Exercise & Growth Disorders & Health Care Systems/Delivery & Obesity 18 Jan 2010 01:57 pm

I’m Still Alive

I knew it had been a while since I last posted an entry, but I was astonished that it had been 2 months.  I apologize for my lazy behavior.  My only real excuse is that I have been following the often painful health care reform news and wanted to wait to write anything about it until there was (or maybe was not) an actual bill to discuss.  I’m still waiting.  But, I do want to mention 2 recent articles of interest.  The first was a nice discussion about hair loss in women.  The article entitled “When Hair Loss Strikes, A Doctor Is a Girl’s Best Friend,” and written by Lesley Alderman appeared in the New York Times on Saturday January 16, 2010.  It is a nice summary of the major causes and treatments for female hair loss, some of which are endocrine.

I would only add to the discussion that in some instances, hair loss is on an auto-immune basis (called alopecia areata if the hair loss is spotty or alopecia totalis if the loss is big time) and is strongly associated with certain other auto-immune disorders, particularly chronic lymphocytic thyroiditis (aka Hashimoto’s thyroiditis) and adrenal insufficiency.  If the hair loss is considerable and sustained over weeks-to-months, I would strongly recommend a visit to a dermatologist before embarking on potential therapeutic misadventures.

The second article which appeared in the New York Times Magazine on Sunday January 17, 2010 was written by Tom Dunkel and was entitled “Vigor Quest.” The article was a very interesting and surprisingly balanced discussion of the attempts by what appears to be an increasing number of people obsessed with prolonging their youth, or at least, their youthful performance in a variety of activities.  My interest in the subject is, of course, as an endocrinologist (not as an aging endocrinologist).  Much of the discussion in the article focused on testosterone and growth hormone, drugs about which much has been written in both the medical and non-medical literature.  The subject has been in the news quite a bit recently with the controversy surrounding use of these drugs in professional athletes.  There is no question that deficiency of either testosterone or growth hormone can impair athletic performance and affect overall vigor.  The still unanswered questions are whether taking one or both of these substances when there is no apparent deficiency can be helpful and if there are potentially serious side-effects.  It is good that the National Institutes of Health has embarked on a long-term (6 years) study of the potential mental and physical benefits of testosterone therapy in elderly men.  They should also consider a companion study of growth hormone.  I for one strongly recommend that until we have much more scientific information, use of these biological agents be limited to patients who have definite deficiencies and symptoms and signs to match the laboratory findings.  But, I just wonder how fast I could swim if………?

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