Part 6 Flashcards by Daniel Ross

Estrone basic facts

E1
Postmenopausal estrogen
Mid potency (1/8 binding of E2)

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Should hormone replacement therapy in women be started earlier or later?

The benefit ratio improves the earlier replacement therapy it started

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Estradiol facts

E2
Premenopausal estrogen
Most potent

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Estriol facts

E3
Pregnancy estrogen
Least potent (1/80th binding of E2)

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Name two selective estrogen receptor modulators

Tamoxifen (nolvadex) and Evista (raloxifene)

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Do SERMs have any positive effects on the brain?

No. Natural hormone replacement does

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What affects do SERMs have on cholesterol and LDL?

Decreased total cholesterol by 5% and decrease LDL by 10%. They don’t have any effect on triglycerides or HDL

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Pregnenolone can proceed into what two hormones?

DHEA or progesterone

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Where is pregnenolone produced?

In the mitochondria in the brain and adrenal glands

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Pregnenolone replacement has what effect on sleep?

It improves REM sleep

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What effect does pregnenolone replacement have on brain and memory?

It improves memory and improves the survival of hippocampal neurons

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True or false. Pregnenolone replacement improves mood, decreases fatigue and helps patients deal with stress

True

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Why could pregnenolone help with multiple sclerosis?

It has a role in repairing the myelin sheath

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What two effects does estrogen have on dopamine in the brain?

It enhances dopamine transmission and it decreases dopamine receptor sensitivity (modulates stimulation)

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What effects does estrogen have on norepinephrine and serotonin?

It modulates norepinephrine transmission and increases serotonin availability

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What are 10 common causes for low progesterone?

1) menopause
2) low LH
3) increased prolactin production
4) stress
5) antidepressants
6) sugar consumption
7) saturated fat
8) excessive arginine consumption
9) decreased vitamins A, B, C and zinc
10) low thyroid hormone

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What are 14 symptoms of low progesterone?

Anxiety, depression, irritability, mood swings, insomnia, pain and inflammation, osteopenia/osteoporosis, low HDL, excessive menstruation, hypersensitivity, nervousness, migraine headaches before cycles, weight gain and low libido

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What are 6 potential side effects of synthetic progestins?

Increased LDL, decreased HDL, increased blood pressure, coronary artery spasm, increase breast cancer risk and increased venous thromboembolism risk

Name 4 beneficial effects of DHEA replacement

Decrease insulin resistance, enhanced immune function, improved ability to deal with emotional stress, improved sleep

Where is DHEA made in the body?

Adrenals, gonads and brain

Low levels of DHEA are commonly associated with what?

Hypothyroidism

What is the only hormone increases with age?

Cortisol

True or false. Low levels of cortisol are associated with Alzheimer’s disease and generalized memory loss

False. Chronically elevated levels of cortisol are associated with Alzheimer’s disease and generalized memory loss. It causes deterioration of the hippocampus.

Chronically elevated cortisol is associated with what nutritional abnormalities?

Decreased magnesium, potassium, B vitamins, vitamin C and zinc

True or False. Chronically elevated cortisol causes the body to increase production of free radicals

True

Clinically elevated cortisol levels are associated with what 19 conditions?

Decreased immune function, fatigue, irritability, sugar cravings, shakiness between meals, confusion, poor sleep, decreased energy, night sweats, binge eating, hypertension, hypercholesterolemia, hypertriglyceridemia, elevated glucose, insulin resistance, increased risk of infections, thin-skin, easy bruising, muscle weakness and abdominal fat

Is vitamin D a vitamin?

No. It is a steroid hormone

What's seven effects does vitamin D have on the immune system?

1) immune modulation 2) stimulates macrophages to produce antimicrobial peptides 3) it decreases inflammatory cytokine levels 4) it improves phagocytosis 5) it decreases dendritic cell presentation 6) it inhibits Th1 cell proliferation 7) it decreases TNF alpha

Living north of what area is the body unable to produce adequate amounts of vitamin D from the winter sun?

35° latitude (bottom of Tennessee and North Carolina)

Elevated vitamin D levels may decrease the risk for what three diseases?

Breast-cancer, multiple sclerosis and type one diabetes

What is the biochemical pathway to Melatonin production?

Tryptophan ---> 5HTP ---> Serotonin ---> Melatonin

What effect does melatonin have on body temperature and blood pressure?

It lowers both

What does melatonin do to growth hormone?

Promotes it's release

How does melatonin affect free radicals?

It is the most effective scavenger of the hydroxyl radical and stimulates production of other endogenous antioxidant enzymes.

How does melatonin affect inflammation?

Is inhibits cox2 and NF Kappa Beta

How does melatonin protect cells and DNA?

It protects against cellular DNA damage from ionizing radiation and ischemia/reperfusion injury

What are the symptoms of temporal arteritis?

The temporal artery is nodular, tender and non-compressible. Spread to the central retinal artery can result in visual loss.

What is the antiaging treatment for temporal arteritis?

Steroids, omega 3 FAs, curcumin and ALA

What are the causes of subarachnoid hemorrhage?

Aneurysm rupture =75 to 80% AVM = 5% Vasculitis, carotid dissection and perimesencephalic SAH = the rest

What is the 30 day mortality of subarachnoid hemorrhage?

Greater than 46%

What percentage of patients with subarachnoid hemorrhage had a sentinel bleed 2 to 3 weeks prior?

50%

What are the risk factors for subarachnoid hemorrhage?

Hypertension, smoking, oral contraceptive pills and stimulant abuse

True or false. Most cervical radiculitis patients will have headache as a complaint as well as neck pain?

True