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Livingwell
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HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY
JUNE 2015
IN THIS ISSUE | 2 Men’s nutrition | 3 Midwives | 4-5 Top events and support groups | 6 High fructose corn syrup
Valley Fever
MEN’S WELLNESS
DEFINED TO A ‘T’
‘Arizona’s illness’ can be extremely debilitating By Debra Gelbart
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Understanding the complexity of testosterone’s impact on men’s health STORY BY D E B R A G E L B A R T | PHOTOS BY R I C K D ’ E L I A
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ow T — a clinically low level of the hormone testosterone — is a medical condition that is misunderstood by many men. Testosterone is a vital part of a man’s health said Harmeet Singh Narula, M.D., an endocrinologist at Banner Health Center in Sun City West. Testosterone, produced by the testicles, “promotes normal development from a boy to a man. It’s responsible for muscle mass, virility, testicular function and libido,” he said. Thinkstock
Testosterone replacement “The Endocrine Society recommends testosterone replacement therapy (TRT) only if biochemical testosterone levels are unequivocally low and the man exhibits the clinical symptoms of Low T (also known as “hypogonadism”) including low energy, low libido, erectile dysfunction or a decrease in lean body mass,” said Shawn Blick, M.D., a urologist with Abrazo Community Health Network. Estrogen, in a form called estradiol, is normally present in men, too, but in low levels. If a physician finds that a man’s estradiol level is too high, it may be because he is obese and his fat cells are converting testosterone to estradiol, causing Low T, Blick explained. Instead of a TRT prescription, the solution may be a medication called an aromatase inhibitor that prevents the conversion to estradiol and brings testosterone levels back in balance. To be accurate, blood testing for testosterone levels should be performed between 7 a.m. and 10 a.m. when the patient has been fasting for at least eight hours. “When testosterone levels are determined at other times of the day, they can be inaccurately low,” Blick said. That could lead to unnecessary treatment, said Gil Brito, M.D., a urologist affiliated with HonorHealth in Scottsdale. In fact, up to 25 percent of men currently receiving testosterone replacement therapy never had their testosterone level checked, Brito said. “Low T is a true condition in men, but replacement therapy is not indicated for men who have low-normal testosterone levels but want them to be high-normal.” Men with low-normal levels and without clinical symptoms of Low T shouldn’t be in treatment, he said. The medication carries warning labels about the risk of stroke and heart attack from using it. TESTOSTERONE, continued on page 5
alley Fever ultimately affects many people who live in Arizona. Indeed, the majority of sufferers in the U.S. live at least part of the year here in the Grand Canyon State. The course of the illness and its prognosis can vary substantially, with health effects ranging from almost non-existent to extremely debilitating. Scientifically known as Coccidioidomycosis — “Cocci” — Valley Fever is caused by a fungus whose spores are inhaled from soil or when dust becomes airborne. The vast majority of Arizona cases are confined to Maricopa, Pinal and Pima counties, said infectious disease specialist John Galgiani, M.D., a professor with The University of Arizona College of Medicine and director of the Valley Fever Center for Excellence in Tucson and Phoenix.
“[Having Valley Fever] was the worst four months of my life medically.” —Lisa Stinchcomb
While two-thirds of the estimated 90,000 Arizona patients who contract Valley Fever every year aren’t sick enough to go to the doctor, for the 30,000 patients who do require medical attention, it can be a nightmare.
Unable to work, think
Gil Brito, M.D., talks with patient Ray Schwann about recent success in treatments, while also checking indicators during a follow-up visit to the urologist’s Scottsdale office.
Lisa Stinchcomb, a pharmaceutical representative who lives in Phoenix, was stricken with severe upper back pain in December of last year. A healthy and active mother of two, she was initially wrongly diagnosed with pleurisy, but three days later she was correctly diagnosed with pneumonia. “I felt like I was dying,” she said. For nearly three weeks, she slept almost all day. Although her back and chest felt better after resting so much, her brain was still foggy. “I felt robbed of any ability to make any important decisions,” she said. She finally was diagnosed with Valley Fever by an internal medicine physician but continued to feel unwell. She made an appointment to see Galgiani, who placed her on medical leave. “He told me my job was to sleep and let my body attack this fungus,” Stinchcomb said. She started to feel better and finally, after another three VALLEY FEVER, continued on page 5
YO U R H E A LT H HEAD TO TOE
Harmeet Singh Narula, M.D., said that testosterone is a vital part of a man’s health. Produced by the testicles, testosterone promotes normal development from a boy to a man and is responsible for muscle mass, virility, testicular function and libido.
WE HONOR
Watch for upcoming articles on the following topics as we provide information on your health — from head to toe. JULY: Colon AUGUST: Ovaries SEPTEMBER: Prostate OCTOBER: Circulatory NOVEMBER: Feet DECEMBER: Skin
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