaluation (REMS) by a pain managing specialist, it may be determined the best course of pain alleviation action may be to switch over your pain medication, or reduce the dose, etc.  This would surely cause concern for an addict, or someone with continuous chronic pain.  

      However, to mitigate this concern, by working with specialists and through education on topic can get a pain patient back on track.  For example, to get a pain patient back on target may require decreasing medication (e.g., transdermal fentanyl) by 25%.  After 4 weeks, with reduced dose the patient reports 5/10 pain & overall improved coping ability with pain sensitivity [Fentanyl is a potent synthetic (man-made) narcotic].  A 100g dose of fentanyl is approximately equal to 10 mg of morphine. Fentanyl stimulates receptors on nerves in the brain to increase the threshold to pain. 

      So when a pain patient has been using Fentanyl to alleviate pain, a reduction of dose by 25% will appear odd but necessary to get pain under control.  It takes a bit of education and understanding through good patient to physician consults.  If medications are not managed correctly the opposite result of adequate pain relief and addiction often occur.  REMS help the pain patient to understand and manage pain relief more effectively. 

      Also if pain is not managed effectively, secondary risks can and do occur.  

 Constipation – Increase fiber intake, and/or use stool softeners will help. 

  1. Opioid-Induced Hyperalgesia – Ineffective pain relief. See your physician.
  2.  Respiratory Depression – Slow rate of breathing, loss of urge to breathe.
  3. Central Nervous System complications – Dizziness, euphoria, drowsiness, etc.
  4. Cardiovascular – Decreased blood pressure, edema (swelling), slow heart rate.
  5. Musculoskeletal System – Osteoporosis, muscle rigidity and contractions.
  6. Skin System – Itching, “this may not indicate allergic reaction.” 
  7. Immune System – Data suggests long-term use, indicates immune suppression. 
  8. Pregnancy & Breastfeed-Neonatal depression, avoid opioid use during feeding. 
  9. Ocular System – Constriction of pupil. 
  10. Gastrointestinal System – Constipation, nausea, vomiting, bowel problems, etc.
  11. Genitourinary System – Urinary retention.
  12. Endocrine System – Hormonal and sexual dysfunction.
  13. Withdrawal Syndrome – Runny nose, shivering, diarrhea, gooseflesh, etc. 

 Note:  If you are a pain patient and experience any of these symptoms see your primary health provider, or refer to your pain management specialist. 

    The FDA REMS guidelines are now required within all pain patient to physician consults; providing the patient an excellent opportunity to learn about the benefits and risks of using pain killers.   This program will no doubt reduce prescription addiction problems; reduce OIH cases and increase pain relief benefits.  Also REMS incorporated into consults will reduce secondary ill-health risk factors that will reduce unnecessary deaths and lawsuits. 

     It is important that through physician and patient consults, the understanding of safety, education and compliance in pain management transpires.   Without education on the matter, this could be a scary proposition for the pain patient.  I’ve stated in many of the articles I’ve written within the “Mirror Athlete with Pain Chronicles,” it is very important you advocate for the best health care possible.  Without your voice advocating for the best care, your pain referral experiences to medical pain specialists can be unproductive, untimely, stressful and cause you more pain and suffering than need be. 

     The point is, if you know you have a problem and your pain is getting worse, get yourself in and ask for a referral from your primary care physician to begin consults with a pain management specialist.  Go into the session with an open mind, be willing to listen and ask for reference materials on the matter to become educated on your pain condition(s).  Ask about the REMS guidelines and learn to manage your pain safely and effectively and follow your pain specialist recommendations for the best prescription use to alleviate pain.  Through smart pain management consults, education and timely/applicable self-referrals your pain alleviation program will work.  Taking a self interest in your ill-health chronic pain circumstances is important if you want to continue quality living experiences while managing pain. 

 To read more on pain management, REMS, secondary effects of opioid use, visit Internet links below [simply cut/paste web address, insert into browser]. 

 References, 

  1. Pain Pathways, http://www.painpathways.org
  2. Federal Drug Administration, http://www.FDA.gov
  3. American Chronic Pain Association Consumer Guide, http://www.theacpa.org  

 Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2011 Copyright, All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter. 





Rehabilitate Self Through Walking

9 04 2010

Marc from Mirror Athlete stops during his 10mile walk.  See  (www.daretowalk.com) and (www.mirrorathlete.com)  current stories/projects to show you how he went from being confined to bed and wheelchair after surgeries back to health.

It took him approximately 3 years to go from 1block to 18mile (best walk). Doctor’s had left him with prescriptions, handicap placard, stay off feet advicement. His mobility aids of choice : Wheelchair, walker, canes. There was no instruction on rehabilitation to get back what he had lost; other than self advocation for more physical therapy and specialist referals. In other words, it was all up to him to find the motivation, strength and applied knowledge to progress to where he is today. Marc had one knowledge based benefit most don’t have… An undergraduate degree in Exercise Science that he used to apply in order to rehabilitate himself.

Marc specializes in fitness, general health, wellness, nutrition and pain management. See his websites: Through his project hub:  At Mirror Athlete.biz 

Also you can follow mirrrorathlete or daretowalk on twitter. You can also sign up as a Face Book fan and follow Mirror Athlete Enterprises through Facebook. Please chime in on discussions if you have time to contribute.   Share your rehabilitative stories, your walking and active movement exercise activity success.  Send your video links to the Facebook discussion room under an applicable health category so we can post videos here as we do at YouTube (mirrorathlete). In this way we share and outreach to millions that are suffering in unnecessary pain. We welcome your support and success stories for the sake of others that need your inspiration and motivation. Good Health to you and your families!

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET2009 Copyright.  All rights reserved, Mirror Athlete Publishing @: http://www.mirrorathlete.com,  Sign up for your Free eNewsletter.





Medical Marijuana Use Pro’s and Con’s

19 06 2009

It is very concerning after speaking with local youth in two states (California and Oregon) regarding marijuana use; there is a nonchalant attitude regarding this drug.  The common answers to my questions, “don’t you think marijuana will harm you in any way if you continue to use this drug?”  Or, if you keep smoking the stuff, aren’t you afraid of addiction and associated health risks?  Much like laying a bet, are you assured you are not gambling with your health or future life endeavors?   The common answers in reply, “Marijuana is no more dangerous than alcohol.”  “As a matter of fact, alcohol is responsible for hundreds of thousands of deaths, broken families, job loss etc., where with cannabis this is not the case.”  The other common answer, “I can quit anytime I want to, it’s not addicting, it’s not a gateway drug and I don’t drink; I choose this drug as my recreational drug of choice as I prefer this vice opposed to drinking.”  Others simply state, “For me there are no problems regarding my use of this drug, therefore, no harm.”  Our youth and many adults don’t appear to regard cannabis as a harmful substance as it like many of our controlled drugs are derived from mother earth, mostly to be tainted by man-made processing chemical manipulation and sold as approved prescription drugs, or recreational drugs (tobacco, spirits, wine and beer).

In other words, “on the street,” cannabis untouched by man appears to be a safer alternative for medicinal purposes (chronic pain alleviation) and recreational use (opposed to alcohol), even though most seem to understand there’s an inherent risk toward addiction (but don’t want to admit it outright) and health risks (e.g., cannabis smoke carcinogens).   My sampling of these queries is rather small, around 50 discussions on this topic where 80-90% concedes (teenagers and adults), cannabis is probably the least harmful of the illegal drugs that should be fully legalized.  And almost all adults within this sampling seem to acknowledge the medicinal properties and benefits for chronic pain sufferers.  I can see the medicinal benefits through the scientific studies, however “all” drugs must have some form of state and federal regulation or greater health and/or addiction problems “will” significantly impact our youth as is with our legal drugs.  Our youth should be of great concern with regard to cannabis legalization.  Any drug including cannabis can have a negative impact on growing minds and bodies especially if one should become addicted during the developmental stage of their lives.  This fact alone can destroy a life before it begins.

I felt it was very important to add two addiction articles to the MAE Health repository since I wrote two previous articles on “Medical Marijuana Use, Part 1 (pain benefits) and 2 (scientific support data) for chronic pain sufferers.”  As you read the two articles, there is a very good case to continue research and development while easing up on state and federal laws for chronic pain sufferer’s use of cannabis.  There is some very good science based around severed or damaged nerve endings where only the THC receivers at the nerve endings provide pain relief through cannabis use.  Science also shows these damaged nerve endings do not respond to the typical opiate prescription; hence pain alleviation through the pharmaceutical prescription gold standard has little to no effect in many chronic pain controlled studies.

Now you are figuring out possibly where I’m going with this.  We must be very vigilant with our children while our states continue to relax marijuana use laws.  I’m in favor of legal marijuana use by chronic pain sufferers.  I’m also very aware and concerned about our children’s access to marijuana should it be fully legalized.  There is a greater probability that distribution abuse and use will occur because of easy access to chronic pain patient’s medicinal prescriptions, or full legalization as an adult recreation drug.  We must not and cannot depend on our government agencies to protect our children from abusing any drug.  It is our responsibility as parents to educate our children, knowing the differences between right and wrong with an understanding of the possibility of addiction and consequences of drug use regardless of whether our society and government deem the substance legal, or illegal.

Control and regulation is very important when dealing with any drug as all forms of mind altering substances have the potential for abuse, health risk, societal harm and addiction.   If there is no, or limited state-federal regulation, control, such as, quasi-legal medical marijuana (read previous MAE achieved Medical Marijuana articles “Pain Benefits,” http://www.mirrorathlete.com/blog) then our government supports a quasi-illegal black market operations by turning a blind eye to states rights and the science backing cannabis pain alleviation.

In other words, if science supports the pain alleviation benefits of any drug including medical marijuana then our federal agencies should recognized the benefits and legalize the drug.  Our federal government should fully recognize states rights for pain patients as opposed to potential imprisonment for those that fall outside of federal guidelines.  Until this is done, like alcohol which we know has the same access and abuse potential by our children… Without federal recognition of cannabis as a controlled substance for medicinal use, substance abuse of the drug will not be monitored and addiction, carcinogenic health risks, with associated mental health probabilities will not be addressed correctly, or adequately.  Instead many cannabis users will possibly be subjected and directed through the penal system for rehabilitation if convicted; which we all know is not the best treatment and rehabilitation course for any drug addict.

Why, because our penal system incarcerates and holds prisoners for breaking the law which is big business unto itself… Incarceration appears to incorporate treatment and rehabilitation for addicts inside, but how successful are these programs really?  And is treatment and rehabilitation this industries main focus?  It sounds like a business that is dependent on law breaking convicts more so than a rehabilitation center for drug addicts.  So, I ask again is this the best course of action to rehabilitate an addict?

I really don’t know since I’ve never been incarcerated, or exposed to these rehabilitation programs.  However, I believe any government run programs are inferior to a third party source.  Really, what am I to think?  Our government has proved time and time again it only knows how to spend money with inefficient government service programs.  It would appear our government is more interested in taxing the American people for unnecessary or inefficient services to grow government.  If the financial rewards and power out weight any human benefits then “We the People,” will come second to power and corruption.  It’s all about power, control and a human trait that cannot be tamed, ‘greed!”

With any drug, “ANY Drug,” there is always the potential for substance abuse.  Cannabis will eventually be fully legalized on a national level, first as is occurring through medical marijuana permits.  The major marijuana composition THC is already legally sold (Marinol) & prescribed by our medical providers.  However, most consumers don’t know this information.

Marinol is listed and classified by the DEA (Drug Enforcement Agency), as a class III legal prescription.  So instead of smoking the cannabis which is the illegal part, you are legally able to ingest the THC oil prescribed by most HMO’s for pain management.  Maybe our government within its infinite wisdom determined it would be easier to control marijuana distribution to our children in this format.  In fact, since Marinol must be refrigerated, it seems to me, it would be easier for our children to get their hands on the tiny capsules, conceal and consume.  If the government was truly concerned about a chronic pain patient wellbeing they would fully legalize cannabis and provide the choice to ingest, or inhale their script.

Part 2, “Marijuana Addiction, Lay Your Bet!” is continued and will be published within July09 issue.  I will post information regarding legal marinol and government greed that will knock your socks off!  You’ll not want to miss the continuation of this article!  Really, is this multi-billion dollar industry concerned about our children’s potential addiction, or is it really about government greed, power and control?

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2009 Copyright, All rights reserved.  Mirror Athlete Enterprises Publishing @: www.mirrorathlete.com, Sign up for your free eNewsletter.





Medical Marijuana Use Pro's and Con's

19 06 2009

It is very concerning after speaking with local youth in two states (California and Oregon) regarding marijuana use; there is a nonchalant attitude regarding this drug.  The common answers to my questions, “don’t you think marijuana will harm you in any way if you continue to use this drug?”  Or, if you keep smoking the stuff, aren’t you afraid of addiction and associated health risks?  Much like laying a bet, are you assured you are not gambling with your health or future life endeavors?   The common answers in reply, “Marijuana is no more dangerous than alcohol.”  “As a matter of fact, alcohol is responsible for hundreds of thousands of deaths, broken families, job loss etc., where with cannabis this is not the case.”  The other common answer, “I can quit anytime I want to, it’s not addicting, it’s not a gateway drug and I don’t drink; I choose this drug as my recreational drug of choice as I prefer this vice opposed to drinking.”  Others simply state, “For me there are no problems regarding my use of this drug, therefore, no harm.”  Our youth and many adults don’t appear to regard cannabis as a harmful substance as it like many of our controlled drugs are derived from mother earth, mostly to be tainted by man-made processing chemical manipulation and sold as approved prescription drugs, or recreational drugs (tobacco, spirits, wine and beer).

In other words, “on the street,” cannabis untouched by man appears to be a safer alternative for medicinal purposes (chronic pain alleviation) and recreational use (opposed to alcohol), even though most seem to understand there’s an inherent risk toward addiction (but don’t want to admit it outright) and health risks (e.g., cannabis smoke carcinogens).   My sampling of these queries is rather small, around 50 discussions on this topic where 80-90% concedes (teenagers and adults), cannabis is probably the least harmful of the illegal drugs that should be fully legalized.  And almost all adults within this sampling seem to acknowledge the medicinal properties and benefits for chronic pain sufferers.  I can see the medicinal benefits through the scientific studies, however “all” drugs must have some form of state and federal regulation or greater health and/or addiction problems “will” significantly impact our youth as is with our legal drugs.  Our youth should be of great concern with regard to cannabis legalization.  Any drug including cannabis can have a negative impact on growing minds and bodies especially if one should become addicted during the developmental stage of their lives.  This fact alone can destroy a life before it begins.

I felt it was very important to add two addiction articles to the MAE Health repository since I wrote two previous articles on “Medical Marijuana Use, Part 1 (pain benefits) and 2 (scientific support data) for chronic pain sufferers.”  As you read the two articles, there is a very good case to continue research and development while easing up on state and federal laws for chronic pain sufferer’s use of cannabis.  There is some very good science based around severed or damaged nerve endings where only the THC receivers at the nerve endings provide pain relief through cannabis use.  Science also shows these damaged nerve endings do not respond to the typical opiate prescription; hence pain alleviation through the pharmaceutical prescription gold standard has little to no effect in many chronic pain controlled studies.

Now you are figuring out possibly where I’m going with this.  We must be very vigilant with our children while our states continue to relax marijuana use laws.  I’m in favor of legal marijuana use by chronic pain sufferers.  I’m also very aware and concerned about our children’s access to marijuana should it be fully legalized.  There is a greater probability that distribution abuse and use will occur because of easy access to chronic pain patient’s medicinal prescriptions, or full legalization as an adult recreation drug.  We must not and cannot depend on our government agencies to protect our children from abusing any drug.  It is our responsibility as parents to educate our children, knowing the differences between right and wrong with an understanding of the possibility of addiction and consequences of drug use regardless of whether our society and government deem the substance legal, or illegal.

Control and regulation is very important when dealing with any drug as all forms of mind altering substances have the potential for abuse, health risk, societal harm and addiction.   If there is no, or limited state-federal regulation, control, such as, quasi-legal medical marijuana (read previous MAE achieved Medical Marijuana articles “Pain Benefits,” http://www.mirrorathlete.com/blog) then our government supports a quasi-illegal black market operations by turning a blind eye to states rights and the science backing cannabis pain alleviation.

In other words, if science supports the pain alleviation benefits of any drug including medical marijuana then our federal agencies should recognized the benefits and legalize the drug.  Our federal government should fully recognize states rights for pain patients as opposed to potential imprisonment for those that fall outside of federal guidelines.  Until this is done, like alcohol which we know has the same access and abuse potential by our children… Without federal recognition of cannabis as a controlled substance for medicinal use, substance abuse of the drug will not be monitored and addiction, carcinogenic health risks, with associated mental health probabilities will not be addressed correctly, or adequately.  Instead many cannabis users will possibly be subjected and directed through the penal system for rehabilitation if convicted; which we all know is not the best treatment and rehabilitation course for any drug addict.

Why, because our penal system incarcerates and holds prisoners for breaking the law which is big business unto itself… Incarceration appears to incorporate treatment and rehabilitation for addicts inside, but how successful are these programs really?  And is treatment and rehabilitation this industries main focus?  It sounds like a business that is dependent on law breaking convicts more so than a rehabilitation center for drug addicts.  So, I ask again is this the best course of action to rehabilitate an addict?

I really don’t know since I’ve never been incarcerated, or exposed to these rehabilitation programs.  However, I believe any government run programs are inferior to a third party source.  Really, what am I to think?  Our government has proved time and time again it only knows how to spend money with inefficient government service programs.  It would appear our government is more interested in taxing the American people for unnecessary or inefficient services to grow government.  If the financial rewards and power out weight any human benefits then “We the People,” will come second to power and corruption.  It’s all about power, control and a human trait that cannot be tamed, ‘greed!”

With any drug, “ANY Drug,” there is always the potential for substance abuse.  Cannabis will eventually be fully legalized on a national level, first as is occurring through medical marijuana permits.  The major marijuana composition THC is already legally sold (Marinol) & prescribed by our medical providers.  However, most consumers don’t know this information.

Marinol is listed and classified by the DEA (Drug Enforcement Agency), as a class III legal prescription.  So instead of smoking the cannabis which is the illegal part, you are legally able to ingest the THC oil prescribed by most HMO’s for pain management.  Maybe our government within its infinite wisdom determined it would be easier to control marijuana distribution to our children in this format.  In fact, since Marinol must be refrigerated, it seems to me, it would be easier for our children to get their hands on the tiny capsules, conceal and consume.  If the government was truly concerned about a chronic pain patient wellbeing they would fully legalize cannabis and provide the choice to ingest, or inhale their script.

Part 2, “Marijuana Addiction, Lay Your Bet!” is continued and will be published within July09 issue.  I will post information regarding legal marinol and government greed that will knock your socks off!  You’ll not want to miss the continuation of this article!  Really, is this multi-billion dollar industry concerned about our children’s potential addiction, or is it really about government greed, power and control?

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2009 Copyright, All rights reserved.  Mirror Athlete Enterprises Publishing @: www.mirrorathlete.com, Sign up for your free eNewsletter.





Diabetes Diet GI (Glycemic Index) Tips

18 11 2008

A good way to manage diabetes through diet is to understand the Glycemic Index (GI).   This is an index that ranks carbohydrate foods on a scale from 0-100.  The higher the GI value the greater the absorption of the food sugar and therefore the greater the blood sugar (glucose) levels in the body. Remember, when a diabetic increases blood sugar then the body requires more insulin.  This is not good for a diabetic. The food groups listed below are carbohydrates that are slower to digest and absorbed.  This helps the body to keep blood sugars lower.

I wrote “Diabetes a Serious Disease,” filed within our health repository including many more disease prevention health articles.  In this article I define diabetes types and insulin function which is critical to metabolize the body’s sugar in order to maintain good health and not risk serious disease, or agitate an existing health condition.

Lower glycemic foods are slower to digest mitigates damage to nerves and blood vessels and also delays hunger pains which aid in managing weight.  Don’t be fooled and falsely lead to believe low glycemic foods allows one an open invite to consumption without thought to calories.  Eating too much of anything, including healthy foods can increase your body weight.

One last note of importance before I provide the popular listing of foods…  The American Diabetes Association and American Dietetic Association have not yet adapted the GI concept.  If you are/aren’t a diabetic and have been having weight management problems, I highly recommend you see your physician and request a blood draw and/or other test to ensure your blood sugars are being maintained at safe levels.   Also, discuss managing your diet through food selections under the Lower Glycemic Food Index (GI) below.

Lower Glycemic Food Index (GI). Slower Acting Carbohydrates (Recommend More in Diabetic Diet) Sugar alcohols (Sorbitol, Maltitol) Soy drinks, milk, yoghurt, Sweet potatoes, yams, vegetables, Fruits – plums, pears, peaches, grapes, grapefruit, cherries, bananas, apples, avocados, fresh juices.  Dried beans, peas, lentils.  Spaghetti, pasta, Basmati rice, Whole grain breads and pita Nuts and seeds.

Higher Glycemic Food Index (GI) Quicker Acting Carbohydrates (Recommend Less in Diabetic Diet) Ice cream (low-fat), frozen yogurt.  White bread, doughnuts, croissants, rice cakes, bagels.  White potatoes, corn, white rice.  Low fiber cereals – Cornflakes, RiceKrispies, Fruit loops, etc.  Pineapple, cantaloupe, watermelon, ripe bananas.  Soda, sugar sweetened sports and energy drinks.  Candy, sugar.

Since I’m not one to follow the letter of the law regarding my own personal diet and cannot give up everything I enjoy; I do recommend you try switching out some foods in your diet to assist in keeping your blood sugars lower and to assist in managing your weight.   I recommend you vary some of the higher glycemic foods consumed daily, to some of the Lower Glycemic Food Index (GI) options.  I’m not advocating an increase in consuming more carbohydrates but instead, substituting carbohydrate food types when considering meal preparation.  Over consumption, regardless of GI food composition would not help you in maintaining, or achieving your weight goals.  If you’d like a larger listing of Lower GI carbohydrates; health stores, magazines, Internet, nutritionist can easily provide this information.

If you’d just like to prepare healthier foods for your family, visit our integrated magazine store and/or health store to find recipe books, diet cook books, etc.  These books & magazines provide a plethora of different ideas on how you can prepare tasteful foods for those with diabetes, or those with weight loss goals, etc.  Our integrated wellness stores also have coupon savings!”  These health magazines can provide more tips, tricks and recommendation in maintaining good health.

Author:  Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET.  2008 Copyright, All rights reserved.  Mirror Athlete Enterprises Publishing @: www.mirrorathlete.com, Sign up for your free monthly eNewsletter.