Xenobiotic Effects on COMT

A xenobiotic is a foreign chemical substance found within an organism that is not normally, naturally produced by or expected to be present within that organism. It can also cover substances which are present in much higher concentrations than are usual.41_SchemaRTS_Eng

  • In humans, 2-Oh and 4-Ohestradiol (catechol estrogens) are rapidly O-methylated to form monomethyl ethers catalyzed by COMT and S-adenosyl-L-methionine.

  • Xenobiotics may strongly inhibit COMT-mediated
    O-methylation of catechol estrogens by xenobiotics and may facilitate the development of estrogen-induced tumors.

  • Xenobiotics may therefore deplete intermediates in the Folate cycle.  Environmental burden of Xenobiotics may create a higher need for methylation support.

Catechol-O-methyl_transferase_baucom-instituteAbstract: COMT genotype, micronutrients in the folate metabolic pathway and breast cancer risk - Goodman JE, Lavigne JA, Wu K, Helzlsouer KJ, Strickland PT, Selhub J, Yager JD; Department of Environmental Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA.

  • Catechol-O-methyltransferase (COMT) catalyzes the O-methylation of catechol estrogens (CEs), using S-adenosylmethionine (SAM) as a methyl donor.

  • Several studies have indicated that the val108met COMT polymorphism, which results in a 3-4-fold decrease in activity, is associated with increased breast cancer risk.

  • Folate, whose intake levels have also been associated with breast cancer risk, and other micronutrients in the folate metabolic pathway influence levels of SAM and S-adenosylhomocysteine (SAH), a COMT inhibitor generated by the demethylation of SAM.

  • Because these micronutrients have been shown to alter SAM and SAH levels, we hypothesized that they could also affect COMT-catalyzed CE methylation.

  • Although measurements of SAM and SAH were not initially collected, a secondary analysis of data from two nested case-control studies was performed to examine whether serum levels of folate, vitamin B12 (B12), pyridoxal 5′-phosphate (PLP), cysteine and homocysteine, in conjunction with COMT genotype, were associated with breast cancer risk. COMT(HH) (high activity COMT homozygote) breast cancer cases had statistically significantly lower levels of homocysteine (P = 0.05) and cysteine (P = 0.04) and higher levels of PLP (P = 0.02) than COMT(HH) controls. In contrast, COMT(LL) (low activity COMT homozygote) cases had higher levels of homocysteine than COMT(LL) controls (P = 0.05).

  • No associations were seen between B12, COMT genotype, and breast cancer risk. An increasing number of COMT(L) alleles was significantly associated with increased breast cancer risk in women with below median levels of folate (P(trend) = 0.05) or above median levels of homocysteine (P(trend) = 0.02). These findings are consistent with a role for certain folate pathway micronutrients in mediating the association between COMT genotype and breast cancer risk.

These findings are consistent with a role for certain folate pathway micronutrients in mediating the association between COMT genotype and breast cancer risk.

Case Study: Susan – Treatment

Methylation-xenoestrogens-baucom-institute

Methylation-nutrition-estrogen-metabolism-baucom-institute

 

  • Treatment: 28 day   detox, gluten, diary, soy free, with  protein smoothie (rice) due to low body weight.
  • Di-indole methane and 3 indole-carbinol for estrogen balance, NAC,(glutathione)
  • Trimethyglycine/Methyl -folate & B12 for methylation support
  • L-theanne/Gaba, 5-HTP to improve sleep and pain control
  •  Co-Q10 support
  • Selenium/Lipoic acid,vit E for anti-oxidant support
  • High concentrate EPA/DHA  Magnesium Glycinate 200mg qhs for alkaline, mineral, and bowel support
  • Probiotics, 50 bill/ FOS
  • Exercise daily, check urine ph goal> 6.6.  Sauna at the gym, alkaline diet, Xenoestrogen awareness!

Susan’s response: “I feel the best that I have felt in years. This is miraculous! I sleep deeper than ever, there are no hot flashes, I’m exercising because I have ENERGY, and my husband says I’m back again because I’m SASSY again!”

Case Study: Susan

  • 49 yo CF recent dx of Stage II Breast Ca hormone Rec +,s/p partial mastectomy, body-case-study-baucom-instituteradiation, irregular periods, shingles, intolerant of Fereston due to Headaches, constipated.  Hx of fibroids, heavy periods, fibrocystic breast. G2P2

  • nl vitals,   Estradiol 26.8pg/ml (0-32.2 menopause range)

  • Sed rate 22 (0-20)

  • Cbc, chem, thyroid panel cholesterol wnl

  • Vit D 153 (30-100)

  • GGT 15   Uric Acid 3.2

  • Glutathione 992

  • MTHFR C677+/A1298C+

  • Cytokine: base Il-6++, IL-17+, IL-12–,IFN gamma ++, TNF-a ++, IL-4++, IL-5–, IL-10++, IL-8++, G-CSF++

How would you approach treatment of this patient?

Spectracell-Methylation-Susan-Baucom-Institute

Testosterone and Heart Disease

low_testosterone_heart_disease_baucom_instituteFor years, we’ve known that low testosterone for men has created many issues but now there is evidence that it is linked to heart disease. Here are a few of the findings (JAMA, Aging Male, Geriatrics, European Heart Journal,Circulation, JACC, JCEM, Endocrinology):

Low Testosterone and Heart Disease

  • Men with coronary heart disease had significantly lower total testosterone.
  • A study showed a correlation between lower testosterone levels and conditions associated with cardiovascular disease.
  • Another study showed that men with coronary heart disease had significantly lower levels than the control group.
  • Low testosterone levels have been shown to be associated with atherosclerosis in men.

High Estrogens and Heart DiseaseHEART-DISEASE-low testosterone-baucom-institute

  • A study showed that elevated circulating estradiol is a predictor of progression of carotid artery issues.
  • High estradiol levels in men were associated with acute myocardial infarctions.
  • Elevated levels of estrogen in men are associated with an increased risk of heart disease.

Testosterone Replacement and Heart Disease

  • A study showed that with an increase of testosterone there was a 14% drop in risk of death.
  • A study revealed that testosterone replacement was associated with a decrease in HDL-C and lipoprotein a.
  • Introduction of testosterone increases coronary artery blood flow in men with coronary heart disease.
  • Testosterone replacement has shown to decrease inflammation and lower total cholesterol.

Do you know a male in his 40′s or older with a history of heart disease in his family? Share these studies and encourage him to seek medical attention, particularly a doctor educated on the connection of hormones and disease prevention.

If you are a medical professional, what are your findings on the connection of low testosterone and heart disease?

There’s a “Pause” for Men Too!

Male-Andropause-BaucomInstitute

Male Andropause. You may have never heard of it, especially if you are a woman under 30. However, it is a very real and prevalent issue for men, especially after age 40. Let’s start with what it is and then what to do about it.

To put it simply, andropause is the steady decline in the hormone testosterone. It usually effects men around the age of 40 and continues for a longer period of time, possibly lasting for decades, than menopause with women which can have more extremeandropause_graph effects but over a shorter period of time. Most men think these symptoms are just a part of aging and that they should just accept their fate. They couldn’t be more wrong. In fact, by age 45-55 men can experience the same types of effects similar to menopause.

The effects can include changes in attitude and mood, mild depression, fatigue, lower sex drive, reduced erections, weight gain in the middle, loss of energy, and reduction in physical agility because of the loss of muscle mass.

So what’s the answer? It seems inevitable. It stands to reason that if the loss of testosterone is the cause then the replacing of testosterone would be the answer. True, but how do you replace an organic chemical that the body itself reproduces? This is where the answer and the problem both lie, as if two sides to the same coin.

Hormone therapy has become more common in treating the effects of menopause in women. However, the side-effects have become too dangerous, like when men take Viagra to enhance their sexual performance. It is not a natural component; therefore the body cannot assimilate it without side effects.

Bio-identical hormones have become preferable due to their natural effects on the body. These same types of bio-identical, natural hormones are now available to men as well. The bio-available testosterone not only increases muscle mass and improves a guy’s general well-being, it also lowers cholesterol, enhances libido and sexual energy, and helps prevent pre-mature heart disease.

If you have these symptoms from aging, even if you are just in your 40’s, don’t wait until they are worse. Contact us today at The Baucom Institute to learn from your own “Age Management Plan” what you need at your age.

What are some symptoms you have noticed in yourself or someone else you care about? We would love to hear from you.

One Patient Among Many

familyMRGrad2013Hi. My name is Beth Rose. I am one patient among many.

I’m one patient among many others who see Dr. Karan Baucom and who has seen significant changes from diagnosis and prescribing changes for me in my daily life.

I began to see “Dr. B.” a few months ago because I was having several symptoms that began to worry me about my health. I have been a fairly healthy person throughout my 52 years.

I was very active when I was younger up until I had my children. Like a lot of moms, our kids take precedence, and we forget about taking care of ourselves! Over the last 20 years I have begun to have aches and pains in my joints, fasciitis in my feet, increasing back pain, terrible heartburn especially at night, increasing fatigue, no energy for running around with my kids, and the last few months terrible pain after eating in my upper torso. I have felt a mess and, with working our business that my husband and I own, I know the stress of that has contributed to the issues.

I had talked to Dr. B. about my family’s health a lot but Dr. B. asked how I was doing. She knew I was under a great deal of stress and could see the fatigue and lack of energy. I made an appointment and soon was undergoing several tests, including a full blood workup, sonograms, and mammogram. When Dr. B. got the test results back, she sat me down and gave me the most thorough report I’ve ever heard about my health! I was amazed with all the information and how it all linked together. My hormone levels were out of whack, I had gallstones, there are nodules on my thyroid, and I have several food allergies among other issues. I was totally shocked.

With advice and direction as well as prescribing a vitamin and bioidentical hormone supplement regimen, I am beginning to feel good again. I have increasing energy and less fatigue each day. Even better, my outlook on life is much more positive, which I think that has everything to do with the hormonal balance.

I appreciate my family physician, who we have been going to since our children were babies, but Dr. Baucom, as my specialist in Restorative Medicine, has been a life changer for me personally. I’ve never seen anyone take so much time with their patients, not only to diagnose and treat but to also educate.

I’ve been through the “School of Longevity” at The Baucom Institute. I hope to graduate with flying colors in the few next the months to come!

Disease Prevention Over Disease Management

american-heart-monthSomething tragic has happened in America’s clinical health agenda. Doctors have trained patients to rely on medicine for the answers rather than on learning ways to help themselves prevent their reliance on medicine or on medical help. The medical community has it all backwards.

You go to the doctor and you get medicine to deal with your issue. You go to the pharmacy to get the medicine the doctor prescribed to deal with your issue. In all that time, there is only an emphasis on how to treat the symptoms of the real problem not really prevent the problem from happening in the first place.

Longevity management medicine places emphasis on disease prevention versus disease treatment. Its medical protocols involve extensive initial laboratory baseline testing, hormone balancing, laboratory test monitoring, patient education, proper diet, nutritional supplementation and appropriate exercise.

At Baucom Institute, for instance, we go to great lengths to find where the patient is in terms of their health when they come to see us and then through extensive testing we determine the proper course of treatment and educating the patient how to change their own lifestyle so that they can help themselves change their own course toward health.

The Baucom Institute is interested in a quality of care with outcome measures which include: improved laboratory test profiles, enhanced strength, increased endurance, and a greater feeling of wellness as the patient works along with Dr. Baucom to achieve personalized life enhancing goals.

What has your experience been in working with a doctor? What have the results been for you?

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Hormone Series – Part VII: Insulin

insulin

Insulin is a powerful hormone which comes from the pancreas gland. Insulin is vital to converting progesterone to testosterone and testosterone to estrogen.

Diabetes is the lack of insulin doing its job of transporting and storing glucose (sugar) inside the cell to be utilized as energy. Instead, the glucose cannot enter the cell because insulin will not transport it.

There is a tragic epidemic being ignored today involving obesity, hypertension, diabetes, and high cholesterol or triglycerides – it is called Syndrome X. It affects the young, the middle aged, and the old. It is a reflection of the processed foods we eat, our lack of dietary restrictions and the fact that these foods contain little or no nutrients.

Without insulin carrying on its function, cholesterol and triglycerides build up in the liver. They in turn create fat, clogging blood vessels, and in turn cause high blood pressure, hyperlipidemia and heart disease. Too much insulin causes inflammation and “AGES” you. Advance Glycation End productS (AGES). Excess sugar creates “AGES” that bind collagen causing wrinkles as well as “free-radicals.” Free-radicals can in turn cause cancer. This is why diabetes and high levels of insulin are associated with a shortened life span if left unchecked.

Maintaining correct insulin balance through proper diet and exercise is a critical component of the Baucom Institute’s longevity and life enhancement program.

 

Hormone Series – Part VI: Cortisol

cortisol

The adrenals are two triangular shaped glands located on top of each kidney. Cortisol is one of several hormones released by these powerful glands. It is released as a “stress hormone.”

Cortisol controls:

  1. Blood sugar
  2. Fat and Protein mobilization
  3. Prevents inflammation
  4. Will make the liver make sugar from fat

The pituitary gland activates the adrenal gland by secreting ACTH. ACTH is adrenocorticotropic hormone. It stimulates the “cortical” layer of the gland to make cortisol. Cortisol has distinct bio-rhythms. It is high in the morning and by the evening is down. Stress alters the rhythm and may eventually cause the gland to become “exhausted.” “Adrenal Fatigue: The 21st Century Stress Syndrome” by James Wilson, ND, PhD, is an excellent book to explain why and how cortisol depletion can result in severe exhaustion. Unfortunately this hormone is not understood by most physicians. It is a test rarely ordered and a syndrome basically ignored.

Stress factors:

  1. Anger
  2. Fear
  3. Death of family member
  4. Divorce
  5. Marriage
  6. Financial Worries
  7. Job
  8. Relationships
  9. Personal Illness
  10. In-laws

Just to name a few, are viewed as stress. These issues if chronic and severe can totally deplete this vital hormone. Thyroid and severe adrenal stress go hand in hand. Low blood pressure as well as low blood sugar may be the only symptoms. Recovery from adrenal stress can take up to a year with treatment to resolve.

Cortisol is vital to the feeling of well-being. Longevity and quality of life are severely compromised when this powerful and needed hormone is barely available. Patients will rely on sugar and caffeine to “boost” their drive because they are unaware as to the real reason for their chronic fatigue.

Since the adrenal gland is needed for survival when compromised, all the other glands suffer as well. The thyroid gland, in trying to pick up the slack, will, in time, become hypo active itself, further compounding the situation.Cortisol-is-a-hormone-300x210

Eventually the immune system falters and Lupus, Crohn’s, colitis, chronic sinus and infections can plague the individual. Abdominal obesity (cortisol paunch) along with decreased HDL cholesterol, increased triglycerides and increased blood pressure herald the demise of this vital hormone. There is acute adrenal fatigue, and mild and high adrenal fatigue. Saliva testing of the morning, noon, evening and night cortisol levels is the best way to determine the level of fatigue.

At The Baucom Institute, treatment is based on the stage of fatigue and support is given to the glands until they are healed. We also encourage your lifestyle and diet be altered. Of course, alleviating the stress factors is paramount to getting the most out of your treatment.

What is your stress level? What do you think your level of well-being is right now?

Hormone Series – Part V: DHEA

happymanwomanIn our series on hormones, there is one that most people don’t even realize is a major player in not only their health but their wellbeing, too. That is DHEA or Dehydroepiandrosterone, a natural steroid made from cholesterol primarily by the adrenal glands. Studies show that DHEA may help with systemic lupus, and may decrease cholesterol. In long term studies, it reduced insulin resistance and also helped relieve depression.

DHEA functions to boost the immune system in auto-immune disease. It is contraindicated in patients that have testosterone or estrogen related cancer.

A low DHEA level may be an indication of adrenal fatigue. Symptoms include:

  • Extreme fatigue
  • Decrease in muscle mass
  • Decrease in bone density
  • Depression
  • Aching joints
  • Loss of libido
  • Lowered immunity

DHEA supplementation must be tested on a regular schedule as it may, in men, convert to estrogen. Although readily available over the counter in health food stores, it is a powerful hormone that should be monitored.

In “DHEA and Adrenal Imbalance,” Dr. Marcelle Pick, OB/GYN NP, states that “The average adult makes about 25 mg of DHEA per day (some more, some less) with dwindling production as we get older. Men at all ages have more DHEA than women. Natural DHEA production is at its highest in your twenties: by the time we reach seventy we only make about 20% of the DHEA we had when we were young. DHEA is a very powerful precursor to all of your major sex hormones: estrogen, progesterone, and testosterone. (Its molecular structure is closely related to testosterone). We call it the “mother hormone” — the source that fuels the body’s metabolic pathway.”

Dr. Pick goes on to say, “Besides DHEA, your adrenals also make the stress hormones cortisol and adrenaline. Adrenal exhaustion from coping with chronic stress — from (among other things) poor nutrition, yo-yo dieting, emotional turmoil, and job-related stress — means your adrenals are bone-tired from pumping out cortisol and they simply can’t manufacture enough DHEA to support a healthy hormonal balance. One thing we do know is that adequate levels of DHEA are needed to ensure your body can produce the hormones it needs when it needs them. In that balanced state your mood is stable and you feel clear-headed, joyful and vigorous. DHEA is the best “feel-good” hormone we know. And it works quickly and effectively when taken with the right combination of support.”

Now, there is evidence to show that healthy levels of DHEA may fight Alzheimer’s disease, cancer, osteoporosis, depression, heart disease and obesity, but there is no clear cut evidence until further studies are done

A DHEA-Depression Study was done and reported by Miranda Hitti in WebMD Health News. “The study was small and brief. It included 23 men and 23 women age 40 to 65 with mild to moderate depression starting in midlife. Two DHEA doses were used. For three weeks, patients took a lower dose — 90 milligrams per day. For the other three weeks, they took 450 milligrams of DHEA daily.

In 23 participants, DHEA cut depression symptoms by 50% or more. A similar reduction was seen in 13 subjects after taking the placebo. Men and women responded similarly. Treatment with the supplement was associated with an increase in testosterone blood levels in both men and women. Taking DHEA for 6 weeks also significantly improved sexual function scores, compared to the scores after taking the placebo or before the study started.”

Do you suffer from symptoms similar to the ones above? If so, which ones and how long?