Kidney Health

Almost everyone is familiar with heart disease, cancer, stroke, diabetes, and high blood pressure. While these are probably the leading causes of health problems and death, most people fail to realize that kidney disorders and overall poor kidney health can be a major contributor to the development of many of these chronic diseases.

To understand how kidney health and various kidney disorders are related to other chronic disease, it is important to know the role of the human kidney towards overall health and wellbeing. One of if not the single most important functions of the kidney is to filter and clean the blood, removing and keeping it free of toxins and other waste products.

When the kidney is not able to properly execute its functions, the result is poor health, and eventually can even result in death. Kidney failure causes toxins and waste products to accumulate in the body, and disrupts the chemical balance, viscosity (thickness) and volume of blood and other body fluids. Eventually, this can lead to high blood pressure (hypertension) and diabetes which in turn can lead to heart disease and stroke. Furthermore, the compromised quality of blood leads to a depleted immune system which increases the risk of cancer and other serious diseases.

In addition to filtering the waste in your body, the kidneys also play a role in releasing the enzyme rennin which controls blood pressure. The kidneys also help the body convert vitamin D into its active form (vitamin d3, or cholecalciferol) which helps with the absorption of calcium from the intestine (for strong bones and teeth) and producing the protein erythropoietin which stimulates the production of red blood cells. Lack of red blood cells can mean you are anemic and can cause anemia-related fatigue.

For more, see this related story about kidney health and hypertension (high blood pressure).

Common Sports Injuries

Now that summer is upon us and the weather is nicer, more people both young and old participate in outdoor activities. As you know exercise is good for your heart and overall health in general. Aerobic activities such as walking, running, hiking, riding bikes, playing tennis, racket ball, baseball, softball, volleyball, football, swimming, etc. are recommended to stay healthy.

But then there are always those unexpected injuries that present at the most inopportune times. Having sustained a knee injury following a fall while running, I’ve suffered an impaired quality of life and inability to run due to chronic knee pain. I am finally considering laparoscopy to have the torn cartilage removed.

The seven most common sports injuries are:

  • Ankle sprain
  • Groin pull
  • Hamstring strain
  • Shin splints
  • Knee injury: ACL tear
  • Knee injury: Patellofemoral syndrome – Injury resulting from the repetitive movement of your kneecap against your thigh bone
  • Tennis elbow (epicondylitis)

Apply ice immediately after a common sports injury. It’s an anti-inflammatory, without many side effects. Use ice for 20 minutes every one to two hours for the first 48 hours after the injury. Don’t use heat during this time — it encourages swelling and inflammation.

Strains and Sprains are the most common sports injuries. Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Suddenly stretching ligaments past their limits deforms or tears them. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. Strains are called “pulled muscles” for a reason: Over-stretching or overusing a muscle causes tears in the muscle fibers or tendons.

Ligaments and muscle-tendon units are like springs. The tissue lengthens with stress and returns to its normal length, unless it is pulled too far out of its normal range. Sometimes, common sports injuries are preventable. Some injuries we bring on ourselves because we’re not conditioned for the activity. Regular daily physical work outs can keep the body conditioned and strong to help prevent injury.

Every workout should start with stretching and a gentle warm-up to prevent common sports injuries. Getting warmed up increases blood flow to the muscles, gets you more flexible, and could decrease injuries. Overuse injuries are common and preventable. Gradually start working out lightly before engaging in the activity full force. Stop when you are fatigued. Muscle fatigue increases your risk of all injuries.

Usually, common sports injuries are mild or moderate — there’s some damage, but everything is still in place. You can treat them at home using the PRICE therapy method which will be discussed later. But you should expect that some common sports injuries may take months to heal, even with good treatment. If a sprain or strain is severe, however, the entire muscle, tendon, or ligament is torn away, and surgery may be needed.

There are three stages of healing once you’ve incurred a sports injury. Stage 1: Inflammation (1 – 4 days) Pain, swelling & redness occur during this process where tissues lack blood flow and triggers the body’s immune response system to remove the damaged tissues. Stage 2: The Proliferative Phase (4 – 21 days), Oxygen and nutrient flow to the damaged area is restored allowing for repair of collagen. Scar tissue is formed. Stage 3: Remodeling Phase (21 days -2 years), scar tissue is degraded and type I collagen is laid down in its place restoring a more normal function.

The PRICE method for treating common sports injuries

Using the PRICE method to treat any common sports injury will help get you back in the game sooner.

Swelling is a normal response to these injuries. Excessive swelling, though, can reduce range of motion and interfere with healing. The key is to limit swelling and start healing faster after common sports injuries.

P — protect from further injury
R — restrict activity
I — apply ice
C — apply compression (Compression with an elastic bandage will help reduce swelling)
E — elevate the injured area (Elevating the injured area above the heart will also reduce swelling)

Apply ice immediately after a common sports injury. It’s an anti-inflammatory, without many side effects. Use ice for 20 minutes every one to two hours for the first 48 hours after the injury. Don’t use heat during this time — it encourages swelling and inflammation.

Over-the-counter pain relievers usually relieve the pain of common sports injuries to a tolerable level. If they don’t, it’s probably time to see a doctor.

As an Anti-Aging Specialist, I would be remiss if I failed to mention recommended nutrients and dietary supplements as well as new procedures such as stem cells to aid in healing of sports injuries.

The correct combination of nutrients, antioxidants, and dietary supplements can work in conjunction with the appropriate medical treatment to facilitate the healing process in less time. Omega 3 fatty acids act as anti-inflammatory agents. Fruits and vegetables contain nutrients, phytochemicals, and antioxidants that aid in the healing process. Herbs and spices such as turmeric, curcumin, bromelain, cinnamon, cloves, basil, thyme, oregano, cumin, chili powder, sage, ginger, parsley, and black pepper all act as anti-inflammatory agents. In addition to these, nutrients such as vitamin A, copper, zinc, and vitamin C fight inflammation, injury, infection and facilitate the healing process.

While stem cell therapy is becoming more available in other parts of the world, it is only available in research here in the United States. Stem Cells are the repairmen of the body and have been used to treat non-healing bony fractures, herniated lumbar (lower back) disc, avascular necrosis (stages 1 – 4) of the shoulder, hip, knee, or ankle, osteoarthritis of the knee, hip, or ankle or degenerative joint disease, partial tear of the rotator cuff, other knee injuries such as a meniscus tear or tear of the ACL or MCL.

Stem cells live inside all of us in various tissues, poised to leap into action to repair damage as it occurs. The problem is that as we age or get big injuries, we often can’t muster enough of these cells to the site to fully repair the area.

When to get medical attention for common sports injuries

If you suspect a serious injury or if you have any of these signs, see a doctor:

  • Deformities in the joint or bone — it looks “crooked,” or moves abnormally
  • You cannot bear weight or can’t use the limb without it “giving way”
  • Excessive swelling
  • Changes in skin color beyond mild bruising
  • It’s not getting any better after a few days of PRICE therapy

Pamela Egan, MN, NP, ABAAHP Diplomat, CDE is a board certified Adult & Family Nurse Practitioner, a Fellow of the American Academy of Anti-Aging Health Practitioners, Certified Diabetes Educator, and Clinical Specialist in Gerontology/Mental Health. She can be reached at 985-892-3031 or

The Hormone Replacement Therapy Debate

Bioidentical Hormones vs. Synthetic Hormones

Now that more and more women are becoming educated on preventative medicine and anti-aging, the debate is heating up and the very bioidentical hormones that have been used safely for decades across the world are coming under fire in the US. Proponents of bioidentical hormones claim that they are safer than comparable synthetic and non human versions of Hormone Replacement Therapy. Of special concern is the fact that the FDA, big Pharma, state medical boards, and the media claim there is little or no evidence to support claims that bioidentical hormones are safer or more effective.

The term “bioidentical HRT” refers to the use of hormones that are exact copies of endogenous human hormones, including estriol, estradiol, and progesterone, as opposed to synthetic versions with different chemical structures or nonhuman versions, such as Conjugated Equine Estrogens. Bioidentical hormones are also often referred to as “natural hormones,” which can be confusing because bioidentical hormones are synthesized, while some estrogens from a natural source, such as equine urine, are not considered bioidentical because many of their components are foreign to the human body.

Women who had lost their quality of life because of Tubal Ligation Syndrome, hysterectomies, or hormone imbalances associated with aging, report getting their lives back with the use of bioidentical hormones. Many who complained of insomnia, weight gain, depression, memory problems, low libido, aging skin, were able to resolve these issues without anti-depressants, benzodiazapines, or sleeping pills. Those who discovered BHRT described a light bulb going back on and getting their lives back. So, if America is a free country, and a woman can choose whether she wants to use synthetic chemicals such as Prempro or Birth Control Pills, have an abortion, or use bioidentical hormones, why is she being denied the right to choose the latter? Why are physicians being threatened not to prescribe BHRT in the state of Louisiana and being forced to send their patients to Texas for treatment? Why are natural forms of Estriol being banned in America? It would appear that our governing bodies and the media are willing to sacrifice women’s health in the interest of protecting big pharma.


Just this morning, Dr. Nancy Snyderman, the medical commentator on the Today Show, instructed all menopausal women not to take any Hormone Replacement Therapy. She cited the very negative outcomes that was seen with the Women’s Health Initiative. This was a vast clinical trial involving more than 100K women and looked at the effect of estrogen and progestin therapy. The study was stopped when it was recognized that women taking Prempro were at a 25% increased risk of developing invasive breast cancer and heart disease. Snyderman went on to express concerns about all forms of Hormone Replacement Therapy including bio-identical hormone replacement because according to her there was “no evidence” to support the claim that they are safer than commonly used synthetic hormones.

Studies Show Bioidentical HRT to be Safe

In actuality, there are hundreds of studies showing the safety of bioidentical hormone replacement therapy which would make one question the honesty of Dr. Snyderman and why she would purposely withhold the truth from women. Furthermore, the US Food and Drug Administration (FDA) have ordered pharmacies to stop providing estriol, stating that it is a new, unapproved drug with unkown safety and effectiveness. This is the same FDA that has approved the use of synthetic birth control pills in 14 year olds to control acne and the use of the depo-provera shot for birth control in young women, which contains the same synthetic progestin as Prempro. Whose side are they on?

Nevertheless, estriol has been used for decades without reported safety concerns and is a component of medications approved for use worldwide. The FDA has acknowledged that it is unaware of any adverse events associated with the use of compounded medications containing estriol, and US Congress is considering a resolution (HR342) to reverse the FDA’s decision to restrict its use.

The definitive article on Bio-Identical Hormones versus Synthetic has been written by Kent Holtorf, MD published in Postgraduate Medicine, Volume 121, Issue 1, January 2009, which evaluates the evidence comparing bioidentical hormones, including progesterone, estradiol, and estriol, with the commonly used nonbioidentical versions of HRT for clinical efficacy, physiologic actions on breast tissue, and risks for breast cancer and cardiovascular disease.
Dr. Holtorf in his work did an exhaustive literature search and reviewed an array of Journal articles and published papers documenting human clinical studies, animal studies, and in vitro experimental work that compared bio-identical and non-bioidentical hormones as well as focusing on the physiological and biochemical aspects of the hormones.

Results showed that patients reported greater satisfaction with HRT’s that contain progesterone compared with those that contain a synthetic progestin. Bioidentical hormones have some distinctly different, potentially opposite, physiological effects compared with their synthetic counterparts, which have different chemical structures. Both physiological and clinical data have indicated that progesterone is associated with a diminished risk for breast cancer, compared with the increased risk associated with synthetic progestins. Estriol has some unique physiological effects, which differentiate it from estradiol, estrone, and conjugated equine estrogens. Estriol would be expected to carry less risk for breast cancer, although no randomized controlled trials have been documented. Synthetic progestins have a variety of negative cardiovascular effects, which may be avoided with progesterone.


                                                  Natural Progesterone

The effect of progesterone compared with Progestin, medroxyprogesterone acetate (MPA) included a 30% reduction in sleep problems, a 50% reduction in anxiety, a 60% reduction in depression, a 30% reduction in somatic symptoms, a 25% reduction in menstrual bleeding, a 40% reduction in cognitive difficulties, and a 30% improvement in sexual function. Overall, 65% of women felt that HRT combined with progesterone was better than the HRT combined with synthetic progestin, MPA.

In conclusion, physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including lower risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT.

Pamela Egan, DNP, CDE
Doctor of Nursing Practice
MS, Metabolic & Nutritional Medicine
Fellow, Metabolic Medical Institute
MN, Gerontology Mental Health
Certified Diabetes Educator

She can be reached at 985-892-3031 or