Ask Iron Lady Doc, Malea Jensen!

[sba220]

Dr. Malea Jensen is a doctor as well as a top NPC bodybuilder (2006 NPC Team Universe middlweight champ)..... Ask her all your questions!

[2hot4u]

what type of doctor is she?

[ironladydoc]

I am family practice as well as do walk-in care. --DR. Jensen

[blogguy]

Hey Malea I miss ya at the shows! hope all is well out ur way :)

[sassy69]

Hi Malea!

My question is, is there a documented point where use of nolvadex would induce premature menopause? For competition use, Anabolics 200x and other similar refs recommend no longer than 8 weeks use. The medical literature is generalyl only in the context of treatment of breast cancer patients. The initial treatment recommendation is to use Nolvadex. I understand the treatment is (or was) generally recommended for 5 yrs. More recent documentation suggests switching over to aromatase inhibitors (AIs) like arimidex after 2 yrs of Nolvadex for improved results. Since AIs won't address ovary-produced estrogen and instead aromatized androgens from the adrenals, I guess that assumes after 2 years on nolvadex, if you were pre-menopausal, you would now be experiencing early menopause. So somewhere between 8 weeks & 2 yrs it looks like nolvadex will induce early menopause. Is there anything that indicates where in that range it actually happens?

[tammyp]

im 38, havent gotten my period in over5 years. no visible problems, though my estrogen is low. is this a big deal? my dr like most doesnt get the bbing world so talking supps is out of the question, though i had this problem before that. your feedback? tia..
tammy

[2hot4u]

My question is this. i had hernia surgery in may of 2007 which was small right above my belly button. they did the mesh lining and recovery was fine. I competed in 2008 won my class at jr usa's and 6th at masters. this off season it seems my fat deposits are right around my belly button. It is weird. I can see my top 4 abs but it looks like a donut around my naval. Do you think this is going to be a problem for me? I am hoping it is just how my body is changing as i age and will go away come show time. or do you think i should go back to the surgery for a consultation?

I met you back in 2004 nationals by angie semsch. She introduced me to you and that next year Dr. Dena Westerfield prepped me for 2 local shows here in st louis where i won both overalls!!! I know you had trained with her a long time ago also. Don't know if you remember me or not but just thought i would mention it.

look forward to your insight on this
lisa

[ironladydoc]

All is good in Des Moines. I am ready for Spring, though! Winter has been long and hard here. Anyway, thanks for the email and hope to see you at a few shows this year. I plan to watch some friends at Jr. Nationals in June.

[ironladydoc]

Tammy,

Something you may want to consider off season is to induce a period with provera 10 mg for 10 days. You should have a period shortly after stopping the provera. This is healthy for the uterus and should not be deleterious to your muscle building career since it is only a short course of progesterone.. Hope this helps.

drj

[ironladydoc]

Lisa,
I want to reassure you regarding this problem. I truly believe showtime prepping will cause resolution of the fat accumulation. Unless you are having discomfort in the area of the repair, I would not see a surgeon for this. It is odd how our bodies change over time. Whether this accumulation is due to the surgery or simply age-related, it will resolve with good dieting for a show.
Yes, I did train with Dena a few years back. I think I remember meeting you! Thanks for the questions!

drj

[ironladydoc]

Miss Sassy!
There really have been no studies on use of nolvadex in fbb's. From a medical perspective, however, there have been studies that indicate an increased risk of cancer in women taking Nolvadex over long periods of time. For this reason, many oncologists switch breast cancer patients from Nolvadex to arimidex after a certain number of years.
Back to your question, though........I think if you were only using the nolvadex for showtime preps, you would not be on it full-time and your risks are lessened.

[2hot4u]

Doctor jensen, thank you so much for your time answering my question. It has relieved my mind to know it should be ok.

[tammyp]

thanks alot! great thread here!

[Gunz]

Glad to have a woman doc on line.

[Gunz]

I use my hands in my job and am prone to carpal tunnel. Since I started heavy lifting, I have pain, tingling, numbness and swelling in my hands and wrists. Does anyone else have this problem, or did my work history set me up for problems? Doc, do you have any suggestions to help me get through my workouts and the painful sleepless nights?

[sassy69]

Miss Sassy!
There really have been no studies on use of nolvadex in fbb's. From a medical perspective, however, there have been studies that indicate an increased risk of cancer in women taking Nolvadex over long periods of time. For this reason, many oncologists switch breast cancer patients from Nolvadex to arimidex after a certain number of years.
Back to your question, though........I think if you were only using the nolvadex for showtime preps, you would not be on it full-time and your risks are lessened.

Hi Malea - Thx for your response. The question was in the context of many people ask if you can stay on nolvadex full-time. The fact that breast cancer patients switch over to adex after a period of time indicates that probably at 2 yrs at least .. but for people who run it for longer than 8 weeks. Is there any sense of at what point this "increased risk of cancer" or induced menopause occurs? At 6 months of continued use? At 3 months? at 1 year? I'm not advocating it because IMO anything you do to induce a certain artificial state of being (particularly if its self-medicated) should not be considered a maintenance protocol. But many people start looking for how long they can and I've heard of people running it for a year straight. I've heard of people being on it "forever" for the estrogen effects only - but then the cost is dry skin, thinning hair & a myriad of other issues associated w/ menopause.

I don't know if such information exists but it is one of those constantly asked questions that I always hear.

[ironladydoc]

Gunz, the thing with carpal tunnel is that it is an inflammatory condition. The median nerve travels thru the tunnel along with other vessles. The inflammed canal pinches on the nerve and it tells you by sending numbness and tingling.
At night you need to avoid sleeping with your wrists bent (curled up). Use of a splint on the palmer side of the wrist at night will discourage the wrists from bending.
When lifting, try not to wrap your wrist since compressions worsens your symptoms. Avoid movements that hurt temporarily while the wrists heal. It takes time to calm that carpal tunnel down.
You may have to consider carpal tunnel release if it continues. Good luck!

drj

[Gunz]

Gunz, the thing with carpal tunnel is that it is an inflammatory condition. The median nerve travels thru the tunnel along with other vessles. The inflammed canal pinches on the nerve and it tells you by sending numbness and tingling.
At night you need to avoid sleeping with your wrists bent (curled up). Use of a splint on the palmer side of the wrist at night will discourage the wrists from bending.
When lifting, try not to wrap your wrist since compressions worsens your symptoms. Avoid movements that hurt temporarily while the wrists heal. It takes time to calm that carpal tunnel down.
You may have to consider carpal tunnel release if it continues. Good luck!

drj

Yeah, that's probably where I'm headed - but not until after this year's show. I will try your suggestions. Thanks.

[la scimmia]

Dr. Malea Jensen is a doctor as well as a top NPC bodybuilder (2006 NPC Team Universe middlweight champ)..... Ask her all your questions!

Ciao Dr. Jensen,
Do you have any sugestions for a athlete with a immune defiancy disorder in regards to supplements to take and diet and exercise? I had a bone marrow transplant 3 months ago and my weight ranges are high. Do you have any ideas or suggestions? Grazie millie, ambra

[Colette Nelson]

Malea... I just wanted to say how special you are to me and I am so happy to see you on our board. It is so nice to have a woman's medical perspective..your advice is going to be so helpful. I wanted to tell you about some stem cell transplants that I am looking into in RUSSIA. They are actually doing transplants for type 1 diabetics. We can talk more on the phone.

Are you sure you don't want to come to the ARNOLD.

Colette

[Angela123]

no questions at the time..just wanted to say, welcome and thank you so much for this thread.

[AmandaDunbar]

Hey Malea! So good to see you on the board! We need to catch up soon! Hope I get to see you around somewhere this year. Hope you're doing well. :)

Amanda

[ironladydoc]

Ambra, I think you have stumped me on this one. I would have to do some reading on Immune deficiency disorder.

drj

[ironladydoc]

Hi buddy! Keep me posted on the findings of the study. A cure for diabetes is in the making. Keep your chin up! Talk to you soon!

malea

[ironladydoc]

Thanks Ondrea! Have a super day

[ironladydoc]

Amanda!! Hi there! Yes, we have to catch up. Hope all is well your way!

malea

[amber castello]

Dr. Malea Jensen is a doctor as well as a top NPC bodybuilder (2006 NPC Team Universe middlweight champ)..... Ask her all your questions!


ciao Dr. Jensen,
Do you think it is possible to loose muscle mass and weight at the same time? What would you reccommend to to do that in a 8 week period? I do have a immune defiancy as well and travel alot. So just wanted feedback from a Doctor whom competes and understands? grazie, Amber :)

[ironladydoc]

amber,

I am assuming you are instead asking if it is possible to maintain or gain muscle mass at the same time as losing weight??
I think you should be more concerned about your lean muscle mass as compared to weight. Weight on the scale tells you very little. It is simply a number........a reference.
When one diets for a show for instance, it is a goal to maintain as much muscle as possible, while losing fat. Ask any bb and you will find that this can be very difficult. For this reason, many dieters take it slow. If you rush fat loss, you risk losing precious muscle. Hope this helps.
drj

[tammyp]

Tammy,

Something you may want to consider off season is to induce a period with provera 10 mg for 10 days. You should have a period shortly after stopping the provera. This is healthy for the uterus and should not be deleterious to your muscle building career since it is only a short course of progesterone.. Hope this helps.

drj

now mind you, i really dont miss it! but do i NEED one, really?

[ironladydoc]

studies say "YES"

[Steph Orr]

Malea, I had a C-section a month ago and the Dr. said not to do any heavy lifting for about 6 weeks except for the weight of the baby. I was just wondering when would be a reasonable time frame to go back to training. I still have a dull pain in my lower abs if I cough, but other then that I feel great.

[ironladydoc]

Congrats! My advice, though, don't rush it. You don't want to ruin the stitch work by the doc by rushing into activities that increase intra-abdominal pressure. Let your body heal. Start with things like bis/tris, calves, light chest, etc after 6-8 weeks rest.

drj

[Colette Nelson]

Malea... sorry about the misunderstanding earlier this week. You know I just want you to be happy......

And you are going to be missed at the ARNOLD.... the booth won't be the same.

Colette

[IRONURSE]

Hi Doc,
My question is: How should supplement or gear doses be adjusted for menopausal women? Anything I should stay away from? I had an emergency partial hys 12 yrs ago (after the birth of my twins) and my natural hormone levels are very low.
Thanks.

[ironladydoc]

Hi Doc,
My question is: How should supplement or gear doses be adjusted for menopausal women? Anything I should stay away from? I had an emergency partial hys 12 yrs ago (after the birth of my twins) and my natural hormone levels are very low.
Thanks.


Thanks for the question, but in my experience, I deal with physiologic levels of hormone replacement. I have checked hormone levels in my menopausal females and then replaced hormones accordingly within normal physiologic ranges. This is either thru oral prescription Prempro, premarin, progesterone or via compounding creams.
I do not think this answers your question, but I have never dealt with women wanting to use hormone replacement to build muscle. I will have to defer your question to Dave Palumbo as he may be able to answer your question more appropriately.

Dr. Jensen

[sassy69]

I'm not Dave but I'm going to generally say that the ratio of test to estro for women is very low anyway. If you are talking about use of AAS for mass building, the issue is your test levels. Any dose of AAS is going to be significantly greater than your natural levels so you're still looking at "standard" recommendations for most of it - menopausal or not. As far as estrogen impact, you would experience a bump in estrogen from any AAS aromatization (depending on the compound you are looking at - e.g. test prop will aromatize a little & produce some estrogen, something like anavar would not). You might find testosterone therapy doses (e.g. topical androgel, etc.) to help w/ low test -driven low sex drive etc. But again, I think that would be part of standard therapy that a doctor would manage. Stepping into the realm of AAS for mass building is most likely no different than for pre-menopausal. You would be starting from commonly suggested low doses (e.g. 5 mg anavar / day) and adjust based on your own response to it.

(Hope that helps a little.)

[IRONURSE]

Doc: Thanks for the response. I will keep an eye out for Dave's reply.

sassy69: Thanks for the great info and food for thought!

[Lee Penman]

Hi Malea!
I have a question for you. I have been experiencing pain and discomfort just to the right of my navel for almost three weeks now and it has meant I haven't been able to work out (first time in thirty years!) I have been to the doc twice. Firts time she said it was a pulled stomach muscle, second that it could be a stomach muscle or a 'smouldering appendix'. She took a WBC and said that if it was the appendix it would show up on that. My WBC came out at 6.9, my Neutrophils at 44.09 (my average is around 5 for WBC and 65 for Neutrophils). She said nothing indicated appendicitis and a scan was not necessary. However, I still have pain and tightness in that area and sitting is generally uncomfortable (like typing this! lol!) Could you give me your thoughts. Private e mail me if poss, if not I undersatand you are busy.

[FitSarah]

Just wanted to say hello!! I think this will be a great thread.

[ironladydoc]

Just wanted to say hello!! I think this will be a great thread.
Thanks for checking in........have a great day

[huge285]

Hey Malea......did you forget LEIGH?

[ironladydoc]

Hey Malea......did you forget LEIGH?
DAve,

Yes, I wrote her back the next day. She asked me to send her a private message so I did. She has not gotten it?? Let me know.

malea

[Lee Penman]

DAve,

Yes, I wrote her back the next day. She asked me to send her a private message so I did. She has not gotten it?? Let me know.

malea
Malea...sorry, I completely missed the private message...just got it! Thank you so much. That sounds like the best diagnosis I have received...it certainly makes sense. I still have a constant discomfort, dull ache and sometimes an 'itchy' feeling in area. Tried to get back into light training this week but that made it worse! Maybe I can turn this into an ongoing reality TV show!
Apologies again for missing the PM...lack of forum savy (lol!)

[ironladydoc]

Malea...sorry, I completely missed the private message...just got it! Thank you so much. That sounds like the best diagnosis I have received...it certainly makes sense. I still have a constant discomfort, dull ache and sometimes an 'itchy' feeling in area. Tried to get back into light training this week but that made it worse! Maybe I can turn this into an ongoing reality TV show!
Apologies again for missing the PM...lack of forum savy (lol!)

Keep me up to date on your progress. I wish I could help you more. Hang in there.

drj

[AmandaDunbar]

Malea! I miss you! Hope to see you this year sometime. We need to catch up! :)

Amanda

[ironladydoc]

Malea! I miss you! Hope to see you this year sometime. We need to catch up! :)

Amanda

Hi Amanda! thanks for writing. Yea, you're right, we do need to catch up. Sorry, I am not the best at staying in touch. I hope you are doing good.
thanks again for writing. Have a super night.

malea

[Lee Penman]

Keep me up to date on your progress. I wish I could help you more. Hang in there.

drj
Quick update...I now think it may be an ulcer. It doesn't hurt when I cough or sneeze etc. but it just feels 'raw' and certain foods irritate it more than others. The stress of training does make it worse though.....and so it goes on. I think I am going to have to pay up for a scan soon just for my piece of mind....and for the sanity of everyone who has to listen to me-lol!

[ironladydoc]

Quick update...I now think it may be an ulcer. It doesn't hurt when I cough or sneeze etc. but it just feels 'raw' and certain foods irritate it more than others. The stress of training does make it worse though.....and so it goes on. I think I am going to have to pay up for a scan soon just for my piece of mind....and for the sanity of everyone who has to listen to me-lol!

An EGD needs to be done to pick up an ulcer or H.pylori. If you suspect gallbladder disease, an US would be the best. If it is an umbilical hernia, CT scan may need to be done, but a good surgeon can feel it without a scan.

Let me know how it goes. Prilosec OTC???

[Lee Penman]

An EGD needs to be done to pick up an ulcer or H.pylori. If you suspect gallbladder disease, an US would be the best. If it is an umbilical hernia, CT scan may need to be done, but a good surgeon can feel it without a scan.

Let me know how it goes. Prilosec OTC???
since the pain was worse today I was seriously considering getting a CT scan to end this once and for all. However, if you say a good surgeon could feel it maybe I will try and find one first...my god, when will this end...lol!

[ripcurlgirl]

studies say "YES"

How does that relate to those of us who have had uterine ablasion? Pretraining I would have a day or two of light bleeding per month. My body fat is low enough that I haven't had one for a few months.

[ironladydoc]

How does that relate to those of us who have had uterine ablasion? Pretraining I would have a day or two of light bleeding per month. My body fat is low enough that I haven't had one for a few months.

I am assuming you have had uterine ablation due to heavy mentrual bleeding. As you know, since an endometrial ablation destroys the lining of the uterus, endometrial ablation is not for anyone who desires to keep her fertility. Also, women who have a malignancy or pre-malignant condition of the uterus are not candidates for ablation. It is my opinion that it is helpful to see a gynecologist who is familiar with, and who is able to provide all of the information that you are concerned about........i.e. the use of Tamoxifen for alternative uses. I am not familiar with the studies of Tamoxifen in women who have had ablation and then subsequently get uterine cancer. As I mentioned before, though relatively small, the risk of developing endometrial uterine cancer increases with use of Tamoxifen to treat, or reduce the risk of, breast cancer. Again, the use of Tomoxifen for alternative uses (bb females), has not been studied.

drj

[Lee Penman]

An EGD needs to be done to pick up an ulcer or H.pylori. If you suspect gallbladder disease, an US would be the best. If it is an umbilical hernia, CT scan may need to be done, but a good surgeon can feel it without a scan.

Let me know how it goes. Prilosec OTC???
Just thought I'd throw you an update. I decided to treat it like an ulcer, started Cimitedrine twice daily. Definite improvement so I think I nailed it. I just switched to Omeprazole today. Just one question. I know it says one 20mg tab/day but with an active condition should I up that to twice daily or 40mg once daily?
I also threw in Glutamine to heal intestinal tract and propolis.

[ironladydoc]

Just thought I'd throw you an update. I decided to treat it like an ulcer, started Cimitedrine twice daily. Definite improvement so I think I nailed it. I just switched to Omeprazole today. Just one question. I know it says one 20mg tab/day but with an active condition should I up that to twice daily or 40mg once daily?
I also threw in Glutamine to heal intestinal tract and propolis.

Leigh,

The recommended dose for acute treatment is 40 mg a day. You can divide the dose as 20 mg twice daily, although not indicated as it has been suggested it needs to be taken on an empty stomach in the morning, followed by a meal 30 minutes later.
Maintenance dose is usually 20 mg a day. I hope this helps.

drj

[Lee Penman]

Leigh,

The recommended dose for acute treatment is 40 mg a day. You can divide the dose as 20 mg twice daily, although not indicated as it has been suggested it needs to be taken on an empty stomach in the morning, followed by a meal 30 minutes later.
Maintenance dose is usually 20 mg a day. I hope this helps.

drj
Thank you. I actually had a lot of excess stomach acid on Omeprazole I guess due to the fact that it does not act immediately. I am now going to switch back to Cimetedrine or Ranitidine until condition totally heals and I can resume my full training schedule (aaah, those were the days, lol!)
Aren't you glad you are not my doctor ...you would be on Valium by now!
Thank you so much though. Your advice is GOLD!

[ironladydoc]

Thank you. I actually had a lot of excess stomach acid on Omeprazole I guess due to the fact that it does not act immediately. I am now going to switch back to Cimetedrine or Ranitidine until condition totally heals and I can resume my full training schedule (aaah, those were the days, lol!)
Aren't you glad you are not my doctor ...you would be on Valium by now!
Thank you so much though. Your advice is GOLD!

Leigh,

Consider this:
Omeprazole is to Payless as Prilosec OTC is to Nike
And:
Prilosec OTC (blocks production of acid) + Ranitidine (neutralizes acid) = Happier stomach

[Lee Penman]

Leigh,

Consider this:
Omeprazole is to Payless as Prilosec OTC is to Nike
And:
Prilosec OTC (blocks production of acid) + Ranitidine (neutralizes acid) = Happier stomach
What can I say...thanks again. I guess what you are saying is buy Prilosec and give it a chance!
We should turn this into a TV show!
I am, as always, grateful for your assistance and PATIENCE!

[Lee Penman]

I felt a responsibility to give you a final update! It was an abdominus rectus strain at the end of the day. I had amazing results when I added 6gms of Chlorella for CGF(Chlorella Growth Factor) a day. Seems to speed tissue healing when all other supplements have failed. Thank you again for your support and patience!

[redline777]

Hi Dr J., hope all is well. I really need your help on a serious issue. one of my close family members had a bone tumour which was benign called osteochondroma.there are two of them growing out of her fibula in her calf. they were removed about 7 months ago. all was well, until last week where she got X rays and the news that the tumours are still there or they have returned. our family are just concerned that the surgeon didnt remove all of the tumour originally, how can this be possible?? what can she do? shes seeking secound opinions and has set another date for surgery. what are ur thoughts? i will keep u posted, any help will be greatly appreciated.

[2hot4u]

malea check your emails