Letter from Dr.Jacobi

Dear Patients,

I will be in Germany from May 3rd to May 24th. As many of you know, Germany is my native country and I am very excited to return for a visit after a 15 year absence. I have several exciting stops planned. First, I will once again staff “The Path of Love,” a week-long spiritual retreat designed to re-connect us with our longing and allow us to recognize the obstacles that prevent us from living our truth. This retreat is being held in Germany, Australia, and the US. It is a powerful and profound experience, not just for the participants! ( If you are interested in this type of work log on to www.pathoflove.net )

My next stop will be the town of Bad Mergentheim, home of the Hufeland Clinic, a treatment center for cancer and chronic illness. This clinic utilizes many of the same treatments as the YNC and claims a 67% cure rate for incurable cancer! I will be visiting and observing some of their therapies to see what we can implement at our clinic. The versatility of our medicine never ceases to astound me…we can truly combine the best of natural and conventional medicine. With increasing numbers of people unhappy with the conventional medical model, my belief in our medicine deepens.

Before I head on home, I will pick up my 82 year-old Granny and we will visit the places of my youth. That means I will drive on the Autobahn!

One last note: with the recent world events I feel a growing need to be positive, loving, and accepting. The world has become a very small place indeed. Let’s not focus on our fears…fear keeps us small and disconnected. The world is such a beautiful place, and as a wise man once said: “life is a mystery: not a problem to be solved but a mystery to be lived.”

Peace and love to you all,
Nirala Jacobi, ND

Drs. Nicolai and Powers will be available to see Dr. Jacobi’s patients during her absence. Please feel free to contact the YNC if you need an appointment.

Male Menopause: Fact or Fiction?
by Paul Nicolai, ND

What is menopause?
According to dictionary.com, menopause is defined as “the period marked by the natural and permanent cessation of menstruation, occurring usually between the ages of 45 and 55.” I can already see there’s going to be trouble here. Obviously, my best option at this point would be to cut my losses by changing the title of this column to “Male Menopause: FICTION.” and go on about my business. Still, though, because I work with quite a few male patients over the age of forty, I think I’ll stick with the title I have for now and continue looking into this “male menopause” idea.

A further look at the medical phenomenon
typically referred to as menopause reveals that this cessation of menses is the direct result of a dramatic decrease in estrogen, the dominant female sex hormone. The typical menopausal woman may experience a multitude of symptoms related to this hormonal change, many of them being completely unrelated to her menstrual cycle. In other words, hormonal alterations can result in whole-body physical, mental, and emotional changes, many of which are experienced as unpleasant or unwanted. This isn’t actually much of a surprise, as wholebody changes of this type routinely occur in many types of hormone deficiencies. Two common examples are decreased output of the thyroid gland and decreased output of the adrenal glands, both of which are typically treated with some type of hormone prescription. In women undergoing menopause, hormone replacement therapy is routinely prescribed with the dual goal of both alleviating symptoms and maintaining bone health.

Can men have a hormonal change that compares to that found in menopausal women?
A recent article in the journal Urologic Clinics Of North America estimates that 1 in 200 men over the age of 40 have abnormally low testosterone levels. Other sources estimate an even higher percentage. In my practice, I routinely see men over the age of forty with symptoms suggestive of this problem. After performing the appropriate testing, a significant percentage of these men can properly be diagnosed as having decreased testosterone levels.

This decrease of testosterone is often referred to as “andropause,” which has been defined as the “cessation of masculinity.” There are other names for this condition that may be more medically correct (as well as more tactful, in my opinion). Two examples are ADAM - androgen deficiency in the aging male, and PADAM - partial androgen deficiency in the aging male. The bottom line? Terminology is not important. What is important is the fact that this phenomenon is very real, not uncommon, and easily diagnosable.

What are the symptoms of decreased testosterone levels?
A decreased testosterone level is the possible cause of a multitude of symptoms, some of which are related to sexual performance, many of which are not. Examples include:

Changes in mood such as fatigue, depression, anger, decreased intellectual capacity, and trouble with spatial orientation.

Changes in body make-up such as decreased lean body mass, muscle size, and muscle strength with an increase in abdominal fat.

Changes in the strength and appearance of the skin.

Decreased bone mineral density. Although typically viewed as a problem faced by menopausal women, approximately 20 to 30 percent of hip fractures occur in men. These fractures are often the first symptom of decreased bone mineral density.

Diminished sexual desire with a decreased quality of erection (often referred to as “ED” or “erectile dysfunction”). A decreased frequency of night-time erections and a longer refractory period (the time between when you reach orgasm and achieve a new erection) are other sexual symptoms often associated with low testosterone.

Are decreased testosterone levels the only cause of these symptoms?
Absolutely not. For any given symptom, there may be a multitude of potential causes. The best way to determine if low testosterone is contributing to your symptoms is to see a qualified physician for a thorough work-up of your health issues.

How are decreased testosterone levels diagnosed?
Although a history and physical examination may provide clues pointing to this diagnosis, the only way to definitively determine a patient’s current testosterone level is to measure several parameters with a blood sample. A proper history and a complete physical exam, even though not reliable by themselves, are also essential in order to make sure that no other diagnoses have been missed and to determine the appropriateness of treatment with testosterone. Depending on the results of the initial workup, it may also be necessary to order additional laboratory studies and imaging tests such as an MRI. Some men may choose to have an additional study done to determine their bone mineral density.

This study, a dual-energy x-ray absorptiometry, aka. “DEXA” scan, gives a patient an approximation of their fracture risk as it pertains to other persons their age.

What treatment options are available?
For many years, testosterone was administered by injection every 2 weeks or so. Because of the uncomfortable peaks and valleys in testosterone levels created by these injections, many other forms of testosterone have been developed. It is now also available in pills, patches, creams, and sublingual tablets. Because not all forms of testosterone therapy are equivalent, the best way to determine which form and dosage is right for you is to consult a physician trained in this type of therapy.

Even if your testosterone level is low, using prescription testosterone may not be the only way to bring it into a range that alleviates your symptoms. There are many lifestyle choices that can dramatically affect your testosterone metabolism. In fact, if you are significantly overweight, drink alcohol, and do not exercise, it is entirely possible that you are turning a significant portion of your testosterone into estrogen. I have actually seen men who have higher estrogen levels than their wives!

Is testosterone therapy appropriate for everyone?
Unfortunately, the answer to this question is no. If you have ever been diagnosed with prostate cancer, you should not use testosterone. Prostate cancer represents an absolute contraindication to testosterone therapy. There are several other situations (called relative contraindications) that should be discussed with your doctor when considering whether testosterone might be beneficial. These include: sleep apnea, polycythemia (too many red blood cells), and symptomatic prostate disease. These may or may not represent problems in your case and do not necessarily preclude the use of testosterone as therapy.

In closing, I’d like to make it clear that I do not believe in a fountain of youth or a quick fix. What I do believe in is a fountain of information and intelligent decision-making that allows patients to receive appropriate treatment, feel better, and function at a higher level.

For more information, please refer to the Lectures, Classes, and Upcoming Events page. During the upcoming months, Dr. Nicolai will be providing lectures on this topic and on hormone replacement therapy for women.

Spring and Summer Are the Perfect Time for Cleansing and Detoxification!

After a winter filled with cold weather and short days, a detoxification and cleansing course is the perfect complement to your naturopathic treatment program as you enter Spring and Summer ready to look better, feel better and re-energize. To help you fit this important course into your busy schedule, we’ve decided to offer three different times, one in May, one in June, and one in July. Detoxification courses are good for almost anyone, but persons who have skin problems, hormonal issues, digestive complaints, or who are trying to lead a tobacco, caffeine, or refined sugar-free lifestyle will find them to be an essential part of their transition towards health. This is also a great time to repeat the detox class if you’ve already done one. Everybody has a time for Spring-cleaning their house and car. Why not make time for this course and do a little Spring-cleaning for yourself and your health?

For more information, please refer to the Lectures, Classes, and Upcoming Events page or call us at 406-259-5096.

HIPAA - Health Insurance Portability and Accountability Act

HIPAA is a federal government mandate, designed to protect patient confidentiality for all health care related information. This law will affect how your information will be handled by all health care providers.

Yellowstone Naturopathic Clinic has always made it a priority to respect the confidential information of our patients – we believe this to be a fundamental part of the doctor-patient relationship and essential to good health care.

While we will not need to make any philosophical changes as a result of this new mandate, demonstration of compliance with the government’s policies will result in several changes, some of which will affect our patients. In particular, there will be more paperwork – documents for you to read and forms to sign.

Please bear with us while we make this transition – we’ll do everything we can to make it as seamless and pain-free as possible. If you have questions, please feel free to ask any staff member or our HIPAA compliance officer (and office manager), Allena Adams.

DISPENSARY POLICIES

As many of you may have noticed, we recently changed to UPS from our previous mail services. We made this change because of steadily increasing shipping costs and a lack of ability to track packages and guarantee delivery. At this time, we believe that UPS offers the best combination of affordability and reliable service.

UPS is most cost-effective for orders with more than one item. To help keep your shipping costs as low as possible, please consider ordering more than one item at a time or combining your order with a friend.

We strive to stock the finest products at the lowest possible cost to you and are committed to making these products easily available to all our patients, whether they live in Billings or at a distance. We honor your business and welcome your feedback. Please feel free to phone, use our e-mail address (ync@180com.net), or drop us a note by mail.

Therapeutic Health Spa News

We would like to welcome Becky Toney. Becky has a diverse background in Cosmetology and management. She is pleased to be part of the staff of the Yellowstone Naturopathic Clinic’s Therapeutic Health Spa and looks forward to helping you with your Spa experience.

Lavender
(Lavandula officinalis)

One of the most precious essential oils.
Fragrance: clean, classic, appeasing.
Best Variety: “lavender fine”
Indications: Respiratory, migraine, depression, fainting, nervous tension, acne, burns, wounds, insect bites. Just to name a few!!!
Its blue flowers bloom at the top of a structure resembling a candlestick; giving a clean soothing scent that is on our most natural perfumes!

Lavender Fine is sold in our Health Spa!

A Message From Dr. Beeson:
I would like to thank all of Yellowstone Naturopathic Clinic’s patients for their continued patience with the recent changes to our clinic policies. We are striving to remain flexible while continuing to serve your needs. Please let us know if you have any concerns.

Yellowstone Naturopathic Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655

ync@180com.net

Dispensary
406·254·9682

dispensary@yncnaturally.com