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Dr Oz: Are Your Hormones Out of Whack?
The work that hormones do is subtle—yet when they fall out of balance, the effects on your health may be anything but.
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Dr. Oz
I think of the body's hormones as musical instruments in an orchestra: Each plays its own part in creating a perfect concert—until the day one is out of tune and throws off the entire melody.

Although it was many years ago, I still remember one of the first patients I saw with a hormonal disturbance. She was a lovely woman in her early 40s who was a little heavy; despite having tried every diet under the sun, she couldn't seem to shed the extra pounds. As we talked and she mentioned a few more of her concerns—dry skin, brittle hair, a lack of energy (even shortly after her morning coffee)—I realized I needed to test her thyroid levels. Sure enough, they were too low. With proper medication, my patient's skin and energy improved, and she was no longer a prisoner to a simple chemical imbalance.

No one should have to live with an untreated hormone problem. Some require medical care, while others may be addressed with lifestyle adjustments, but almost all are treatable. Here is a guide to some of the most common signs of hormone imbalance—and what you can do to restore harmony.

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    Foods for a Healthy Pregnancy
    Dr. Oz

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    Can lemons help cure morning sickness? Does eating dark chocolate and drinking coffee help decrease certain pregnancy concerns? Dr. Robert Greene says yes! Dr. Oz talks to Dr. Greene about his advice for soon-to-be moms and his book Dr. Robert Greene's Perfect Hormone Balance for Pregnancy: A Groundbreaking Plan for Having a Healthy Baby and Feeling Great. He shares four foods women can benefit from during pregnancy:

    • Lemons: Dr. Greene says keeping a lemon handy at all times and sniffing it when you feel nausea coming on can help curb morning sickness. "The part of our brain that is most directly connected with the nausea center is our sense of smell," he says. Just as certain smells make you feel sick during pregnancy, Dr. Greene says the strong, cleansing fragrance of a lemon can rapidly help nausea subside. "If you ignore and don't correct nausea during the first trimester of pregnancy, that increases the risk of preterm labor and blood pressure problems in the third trimester," he says.
    • Iodized salt: At least a half teaspoon of iodized salt a day should be a part of a pregnant woman's diet. Dr. Greene says women who use little salt or use "designer salts" and sea salt without iodine added can negatively affect their child's IQ. "We need to have enough iodine in order to produce enough thyroid hormones," he says. "Ten to 15 percent of women may have below-normal thyroid levels during pregnancy, and it can have a measurable effect on a child's IQ."
    • Dark chocolate: Some of the highest amounts of antioxidants are found in dark chocolate, and Dr. Greene says eating it in moderation is very healthy for pregnant women. "Eating foods that naturally have a significant amount of antioxidants can help reverse or improve the ability of the blood flow through the placenta and reduce preeclampsia," he says.
    • Coffee: Dr. Greene says the theories of why coffee is bad for pregnant women have been proven false, and he says coffee can in fact help an expecting mother. "Coffee seems to reduce the instance of gestational diabetes," he says. "Moderation is the key, but clearly we don't have the concerns with coffee that we once thought existed."
    The information provided here is for entertainment and informational purposes. You should consult your own physician before starting any treatment, diet or exercise program. The opinions expressed by the hosts, guests and callers to Oprah Radio are strictly their own.

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      What to Ask Your Doctor About Hormone Therapy
      JoAnn Manson, MD, author of Hot Flashes, Hormones, and Your Health, suggests asking yourself three questions before going to the doctor.
      Hormone therapy
      Photo: © 2008 Jupiterimages Corporation

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      Amid all the recent confusion about hormone therapy (HT), it is still an appropriate option for some women. Although it's been proven as a treatment only for hot flashes, night sweats, and vaginal dryness, it may also improve sleep, mood, and concentration.

      But like most medications, HT carries risks, including higher rates of stroke, blood clots in the legs and lungs (perhaps less of a problem with patches or gels than pills), breast cancer (especially with combination estrogen and progestin), and, for older women, heart disease. So it's worth trying other options first—layered clothing, portable fans, exercise, relaxation techniques, and avoiding dietary triggers such as alcohol, caffeine, and spicy foods. And although research findings are decidedly mixed, some women report hot flash relief from soy, black cohosh, and certain antidepressants.

      If, however, none of these strategies work, and you want to consider HT in consultation with your doctor, ask yourself:

      1. Do I have hot flashes or night sweats that disrupt my sleep or quality of life?
      If the answer is yes, HT may be a good option for you, especially if you have recently entered menopause. If, however, vaginal dryness is your sole complaint, try low-dose topical or vaginal estrogen products, which do not have the same systemic absorption as pills or patches and can be used safely for longer. If you're concerned about bone health, be sure to get adequate calcium, vitamin D, and weight-bearing exercise, and ask your doctor about the nonestrogen medications available for preventing osteoporosis.

      2. Does my health profile make hormone therapy too risky? 
      Any woman who has a history—or high risk—of breast, uterine, or ovarian cancer should avoid hormone therapy. The same is true for those with liver or gallbladder disease or unexplained vaginal bleeding. And if you're more than ten years past menopause or have an elevated risk of heart disease or stroke, HT is not a good choice for you either. If none of these health issues applies to you, then you may be a good candidate for HT.

      3. Am I comfortable with the idea of using hormone therapy? 
      If—and only if—your symptoms and health profile suggest that hormone therapy is appropriate, you'll need to rely on your own information gathering and instincts to make the decision. Despite society's tendency to "medicalize" menopause, keep in mind that it is not an "estrogen-deficiency disease" but rather a natural stage of life. Interestingly, we no longer refer to hormone therapy as HRT, because the R stood for "replacement"—when, in fact, there is nothing missing. (Premature menopause due to surgery or ovarian failure is different: In these cases, HT is treating a medical condition.) If you are hesitant to take hormones for any reason, you should firmly resist pressure from your doctor, partner, or peers to do so.

      On the other hand, if you decide to try HT (and have no risk factors), keep in mind that it is best taken for only two to three years and, as a general rule, no more than five.

      As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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        How to Sleep Better and Have More Energy
        In an excerpt from his book, The Source, Woodson Merrell, MD, explains how to get quality sleep quickly and easily.
        Sleeping
        Photo: Thinkstock

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        One of the comments I frequently hear from patients is "I don't need a lot of sleep." A corollary of this is the oft-repeated phrase "I don't have enough time to sleep." As gently as I can, I break the news that adequate, regenerative rest is a critical foundation of health as well as a source of abundant energy.

        Inadequate sleep is now associated with heart disease, diabetes, and obesity, among other chronic diseases. Recent investigations have helped prove that eight hours a night is optimum for cellular rejuvenation, and yet, according to one study, 71 percent of Americans get less than that—and are sleep deprived. Much of our sleep debt has been run up by choice—people just don't want to turn out the lights. But insomnia is also on the rise. One study put the national price tag of treating it at $14 billion.

        Most people probably don't have time to catch up on lost sleep by napping in the middle of the day (God bless the cultures that encourage a siesta), but you can make adjustments in your habits to improve the quantity and quality of regenerative rest at night.

        I'll share some very simple and practical—nonpharmaceutical—ways to improve your sleep. Before you try them, consider talking to your doctor if you're averaging less than seven hours a night or always feel tired. Snoring, stress, heartburn, and chronic pain can all disrupt your rest and may be symptoms of serious health issues.

        How to get a good night's sleep
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          Hormone Replacement Therapy Q&A Webcast Transcript
           

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          Oprah:
          Okay. So we're keeping the conversation going from today's show about hormone replacement therapy. I'm taking the night off, so you've got Dr. Christiane Northrup all to yourself. I say that she wrote the Bible on menopause, The Wisdom of Menopause. We hit a big old nerve with our shows. More than 22,000 of you responded online wanting to know more. So here you go. Take it away, Dr. Christiane Northrup.

          Dr. Northrup:
          Hello, everybody. I'm taking your phone calls live tonight, so call 866-677-2496. That's 866-OPRAH-XM. Call with all of your questions. So let's get started. First up, Sylvia is joining us from Agoura Hills, California. Hi, Sylvia. What's your question?

          Sylvia:
          Hi, Dr. Northrup.

          Dr. Northrup:
          Hi.

          Sylvia:
          Hi. I'm years old 53. I went to menopause in 2001. All my friends have menopause symptoms except me. I've always maintained a good diet, and I never gained a lot of weight, so I was wondering, is this normal?

          Dr. Northrup:
          This is ideal, Sylvia. Thank you so much for calling. You set the tone for the whole evening. You are one of those people who sailed through menopause and perimenopause because your diet is good, your exercise is good, your adrenals are good and you've taken good care of yourself. So congratulations. You are super normal.

          Sylvia:
          Oh, thank you.

          Dr. Northrup:
          Okay, good. You don't need to worry. No truck is going to run you over that's named menopause.

          Sylvia:
          Okay, good.

          Dr. Northrup:
          All right? Okay. Thank you. All right. Elizabeth from St. Louis is on the phone. What's your question, Elizabeth?

          Elizabeth:
          Hi, Dr. Northrup.

          Dr. Northrup:
          Hi.

          Elizabeth:
          My question has to do with discontinuing the use of birth control pills.

          Dr. Northrup:
          Yep.

          Elizabeth:
          What is the best way to get off The Pill, say if it's a person that's been taking it for over 20 years and if you are of perimenopausal age? Should you gradually reduce the dosage or just quit cold turkey?

          Dr. Northrup:
          It actually depends whether or not you need birth control. You actually need birth control for a full year after you've had the final menstrual period. So it depends a lot on that. If you're using The Pill for perimenopausal symptoms, that's another conversation, and you can, believe I or not, switch from The Pill to a type of hormone replacement. But when you're done with needing birth control, a year after your final menstrual period, then you can simply stop them. And if your diet is good and you're exercising and so on, you might do absolutely fine. The body always goes through a readjustment period when a person stops The Pill, whether they're 30 or 45. So you'd have to just stop and see what happens.

          Elizabeth:
          But you can have perimenopausal symptoms while you are still on The Pill. Is that correct?

          Dr. Northrup:
          Most people don't. You can, because the brain changes. But most people don't. The Pill kind of quiets everything down because it puts the ovaries to sleep.

          Elizabeth:
          Yes.

          Dr. Northrup:
          All right.

          Elizabeth:
          Well, thank you very much.

          Dr. Northrup:
          All right. Thanks, Elizabeth. Another Skyper standing by, Phillipa, a 27-year-old from Elkins Park, Pennsylvania. Hi, Phillipa. You're pretty young for this show.

          Phillipa:
          Hi, Dr. Northrup. This is my question: I went to the doctor less than a month ago, and my testosterone level was high and my question is, is it going to affect me in getting pregnant any time soon or, you know, the question—the answer that I got from the doctor wasn't, how do I say it, it didn't settle my questions, I guess or it didn't answer my questions.

          Dr. Northrup:
          Okay. Are you having normal periods?

          Phillipa:
          No, I'm not. It's very irregular, and that was the reason I went to the doctor.

          Dr. Northrup:
          Okay. What you can do is I would continue to work with your doctor, perhaps a gynecologic endocrinologist. But I want you to know that through proper diet and exercise, you can get your levels back to normal, because a lot of what you have is related to lifestyle. And I would assume that you're going to have no problem getting pregnant. I want you to begin thinking of yourself as a healthy, 27-year-old, very fertile young woman. That alone will reduce stress in your body and you'll feel better. I would check out my book, Women's Bodies, Women's Wisdom. There's a whole chapter on this.

          Phillipa:
          Okay. And another question. So the soy and the edamame that I'm eating is not going to help at all? Because I read online that it can decrease your testosterone level.

          Dr. Northrup:
          What you want to do is follow a high-fiber, healthy fat diet. The main thing to cut down on is white foods: sugar, white flour, white potatoes and prepared foods. Things like that. Okay?

          Phillipa:
          All right, got it. Thanks, doctor.

          Dr. Northrup:
          Thank you, Phillipa. Corinne is Skyping us all the way from Australia. Corinne, what time is it there?

          Corinne:
          Oh, it's now 1 o'clock. 1 p.m.

          Dr. Northrup:
          Oh, good.

          Corinne:
          It's Friday for us.

          Dr. Northrup:
          That's good. It's not the middle of the night. So what is your question?

          Corinne:
          Thank you for answering my question. I am concerned about the quality of the bioidentical hormones. There seems to be—(inaudible)—but the manufacturing doesn't seem to be standardized and it seems to rely on the doctor being able to find a good compounding pharmacy, so how can I be assured that I will get a good quality of hormone?

          Dr. Northrup:
          The way you do that is to know that very good quality bioidentical hormones that are very nicely tested are available in all pharmacies. You read the label, and you make sure that what you're taking is progesterone. Not medroxyprogesterone acetate, but progesterone, and then you look for estradiol. Sometimes 17 beta estradiol. And those are bioidenticals and you'll be fine with those. You just have to sort through what's available in the pharmacies, and all you have to do is read the package insert and it's right there. Or the PDR. The Physician's Desk Reference will tell you, and they list everything. All right?

          Corinne:
          Great, thanks. Thank you very much, Dr. Northrup. Thank you.

          PAGE 1 of 10

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