Monthly Archives: March 2016

compounded hormone prescriptions reach 26 to 33 million a year

In spite of the best efforts of the conventional medical profession, women show their preferences by supporting the use of Bioidentical HRT. There is good reason for this – women feel better on it, and do better. Although the medical profession may denigrate BHRT, the FDA said that  they have never had a complaint about BHRT.  Note my post of Aug 26th below:

FDA admit no adverse report on Bioidentical HRT

One of the criticisms of Bioidentical HRT is that it is not FDA approved. It does not need to be, as it is not synthetic. It is interesting however that there has never been a complaint of an adverse event to the FDA – yet there are numerous adverse event report about the synthetic HRT. Here is part of a transcript from a recent Press conference run by the FDA.

The FDA had a press conference on BHRT. They generally were negative about BHRT.Here is one of the questions put to Kathy Anderson of the FDA (USA)

Anna Matthews(Reporter): Hi. Couple of questions; one is have you guys received any reports of adverse events or other harm to patients from these products?

Kathy Anderson: Sorry, this is Kathy Anderson. With your respect to your question about whether we received any adverse event reports, we have not.

Untested, unapproved compounded hormone prescriptions reach 26 to 33 million a year

The North American Menopause Society News, 12/22/2015

Despite the risks, the number approaches that for FDA–approved hormone therapies. The number of prescriptions for mostly unregulated compounded hormone therapy for women at menopause has reached an estimated 26 to 33 million a year. That approaches the 36 million prescriptions per year for well–regulated and tested FDA–approved hormone therapy, shows an analysis of the market compounded hormone therapy market, published online this month in Menopause. Nearly 500 pharmacists (118 compounding and 365 independent community pharmacists) completed the survey, which asked about the number of compounded hormone therapy prescriptions filled, the percentage of total volume, the percentages of different types of compounded hormone therapy sold, and what growth the pharmacists expected for these medications in the next 2 years. The analysts then estimated the size of the market based on the responses and the average percentage of compounding reported by the national Community Pharmacists Association and the industry market research firm IBISWorld. The authors highlighted concerns over the lack of clinical data about the safety of compounded hormones as well as fears over the quality of these products. Some contained too much of the prescribed estrogens and some too little progesterone, an imbalance that can allow overgrowth of the uterine lining and lead to cancer.


This is one doctor’s (well credentialed opinion) and not the last word on the need for mammograms. As you have no doubt realised by now, I am not fan of regular mammograms. See previous posts. However, I believe it is an individual decision that all women must make, as to what they decide is best for them. My complaint is that women are not given both sides of the debate due to various biases and commercial interests. Breast screening and the Think “Pink” campaign is big business and very lucrative for many.  The alternative side needs to be told.

This is Dr Ben’s Bio:

Dr. Johnson’s medical career spans over thirty years, from his graduate work in immuno-pathology in 1976 to his current concentration-writing and speaking on staying healthy, especially for women in the area of breast health. In 1997 Dr. Johnson began to formally combine conventional and complementary medicine, moving back home to Georgia and founding a complimentary/alternative cancer clinic in Atlanta, The Immune Recovery Foundation. Turning in 2004 to breast cancer research and breast health education, Dr. Johnson founded the International Cancer Foundation in Rossville, Ga. Dr. Ben, as he is known, has helped thousands of women, and health care professionals around the world seek his advice.

Diagnosed with Lou Gehrig’s disease in 2003 and finding no hope in either conventional or alternative medicine, Dr. Ben met Alex Loyd, creator of the “Healing Codes™”. Dr. Ben’s subsequent work with Loyd’s procedures-addressing the core emotional/energy issues that control every aspect of our lives-and relief of the “incurable” symptoms of ALS led to Dr. Johnson’s appearance in the best-selling, 2006 documentary film The Secret™ and co-authoring of the best selling book The Healing Codes and The Secret of Health: Breast Wisdom.

Dr. Ben owns Dr. Ben Johnson Services LLC, a business promoting natural health care products, and healthy breast cancer screening for women. Always looking for more ways to spread his message of health and wholeness, Dr. Ben has just finished “Healing Water” released in June of 2011 and a new book on Thermography and the health problems associated with mammography to be released in 2012.


Video of Dr Johnson’s talk can be viewed at :

Dr. Ben Johnson: I wrote a book for women, The Secret of Health Breast Wisdom1 because we, as a medical society, are giving women breast cancer with our demanding that they get mammograms. Mammograms cause breast cancer. Period. So mammograms are not healthy for women. Women should not be getting routine mammograms. That’s crystal clear, published in the peer review literature.

And yet today, if a woman went to her gynaecologist or family doc, she would have this shoved down her throat, extreme coercion to go get this mammogram that is causing breast cancer. It’s not saving lives. You have a 4% increased risk of dying if you get mammograms, period.

Ty Bollinger: So the detection technique that we’re using, the primary technique that we use to detect breast cancer, is causing breast cancer.

Dr. Ben Johnson: Absolutely, it’s a terrible test; you know smashing women’s breasts and then irradiating with cancer-causing radiation. And then it’s so insensitive. For women under 50, it’s only like 52% effective, sensitive. That means 52 is pretty close to 50, right?

Ty Bollinger: Yeah.

Dr. Ben Johnson: So about half. That means that half the women that have breast cancer, it would not detect their cancer. That’s a terrible test. And so there are much better tests. And yet this is what’s still being crammed down women’s throats today. Terrible test, causes breast cancer.

Ty Bollinger: And it doesn’t detect, it detects 50% and causes cancer. You said there were better options. What better options are there for detecting breast cancer?

Dr. Ben Johnson: Well there’s two better options. If you’ve got a lump, if you think you’ve got something, ultrasound is great. It’s a test of anatomy. Mammograms are tests of anatomy. Ultrasounds are tests of anatomy. MRIs are tests of anatomy. So if you’ve already got a lump, you want a test of anatomy.

So, that would be like an ultrasound because they can see the lump, they can see its consistency. They can see where there’s calcium in it. And they can look at blood flow because tumors are going to have increased blood flow. So, for instance, a sensitivity of ultrasound is up around 80%. It’s much higher than mammograms. And the sensitivity is higher too.

But if you’re looking about prevention, if you’re talking about screening, there’s really only one device out there and that is thermography. An infrared thermal camera. Nothing touches the lady. Nothing smashes her breasts. There’s no cancer causing radiation.

As we sit here, we are omitting heat in the spectrum called infrared. There’s infrared, visual, and ultraviolet. So this is the infrared spectrum of light, which our eyes don’t see, but which is very detectable by the camera. The military developed this so that they could see people sneaking at them at nighttime and so that they could shoot down missiles and things because they’re producing heat.

Ty Bollinger: Sure, like night vision goggles.

Dr. Ben Johnson: There you go. Night vision goggles are infrared goggles. So we use it as a medical application to detect hotspots in the breast.

Well long before there was a tumor there, there were cancer cells. Probably 8 to 10 years before there was a tumor, there were cancer cells starting to grow. Two cells, four cells, 16 cells, 144 cells, etc. It takes about eight years until you get to about a centimeter in size for a mammogram or an ultrasound to detect it. Well that’s too late. Because that one-centimeter tumor, about five-sixteenths of an inch, less than half an inch, is about one billion cells.

When you get to one billion cells, the cancer has already eroded into the lymphatic system and the venous system and it’s shedding cancer cells all through the body. So that’s why mammograms—one of the many reasons mammograms don’t save lives,
it is NOT early detection. That’s one of the little lies they’ve propagated along. “Early detection saves lives. Get your mammogram today.”

Ty Bollinger: Right.

Dr. Ben Johnson: Well, that statement’s true. Early detection does save lives. It’s just that mammography is not early detection; it’s too late. And then the cancer-causing radiation. So the long and the short is you’re causing much more breast cancer with mammograms than you are detecting.



This Country Said No To Mammography Screenings. And That’s Amazing

This Country Said No To Mammography Screenings. And That’s Amazing

Mammography screening is the general, worldwide accepted way to conduct breast cancer screening. There are entire months dedicated to pushing the process on women, stiff fearful warnings posted in general practitioners’ offices and talk show fodder biased towards the screenings as well. That happens everywhere….except Switzerland (now).

Last year the Swiss Medical Board conducted a review of mammography screening and their findings exposed something rather unexpected. They assessed that these screenings cause more harm than good. In fact, via their studies, they found that the screenings really only saved 1 in 1000 women who died. On the contrary, the failure of the process, or unsafe side effects, were the actual greater concern.

From the study:

3 Primary Reasons the Swiss Medical Board Recommended No More Systematic Mammograms

In a perspective piece published in the New England Journal of Medicine,2 two members of the Swiss Medical Board’s expert panel explained how they reached their conclusions. Three primary factors came into play:

1. Outdated Clinical Trials

The ongoing debate over mammography screening is based on a “series of re-analyses of the same, predominantly outdated trials.” The first mammography trial began more than 50 years ago and the last trial was in 1991.

The mammography benefits that were supposedly found during these trials were prior to the era of modern breast cancer treatment, in which the prognosis of women with breast cancer has improved significantly from even two decades ago. The expert panel questioned:

Could the modest benefit of mammography screening in terms of breast-cancer mortality that was shown in trials initiated between 1963 and 1991 still be detected in a trial conducted today?”

2. The Benefits Did Not Clearly Outweigh the Harms

The experts noted they were “struck by how nonobvious it was that the benefits of mammography screening outweighed the harms.”

They cited a recent study published in British Medical Journal (BMJ)3 — one of the largest and longest studies of mammography to date — involving 90,000 women followed for 25 years. It found that mammograms have absolutely NO impact on breast cancer mortality.

Over the course of the study, the death rate from breast cancer was virtually identical between those who received an annual mammogram and those who did not, while 22 percent of screen-detected invasive breast cancers were over-diagnosed, leading to unnecessary treatment. The experts noted:

“This means that 106 of the 44,925 healthy women in the screening group were diagnosed with and treated for breast cancer unnecessarily, which resulted in needless surgical interventions, radiotherapy, chemotherapy, or some combination of these therapies.”

A Cochrane Collaboration review also found no evidence that mammography screening has an effect on overall mortality,4 which, taken together, seriously calls into question whether mammography screening really benefits women. According to the authors of the Cochrane review:

“If we assume that screening reduces breast cancer mortality by 15% and that overdiagnosis and overtreatment is at 30%, it means that for every 2000 women invited for screening throughout 10 years, one will avoid dying of breast cancer and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily.

Furthermore, more than 200 women will experience important psychological distress including anxiety and uncertainty for years because of false positive findings.”

3. Women’s Perceptions of Mammography Benefits Do Not Match Reality

The experts also said they were “disconcerted” by the profound discrepancy between women’s perceptions of mammography benefits and the actual benefits.

In one survey, most women said they believed mammography reduced the risk of breast cancer deaths by at least half and prevented at least 80 deaths per 1,000 women screened. In reality, mammography may, at best, offer a relative risk reduction of 20 percent and prevent in absolute terms only one breast-cancer death per 10,000 women. The experts asked a long overdue question:

“How can women make an informed decision if they overestimate the benefit of mammography so grossly?”

The sad reality of course, is that they can’t. Many women are still unaware that the science backing the health benefits of mammograms is sorely lacking. Instead of being told the truth, women are guilt-tripped into thinking that skipping their yearly mammogram is the height of irresponsibility. It can be hard to stand your ground against such tactics. After all, you expect health professionals to know what they’re talking about, and to give you the best advice possible.

When it comes to cancer prevention, however, many doctors are just as confused and manipulated as the average person on the street because of the relentless industry and media propaganda that downplays or ignores research that dramatically contradicts their profit-based agenda.

Indeed, mounting research shows that more women are being harmed by regular mammograms than are saved by them. In light of such facts, avoiding an annual mammogram is hardly an irresponsible act.

Ditto for saying “no thanks” to 3D tomosynthesis, which exposes you to an even greater amount of cancer-causing radiation for virtually no additional benefit. Please understand that there are other screening options, each with their own strengths and weaknesses, and you have a right to utilize those options. Also remember that in order to truly avoid breast cancer, you need to focus your attention on actual prevention and not just early detection.

Mammography screening is big business. And big business usually means an implied false sense of security and a misappropriation of information. That’s just how things are. Breast cancer reduction has been shown to be effective when there are dietary changes, such as much lowered fructose intakes, lowered protein intakes and increased Vitamin D. Eat high fiber vegetables, don’t smoke, don’t drink too much, get sleep. These are the things your body is craving.

Taking Vitamin D in menopause a waste of time (and money)

JAMA Intern Med. 2015 Aug 3. doi: 10.1001/jamainternmed.2015.3874. [Epub ahead of print]

Treatment of Vitamin D Insufficiency in Postmenopausal Women: A Randomized Clinical Trial.

Author information

  • 1Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison.
  • 2Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison2Quality and Patient Safety Analysis, Saint Luke’s Health System, Kansas City, Missouri.
  • 3Department of Computing and Biometry, University of Wisconsin College of Agriculture and Life Sciences, Madison.



Experts debate optimal 25-hydroxyvitamin D (25[OH]D) levels for musculoskeletal health.


To compare the effects of placebo, low-dose cholecalciferol, and high-dose cholecalciferol on 1-year changes in total fractional calcium absorption, bone mineral density, Timed Up and Go and five sit-to-stand tests, and muscle mass in postmenopausal women with vitamin D insufficiency.

Design, Setting, and Participants:

This randomized, double-blind, placebo-controlled clinical trial was conducted at a single center in Madison, Wisconsin, from May 1, 2010, through July 31, 2013, and the final visit was completed on August 8, 2014. A total of 230 postmenopausal women 75 years or younger with baseline 25(OH)D levels of 14 through 27 ng/mL and no osteoporosis were studied.


Three arms included daily white and twice monthly yellow placebo (n=76), daily 800 IU vitamin D3 and twice monthly yellow placebo (n=75), and daily white placebo and twice monthly 50,000 IU vitamin D3 (n=79). The high-dose vitamin D regimen achieved and maintained 25(OH)D levels ≥30 ng/mL.

Main Outcomes and Measures:

Outcome measures were 1-year change in total fractional calcium absorption using 2 stable isotopes, bone mineral density and muscle mass using dual energy x-ray absorptiometry, Timed Up and Go and five sit-to-stand tests, functional status (Health Assessment Questionnaire), and physical activity (Physical Activity Scale for the Elderly), with Benjamini-Hochberg correction of P values to control for the false discovery rate.


After baseline absorption was controlled for, calcium absorption increased 1% (10 mg/d) in the high-dose arm but decreased 2% in the low-dose arm (P = .005 vs high-dose arm) and 1.3% in the placebo arm (P = .03 vs high-dose arm). We found no between-arm changes in spine, mean total-hip, mean femoral neck, or total-body bone mineral density, trabecular bone score, muscle mass, and Timed Up and Go or five sit-to-stand test scores. Likewise, we found no between-arm differences for numbers of falls, number of fallers, physical activity, or functional status.

Conclusions and Relevance:

High-dose cholecalciferol therapy increased calcium absorption, but the effect was small and did not translate into beneficial effects on bone mineral density, muscle function, muscle mass, or falls. We found no data to support experts’ recommendations to maintain serum 25(OH)D levels of 30 ng/mL or higher in postmenopausal women. Instead, we found that low- and high-dose cholecalciferol were equivalent to placebo in their effects on bone and muscle outcomes in this cohort of postmenopausal women with 25(OH)D levels less than 30 ng/mL.

Trial Registration: Identifier: NCT00933244.

Why different painkillers are only effective for certain types of pain

Why different painkillers are only effective for certain types of pain
December 16, 2015 6.35am AEDT .

Maree Smith
Executive Director, Centre for Integrated Preclinical Drug Development and Professor of Pharmacy, The University of Queensland

Disclosure statement

Maree Smith currently holds competitive research grant funding from the Australian Research Council in collaboration with Boehringer Ingelheim GmbH, from the National Health and Medical Research Council and from The University of Queensland (CIEF grant) in collaboration with Que Oncology. Maree Smith is named inventor on patented AT2 receptor antagonist technology for the relief of neuropathic and chronic inflammatory pain, commercialized by the UQ spin-out company, Spinifex Pharmaceuticals (2005-2015), that was acquired by Novartis in mid-2015. Maree Smith conducts contract R&D studies for a large number of companies in her role as Executive Director of the Centre for Integrated Preclinical Drug Development at The University of Queensland. She is currently President and Board member of the Australian Pain Relief Association (APRA) and she is a member of the Editorial Board of Pain: Clinical Updates.

Whether it’s your head, tooth or back, when you’re in pain, it’s hard to think about anything else. If it’s not too strong, some can ride it out. But in many cases, the pain just gets worse and won’t go away until you take something.

Medicines that kill pain are called analgesics and they vary in how they work. No single painkiller can relieve all types of pain. Those that work for mild pain usually have little effect on severe pain unless combined with a stronger painkiller.

If you want to effectively control your pain, you will need to match your medication to its type and severity.

Nociceptive pain

Nociceptive pain is caused by damage to body tissue. If the pain is mild, such as a headache or a sprained ankle, commonly used over-the-counter painkillers are effective. These include tablets containing paracetamol (Panadol), aspirin, or non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

Paracetamol helps to dampen pain signals to the brain. NSAIDs inhibit the activity of the enzymes that lead to pain, inflammation and fever being produced in the body.

If you want to control your pain, you will need to match your medication to its type and severity.


Combination tablets, which have a small dose of codeine plus paracetamol, aspirin or ibuprofen, can be used to treat moderate pain. In Australia, you can buy these kinds of painkillers only in a pharmacy. Those sold over the counter have brand names such as Panadeine, Aspalgin and Nurofen Plus.

The government recently announced it will make any medication containing codeine available only with a prescription from mid-2016.

It is important to remember the maximum adult dosage for paracetamol is four grams (eight tablets) per day. Taking more than the recommended dose can cause damage to your liver.

Painkillers typically prescribed by a doctor to relieve acute to moderate pain are codeine together with paracetamol tablets (Panadeine Forte) and tramadol tablets, which are opioid pain killers.

The severe pain you experience following a broken bone or an operation usually needs strong painkillers that your doctor would prescribe. This may be morphine given as a tablet or by injection.

Morphine-like medicines relieve pain by interacting with specific proteins called opioid receptors, which are located in the brain, spinal cord and other parts of the body. These opioid receptors are the same ones the body’s own natural pain-killer molecules, called endorphins, use.

Neuropathic pain

Neuropathic pain is pain caused by damage to the nerves. Painkillers such as morphine, NSAIDs and paracetamol that are effective for the relief of nociceptive and inflammatory pain conditions are not effective for the relief of neuropathic pain.

This is because the underlying mechanisms that cause neuropathic pain following nerve injury are different from those that induce nociceptive and acute inflammatory pain.

Medications originally developed to treat depression and epilepsy are recommended as first-line treatments for the relief of neuropathic pain.

Antidepressants alleviate neuropathic pain by boosting the body’s own pain-fighting pathways. This includes boosting signalling in the brain which inhibits pain-signalling at the level of the spinal cord. The detailed mechanisms by which anti-epileptic drugs alleviate neuropathic pain are diverse but the net effect is to dampen pain signals.

Migraine pain

Paracetemol is an effective painkiller for mild pain. Pete/Flickr, CC BY

Migraine is a particularly debilitating type of pain. It is often accompanied by nausea, vomiting and sensitivity to light and sound. It can last for a few hours or several days.

Migraine affects about 12% of Australians. Some experience auras such as flashing lights or changes in smell perception, which can serve as early warning signs the migraine is coming.

If painkillers such as paracetamol, aspirin, ibuprofen or ergotamine (made specifically to relieve migraine by narrowing blood vessels in the brain) are taken at the onset of the aura, the migraine can often be stopped or its severity reduced. For those suffering a severe migraine attack, prescription medications known as triptans can be effective treatments by reversing the brain blood vessel dilation.

Chronic inflammatory pain

Chronic pain affects up to one in five adults. One of the most common is pain from osteoarthritis, the most common type of arthritis.

Osteoarthritis pain is a chronic inflammatory pain caused by arthritic joint disease, typically in the knee or hip. As the joint cartilage and underlying bone break down, the joint becomes inflamed and this triggers the pain. The first-line painkiller for osteoarthritis pain is paracetamol.

For people with more severe pain, NSAIDs such as naproxen may be more effective. But chronic use of these is associated with an increased risk of side effects, especially bleeding and ulceration of the stomach lining. Less commonly, morphine or strong morphine-like analgesics are prescribed.

Cancer pain

Most cancer pain is caused by the tumour pressing on bones, nerves or other organs in your body. Pain can also be caused by the cancer treatment such as chemotherapy or radiotherapy. Oral morphine-like analgesics taken regularly, often in combination with paracetamol, are prescribed for moderate to severe chronic cancer pain.

Although drowsiness usually occurs at the start of treatment or after a dosage increase, this typically reduces after a couple of weeks. Anti-nausea and laxative agents are given at the beginning of treatment to minimise the side effects of nausea, vomiting and constipation. Nausea usually lasts no more than two to three weeks.

However, as constipation persists, it is very important that laxative use is maintained. For cancer pain involving nerve impingement, your doctor will add a prescription painkiller for neuropathic pain.

Coffee companion: how that muffin or banana bread adds to your waistline

Coffee companion: how that muffin or banana bread adds to your waistline

October 13, 2015 7.12am AEDT

You’re better off sticking with a standard flat white or skim latte, and skipping the cake on the side. Whether it’s a coffee in hand as we walk through the office door, or a way to beat the 3pm slump, many of us rely on our local barista to get us through our working day. Australians consume a total of 16.3 million cups of coffee each day.

But while it’s easy to adjust your daily energy intake to account for the 300 kilojoules in your small skim latte, the snack you grab on the side – or the coffee alternative – could be using up to half your daily kilojoule (kJ) allowance.

Our latest study looked at drinks and sweet snacks in five coffee chains that combined have more than 2,000 stores around Australia: McCafé, Gloria Jean’s, Michel’s Patisserie, The Coffee Club and Muffin Break. If you can’t go past the banana bread, pastries, muffins and cakes, it’s likely you’re consuming too much energy, saturated fat and sugars.

Daily energy allowance

The Australian Dietary Guidelines recommend we limit the intake of saturated fat, salt, sugars and alcohol, and eat according to our energy needs to maintain a healthy weight.

Fast food outlets, bakeries and coffee and doughnut chains in New South Wales, the ACT and South Australia are required to place the kilojoule content on their menu boards and prominently feature the average adult daily energy intake of 8,700kJ.

This figure is approximately how many kJ an “average” adult needs each day to maintain weight, but this varies according to your age, height, sex and level of physical activity. You can find the the approximate number of kilojoules you need in a day by using this calculator.

Eating just 500 kilojoules extra a day for a year and not compensating by doing more exercise could mean a weight gain of almost five kilograms over a year.

Fast energy

Taking a closer look at the offerings at the five coffee chains, we found one-third of cold coffee-style drinks, two-thirds of sweet snacks and almost half the large hot flavoured drinks had more than 1,800kJ or 20% of the recommended daily intake of energy per portion.

Some sweet snacks such as Muffin Break’s double choc jumbo cookie and Coffee Club’s mudcake had more than 3,600kJ or 40% of the recommended daily energy intake.

Some hot drinks, including Muffin Break’s hot chocolate and chai latte, provided almost 50% of the daily intake of saturated fat.

Iced coffee and chocolate drinks are notorious for their cream and ice cream, and are often found in super-sized portions. Four of the cold drinks had more than an entire day’s intake of saturated fat and 16 had more than 50% of the recommended daily intake. The Coffee Club’s iced coffee had 39g of saturated fat (163% of the recommended daily intake) and McCafé’s coffee kick frappe had almost 20g of saturated fat.

Eight cakes provided over 100% (and 16% of sweet snacks provided over 50%) of the daily intake of saturated fat. This included croissants (52-65% of the recommended daily intake) and jumbo cookies (69-94%).

Over half (54%) the cold beverages and 16% of the sweet snacks had more than half the daily intake of sugars. Coffee Club’s mudcake had the equivalent of 21 teaspoons of sugar and a Gloria Jeans iced coffee had 14 teaspoons.

Perhaps most surprisingly for some, the humble banana bread is nowhere near as healthy as it sounds. McCafé banana bread has 2,570kJ, 30% of daily energy intake, and has 12 teaspoons of sugar.

While the study did not include independent cafés, a creamy coffee and a pastry or banana bread from your local café or bakery will likely be loaded with just as many kilojoules.

Healthier alternatives

The good news is that we found healthier options with lower energy, less saturated fat and sugars and smaller portion sizes. While still not a healthy food, a macaron could be a better way of getting your sugar fix with only 450kJ and three teaspoons of sugar. McCafé offered a mini muffin that has 440kJ.

But some healthier-sounding options may not be great choices. While a skim flat white is a good choice, “skim” or “low fat” does not necessarily mean low in sugar or energy. A large skim Tim Tam iced chocolate from Gloria Jeans, for instance, has 20 teaspoons of sugar.

It pays to look at the kilojoule labelling in the states where it is required by law, or in other states that have not yet made energy labelling compulsory, check out websites such as this for energy information.

But if you’re after a caffeine fix, you’re better off sticking with a standard flat white or skim latte, and skipping the cake on the side.

Making healthy choices easier

Poor diet and excess weight increase the risk of developing a number of chronic diseases and ten cancers, including bowel, endometrial and post-menopausal breast cancer. Almost 4,000 cancers diagnosed in Australia each year are linked to excess weight and obesity.

Our study did not collect consumption data but the latest information on what Australians are eating shows that just over one-third (35%) of total energy consumed was from “discretionary” junk foods and drinks.

Spending on high-energy fast food and eating out increased by 50% from 2003 to 2010. But while much of the scrutiny of fast food chains is on those providing meals, there has also been a rise in the number and popularity of coffee chains.

To help Australians make better dietary choices, we’re calling on coffee chains to provide smaller, healthier portion sizes across their drink and snack ranges. They should also address the levels of unhealthy nutrients in their snacks and drinks by reformulating menu items to reduce saturated fat, sugar and energy content.

There’s no need to cut these drinks and snacks out of your diet altogether, but next time you pop out for a coffee, consider how many kilojoules you’re consuming and what you’re prepared to go without later.

The author would like to acknowledge the contribution to this article by Wendy Watson, Nutrition Project Officer, and Clare Hughes, Nutrition Program Manager, who are both at Cancer Council NSW.

Hidden and unexplained: feeling the pain of fibromyalgia

Fibromyalgia is a common and disabling condition. it is often misdiagnosed, as no accurate tests is available for it. There has been no effective treatment either, until recently, when good results have been obtained by using low dose naltrexone (LDN) for fibromyalgia. See my web site for more information on LDN and the research on its use in fibromyalgia and other auto-immune diseases.

Hidden and unexplained: feeling the pain of fibromyalgia

December 17, 2015 11.40am AEDT

Disclosure statement

Bernadette Fitzgibbon receives funding from National Health and Medical Research Council and Arthritis Australia.


Monash University provides funding as a founding partner of The Conversation AU.

Victoria State Government provides funding as a strategic partner of The Conversation AU.

For some people, waking up every day means the start of persistent pain that affects their mood, thinking and relationships. This experience is more difficult when the pain doesn’t seem to have a cause; at least not a visible one.

That’s the reality for people with fibromyalgia, a chronic disorder characterised by pain and muscle tenderness throughout the body where even the slightest touch can be sensitive. Sufferers often have other health issues, including sleep difficulties and fatigue.

For a long time, fibromyalgia was thought of as a medical mystery. Technological advancement has allowed us to look closer. Today, it is a recognised disorder, part of a group of chronic pain syndromes described as central nervous system disorders.

The condition affects more than four times as many women as it does men. With as many as 2-5% of the developed world living with fibromyalgia, it is far from uncommon. Yet targeted and effective treatment options aren’t available for the condition. And compared to fibromyalgia’s impact, this area of research remains highly underfunded.

Chicken or egg?

Fibromyalgia has a long history of stigma. Some explanations even pinned it down to being psychosomatic, “made up” and “all in your head”, as well as a condition people needed to “just get over”.

There may be some truth in saying fibromyalgia is “all in your head”, but more as a reflection of associated brain changes than a figment of the imagination. An explosion of recent research has shown brains of fibromyalgia sufferers are made up differently. There are variations, for instance, in regions key to how we think and feel.

Even the slightest touch can be sensitive for fibromyalgia sufferers. vaXzine/Flickr, CC BY

Although our understanding has taken a dramatic leap in the last few decades, we can’t shut the book on fibromyalgia’s exact cause or causes. The reported brain changes pose a real chicken and egg scenario: are these brain changes causing fibromyalgia, or is fibromyalgia causing the brain changes?

The condition may have multiple causes. Some suggest biological factors, including a genetic basis for the disorder. Other research shows a history of sexual, emotional and physical abuse among sufferers. Psychological factors, including responses to chronic stress, have also been shown to contribute to its cause.

None of these are likely to be independent of each other.

Links to mood disorders

Further complicating explanations of fibromyalgia include its link to other illnesses, such as mood disorders like depression. This relationship likely reflects the fact they share some of the same biological processes, such as inflammation.

Inflammation occurs when injury or infection triggers the production of messenger molecules that flood to the site of injury as part of an immune response. It is now believed that, like injury to the body, psychological adversity and mental illness can trigger the same immune response affecting the brain.

And recent research suggests the occurrence of fibromyalgia or depression may increase the likelihood of the other. Regardless of what came first, though, the presence of mood disorders in fibromyalgia is linked to more pain and reduced quality of life.

It comes as no surprise, then, that if medical professionals and scientists can’t explain what causes fibromyalgia, it is even harder for the person living with the condition. In fact, those diagnosed have a significantly harder time understanding or explaining their pain to people with other disorders, like arthritis for instance.

Treatment options

It can take years to receive a fibromyalgia diagnosis, and some may have been misdiagnosed with one or more other conditions beforehand. This can be very frustrating for the patient as well as their doctor.

Despite the poor response rate, pharmaceutical methods are the main treatment option for fibromyalgia. Chris Frewin/Flickr, CC BY

Currently, the best method of diagnosis is classification-based. Physicians assess the number of possible body areas where someone experienced pain in the last two weeks, and the severity of other symptoms, including fatigue and cognitive function.

Following diagnosis, there is no universally effective treatment plan. It usually includes a multi-method pain management regime from a team of health care providers. But responses to treatments can be no better than chance, regardless of whether these are pharmacological or others such as acupuncture or hypnotherapy.

Despite the poor response rate, pharmaceutical methods are the main treatment option. Prescriptions are commonly made out for non-steroidal anti-inflammatory drugs (such as ibuprofen), opioid analgesics (such as codeine), antidepressants, or anticonvulsants (drugs used to control seizures that also affect pain signals).

Because there is no clear treatment target for fibromyalgia, drug doses needed to manage symptoms have significant side effects. These include problems with thinking, drowsiness and the risk of drug dependency.

We don’t know exactly what causes fibromyalgia, but treatments need to be developed based on what we do know. For instance, we know there are brain changes. One promising treatment may therefore be brain stimulation techniques like Transcranial Magnetic Stimulation (rTMS); a non-invasive technique that can change the activity of neurons in the brain.

There is a clearly an urgent need to provide targeted and effective treatment options for fibromyalgia sufferers. Considering how far we have come in explaining the unexplained pain of the condition, there is real hope for the future.

Five tips on how to talk to kids about dementia

Five tips on how to talk to kids about dementia

September 16, 2015 6.18am AEST

Surveys of children revealed they don’t like being lied to about the degenerative condition. Author provided

Why does Mum do silly things like put salt in my hot chocolate?

With 900,000 Australians expected to be living with dementia by 2050, these are the types of questions more and more children will be asking as they come to know someone living with dementia. But are parents, caregivers and educators prepared for these questions?

Alzheimer’s Australia’s first national survey of dementia awareness last year would suggest that the answer is no, with people with dementia reporting low community awareness and understanding of the condition.

So how do we talk to kids about dementia and what do they want to know? I recently ran focus groups and interviewed over 40 children, people with dementia and the loved ones – including children – of people with dementia. This is what they told me.

1. Tell the whole truth

Children want adults to be completely open and honest about dementia. In the words of a 10-year-old boy:

I wouldn’t say everything will be okay because I hate – I absolutely hate it – you’d rather someone say to you, yeah, your grandma’s never going to get better.

We need to tell children that there is presently no cure for dementia and that the health of the person with dementia will get worse. This may be upsetting, but is important to ensure your child’s trust. If you are unsure about how much to say, let your child ask the questions. This will help you gauge your child’s current level of understanding.

Kids need to know why grandma does silly things like put the keys in the fridge. from

2. Remind children that their loved one is still a person

Remind your child that Grandpa is still Grandpa, that Mum is still Mum. A 12-year-old girl said:

It’s important to know that there is actually a person underneath […] they’re not just some random now they’ve got a disease […] they’re still special.

Children with a loved one with dementia were also emphatic that knowing it’s not the fault of the person with dementia, and that they cannot help or control what they do, was the one key thing that helped them understand the change in their loved one.

3. Prepare children for the unexpected

Parents spoke about the unpredictability of dementia and how it was confusing for their child. Children told me that inconsistencies in the behaviour of a person with dementia made them wonder whether the person was making the behaviour up.

Dementia is different for everyone. We need to emphasise this and talk about all the behaviour changes that people with dementia can experience. Children described the changes they saw in a loved one, such as in personality or mood, rather than memory loss, as being the hardest to understand. Fear often comes from the unknown; so by keeping your child informed, it may reduce any fear that your child may feel around your loved one.

4. Brainstorm activities for children to do with a loved one

Fear or awkwardness around people with dementia can also be because of not “knowing what to do”. Children can listen to music, look at old photos, show videos on their iPad, play games, or do craft with their loved one with dementia.

This also means the time spent with their loved one is likely to be fun and happy. Parents should emphasise that showing love and kindness is key and, most importantly, that you do not need a good memory to have a good time.

Find something children can do with their loved ones. from

5.Look for positives

The children described some beautiful positives:

they’re cool in a way because they are quirky […] I liked that they were different.

We need to seek and share positives with children. Emphasise the good times; for example, take photos of your child and your loved one together during happy occasions.

These findings are informing the development of a government-funded education program for Australian schoolchildren about dementia.

Some children and grandchildren of people living with dementia have already started the conversation about dementia. They have spoken candidly about what it is like having a loved one with dementia, in a bid to help other children better deal with the condition. You can watch their videos here.

Waking Up from the Synthetic Hormone Nightmare

Waking Up from the Synthetic Hormone Nightmare by Jeffrey Dach MD

Nightmare_on Elm StreetWaking Up from the Synthetic Hormone Nightmare

by Jeffrey Dach MD

link to this article

Shirley is 52, and suffering from menopausal symptoms of hot flashes, night sweats, insomnia and mood disturbance. The next chance she had, Shirley asked her doctor for bioidentical hormones. Instead,  her doctor offered her a prescription for Lexapro, an SSRI antidepressant.  Shirley declined the prescription and ran out the door crying all the way home. A few days later, Shirley was sitting in my office asking, “Why won’t my doctor give me what I want, bioidentical hormones?”

Upper left image: Nightmare on Elm Street courtesy of Wikimedia commons

Ghost Writing – A Shocking Medical Scandal

I explained to Shirley that her doctor’s opinion is shaped by misleading information in medical journals corrupted by a technique called medical ghostwriting, a shocking scandal uncovered by  Senator Grassley’s Committee.(1)  In this sinister practice, the prestigious name of an academic MD “opinion leader” appears as author.  However, unknown to the reader, the article is actually written by the drug company’s paid-for-hire writers.  Grassley discovered that sixty articles on women’s hormones were ghostwritten, downplaying the adverse effects of synthetic hormones, and casting doubts about bioidentical hormones.  Medical ghostwriting is scientific misconduct and fraud which harms society and corrupts the medical literature.

A Brief History of Synthetic Hormones – Re-Living the Nightmare

Let’s review a short history of synthetic hormone replacement as brought to you by the Drug Industry. (2)  Many people have forgotten about the disaster of DES, Diethylstilbestrol, the first synthetic hormone invented in 1938.  This carcinogenic, monster hormone was approved by the FDA and given to millions of women from 1940 until it was banned in 1975 when it was shown carcinogenic.  The first report of cervical cancer in the daughters of DES treated women was published in April 1971 in the New England Journal of Medicine.(3-4)

Next, the Drug Industry invented Premarin, a horse estrogen isolated from the urine of pregnant horses.   Available since FDA approval in 1942, Premarin has caused an estimated 15,000 cases of endometrial cancer, representing the largest epidemic of serious iatrogenic disease ever reported.(5-8)    One might think this would be the end of any drug.   However Premarin was promptly rehabilitated with the addition of another synthetic hormone, a progestin, to prevent endometrial cancer.  Thus, in 1995, Prempro was born, a synthetic hormone pill containing both Premarin (the horse estrogen) and Provera (the progestin).  Again, this was FDA approved,  thought safe and handed out freely to millions of women.

However, storm clouds soon appeared on the horizon when four large scale studies showed increased breast cancer and heart disease from this estrogen-progestin combination pill.  The  Breast Cancer Detection Demonstration Project, published in 2000, showed an eight fold increase in breast cancer for estrogen-progestin users.(9)  The Swedish Record Review, published in 1996, had a fourfold increase in breast cancer with progestin use.(10)  The Million Woman study, published in Lancet in 2003, had a fourfold increase in breast cancer for estrogen-progestin combination users compared to estrogen alone users.(11)  The brakes came on to this synthetic hormone experiment in 2002 with the JAMA publication of the Women’s Health Initiative (WHI), an NIH funded study terminated early because of increased breast cancer and heart disease in the estrogen-progestin users.(12)

2AbandontheSinkingShipofSyntheticHormonesAbandoning the Synthetic Hormone Ship

Two important things happened after this 2002 WHI study was published.  Smart women abandoned synthetic hormones and switched in large number to bioidentical hormones, producing an immediate decline in breast cancer rates of about nine per cent.(13,14)  A second important thing happened.  Apparently, women have decided to turn to lawyers to protect them, since the FDA has been unable to do so.  Thirteen thousand women have filed cases in court claiming synthetic hormones caused their breast cancer.  These cases are slowly working their way through the court system, and the jury is still out, so stay tuned.(15) Left image: Abandoning the Sinking Ship courtesy of wikimedia commons.

Dispelling the Myths and Misconceptions

Over the years, I have compiled a list of myths and misinformation commonly encountered about bioidentical hormones in newspapers and magazines.  Here are a few of them, followed by the corrections.  The misinformation is in italics, with the correct information to follow.

Myth Number One:The term bioidentical hormone is undefined and has no meaning.”

This is incorrect.  Bioidentical is a term which is defined as having the exact same chemical structure as hormones found naturally in the human body.   Bioidentical Hormones are the ones circulating in your blood stream right now.

Myth Number Two: “There is no proof that Bioidentical Hormones are safer and more effective than synthetic hormones…All of the evidence that we have suggests that all of these hormones should be painted with the same brush,”

This is incorrect and misleading.  As we have seen in the above short history of synthetic hormones, there exists a large body of science showing that synthetic chemically altered hormones cause cancer and heart disease.(9-14)  On the other hand, medical studies have found bioidentical hormones are safe with no increase in breast cancer or heart disease compared to non-hormone users. (33-41)  An excellent review of this medical science can be found in a 2009 article by Kent Holtorf MD in Postgraduate Medicine. (16)

Myth Number Three:Bioidentical Hormones are not FDA approved.”

This is blatantly incorrect.  There are twenty or so FDA approved bioidentical hormone preparations widely available at corner drug stores. Here are a few examples: Vivelle-Dot, Estrace,  Climara, Prometrium, Androgel , etc.

Myth Number Four:Bioidentical Hormones made by compounding pharmacies are Non-FDA approved.”

This is not only incorrect, it is misleading and deceptive.  Compounding pharmacies are regulated at the state level, and do not fall under FDA jurisdiction.   So, of course compounding is not FDA approved.  No FDA approval is required or even desired.  Your local hospital pharmacy is a compounding pharmacy that makes up life saving medication such as IV antibiotics with no FDA oversight or “approval”.  The FDA approval process is designed for manufactured capsules and tablets, and is impractical and unnecessary for compounded medications prepared to order by hand.   Are we going to reject IV antibiotics from the hospital pharmacy because these are non-FDA approved compounded medication?  Of course not.  Compounding is here to stay.

Myth Number Five: “Unless a woman has symptoms of hot flashes and night sweats, she doesn’t need hormones.”

This is incorrect.  In addition to night sweats and hot flashes, there are many other valid symptoms of hormone deficiency such as insomnia, cognitive dysfunction, menopausal arthritis, evaporative dry eye, anxiety, panic, mood disorder, vaginal dryness, and decreased libido and post hysterectomy.  These are all good indications for prescribing bioidentical hormones. (17-25)

Myth Number Six:  “The idea that Menopause is a Hormone Deficiency Disease was disproven, and the idea that hormone replacement rejuvenates youth, or prevents degenerative diseases is also disproven….Hormones decline with age, and is normal and does not require treatment.”

This is incorrect. There is no question that hormonal decline is a health risk. Three separate studies have shown low testosterone in males carries a 40% increase in mortality.(26-28)  Studies in females show the same findings, with low hormone levels in women after hysterectomy associated with increased mortality. (29)(30)  Hormonal decline is a direct cause of degenerative diseases of aging, all of which may be prevented or partially reversed by replenishing hormone levels, a vastly more effective treatment which competes directly with the Drug Industry.(42-46)

Myth Number Seven: “Hot flashes and sweats in menopausal women can be treated with SSRI antidepressants.  They don’t need to use hormones.”

This is not only wrong, it is criminal. The use of SSRI antidepressants for menopausal symptoms is NOT FDA approved, and is a cruel mistreatment and medical victimization of women.  This practice should be halted immediately.  Studies of SSRI drugs show they are no better than placebo for most cases of depression(31), and they are not much better than placebo for menopausal hot flashes. (32)  Synthetic hormones are bad enough, they cause cancer and heart disease.  SSRI drugs like Lexepro,  Effexor and Pristiq are even worse; they are chemically addictive with horrendous withdrawal effects.  Avoid becoming a medical victim.  Stay away.

In Conclusion:

wake upIt is time to WAKE UP from the nightmare of synthetic hormones, known for decades to cause cancer and heart disease.  You can put lipstick on a pig, and it is still a pig.  The drug industry can spin, deceive, and misleading the medical journals and media.  Yet, after all the lies and propaganda, synthetic hormones remain monsters that should be avoided.   Smart women have made the switch to safer and more effective bioidentical hormones.  The future of medicine is your choice to make.  Hopefully, this article has awakened you to the natural choice.

For More Information, here are some leaders in the field of bioidentical hormones providing trustworthy information in books, articles and web sites:  David Brownstein MD, Kenton Bruice MD,  John Crisler DO, Kent Holtorf MD, Steve Hotze MD, Sangeeta Pati MD, CW Randolph MD, Ron Rothenberg MD, Erika Schwartz MD,  Jonathan Wright MD, and Joseph Mc Wherter MD.

Disclaimer: This article is for educational purposes and not intended as medical advice, and it is recommended you work closely with a knowledgeable physician before making any decisions regarding hormone treatment.  Please feel free to share this article with your doctor.

Jeffrey Dach MD
7450 Griffin Road, Suite 190
Davie, Florida 33314
(954) 792-4663

Author Biography: Jeffrey Dach MD is founder of  the TrueMedMD clinic in Davie, Florida specializing in bioidentical hormones and natural thyroid.  He is the author of the book, Natural Medicine 101 available on Amazon, and offers a free email newsletter.

How hormones make us feel hungry and full

Chemical messengers: how hormones make us feel hungry and full

September 25, 2015 2.20pm AEST

Whether or not you feel inclined to eat depends on the balance of the activity between two sets of neurons. Dennis Skley/Flickr, CC BY-ND

Hormone levels also change when we lose weight. As much as we battle to trim down via diets and eating patterns, they’re also the reason most of us will regain the weight we lose – or more.

The body’s system for regulating food intake is coordinated by the hypothalamus, which is located under the midline of the brain, behind the eyes:

Within the hypothalamus are nerve cells that, when activated, produce the sensation of hunger. They do so by producing two proteins that cause hunger: neuropeptide Y (NPY) and agouti-related peptide (AGRP).

Quite close to these nerve cells is another set of nerves that powerfully inhibit hunger. They produce two different proteins that inhibit hunger: cocaine and amphetamine-regulated transcript (CART) and melanocyte-stimulating hormone (αMSH).

These two sets of nerve cells initiate and send hunger signals to other areas of the hypothalamus. So, whether you feel inclined to eat or not depends on the balance of the activity between these two sets of neurons.

But what determines which set of neurons dominates at any given time?

The activity is mainly controlled by hormones that circulate in the blood. These come from tissues in various parts of the body that deal with energy intake and storage, including the gut (which receives and digests the food), the fat (which stores the energy) and the pancreas (which makes hormones that are involved in energy storage, such as insulin).

Hormones in the blood

Let’s take a closer look at how each of these blood-circulating hormones work.

Ghrelin is made in the stomach. It stimulates hunger by entering the brain and acting on the neurons in the hypothalamus to increase the activity of the hunger-causing nerve cells and reducing the activity of hunger-inhibiting cells. As the stomach empties, the release of ghrelin increases. As soon as the stomach is filled, it decreases.

Insulin-like peptide 5 (ILP-5) was found to stimulate hunger in 2014. It is the second circulating hormone to have this effect and is mainly produced in the colon. But we still don’t know its physiological role.

Cholecystokinin (CCK) is produced in the upper small bowel in response to food and gives a feeling of fullness. It is released soon after food reaches the small bowel. Researchers have found CCK can stop a mouse from eating as soon as it’s injected into the brain.

Peptide YY, glucagon-like peptide 1 (GLP-1), oxyntomodulin and uroguanilin are all made from the last part of the small bowel and make us feel full. They are released in response to food in the gut.

Leptin is the most powerful appetite-suppressing hormone and is made in fat cells. It was discovered in 1994. The more fat cells we have, the more leptin the body produces.

Amylin, insulin and pancreatic polypeptide are made in the pancreas. Studies in the United States have shown that when insulin enters the brain it inhibits hunger, telling the brain “there is enough energy in the body, take a rest”.

Amylin, discovered in 1981, is made in the same cells that make insulin (the beta cells). It has been shown to inhibit food intake.

The exact role of pancreatic polypeptide is not yet known, but there is evidence that it inhibits hunger.

The hypothalamus also receives signals from pleasure pathways that use dopamine, endocannabinoids and serotonin as messengers, which influence eating behaviour.

Once full, the stomach reduces the desire to eat both by lowering ghrelin production and by sending a message to the hypothalamus. Ghrelin levels reach a low around 30 to 60 minutes after eating.

Levels of hormones that make us feel full – CCK, PYY, GLP-1, amylin and insulin – all increase following a meal to reach a peak about 30 to 60 minutes later.

All the hormones then gradually return to their fasting levels three to four hours after a meal.

How weight loss affects our hormones

Several studies have found that diet-induced weight loss is associated with hormone changes that, together, promote weight regain.

Following weight loss, leptin levels decrease profoundly. Other hormonal changes include increases in circulating ghrelin, GIP and pancreatic polypeptide and reductions in PYY and CCK. Almost all of these changes favour regaining lost weight, by increasing hunger, reducing satiety and improving the capacity to store fat. These hormonal changes seem to be present for at least one year after weight loss, leading to a persistent increase in hunger.

These findings suggest suppressing hunger after weight loss – preferably with a replacement of hormones – may help people maintain their new weight.

Several of these agents have recently been approved by different regulatory bodies in the United States, Europe or Canada, but only one – liraglutide – is a version of one of the naturally occurring appetite suppressants (GLP-1). The ideal medication to maintain weight loss would be a long-acting mixture of three or more of the blood-circulating hormones we examined above: leptin, amylin, GLP-1, PYY, CCK and oxyntomodulin.

But producing such a mixture is proving a considerable challenge, so researchers continue to investigate how this might be done.