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Introducing Doctor Formulated
Andrew L. Rubman, N.D.
Naturopathic Physician Southbury CT, USA Clinic for Traditional Medicines
Dr. Andrew L. Rubman is a naturopathic physician and founder of the Southbury Clinic for Traditional Medicines in Connecticut. He is a member of the American Association of Naturopathic Physicians and was inducted into the association's elite Founder's Club. He is also a Fellow of the International Association for Medical Preventics and a member of the National Center for Homeopathy, the Orthomolecular Medical Society, and the National Science Honor Society. His most current project has landed him as the primary formulator of Estromin® AHS, a unique blend of botanical components clinically documented to restore hormonal balance in women. Estromin®, combined with fibrinolytic enzymes, provides women with a direct defense against uterine and breast abnormalities.
FibroVera is intended to modulate hormonal response, restoring inherent processes in a woman's body, easing inflammation, and enhancing the removal of excess fibrin. Each component was carefully selected using only well researched and clinically supported ingredients. The cooperation of Arthur Andrew Medical, the premier enzyme developer, and Dr. Andrew Rubman ND, specializing in holistic endocrinology (study of hormones), has led to the development of one of the most advanced hormonal support products available.
Estrogen stimulates cellular tissue growth especially in the estrogen sensitive female reproductive organs. The hormone progesterone makes tissue more fertile and helps to control duration and intensity of estrogenic effect. When a woman's estrogen / progesterone production and tissue effects are balanced, normal menstrual cycling continues until menopause. Imbalance in natural hormone levels, as well as exposure to hormone-like substances (xenosteroids) from pharmaceutical drugs and environmental exposures, can evoke many disturbances in the female reproductive tissues. Such imbalances may trigger abnormal tissue growth within the breast and other female reproductive areas. This activity within the uterus can lead to the development of fibrin nests and eventually the growth of fibroids. Progesterone is particularly vulnerable and healthy levels can begin to naturally diminish with age; predominantly due to the effects of environmental and psychological stress. Ideally the best course of action is to supplement dietary components that restore hormonal equilibrium.
Diindolemethane (DIM), extracted from the Brassica family of cruciferous vegetables, has been shown to modulate estrogen metabolism, preventing undue synthesis through aromatization of androgens, thus allowing the body to preferentially create more healthy products like 16-á OH-estrogens, and less 2-á OH-estrogens., The 2-á OH-estrogens create pro-carcinogenic metabolites (bad) and the 16-á OH-estrogens create anti-carcinogenic metabolites (good). This is extremely significant to naturopathic oncologists concerned about maintaining positive estrogen effects, while avoiding the promotion of the disruptive effects. After prescribing DIM, I have seen symptomatic improvements in patients being treated for uterine fibroids.
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Hormonal imbalances - The Fibrin Connection
As a naturopathic physician specializing in peri and post-menopausal endocrinology, I have sought to address and manage the transition both into and through menopause. During this transition several hormonal changes take place, among them, the tendency towards an imbalance between progesterone and estrogens. This deregulation often triggers pro- inflammatory responses such as excessive fibrin deposition which can accumulate as abnormal tissue growth in the breast and uterus.
Fibrin (scar tissue), the key building block of tissue repair, is created by the uterine muscle (myometrium) in response to normal cycling, pregnancy, and challenges like miscarriages, etc. The normal process of fibrinolysis (fibrin dissolving) can be enhanced by introducing fibrinolytic (fibrin lysing) enzymes. Serrapeptase is an exceptional fibrinolytic enzyme, able to digest and liquefy large amounts of fibrotic scar tissue. Serrapeptase also exerts extremely high anti-inflammatory properties, which may alleviate pressure induced by menstruation. This enzyme is available by prescription only in Europe as the ethical drug Dasen® manufactured by Takeda Pharmaceuticals. Serrapeptase is extremely safe and shows maintained health benefits for long time use. Bromelain is another highly regarded enzyme with the potential to digest necrotic (dead) proteins. Fibrin is recognized as necrotic (non-vital) tissue by Bromelain and broken down and released into the bloodstream for excretion. Bromelain is extracted from pineapple stem and is commonly used as the main ingredient in meat tenderizer as it easily breaks down and softens necrotic proteins. Papain is a cysteine protease extracted from the papaya fruit (Carica papaya), which is also commercially used in tenderizing meats and other proteins. Papain blocks some pro-inflammatory metabolites that accelerate and worsen the inflammatory process. All of these enzymes exert noticeably strong proteolytic (protein digesting) and anti-inflammatory properties. A blend of proteolytic enzymes from rare, but sustainable, rainforest botanicals has been added to FibroVera to work synergistically with Serrapeptase and Bromelain to soften and liquefy scar tissue transforming it back into soft circulating fibrin fragments. These fragments may accumulate and thicken the blood making it necessary to involve yet another enzyme, Nattokinase, a fibrinolytic enzyme mimicking plasmin. Oral administration can enhance the fibrinolytic activity in the plasma for long periods of time. This activity is related to induction of tissue plasminogen activator, which in turn increases plasmin activity. Plasmin is the body's natural blood thinner responsible for maintaining normal blood solvency by removing unnecessary accumulated protein. Nattokinase, the enzyme produced by the bacillus Natto, is actually 60% stronger than plasmin itself. Nattokinase helps normalize blood viscosity by dissolving the lysed fibrin fragments. It is necessary to use several types of proteolytic enzymes, as proteins have different amino acid sequences that require a variety of enzymes to cleave (break) them. The 6 classes of proteolytic enzymes include: serine proteases, threonine proteases, cysteine proteases, aspartic acid proteases (e.g. plasmepsin, metalloproteases, & glutamic acid protease).
Estrogen dominance: what you need to know
Estrogen dominance: what you need to know
The phenomenon of Estrogen Dominance has been widely discussed with its relationship to fibroid growth. It is a prime contributor to the deregulation of normal function experienced by not only women approaching, transitioning, and resolving the challenge of menopause, but also those young women experiencing difficulty with menarche (the beginning of fertility). This imbalance is initially characterized by a number of factors:
A decrease in DHEA due to stress, aging, poor diet, side effects of prescription drugs etc.
A decrease in progesterone effect due to absolute decrease in synthesis secondary to inadequate cholesterol down-conversion and increasing insensitivity of progesterone receptors.
The activation of a cross-conversion pathway that forces progesterone to act as a source for the synthesis of estrogens; decreasing both its bioavailability as a hormone, and as a substrate for the formation of adrenal cortical hormones.
This concept, unfortunately like most of endocrinology, is difficult for the average person as well as many physicians to fully comprehend. Why is this concept important? It demonstrates that the best way to not only address conditions such as abnormal tissue growth and inflammation, is by providing the body with natural compounds that it can use to enhance processes that it already has in place to decrease symptoms and potentially undo tissue changes.
The inclusion of a DHEA supplement may indirectly increase progesterone synthesis and act to alleviate the need for available progesterone scavenged to promote a significant source for the synthesis of estrogen; relying less on progesterone as source for estrogen conversion allowing progesterone to act freely opposing estrogen., This process is further supported by specifically including DIM in FibroVera, to discourage the aromatization of testosterone into estrogens. I have studied the emerging literature and incorporated it into treatment regimes for over a decade and now feel comfortable enough about its metabolism and effects to include it in an OTC formula. Yes, it is a steroidal hormone precursor, however at the dosage levels supplied; it can be regarded as underwriting the proper synthesis of the estrogens and testosterone as well as the balance and effects of a myriad of neurotransmitters in the central nervous system. It is included at synergistic dose levels to help the individual not only do better, but feel better as well. The peer-reviewed research supports the safety and efficacy of DHEA and this inspires our choice and confidence.
Given the proper support, a woman's body can not only control, but reverse the excess secretion of fibrin that can begin to manifest itself as arterial plaque, fibrous breasts, endometriosis and even fibroid tumors. Simply, chronic inflammation supports fibrosis, which under the influence of hormonal deregulation leads to fibrin deposition as plaque, fibroid cysts and tumors, cavity inflammation with adhesions like endometriosis and Pelvic Inflammatory Disease (PID), and diminished functionality and longevity across almost all tissue lines. If you were to ask me about the field of "Anti-aging Medicine", I would tell you to start here. Even the efficacy of the estrogens in activating receptors in bone tissue, a factor contributing to osteoporosis is compromised by these imbalances and substrate issues.
Hormones and Mood - From menarche, through PMS, to peri-menopause
Besides provoking inflammation and inappropriate fibrin deposition; hormonal shifts, imbalances, and inefficient processing can dramatically affect mood and temperament. FibroVera contains two groups of compounds that modulate these issues. The first group deals with the associated symptom clusters.
Calcium and magnesium adequacy are essential to pain modulation and pain perception modulation as well as cramping and other PMS-like symptoms. Calcium absorption from the gut is normally tricky, providing a caprlyate "butter-fat salt" (a short chain fatty acid like that found in mother's milk) allows it to be completely taken up into the system within an hour via the same pathway that nursing infants absorb calcium from their mother's milk. I have chosen the caprylate form because it exerts an anti-yeast effect beneficial to the healing process of many tissues. This is another benefit of nature supporting the young with perfect foods. The body never forgets.
Magnesium ammoniate is an alkaline magnesium salt extracted from sea water. Magnesium is a very active coenzyme. If an enzyme is a vehicle; then coenzymes would be the fuel that powers it. Without the fuel that coenzymes provide to these enzymes, it is virtually inert and cannot react. Every time an enzyme acts in the body, a coenzyme is needed to fuel that process. If no coenzymes existed in our diets, the enzymes in our body would be useless. High doses of systemic enzymes can actually heavily deplete coenzyme resources as they work. FibroVera contains magnesium used as a coenzyme as well as an active ingredient. This ensures a well-absorbed magnesium source with the added benefit of the physiologic alkalization properties of ammoniate. Furthermore, insufficient supplementation of magnesium can make many hormonally-mediated problems such as menopause and PMS symptomatically worse. We also know that the uptake of most dietary calcium from the gut is mediated by a transport mechanism that is set by magnesium. Clinical studies show adequate supplementation of magnesium helps increases the uptake of calcium.
GLA works so well in the Clinic at relieving much of the "PMS" associated symptomatology, including breast, joint and muscle tenderness that it was an essential ingredient to include in FibroVera. This important anti-inflammatory; omega-6 fatty acid is known to work synergistically with many of the other components found in our formula by adding in another distinct modulator of inflammation, specifically the leukotriene and aracadonic acid cascades.,
5-HTP (5-hydroxytryptophane) - Is a precursor for the neurotransmitter serotonin. Pharmaceutical SERMs (serotonin reuptake inhibitors) are prescribed for many hormonally related mood disturbances. The "disease entity" PMDD (Premenstrual Dysphoric Disorder) was created to justify reimbursement for this practice. We know that stress may decrease the bioavailability of progesterone to act as a precursor for hormones of the adrenal cortex. Serotonin reserves are challenged to compensate for this deficiency. Rather than increase the concentration of serotonin by interfering with the normal recycling process that naturally occurs within the synapses (meeting grounds) between neurons in the central nervous system, the 5-HTP in FibroVera helps the body to create more serotonin naturally. Peer-reviewed research has established serotonin deficiencies to be related to depression, sleep, fatigue, fibromyalgia, and tension headaches.,,,,
Dong Quai produces a relaxing effect on the muscle of the uterus by decreasing sensitivity to inflammation thus making it useful for painful menstruation. This botanical, once only found in Asian pharmacy, is now being used in Europe and the Americas as a female tonic, showing particular value in mediating hormonally related symptoms, most notably inflammation, tenderness, and swelling., Although few Western studies evaluating the biochemical mechanism of action for Dong Quai exist, it has been revered in Traditional Chinese Medicine for its ability to modulate the effects of what we would call "hormonal transitions and challenges." Translated from a prominent Chinese medical text, in the female body, Dong Quai "returns order and harmonizes vital energy."
Hormones and the Liver - Helping the body help itself
The second group of hormone modulating compounds included in FibroVera target livr function as the primary site of hormone metabolite processing. Enhancing this function serves to improve fibrin debris removal , decrease persistence of cirulating hormonal metabolites, and strenghthen the myriad of supportive functions that the liver provides.
P5P (Pyridoxal-5-Phosphate) - This Vitamin B6 derivative is used by the central nervous system in the synthesis of serotonin and norepinephrine, and by the liver in hormone metabolite management. P5P is approximately 10 times more potent then conventional pyridoxine HCl (Vitamin B6). This vitamin salt is a catalyst and The second group of hormone modulating compounds included in FibroVera target livr function as the primary site of hormone metabolite processing. Enhancing this function serves to improve fibrin debris removal , decrease persistence of cirulating hormonal metabolites, and strenghthen the myriad of supportive functions that the liver provides. of cofactor in a large number of processes in the liver and central nervous system helps improve menopausal symptoms, symptoms of PMS such as breast pain or tenderness (mastalgia) and PMS-related depression or anxiety.,,
Milk Thistle Seed - Is a traditional Western botanical which has been extensively studied for its use in supporting healthy liver function.,, In conjunction with dandelion root, it serves to normalize bile synthesis and appetite, disturbances particularly gastritis associated with hormonal imbalances. Dandelion can assist the body to remove exogenous (external) estrogen metabolites from hormone therapy or contaminated food, (xenosteroids). These anti-inflammatory, antioxidant, and diuretic botanicals directly increase the liver's ability to bind hormonal metabolites to bile and effectively move them into the intestine.,, This is essential in balancing the community of hormones that directly and indirectly influence fibrin deposition and its removal.
Hyssop - This herb has been used since Biblical times as a "cleanser" for women with symptoms associated with the menses. In more modern times, traditional naturopathic physicians have employed it as an antispasmodic and uterine tonic. I have found it invaluable in the initial treatment of the symptoms associated with uterine fibroids and mastitis and an important therapeutic component of fibrinolytic protocols.,
What about progesterone creams and other remedies?
I must say that I have been asked why I have not chosen to include certain components that either others have used, or have reputed positive effects in formulas attempting to do what FibroVera does.
First on the list is progesterone, certainly not because it is not valuable for women with hormonally mediated problems, far from it. Rather than taken orally, progesterone is much better used as a transdermal cream at a dosage level and frequency determined by a comprehensive hormonal assessment. This testing is done with the collection of a urine specimen, performed by a specialty lab, and interpreted by a highly skilled physician. While OTC progesterone preparations (< 1.6%) are available from highly reputable firms, like Arthur Andrew Medical, this additional component needs to be added in on an individual basis.
The other common ingredients used in many proprietary formulations are botanical isoflavones, typically derived from soy and wild yam. While providing some modulation of estrogen receptors, there have been some disquieting short term problems as well as insufficient long term studies that dissuade me from incorporating them into FibroVera.
The importance of following a sound dietary regime cannot be overemphasized. In general avoiding those foods that tend to provoke inflammation (fried foods, grain glutens, and known individual allergens) and including anti-inflammatory fresh fruits and vegetables as well as sound dietary habits will be very important in aiding associated conditions overall as well as enhancing the benefits of FibroVera.
In summary, FibroVera has been designed to work as a part of a balanced food and supplement regimen to target those symptoms associated with hormonal imbalances complicated by inflammation and fibrous tissue changes. In the short term, usually within a few weeks, women should expect to feel and function better. Within a few months, they should notice a decrease in the effects of such issues as fibrous breasts, endometriosis, and uterine fibroids. FibroVera can be safely used by middle-aged women without significant side effects or dangerous interactions with prescription drugs.
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