Implementation of targeted dietary and lifestyle approaches is an extremely powerful way to reduce stress, minimize inflammation, and reduce the risk for illness and chronic disease. True, the many biochemical processes involving cortisol and other hormones, stress, and inflammation and their impact on health and disease risk are complex and elaborate. The therapeutic diet and lifestyle strategies, however, are not. The more we learn about the way the body responds to the demands placed on it, as well as its extraordinary healing power, the more we are valued as professionals who can effectively change people’s lives by improving health, inspiring change, and increasing longevity.
As with MCD, the hallmark of FSGS is the presence of proteinuria, which can vary in severity from only 1 to 2 g/day to more than 10 g/day. Unlike MCD, at presentation, patients with FSGS are more prone to have concomitant microscopic hematuria (up to 50% of the time), hypertension (33% of the time), and a depressed glomerular filtration rate leading to elevated serum creatinine levels (33% of the time). Typically, patients with heavy proteinuria present clinically with signs and symptoms of the nephrotic syndrome (see earlier). As with MCD, serum complement levels are normal.
Gynecomastia is a common adverse effect of bicalutamide (Casodex) therapy that may prompt some men to discontinue prostate cancer treatment. Tamoxifen has been recommended as a preventive agent for gynecomastia in these patients. A double-blind study of 282 men randomized to receive 20 mg of tamoxifen once per day with bicalutamide or bicalutamide alone found that after six months, gynecomastia and breast pain were significantly reduced in men who received tamoxifen ( versus percent in the control group). 41 An Italian randomized controlled trial of 80 participants also found that 20 mg of tamoxifen once per week is as effective as 20 mg once per day. 42