What the ZRT Docs Are Reading

The ZRT Clinical Consultants Thursday, June 06, 2019

Here at ZRT, we clinicians are always reading. When we aren’t on the phones or completing laboratory reports for you, we are constantly researching and reading. We read everything from the books that some of you are writing to articles on Pubmed and Medscape. We thought that it might be fun to tell you what is currently on our reading agenda.

Dr. David Zava

When asked to write in brief about what I am reading, the only thing that came to my mind was, “a lot”. I’m always reading scientific journal articles related to the tests and research (R of ZRT) we are actively engaged in with many different research groups around the globe, which include mostly organizations with NIH grants, as well as sports organizations and the military. I serve as a consultant for these research organizations to help interpret the tests we are asked to perform in saliva, dried blood spots, and dried urine. The science articles that have the greatest stick to my neurons these days are those involved in providing a deeper understanding of stress and circadian rhythms of cortisol and melatonin, as well as norepinephrine and epinephrine. In my breast cancer research over the past 40 years, and diurnal cortisol/melatonin testing we have done on breast cancer patients, it is crystal clear that cortisol and melatonin do not have normal circadian rhythms in many of the patients we have tested who indicate a history of breast cancer, or who are at high risk for it and possibly harboring an occult tumor. The journal articles I have gleaned the most knowledge from as regards the brain-adrenal feedback systems related to stress, and diseases like cancer, diabetes, and cardiovascular, include those by Nicolaides NC, Frontiers in Endocrinology, 2017 [1]; Bahrami-Nejad Z, Cell Metabolism, 2018 [2]; Champaneri S, Metabolism, 2012 [3]; Yehuda R, Endocrinology, 2011 [4]. For the scientist geeks, of which I’m proudly in that camp, I’m also reading “The Innovators” by Walter Isaacson, which is a historical account of scientific innovators such as Steve Jobs and Bill Gates, among many others, that created the digital age, software, and computers as we know them today. And then there’s a book I’m currently reading entitled “American Moonshot: John F Kennedy and the Great Space Race” by Douglas Brinkley, which takes us back to the beginning of the Second World War when Kennedy was just a young man, his father was working for Roosevelt’s administration, and Von Braun was making V2 rockets for Hitler that were raining terror on England. There is mention of the Manhattan Project that took place in part in Oak Ridge Tennessee, where my father was sent to work on this secret project, and where I was born into this mecca of scientists. Growing up in Oak Ridge, the science city, is what sparked my interest in science and probably why I’m doing what I’m doing today.

Dr. Kate Placzek

I recently read “PCOS SOS, A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness” by Dr. Felice Gersh. The book completely absorbed me, I couldn’t put it down. I finished it in just one day. Dr. Gersh draws from nearly 40 years of clinical experience in gynecology, to write beautifully and reveal extraordinary ways in which the body can heal itself from PCOS. In this book, Dr. Gersh brings forth the protocol that prioritizes supporting the body’s normal rhythms and processes. PCOS SOS is a culmination of years of work, the product of real passion and commitment to understand the underlying mechanisms behind PCOS, transcending conventional approaches. It blends clinical innovation with a clear and powerful writing style to achieve perfection in combining cutting-edge research publications with a clinically actionable road map to create comprehensive, inspiring and practical health strategies that patients can implement immediately.

PCOS SOS is a ground-breaking work that will endure as a paramount read for anyone who wants to understand, approach and heal from PCOS. I hope this book is as widely read as it deserves to be. I expect the number of transformative success stories will be remarkable.

Dr. Sherry LaBeck

On the heels of Dr. Kate’s beautifully, expressive review of Dr. Felice Gersh’s new book, and contrary to Dr. Smith’s assertion that “we can’t all talk about the same book,” I present my review version.

In her new book, PCOS SOS, A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness, Dr. Felice Gersh encourages women with polycystic ovarian syndrome (PCOS) to try to “live in sync” with their body’s natural rhythms, as well as in harmony with their environment. She goes on to explain in very realistic, practical terms how to accomplish this. Thus, Dr. Gersh has written step-by-step chapters for managing the symptoms and health consequences of this often-misunderstood condition.

PCOS SOS is an exceptional guidebook for a patient to navigate her individual PCOS journey and the health concerns she encounters. Yet, the information presented would benefit any health care practitioner presented with a patient or patients with a possible PCOS situation.

Each information-packed chapter has a troubleshooting section where Dr. Gersh answers common questions specific to the chapter. A “quick summary” then follows as a reminder of the important points covered. Chapters conclude with a list of “healthy habits” to be checked off with implementation. Each section includes natural options, along with conventional medications that can be advantageous. All in all, I found Dr. Gersh’s book to be insightful, accessible and engaging.

Dr. Allison Smith

I had to chuckle because we’ve all most recently read Dr. Gersh’s book in the clinical department here at ZRT, so eloquently reviewed by Dr. Kate, but we can’t all talk about the same book. As anyone who does any writing in the Health and Wellness space knows, you read tons more than you actually write – but you don’t always have time to digest a book while you’re wading through medical journals. So, what I’m reading right now actually isn’t a book at all – it’s something I’ve been keenly interested in for the last few years (lecturing on it, writing about it) and rather than a book, is more a collection of studies and reviews on the topic of the circadian rhythm’s association with disease. I’ve picked one and would love to share a couple of neat tidbits you might find applicable to your practice.

The article piquing my interest, Diurnal Variation of Circulating Interleukin-6 in Humans: A Meta-Analysis [5], published in PLoS One a couple years ago teases out important details on the diurnal rhythm of IL-6. IL-6, best known for its role in modulating the immune response as an inflammatory cytokine that works with IL-1β, TNFα, and IFNɣ, peaks at night and troughs in the mornings. Did you know that at night, cytokines help regulate sleep and contribute to sleep architecture? When the circadian rhythm of IL-6 is disrupted – loses its variation or phase shifts to higher levels during the morning – the result is daytime fatigue and/or sleepiness. Talk about tired and wired!

What struck me the most when reading this article was how similar it felt to reading about cortisol and how our understanding of its relationship to health and disease has evolved beyond 24-hour highs and lows into a much more comprehensive territory, where we scrutinize the daily slope just as much as the individual highs and lows. Regarding IL-6’s similarity to what we’re finding with cortisol rhythms, a recent study in the Journal of Atherosclerosis and Thrombosis: Interleukin-6 Level among Shift and Night Workers in Japan: Cross-Sectional Analysis of the J-HOPE Study [6], found elevated IL-6 levels in night workers and a positive relationship to cardiovascular disease, although the study design did not control for time of day for IL-6 draws (darn!). I just know more research is forthcoming as researchers have already expressed interest in overnight and diurnal IL-6 levels in PTSD, insomnia, and depression – and these are cohorts known for their altered cortisol patterns. The overlap intrigues me!

Dr. Katrina Wilhelm

What Your Doctor May Not Tell You About Breast Cancer

The seminal work written by John Lee, MD, our very own David Zava, PhD, and Virginia Hopkins, highlights the pivotal role natural progesterone can play in protecting women from developing breast cancer.

Among the steroid hormones, progesterone tends to drop first for women who are moving into their perimenopausal phase and can even decrease cell sensitivity to thyroid hormones, as well, creating symptoms of thyroid deficiency when free T3 uptake drops.

While natural progesterone is readily available as an OTC cream, products often come in a squeeze tube asking you to apply a “pea” sized amount of cream, never really assuring a specific dose per application due to volume variability.

I recommend looking for a professional brand with a metered dose dispenser –- that way you and your patient both know exactly what dose is being delivered. My favorite topical progesterone cream delivers 20 mgs per pump, which works excellently with the ZRT saliva testing topical ranges, which were developed for use with 10-30 mg of topical progesterone per day.

Dr. Alison McAllister

Overcoming Overwhelm by Dr. Samantha Brody

Sadly, reading this book won’t magically take you away from your stressors, give you a million dollars or put you on a beach in Tahiti where you eat amazing fruit while engulfed in the scent of local flowers. If only managing stress was so easy. This book is a workbook and I think it’s a great one to get people to look at what they want in their lives, the energy, the values, and their choices. One of the things we know about the physiology of stress is that our responses, and the feeling that we can respond, help decrease stress. Dr. Brody’s workbook is about taking control of what stresses we allow in our lives, what our life priorities are and how we choose to respond to them. I think that in this world where things are constantly coming at you, it’s really nice to have a tool that encourages people to just stop and say – How are you spending this life? Is this what brings you happiness? Are you getting what you want and then making choices to adapt to things that you can’t change? This book isn’t written for doctors/healthcare practitioners, but boy, I can’t think of a group of people who really need it more as a profession facing overwhelming burnout rates. This is geared to be a workbook talking about practical approaches, understanding some physiology and then some deeper questions I think we all need to ask ourselves. I recommend checking it out; if it doesn’t speak to you, I’m sure that you will have at least one person in your life who needs it.