We tend to think that migraine are headaches typically seen in women. Indeed the incidence of migraines is 3 times more common in women. But they also occur in men .Here is a new study from the Netherlands that found that migraine in men may well be associated with high estrogen levels.

As men age, high estrogen levels are not uncommon. Along with decreasing testosterone levels , we tend to see aromatization or conversion of testosterone into estradiol (estrogen). We know that elevated estrogen in men is not a good thing. It can lead to premature heart attacks and strokes, prostate enlargement, water retention and fat gain. Now we learn that it can be a culprit in migraine. The reason; men tend to gain fat as they age. Our fat cells secrete an enzyme called aromatase, which is responsible for the conversion.

What's the big deal ? Most physicians practicing traditional medicine rarely, if ever obtain estrogen levels in male patients. Those of us practicing anti-aging medicine do this on a routine basis.

Bottom Line : Men , ask your doctor to draw your hormone levels, and make sure estradiol is included.

Read Original Article Here: https://www.medpagetoday.com/neurology/migraines/73741

I think it's fair to say that most practitioners in functional medicine as well as most health enthusiasts embrace the importance of our microbiome, I'm talking about the trillions of organisms that colonize our gut. 80% of our immune system comes from the gut. It is becoming increasingly appreciated that the gut-brain connection is equally important. Your moods may well be affected by what organisms are found in your gut, which in turn can affect your neurotransmitters. This is not a small deal because of the magnitude of mental illness in the Western world. Why we just recently lost two successful celebrities, Kate Spade and Anthony Bourdain to suicide.We know that meds are not the complete answer. The research on the gut-brain connection is emerging. Because the microbiome varies from one individual to another, taking probiotics in mass may not be enough. One day we may be able to select which probiotics and prebiotics work best for a given individual with a given mood disorder.

Read Original Article Here: https://www.menshealth.com/health/a20646914/probiotics-benefits-gut-mental-health/

Europe does not wholly endorse the stringent Blood pressure (Bp) guidelines recently released in late 2017 by both the American Heart Association (AHA) and the American College of Cardiology (ACC) . The European guidelines are a bit more pragmatic. Their primary goal is to get the systolic Bp below 140 mm Hg.

I concur that getting all patients below 140 mm Hg should be a first goal. Sure getting everyone below 130/80 might be ideal but at what cost? and with how many meds? Furthermore, such guidelines could be detrimental to the elderly and infirm.

Guidelines have their place, but they don't replace sound medical experience and judgment.

See Original Article Here https://www.medpagetoday.com/cardiology/hypertension/73384

Most folks remember the results of the WHI (Women's Health Initiative) released in 2002. Basically there was an increase in cardiac risk, blood clots and breast cancer in those using estrogen.However, what you might not remember is that the average age of the women in this study was 61 (making them clearly postmenopausal),an age where one would certainly expect to see heart disease. Also, the hormones used were equine estrogens,derived from the urine of pregnant horses. Most importantly all these estrogens were administered orally. Oral administration ensures that all drugs undergo the " first pass " effect in the liver, it's been shown that many of these estrogens metabolize in the liver to inflammatory compounds..NOT GOOD

This study which has one disadvantage in being observational in nature, studied over 45,000 women over a period of 7 years. There was no increase in breast cancer , stroke or heart disease.

This is promising news. I have always prescribed topical /intra-vaginal estrogen for many years. Using bio-identical hormones, seeking hormonal balance, and knowing how to test HRT in an ongoing fashion is the key to safe hormone administration.

Read Original Article Here: https://www.medpagetoday.com/meetingcoverage/nams/68526