-------------------------------------------------------------------------
PD AND HORMONES PART FIVE OF FIVE
-------------------------------------------------------------------------

-----25------------------------------------------------------------------
Data suggest estrogen may help prevent Alzheimer's
-------------------------------------------------------------------------

Copyright _ 1996 Nando.net
Copyright _ 1996 N.Y. Times News Service

(Jul 31, 1996 02:00 a.m. EDT) As the number of patients with Alzheimer's
disease continues to climb, researchers are studying the possibility that=
 a
common and already approved drug, estrogen, may help to prevent or delay
it, and even reverse some of its symptoms.

Though far from conclusive, the evidence so far is highly suggestive. The
evidence, derived from experimental animals and from women after menopaus=
e
taking estrogen supplements, has prompted two major studies to assess the
effectiveness of estrogen replacement in currently healthy older women an=
d
in those in the early stages of the disease.

Although no comparable studies are planned for men, who are less likely
than women to develop Alzheimer's disease, there are hints that older men
may benefit from supplements of testosterone, which is converted to
estrogen in the brain.

Dr. Stanley Birge, a geriatrician at the Washington University School of
Medicine in St. Louis, called the estrogen work "terribly exciting, the
most promising thing that's happened so far in Alzheimer's disease," the
most common form of dementia.

If the early findings are supported by the new clinical trials, he said,
"estrogen has the potential to prevent two-thirds of Alzheimer's cases."

At an international Alzheimer's conference in Osaka, Japan, which ended o=
n
Monday, Dr. Sally Schumacher described the first large-scale study of
whether estrogen can prevent or delay dementia, using the products Premar=
in
or Prempro, the hormone-replacement therapy already being taken by millio=
ns
of postmenopausal women.

Premarin, a mixture of about 10 different estrogenic hormones, gets its
name from pregnant mare's urine from which it is derived. Prempro is a
combination of Premarin and a progesterone, used to prevent Premarin from
overstimulating and causing cancer in the uterus.

Dr. Schumacher, a psychologist at Bowman Gray School of Medicine in
Winston-Salem, N.C., who is directing the prevention study in healthy old=
er
women, said "most people in the field are quite excited" about estrogen's
role in Alzheimer's.

But she cautioned against jumping to premature conclusions. She said many
questions remained to be answered, including whether Premarin's promise
would hold up in the trial against a dummy drug, whether its benefits wou=
ld
outweigh its risks and whether progesterone in the combined pill might
negate estrogen's effects on the brain.

Other questions to be resolved include estrogen's precise mode of action =
in
the brain and, if it is proved effective, at what age to start therapy. D=
r.
Schumacher pointed out that while the symptoms of Alzheimer's disease
usually did not become apparent until the late 60s or 70s, the disease
process in the brain often started before menopause.

In The Journal of the American Geriatrics Society in July, Birge summariz=
ed
the diverse findings that support a role for estrogen as a preventive and
treatment for dementia.

These include population studies that show a reduced incidence of
Alzheimer's disease and other dementias in women who took estrogen after
menopause; clinical studies that found less severe symptoms of senility i=
n
Alzheimer patients who happened to be on hormone replacement, and studies
in laboratory animals demonstrating estrogen's ability to stimulate
nerve-cell growth and branching in the critical regions of the brains
involved in Alzheimer's disease.

Estrogen also improves circulation in the brain, which can foster
continuing health of brain neurons.

Perhaps most intriguing is growing evidence that specific subcomponents o=
f
Premarin may have a more potent effect on brain neurons than the drug
itself but would be free of the potential risks to the uterus and breast
associated with the combination of estrogens in Premarin.

Birge, who directs the university's Older Adult Health Center, said he wa=
s
most excited by the prospect of developing a custom-designed estrogenic
molecule that stimulated growth of brain neurons but not cells in the
uterus and breast, which can raise the risk of cancer in these organs.

These unwanted effects are associated with the estrogens naturally produc=
ed
by women before menopause as well as with Premarin, the most widely used
estrogen replacement in postmenopausal women.

Dr. Roberta Brinton, a molecular pharmacologist at the University of
Southern California in Los Angeles, reported at the Osaka meeting that on=
e
of the hormones found in Premarin, equilin, was even more effective than
estrogen in stimulating nerve-cell growth and branching in the brain. The
greater the number of connections between brain cells, the better this
organ can process information.

Current studies in women are assessing the effectiveness of Premarin both
as a preventive and as a treatment. The federally sponsored prevention
study being directed by Dr. Schumacher at 38 medical centers expects to
enroll 8,000 healthy women 65 and older from among the 27,000 women who
will participate in the Women's Health Initiative hormone-replacement
trial.

The women, who will be randomly assigned to receive either hormone
replacements or a dummy medication, will be treated for at least six year=
s
and evaluated each year to determine how many in each group develop signs
of Alzheimer's disease.

Those assigned to hormone treatment who have a uterus will take the hormo=
ne
combination Prempro. Both drugs are being donated by their manufacturer,
Wyeth-Ayerst Laboratories.

A second study, being conducted at Alzheimer research centers around the
United States, is testing whether Premarin can stabilize or even improve
the cognitive functions of 80 women who are in the early stages of
Alzheimer's disease. The women, all of whom have had hysterectomies, will
be treated for six months, Birge said.

-----26------------------------------------------------------------------=
-----
Menstrual cycles could affect disease treatment
-------------------------------------------------------------------------=
-----

Copyright =A9 1996 Nando.net
Copyright =A9 1996 The Boston Globe

(Aug 6, 1996 01:47 a.m. EDT) What if you had breast cancer and discovered=
 that
timing surgery to coincide with a particular point in the menstrual cycle=
 might
make a difference in your prognosis?

Or what if you had diabetes and learned that insulin sensitivity varies w=
ith
menstrual rhythms?

And what if you were plagued by other miseries, like migraine headaches o=
r
yeast infections or systemic lupus erythematosus, that also seem to wax a=
nd
wane along with the menstrual cycle?

Would you use menstrual cues to time your surgery, to watch your blood su=
gar
extra closely, or to predict the onset of troubling symptoms?

Chances are you would -- in these and many other cases.

In fact, if you're among the millions of women who have not yet hit menop=
ause,
you've probably already become a kind of amateur scientist, searching for
connections between your own monthly rhythms and the ups and downs of you=
r
health.

The problem is, the medical establishment hasn't exactly shared in this
enthusiasm for finding links between menstrual rhythms and patterns of di=
sease.
Until recently.

Like the circadian, or daily, rhythms now known to be part of many basic
biological processes, like hormone secretion and temperature control, our
bodies also have longer rhythms, none more obvious than the menstrual, or
monthly, cycle.

To be sure, the question of why humans and many other primates menstruate=
 --
pass blood from the uterus periodically when conception does not occur --=
 is
still an open one.

Perhaps evolution just isn't done with us yet. In fact, if women held the
evolutionary cards, maybe we'd get rid of menstruation, especially if we =
could
have babies without it.

Or perhaps menstruation, just as the textbooks say, is what happens when
something else -- conception -- doesn't happen, though in energy costs to=
 the
body, it seems a high price to pay for a fancy reproductive design.

Or perhaps, as maverick scientist and MacArthur "genius" award recipient =
Margie
Profet contends, menstruation is the female's way of getting rid of all s=
orts
of nasty bacteria and other pathogens that ride into the body on the tail=
s of
sperm.

Profet, an enthusiastic visiting scholar at the University of Washington =
in
Seattle and author of a controversial article on menstruation three years=
 ago
in the Quarterly Review of Biology, thinks menstruation, far from being a=
n
evolutionary accident, is a nifty adaptation to the threat of infection.

Citing evidence from numerous species, including those that may menstruat=
e
invisibly, she says that "sperm are vectors of disease" and that menstrua=
tion
exists "to protect the uterus and oviducts from colonization by pathogens=
."

Whatever its reason for being, the menstrual cycle in humans is a lot mor=
e
complex -- and potentially more closely linked to the rhythms of health a=
nd
disease -- than scientists used to think.

Susceptibility to AIDS infection, for instance, may vary as hormone level=
s
fluctuate across the menstrual cycle.

In May, scientists at the Aaron Diamond AIDS Research Center in New York =
and
the National Institute of Child Health and Human Development found that m=
onkeys
given a high dose of progesterone were more likely than other monkeys to =
become
infected by SIV, the monkey AIDS virus, following vaginal exposure to the
virus.

Cindy Pearson, executive director of the National Women's Health Network,=
 notes
in a soon-to-be-released newsletter that this study involved monkeys, not
women; SIV, not HIV; and progesterone implanted in pellets under the monk=
eys'
skin, not the body's own natural surges of the hormone.

Still, the network is "extremely concerned" because the study showed that=
 when
progesterone is high, vaginal tissue thins, perhaps making it easier for =
the
AIDS virus to gain entry.

This suggests that women who have sex with HIV-positive men might be more
vulnerable during the second half of their cycles, and that women using
progesterone-based birth control, such as Norplant and Depo-Provera, migh=
t also
be at extra risk.

And there are other potential links between health and menstrual rhythms,
though the quality of the research varies from study to study, says
epidemiologist Sioban Harlow of the University of Michigan, who has combe=
d the
medical literature looking for such links.

Basic metabolic rate, for instance, appears to be higher in the second ha=
lf of
the cycle, with women often consuming -- and expending -- 500 extra calor=
ies a
day. "You're hungrier and with reason, not because of lack of will power,=
" says
Harlow.

Immune function also seems to fluctuate with the time of the month -- in =
still-
perplexing ways. Some researchers say progesterone acts as an immune
suppressant; others have found that infection-fighting white cell counts =
are
lowest when estrogen is highest.

In one study, Dr. Barbara Mittleman, an immunologist at the National Inst=
itute
of Mental Health, found that the kind and degree of immune fluctuation ac=
ross
the menstrual cycle seems to vary from woman to woman.

Yet some auto-immune conditions clearly wax and wane with menstrual rhyth=
ms,
among them rheumatoid arthritis and systemic lupus erythematosus, says Dr=
. Balu
Athreya, a rheumatologist at Thomas Jefferson University in Philadelphia.=
 The
worst flare-ups of lupus, for instance, often come in the luteal phase.

And with arthritis, some hormones -- like those in pregnancy -- often off=
er
relief, while those of lactation may make it worse.

Asthma, too, seems to flare just before menstrual periods, many women say=
,
though a 1989 review found that detailed studies on the subject showed no=
 clear
pattern.

It has also been shown that progesterone, the dominant hormone of the sec=
ond
half of the cycle, can trigger adverse changes in cholesterol, says Dr. J=
oAnn
Manson, co-director of women's health at Brigham and Women's Hospital in
Boston. Because younger women are at low risk of heart disease to begin w=
ith,
however, these fluctuations may not pose a huge risk.

Far more likely to cause grief are migraine, acne, panic attacks, changes=
 in
bowel function and an increased tendency toward epileptic seizures -- all=
 of
which have been shown to get worse before a woman's period, says Dr. Kare=
n
Carlson,director of Women's Health Associates at Massachusetts General Ho=
spital
and a co-author of the Harvard Guide to Women's Health.

Diabetic women, too, may have an extra tough time just before their perio=
ds,
she says, because progesterone increases resistance to insulin. This mean=
s it
takes more insulin to get sugar into cells -- so diabetic women may need =
to
increase insulin as their periods approach.

But of all the potential links between menstrual rhythms and health, perh=
aps
none has greater implications than the timing of breast cancer surgery to
ovulation.

"This is really where the rubber meets the road," says Dr. William Hrushe=
sky,
senior attending oncologist at the Samuel Stratton Veteran's Administrati=
on
Medical Center in Albany, N.Y.

For years, says Hrushesky, the idea that the timing of breast surgery mig=
ht be
important was greeted "with ridicule; then (it) went to outright hostilit=
y,
then has been ignored."

But even skeptics like Dr. Kent Osborne, chief of medical oncology at the
University of Texas Health Science Center in San Antonio, now say "what's
really needed is a prospective trial" in which menstrual data are correla=
ted
with timing of surgeryand results are compared.

So far, there have been about 20 retrospective studies in women with brea=
st
cancer. About a dozen of them have concluded that, at least in women whos=
e
cancer has spread to underarm lymph nodes, the best time for surgery may =
be
just after ovulation, when estrogen is falling and progesterone is surgin=
g.
This is the early part of the luteal phase, or second half, of the menstr=
ual
cycle.

In 1991, an American study of nearly 300 women found the luteal phase was=
 best
for surgery, as did a British study of nearly 250 women. In a 1994 study,=
 the
British team noted that the high progesterone in the luteal phase seems t=
o
contribute to "significantly better survival."

A 1994 Italian study of nearly 1,200 women came to a similar conclusion,
finding that women who had surgery in the luteal phase had a "significant=
ly
better prognosis" than those who had surgery in the follicular, or first =
half
of the month.

Some other studies have found no relationship between the timing of surge=
ry and
prognosis, but there are theoretical reasons why there might be a connect=
ion.

In the first half of the cycle, women have high levels of estrogen withou=
t any
accompanying progesterone. Estrogen can trigger a tumor growth factor cal=
led
IGF-1 and may increase enzymes like cathepsin-D that help cancer spread.

By contrast, there are hints that progesterone may damp down such enzymes=
 and
keep small blood vessels from leaking cancer cells into the bloodstream. =
Both
estrogen and progesterone may also influence immune response to cancer, t=
hough
how this plays out across the menstrual cycle is difficult to pin down.

The bottom line, as the Society for Menstrual Cycle Research has been say=
ing
for nearly 20 years, is that more research is needed into the menstrual c=
ycle's
effects on health.

Until that research is done, one of the best things you can do for your o=
wn
health is to keep records of recurring symptoms and chart them against yo=
ur
menstrual cycle.

Whichever way your data turns out, says Carlson, you'll get valuable
information. You may find some connections with menstrual rhythms that yo=
u
never suspected.

And some troubles that you might have linked to monthly periods may turn =
out to
be utterly random strokes of fate.

One of the most controversial conditions linked to menstrual rhythms is P=
MS, or
premenstrual syndrome, now also called premenstrual dysphoric disorder.

Politically, PMS represents a no-win situation for feminists.

The risk in legitimizing it is in "medicalizing" the normal menstrual pro=
cess
and potentially branding all women as sufferers of emotional distress bef=
ore
their periods, says Ann Voda, director of the Tremin Trust Research Progr=
am on
Women's Health at the University of Utah College of Nursing.

On the other hand, failing to recognize the genuine suffering of some wom=
en --
perhaps 5 to 8 percent, according to Nancy Fugate Woods, director of the =
center
for women's health research at the University of Washington in Seattle --=
 is no
solution either.

Clearly, some women do have a terrible time as their periods approach, wi=
th
bloating, breast tenderness, irritability, changeable moods, depression a=
nd
fatigue among the symptoms.

One hypothesis is that this misery is caused by low levels of the brain
chemical serotonin, though this is not proved.

Still, for some women, the premenstrual time does seem to be "almost a
serotonin-deficiency state," says Dr. JoAnn Manson, co-director of women'=
s
health at Brigham and Women's Hospital. And some, she says, get "a good
response to Prozac," an antidepressant drug that increases serotonin leve=
ls.

For others, the anti-anxiety Xanax taken for a week before the period may=
 also
help, says Dr. Karen Carlson, director of Women's Health Associates at
Massachusetts General Hospital.

-----27------------------------------------------------------------------=
---
Date:    Sat, 17 Aug 1996 12:06:26 -0400
From:    Joyce Tames <[log in to unmask]>
Subject: Re: Estrogen vs. PD symptoms
-------------------------------------------------------------------------=
---

Hi,  this is a interesting thread to be revisited.

Four years ago when I was 48 and not yet menopausal,  Chuck noticed and
video documented my daily for four months.  He did this because he notice=
d a
VERY distinct increase in my symptoms coincident with my beginning and mi=
d-
cycle processes.

He had been questioning Dr. Fahn about this for some time without any fir=
m
indication that this had been documented in the PD world.   Although Fahn
did acknowledge that he had heard about this in the UK where there is a m=
uch
larger younger PD population.

When he saw the tape he was most impressed.  Chuck filmed at the same
excercises...i.e.  holding a cup( for easier viewing tremor),  resting ar=
ms
and hands,  hand, body, leg tremors  every day at the same time.   That
together with a daily diary broken into 4 hour segments was absolute proo=
f
that I had been experiencing the monthly effects.   We could even predict
almost to the hour when the symptoms would begin and end.

Shortly after submitting the tape to Dr. Fahn, I received a phone call fr=
om
some PD people in Chicago and Virginia thanking me for the film and also
acknowledging that this was a problem in their areas but one which was ne=
ver
nationally recognized.

When over the years Fahn suggested that no Estrogen be administered becau=
se
it would interfere with the meds I was taking,  I never brought it up aga=
in.
I was able to program my schedules for the upcoming BAD PERIODS and since=
 I
knew that the added tensions were excused.

I posted this on the list some year or so ago and we went through a few
weeks of disucssion where other women also confirmed this phenom.  It was
never followed through.  Now, Im 52 and have additional "withdrawal"
problems not unlike when I was 48.

Since the subject has been brought up again,  can we have imput from othe=
r
gals re their monthly PD symptoms relating to their cycles.  Maybe we can
stir up something interesting now that we are worldwide.

Joyce

-------28----------------------------------------------------------------=
---
Date:    Fri, 16 Aug 1996 15:57:17 -0400
From:    "J.R. Bruman" <[log in to unmask]>
Subject: PDF Summer Newsletter
-------------------------------------------------------------------------=
---

Gleanings From PDF Newsletter (Summer 1996)

-Volunteers sought for trial of OPC14117 at Bethesda, MD

-Volunteers sought for study of dextromethorphan, same site

-Postmenopausal volunteers sought for study of effects of
estrogen on PD symptoms and on response to levodopa.......

-----29------------------------------------------------------------------=
---
Date:    Sat, 17 Aug 1996 07:02:10 -0400
From:    Barbara Blake-Krebs <[log in to unmask]>
Subject: Estrogen
-------------------------------------------------------------------------=
---

Joe Bruman  wrote  in  part--"Postmenopausal volunteers sought for study =
of
effects of estrogen on PD symptoms and on response to levodopa."

In light of news reports yesterday on studies showing that estrogen
replacement in women significantly reduces or delays onset of Alzheimers
Disease, this proposed study is most intriguing!

Barbara Blake-Krebs (55, dx 1984)
[log in to unmask]

-----30------------------------------------------------------------------=
---
Date:    Sat, 17 Aug 1996 14:13:33 -0400
From:    "Kathrynne Holden, MS, RD" <[log in to unmask]>
Subject: Re: Iron
-------------------------------------------------------------------------=
---

[log in to unmask] wrote:
> There seems to be a lot of controversy in regards taking supplemental
>iron - particularly women past child bearing age.

Yes, in relatively recent years researchers have found some correlations
between iron and heart disease. It was thought that estrogen was
protective against heart disease, and that it explained why fewer women
than men have heart disease, until post-menopause.

Now it's believed that iron plays a role, and that women regularly lose i=
ron
via menstruation; following menopause, this avenue ceases to exist, and t=
hus
women are at the same risk for heart disease as men. There are some vitam=
in
pills that do not contain iron. If you are at risk for heart disease, I'd
definitely speak with your physician about the advisability of using such
vitamins.  Your physician will then need to perform blood tests regularly=
, to
assess your iron status......

> Some neurologists frown on iron supplements for PWP but say it
> is ok to take dessicated liver tablets for slight anemia.  I don't have=
 a
> clear picture on this subject and hope you will comment on this.

I'm not aware of any interactions with PD meds; however, iron supplements=
 can
cause GI distress, anorexia, nausea/vomiting, constipation, bloating -- a=
nd it
may be that physicians are concerned about these possible effects, as the=
y
could be additive used in conjunction with PD meds. Does anyone know of a=
ny
other reasons why PWP should not use iron supplements?

Kathrynne Holden, MS, RD

-------------------------------------------------------------------------=
--
Date:           Mon, 19 Aug 1996 21:53:28 -0400
From:           Ron Reiner <[log in to unmask]>
Subject:        Sperm Cells - Maybe 10 Years Hence!
-------------------------------------------------------------------------=
--

Sperm Cells Promote Regeneration of Brain Cells

Source: PR Newswire

SOUTH SAN FRANCISCO, Calif., Aug. 16 /PRNewswire/ via Individual Inc.
-- The Following Has been released by Theracell, Inc.:

Sperm cells from the testes of humans, implanted into the brain of victim=
s
of Parkinson's disease, stroke, Lou Gehrig's disease, and those who have
traumatic brain injuries, promote regeneration of healthy brain cells.

The technique centers around the Sertoli cell, a testes-based cell that
releases an immuno-suppressive agent that enables sperm cells to survive =
and
grow. Animal tests have shown that transplanting Sertoli cells into rat
brains helps various therapeutic agents survive and promotes regeneration=
 of
brain cells.

Theracell, Inc., a subsidiary of Titan Pharmaceuticals of South San
Francisco dedicated to developing treatments for central nervous systems
diseases, has just licensed the technology from co-developers at the
University of South Florida in Tampa, and will be using it initially to
develop products for Parkinson's disease.

If you would be interested in interviewing Dr. Lou Bucalo (Titan
Pharmaceuticals) about this new technology, please call Tanya Nizzi of
S & S Public Relations, 847-291-8420 ext. 223.

SOURCE Theracell, Inc.

/CONTACT: Tanya Nizzi of S & S Public Relations, 847-291-8420 ext.
223/

-------------------------------------------------------------------------=
--

[log in to unmask]
--