Wednesday, September 30, 2015

Why won't anyone believe I have a thyroid problem?!?!

I get that question all the time. Most health care providers check a T4  and a TSH. If they fall within the lab's normal range, you're told you are normal. But there is more to it than that. There are other labs; there are "optimal levels" vs. "normal levels" and your thyroid function is tied to the rest of your endocrine system, especially your adrenal glands. I'll go through some of these things below.

TSH (thyroid stimulating hormone), which is produced in your pituitary, is not the most sensitive test. Free T3 is the best clue. There are also thyroid antibodies to be checked, T4, RT3, etc.  But labs have to be clinically correlated with the patient. How a patient feels is the best indicator of what's going on.

Free T3 is the active hormone. T4 is a pro hormone. T4 must convert to the active T3 hormone. T3 is needed for fat loss. It protects against arrhythmias. T3 decreases with stress and aggressive dieting and with heart disease and congestive heart failure.

Synthroid (generic is levothyroxine) is a commonly used medication for hypothyroidism (underactive thyroid). It contains only T4.  Replacing T3 + T4 provides many people a better quality of life, because many factors decrease T4 to T3 conversion including: dieting and stress, zinc, selenium and iodine deficiency, and certain drugs such as amiodarone, beta blockers and dilantin.

If you're reading this blog, you probably already KNOW the symptoms of hypothyroidism. But common ones are shown above. There are multiple causes of hypothyroidism. Secondary hypothyroidism is caused by failure of the pituitary to regulate the thyroid. Tertiary hypothyroidism is caused by failure of the hypothalamus (a region of the brain) to regulate the pituitary.  Primary hypothyroidism, which is most common, is caused by failure of the thyroid itself.  As mentioned above there can be failure to convert T4 to T3. There is also a condition called "thyroid resistance" where the receptors for thyroid hormone fail. And finally, adrenal insufficiency can cause hypothyroidism, because lower cortisol levels affect thyroid production, conversion and receptor uptake. 

Patient before and after thyroid replacement

Hypothyroidism can mimic menopause, andropause and adrenal fatigue. Normal lab values are not necessarily "optimal values". 
If you are experiencing any of the symptoms above, schedule an appointment and get checked out! It's time to stop making excuses and quit blaming normal aging for how you feel.


If there are any other topics you would like for me to cover, post below!

Anne R Trussell MD

Sunday, September 27, 2015

What is your real risk for a heart attack or stroke?

The way most doctors test for heart disease is with a lipid panel. I'm sure you have all seen them. Your doctor talks to you about keeping your total cholesterol under 200, lowering your LDL (the bad cholesterol), raising your HDL (the good cholesterol) and the ratios among these different lipids. But are traditional lipid panels and known risk factors like smoking, obesity, high blood pressure and diabetes enough to really predict your risk of heart disease and stroke? And what if you've already had a heart attack or stroke? Are these numbers enough to manage your disease?

You may be surprised to learn that 50% of people with normal cholesterol levels have heart attacks. That's why we offer the Berkeley HeartLab advanced lipid and genetic testing. You can't change your genetics, but you can modify your risk factors. For example, the actual LDL (bad cholesterol) number may be low, let's say 100, but the number of particles and the size of the particles that make up that number can vary widely. We want fewer particles and larger particles because they don't cross the artery membrane to form plaques leading to atherosclerosis. You can't determine that with traditional testing. If you KNOW what you're dealing with, you can often take supplements such as Co-Q10, and omega 3s to shift the particles to a safer size.

This is just one thing we look at on a Berkeley HeartLab profile. We look at your risk of developing diabetes; your Vitamin D level; your genetics tell us if you are at risk for aneurysms and Alzheimer's disease. And if you already have plaque buildup, it will tell us if that plaque is stable or prone to rupture which causes heart attacks and strokes. Many patients are time bombs that feel perfectly normal.

The Berkeley Heart Lab Cardio IQ Solution offers a comprehensive approach to heart health. We assess your baseline risk to individualize your cardiovascular disease risk.

We can offer personalized therapy by using your advanced testing and genetics to help determine the therapy you need to achieve better health now and in the future, such as initiating or intensifying medications, identifying opportunities for adjunct therapy, and helping you set diet, exercise and lifestyle targets. We always want to work with your primary care physician or cardiologist, sharing these results, so that you get the best treatment possible. 

We can then monitor your response to therapy.

There is ongoing patient support through Clinical Educators that help patients further understand what their test results mean for there lifestyle and work to help you adopt reasonable and realistic goals individualized to your likes and dislikes.

The 4myheart Program is available at no extra cost for patients when you have testing done. This includes online and personalized support from the Clinical Educators. 

Pictured above are my parents. They will be 78 years old this year. They are still very active and volunteering in the community in various ways, besides helping out with our four kids. My dad has had carotid artery surgery, heart stents and a bypass, plus diagnosed with an aneurysm. But he has not had a stroke, nor a heart attack nor an aneurysm rupture because I was able to assess his risk for these based on genetics and advanced testing parameters. With no symptoms and no advanced testing, he could have died before we were able to diagnose him correctly. 

Quest Diagnostics, who actually performs the Berkeley HeartLab testing will bill your insurance for the tests. Although our office does not accept insurance nor file insurance, we can provide you with a coded receipt for your office visit to submit to your insurance yourself.

Call today to schedule your appointment or for more details....501-228-6237.  Know what your real risk is for heart attack and stroke!

Anne R Trussell MD
Sei Bella Med Spa

Wednesday, September 23, 2015

Stressed? Need to pamper yourself? Get the Trussell Special Facial

One day at the office I had 50,000 things going. I was stressed and apparently talking 90 miles a minute. Sound familiar? We all have those days whether we are stay at home parents, work from home or drive to an office or multiple offices everyday. Prolonged stress is not healthy for us. It stresses our adrenals and leads to adrenal fatigue, creates anxiety and sometimes depression, all of which has adverse affects on the appearance of our skin. We have to be healthy on the inside to look our best on the outside. So what can you do to fix both? Get a facial!!

Our wonderful aesthetician, Kristi, created what she calls the Trussell Special Facial. I first got into a comfy robe, under some nice warm blankets, in a cool, dark room. The soft music in and of itself was so relaxing. Kristi has such a soft, sweet voice too. I truly was asleep before she was done. The hand and arm massage was an added bonus! Kristi used a pomegranate massage cream and Celadon Meridian Crown & Mountain Shan Tools to relax my muscles to the consistency of noodles......

For the facial treatment she used a deep cleansing oil followed by a balancing toner and then did a second cleanse with an AHA rejuvenating cleanser. I also got a wonderful rejuvenating mask with Himalayan red rice stem cells, peptides and soothing botanicals. She completed this hour long facial with Skin Therapeutics' Cell C-10, a hyaluronic vitamin moisturizer, an oil-free lotion and clear sunscreen. There were multiple other steps in between. I just hit the highlights. Kristi has the perfect touch when doing a facial massage. This is truly the most relaxed I have ever been with a facial.

Do your body, face and arms a favor. Or help a friend! Get them a gift certificate. Spend an hour getting a facial from Kristi. She can customize a facial just for you. Check out some of the options and prices on our website. Or.... if you want just what I had, say you want the Trussell Special Facial....$110.

And hey....this isn't just for us girls. Guys get facials all the time and reap the same benefits we do!

Anne R Trussell MD
Sei Bella Med Spa

Monday, September 21, 2015

What exactly is bleaching cream?

When you hear the term "bleaching cream" it is most often referring to hydroquinone, the most effective skin lightening agent on the market. Hydroquinone is best known for its ability to lighten and reduce the appearance of brown spots and improve overall skin tone. It is a naturally derived antioxidant found in a wide variety of plants and foods such as berries, wheat and grains, beans, tea, coffee, red wine, broccoli and onions. While these darker areas are not life threatening, they can definitely make us more self-conscious.

Melanocytes, the color- producing cells within the skin, can sometimes produce excess color called melanin. This causes the brown spots we see on our face. Hydroquinone works by inhibiting these color-producing cells, thus lightening the brown spots. So hydroquinone doesn't actually "bleach out" the brown spots, rather it works to keep the brown spots from forming in the first place.

Hydroquinone is FDA approved and classified as a skin-lightening ingredient used to lighten areas of darkened or discolored skin.

Hydroquinone has been used as a treatment for skin discoloration in the US since the 1950's. Millions of patients have used products that contain it. A prescription from a physician for 4% hydroquinone is required or it may be purchased directly from the physician's office. At Sei Bella we carry several products that contain 4% hydroquinone.  Buying off the internet often results in receiving products that are expired or bottles containing something other than what you think you've bought, so be very wary of deals that look too good to be true. And remember 4% hydroquinone can only be dispensed or prescribed by a physician in the U.S.

Hydroquinone has long been regarded as the gold standard for treating skin discoloration. Numerous clinical studies have proven its safety and efficacy over the years. Uncommon side effects could include transient skin irritation, dryness, minor redness or a mild burning sensation. I've used Obagi c-Clarifying serum for at least 10 years and never had a reaction. I started using it after one of our babies was born to get rid of melasma and then I've kept using it for maintenance and to keep my skin more even-toned since then.

As with any prescription, you need to use it as directed.  Do not use it at the same time you are using other skin lightening products.  If you are pregnant or nursing it is not recommended you use hydroquinone products. Always use sunscreen after applying hydroquinone to the skin.  I personally like to use it twice a day, so I do not apply the sunscreen at night, but definitely do in the morning.
If you have dark spots due to pregnancy, hormone replacement, birth control pills or due to sun damage, then 4% hydroquinone is the best choice to get rid of them. Other things you can do to enhance the 4% hydroquinone treatment is microdermabrasion and a series of milder facial peels. Our expert esthetician, Kristi, can help you choose just the right one for your skin type.  We have 4% hydroquinone creams, lotions and serums to choose from and can advise you on the correct one. Call or come by today!

Anne R Trussell MD