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A word of caution: use Prometrium buy 75mg clopidogrel with mastercard, not Provera (medroxyprogesterone acetate) order 75mg clopidogrel with mastercard, the most common progestin generic clopidogrel 75 mg visa, or synthetic form, of progesterone. Many physicians prescribe progestins to patients suffering from irregular periods, fibroids, and/or heavy bleeding. Though the words frequently are used interchangeably by physicians and the media, progesterone and progestins are different biochemically, which means they have very different effects on the body. In study after study, Provera has been shown to increase the risk for breast cancer, depression, weight gain, blood clots, and cardiovascular disease (stroke and heart attacks). In the best evidence of progestins and heart disease, women aged forty-five to sixty-four were randomly assigned to receive Provera, Prometrium, or a placebo. One study, of more than eighty thousand women followed for eight years, showed no increased risk of breast cancer when using 40 Prometrium. An important point about progesterone is that one of its main security jobs is to protect the endometrial lining from overgrowth, precancer (hyperplasia), and cancer. The only bioidentical progesterone shown to prevent buildup in the uterine lining is Prometrium. Prometrium, taken in 100 mg or 200 mg tablets, can do anything progestins can do, but better and more safely. Women with peanut allergies might consider compounding natural progesterone in another base oil, which would have to be ordered by a physician who’s comfortable working with a compounding pharmacy. The only situation in which progestins might be appropriate is for incarcerated sex offenders, because progestins removes sex drive in both men and women. Her periods are heavy, and as a result, she has low ferritin, which is the most sensitive indicator of iron levels. Because of that and her disrupted sleep, I wrote a prescription for Prometrium, which acts as a somnolent. She and her husband have learned to take advantage of every morsel of increased interest. It’s more complicated, as I described earlier, and relates to progesterone “resistance. Magnesium, 200 mg/day, helps with bloating, as does vitamin B6, 50 to 100 43 mg/day. B is involved in the production of many neurotransmitters, including serotonin, which controls mood, sleep, and appetite, and dopamine, which controls pleasure and satisfaction. Consumption of excess refined carbohydrates causes loss of magnesium through the urine. I’m not sure why this works, but it may reduce cortisol—less stress, more progesterone. Homeopathy is a form of complementary medicine in which clinicians treat clients with diluted preparations called remedies. You would need to see a homeopath for this individualized therapy, which might be worthwhile and confers little risk. For two cycles, fourteen women sat in front of a bright light (10,000 1x cool-white fluorescent light), compared with dim red light, for two weeks before their period. John’s wort is superior to placebo for depression, based on a review of twenty- three randomized trials 54 of 1,757 patients. But consult with your doctor if you already are taking an antidepressant or antipsychotic medication. However, bioidentical hormone replacement can be useful for irregular menstrual cycles once you’ve been thoroughly evaluated by your local physician, and it improves sleep in perimenopause. Progesterone in Balance When you’ve got your progesterone at its proper level—not too little and not too much—you feel like Goldilocks in the just-right bed: sleepy at the right times, triumphant, and content. I blamed estrogen for many of my new physical quirks: painful periods that interrupted my childhood at age ten; breasts and hips that grew too fast and caused stretch marks; and breakouts that perplexed even my dermatologist. Hormones in general, and estrogen in particular, felt inscrutable, volatile, and beyond my comprehension. I mentioned this in the last chapter, but it’s worth repeating: estrogen is the hormone that most defines you as a woman. In fact, estrogen is the primary female sex hormone, made by all animals with a spine (“Mom, duh! In humans, the female brain becomes exquisitely sensitive to estrogen at puberty, and this continues until about your mid-forties, when the brain becomes less sensitive again —that is, the ovary is increasingly numb to the admonitions of the ovaries, and vice versa. At puberty, release of estrogen increases the feel- good chemicals of oxytocin, the arbiter of love and affiliation, and dopamine, the neurotransmitter of pleasure, satisfaction, and reward- based learning. With its biochemical girlfriends, oxytocin and dopamine, estrogen kick-starts your period at around age ten to fifteen. Estrogen: Archetype of Femininity Here’s the short version of what estrogen does: • Externally, estrogen gives you hips and breasts. Estrogen is nature’s Prozac, adjusting the level of available serotonin—another important neurotransmitter—so that it’s in more ready supply.

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Your goal is to search in your own organs and body tissues for the substances that may be robbing you of health cheap clopidogrel 75 mg on-line. Then you will only hear resonance with substances that are ac- tually in the body fluid 75mg clopidogrel visa. Since this cannot be proved with certainty purchase 75mg clopidogrel visa, obtain several urine samples from different persons whom you believe to be healthy and make several test specimens in order to compare results. Label your specimens Urine A (child), Urine B (woman), Urine C (mine), and so forth. Electronically, a dead specimen is equivalent to a live specimen, so that pasteurization of the milk does not help. Use your own, if you have deparasitized yourself and test negative to various fluke stages. When you test with a substance on one plate and nothing on the other, you are searching your entire body for that substance. By putting a tissue sample on the other plate you are testing for the substance specifically in that tissue in your body, and this is much more sensitive. To find mercury in your kidneys you would use a mercury sample on one plate, and a kidney sample on the other. If you put a substance on each plate, a resonating circuit means the two samples have something in common. For exam- ple, if you have mercury on one plate and some dental floss on the other, a positive result indicates mercury in the floss. Test your skin for the presence of brown sugar, using the newly made sample bottle and your skin specimen. Prepare a paper applicator by tearing the corner from a white unfragranced paper towel. Dip the paper wick in the pint of sugar water and apply it to the skin of your inner arm where you can rub freely. Leave the shredded wick on the skin and tape it down with a piece of clear tape about 4 inches long (this increases the time you have to work). Place your skin tissue specimen on one plate and the sugar specimen bottle on the other plate. As soon as you hear resonance, implying that the skin has absorbed the sugar solution (which may take a full minute), replace the skin specimen with one of liver and listen for resonance again. After five to ten minutes the sugar will be gone from all of these tissues and your experiment is ended. Notice that you have only a few minutes to get all your testing done after the skin has absorbed the test substances. Assemble the products named in the isopropyl alco- hol list (page 45) and benzene list (page 163)... Place the isopropyl alcohol test substance on one plate and your products, in turn, on the other. This is such a global tragedy that people must protect themselves by using their own tests. Rather than assur- ances, regulatory agencies should provide the consumer with cheap and simple tests (dip sticks and papers so we need not lug our Syncrometers around). Even if some test should fail, not all tests would fail to find an important pollutant like benzene. If your aluminum specimen actually has cadmium or cop- per in it, you are also testing for these in your brain. Leave your purest aluminum test substance on one plate, and replace the brain sample with these items, testing them one at a time. Choose tissues like kid- ney, nerves, brain, liver, in addition to white blood cells. I have never dissected human tissues and subjected them to confirmatory laboratory tests. It seems reasonable that because skin and tongue are directly provable, that other tissues work similarly. Testing Someone Else Seat the person comfortably with their hand resting near you. Since you are touching this person, you are putting yourself in the circuit with the subject. A coil of about 10 microhenrys, worn next to the skin, works well and is easily made. Obtain insulated wire and wrap 24 turns around a ball point pen (or something about that size), closely spaced. Nevertheless, ortho-phospho-tyrosine, Salmonella, mercury in your kidneys, aluminum in the brain all show up in the saliva, too. This test is not as sensitive as having the person present in the circuit, though.

Five weeks later He had remaining cavitations done yesterday and is scheduled for metal removal from dental ware in several weeks order clopidogrel 75 mg mastercard. Arlette Shapiro Intestinal Cancer Arlette is only 23 years old and has been diagnosed with Rheu- matoid Arthritis because of wide-spread pain buy 75 mg clopidogrel otc. While with the alternative doctor buy generic clopidogrel 75 mg online, she had all the mercury taken out of her teeth. I began by explaining that her shoulder and upper arm pain is caused by gallstones in the liver; she can easily wash them out in one evening and be free of shoulder pain the next day. Her hand and foot pain is due to kidney stones and she can dissolve these out in 3 to 4 weeks with our herbal recipe. That leaves the knee pain, which may indeed be rheumatoid arthritis, namely, tooth bacteria invading her knee joints. She will go off the items on the benzene list as well as shampoo and hair spray and cosmetics that list “Prop. But she had frequent nausea with fatigue attacks, and her arm pain extended into the armpit. Ken Stanley Prostate and Intestinal Cancer Ken, age 70, came with his wife, without a special reason, but only because his family members were riddled with cancer. Ken had such high levels of fluke stages in his body fluids that we will sample them for microscope observation. He had mysterious illnesses, one after another, that could not be diagnosed but which went away eventually, on their own. He has kept excellent notes which he brought in and it is evident that he is suffering severe para- sitism that may even elude me. Summary: Joshua cleared up his prostate cancer in 2 weeks and is enjoying the new body care products. He was astonished and dismayed that purchased drinking water may be more polluted, by far, than city water. Summary: Can she accomplish all this and improve the appearance of her cervix in 10 days? Elsa Elizondo Not Cancer Elsa is 71 years old and came in for urinary tract problems. But the solvents she has in her are causing her parasite stages to progress and multiply. But a simple increase in consumption of moldy food (contains aflatoxin) such as apple cider vinegar or nuts could cause a propanol build-up in her and then cancer. It is the same breast where she had many breast infec- tions while nursing babies. She is advised to stop using essential oil products and go off the entire benzene pollution list as well as shampoo and commercial beverages. She sees that she got rid of her cancer the first time without going off them and this proves to her keen mind that she does not absolutely have to go off it. Perhaps she stopped in time: She is a conscientious, health-minded, intelligent per- son. She has gone off her essential oil products and wants to inform the manufacturer of their benzene pollution. I reminded her to continue on parasite mainte- nance program and stay off the entire benzene list. Final Summary: We need many more persons like Kim who are so shocked that health foods and health products are polluted that it sim- ply is unbelievable. Hopefully, she will turn her anger on the correct culprits after she has accepted the truth. Lydia Massey Pancreatic, Intestinal, Uterine Cancer Lydia is with her husband and needs to be checked for carrier status of the intestinal fluke. Her intelligence is impressive, she includes herself in the health picture of Gerry! But she developed a pain over the upper mid-chest (she put her hand right over the thymus gland) and visited her regular doctor. Note: I could have easily missed the propanol if I had not searched the liver for it. Summary: It is always a delight to work with a client who can dis- pose of new furniture or carpets without regrets when health is at stake. Shirley was inspiring to our office with her ease of choosing health before gold crowns and expensive new furniture. She does not eat turkey or chicken because of her sensitivity to Salmonella (gets sick right away). I tried to impress on her the need for speedy re- moval of tooth infections and benzene. Four days later Although Helen is not interested in removing the metal from her mouth, she has just returned from seeing the dentist. The dentist found no X-ray evidence of any tooth abscess or cavities, but Helen did have several cavitations cleaned. Five days later She is feeling better than 1 week ago, but she still has her ups and downs.

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The Vaughan-Williamsscheme is more challengedwhen one be- ginstoconsider the effectofantiarrhythmic drugson the potassium channel buy generic clopidogrel 75mg line. As a result order clopidogrel 75mg amex, application of the Vaughan-Williams system becomes very difficult in some cases generic 75mg clopidogrel with mastercard. Ultimately, the classification of some drugsappears to be a matter of consensus rather than a matter of science. Although the Vaughan-Williamsschemethusappears incapable of offering definitive classification for all possible mixtures of sodium- and potassium-channel blockade, it nonetheless suggests a frame- work for characterizing evendifficult-to-classify drugs. The frame- work becomes apparent when onethinks of the general interplay of sodium-blocking and potassium-blocking properties as represent- ing a continuum of possible effects instead of a categorical series of discrete effects (Figure 2. The advantageofthinking about drug effects along a continuum is that hard-to-classify drugs, suchasmori- cizineand amiodarone, can be positioned at appropriate points along the continuum instead of being arbitrarily assigned to a specificclass. The Vaughan-Williams classification system, thoughad- mittedly imperfect, helpstolocate drugs along the continuum,and therefore helpstoelucidate the electrophysiologic properties even of drugs that are difficult to formally classify. As ithappens, the Vaughan-Williamsscheme also allowsoneto make other clinically relevant generalizations aboutantiarrhythmic drugs. What emergedwas a new approach to the classification of antiarrhythmic drugs; the inventors imaginatively named the approach the Sicilian Gambit. The Vaughan-Williamsscheme is based onwhether drugs pro- duce block in oneormore of a few sites on the cell membrane, but the Sicilian Gambit takes into account a host of additional actions 50 Chapter 2 of antiarrhythmic drugs—the typeand degree of blockadeofchan- nels, antagonistic and agonistic effects on receptors, effects on the sodium–potassium pump, the time constants of binding to cellular sites, effects on second messengers, and the affinity for binding on the basisofwhether the cell is in an active or inactive state. Digoxin Relative potency of block: Low Moderate High A=Activated state blocker =Agonist =Agonist/Antagonist I = Inactivated state blocker Figure 2. Effects of each drug onchannels, receptors, and pumps are shown, as are someoftheclinical effects. Introduction to antiarrhythmic drugs 51 Two major differences exist between the Vaughan-Williams schemeand the Sicilian Gambitapproach. First, the Sicilian Gambit is far more thorough than the Vaughan-Williams systemindescrib- ing the precise actionsofantiarrhythmic drugs. Second, inasmuch as each drug is essentially in its own class (since notwo drugs are exactly alike in all the ways listed), the Sicilian Gambit is notatrue classification system. It is, in fact, useful to have a complete tabulation of all known effects of antiarrhythmic drugs. Such a table allowsonetoeasily compare the recognized similarities and differences among drugs. Further, when the mechanisms of arrhythmias have become more precisely delin- eated, precise knowledgeofindividual drugs may helpinformu- lating more accurate guesses as to effective pharmacologic therapy (which was a specificgoal in devising the Sicilian Gambit), although it islikely to be always true that nearly identical patients with nearly identical arrhythmias often respond differently to the same drug. However, because the Sicilian Gambit is not a true classification system, it does not offer much help to the average clinicianinlearn- ing aboutorcommunicating aboutantiarrhythmic drugs. Es- pecially for the nonexpert, the Vaughan-Williams system, with all its limitations, remains the most useful meansofcategorizing an- tiarrhythmic drugs;it is the system that will be used throughoutthis book. Yet, because of their varied effects on the sodium channel and the potassium channel, drugs assigned to Class I can behave very differently from oneanother. The major clinical features, electrophysiologic properties, and adverse effects of Class I antiarrhythmic drugs are summarizedinthe accompanying tables. Unfortunately, they are also moderately effective in causing both major varieties of side effects—end-organ toxicity and proarrhythmias. Quinidine Quinidine is the D-isomer of the antimalarial quinine, a drug that was noted to be effective in the treatmentofpalpitationsaslong 55 56 Chapter 3 Figure 3. Quinidine itself was recognized as an effective antiarrhythmic agent in the early twentieth century. Clinical pharmacology Quinidine isadministered orally as one of three salts (quinidinesul- fate, quinidine gluconate, or quinidine polygalacturonate). All three forms of the drug have beenmade available because some patients tolerate one salt better than another. Approximately 80–90% of the sulfate preparationis absorbed after oral administration,and peak plasma concentrations are reachedwithin 2 hours. The gluconate and polygalacturonate preparations are absorbedmore slowly and less completely than the sulfate formulation. Quinidine is 80–90% protein bound in the circulation and has a large volumeofdistribu- tion. The concentration of the drug is 4–10 times higher in the heart, liver, and kidneys thanit is in the circulation. Its elimination half-life is 5–8 hours but may be prolongedinpatients with congestive heart failure or in the elderly. Electrophysiologic effects Quinidine blocks the sodium channel and slows the rate of depo- larization of the actionpotential. Its effects on the potassium channels result in prolongation of the actionpotential and, therefore, of the refractory period.

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