2010-11-03 Jay Mead MD Bio-Identical Hormones and the Value of Saliva Testing
The Use of Bioidentical Hormones
and the Value of Saliva Testing
An Interview with Jay Mead MD
November 3, 2010, By Kirkham R. Hamilton, PA-C
© copyright 2010, Prescription 2000, Inc.
www.prescription2000.com
Download as PDF | Return To Audio Interview
KIRK HAMILTON: Hi, my name is Kirk Hamilton, your host of Staying Healthy Today, and our message is simple: To provide you credible usable health information from interviews and our educational resources to help you Stay and Be Well in the busy modern world. Please take a few moments before or after listening to this interview to browse through the Prescription2000.com website, the home of Staying Healthy Today Radio, for our free educational services.
Today's show topic is Chronic Disease Prevention, the Use of Bioidentical Hormones and the Value of Saliva Testing. Our guest today is Dr. Jay Mead, president and medical director of Labrix Clinical Services. Dr. Mead is a leading expert in salivary hormone testing. He has been a practicing clinician for more than 20 years, a board-certified pathologist, a retired United States Air Force flight surgeon, and cofounder of a progressive full service complementary and alternative medicine clinic. Dr. Mead is also coauthor of the book "Slim, Sane and Sexy - Pocket Guide to Natural Bioidentical Hormone Balancing" published in 2008.
Welcome Dr. Mead. Thanks for coming on the show today.
DR. JAY MEAD: My pleasure, Kirk.
KIRK HAMILTON: So tell me. How does a pathologist, a flight surgeon, become a progressive integrative medicine doctor and then medical director of a progressive laboratory that's known for saliva testing?
DR. JAY MEAD: Well, it's a long story but I'll try to shorten it. Actually, a few years ago, 13 years ago approximately, a little voice in my head kept suggesting that I try actually seeing patients and being a physician rather than a pathologist sitting behind a desk looking down a microscope and consulting with other doctors. And this little voice led me to go into clinical practice which I did with Roy Swank of the famous multiple sclerosis diet fame. He actually took me into his clinic for a year and showed me that you could - you can affect a disease by controlling the environment of the individual. In this case just controlling the amount of saturated fats they ate. And that peaked my interested in things other than I learned in medical school, which was basically, you know, get the symptoms straight and get the right drug for it and your visit's over. So I started looking at the environmental aspect of illness and in particular MS. And then I spread that out as I moved along. He closed his clinic a year later and I actually had an intern from the naturopathic college following me around over at his clinic for a while and she kept nagging me about, well what about nutrition, what about heavy metals, what about hormones, what about the inflammatory status of this individual, etc. And none of which I knew much about so I kind of passed her off like my professors did me in medical school when I asked a question I didn't have an answer for, but it caused me to actually pursue some naturopathic training in that I went to the National College of Naturopathic Medicine in Portland, Oregon, spoke with the president and he had an opening in his pathology department. And we talked about my interest and what I'd like to achieve. And so he let me teach. He paid me to teach at the college which didn't require eight hours a day at work, four perhaps, and the other four I spent in their clinics and going to their classes and I learned a whole new world of medicine and looking at the patient holistically and preventing disease rather than the treating the disease once it occurs. So that got me on my path to opening the Center for Integrative Medicine. I've brought on a naturopathic physician, Dr. Lommen. She actually - basically I would consider her cofounder of the clinic. She came on very shortly after I opened it and we actually saw patients together. You could get an MD/ND integrated visit at that clinic and we had a very successful experience. Not only was it gratifying for me as a physician, but it was extremely helpful for the patients and we saw amazing results. Results I would have never seen on an allopathic pathway.
KIRK HAMILTON: Let me ask you. Staying on that same topic of diet because I want to enter into something that I know you're a big advocate of and you have on your website and that - you're a China Study advocate, correct?
DR. JAY MEAD: Yes.
KIRK HAMILTON: And we know that you are director of a salivary - well, a laboratory - but it's known for salivary hormone testing. But if you read the China Study and you read Colin Campbell's little pamphlet which is a summary of it, he's not big into hormones. In fact, he'll say the higher that estrogen and testosterone from animal food in particular, the higher the increased risk of breast cancer and prostate cancer, and I was wondering how you reconcile being a China Study advocate and then being a bioidentical hormone supporter on the other hand?
DR. JAY MEAD: Well that's fairly easy. You know I certainly respect Dr. Campbell and I think his work has been extremely helpful. However, this isn't - the work I do is about balancing hormones. And he's absolutely correct, excess estrogen, not testosterone, I would certainly take issue with that comment. But certainly increased estrogens in our food and in our environment and in our own making - that is to say, when we gain weight that that extra fat that we gain around our bellies and our thighs and hips actually consumes our testosterone and converts it to estrogen and that happens both in males and females. And that excess estrogen is dangerous. And so all of the work we do actually at the laboratory and in our clinical practice is to get individuals on a path to wellness which would include nutrition which would reduce their estradiol production because they're gonna lose weight, but also balance off the excess estrogen with the anti-estrogen hormone that's made naturally in our bodies, but decreases with age and that hormone is progesterone. T. Colin Campbell doesn't mention progesterone in the China Study that I'm aware of. It's been a few years since I've read it, but I don't recall him speaking at all to progesterone.
KIRK HAMILTON: Well let's talk about then, I guess you could explain how you got into hormones in the first place because I kind of skipped that. That was my fault. How did you get involved doing salivary hormone testing or testing for hormones, and then we'll get into what a bioidentical hormone is?
DR. JAY MEAD: Okay. On my path through the years of getting involved in complementary and alternative medicine, Dr. Lommen who joined my clinic was a keen advocate on hormone balancing.
And so we actually instituted saliva testing very early on in our clinic, and this was before we had our own laboratory. But we used it to test every patient for their steroid hormone levels and that would be all the sex hormones and cortisol. And we used that baseline testing to decide how we were going to rebalance somebody's hormone levels and maybe we can digress for a moment and get back to that topic. So I got interested therefore in saliva testing in general and the benefits of it and the value of it as compared to serum and urine for looking at steroid hormone levels, in particular those levels after one initiates a topical therapy.
KIRK HAMILTON: Well let me ask you then. How does you know - the logic of hormone replacement is logical in the sense that - and you'll hear this at every conference because I've been to serum people and high dose people, low dose people, salivary people, I mean I've gone to a wide variety of conferences and the alternative medicine people will say as you age your hormone levels go down so it's reasonable to replace them. Okay, so that's logical.
DR. JAY MEAD: Uh-huh.
KIRK HAMILTON: But from there it gets a little crazy in my opinion in that first of all I don't know if there's any long term studies on bioidentical hormones 20, 30 years to be able to say you're gonna live longer or you're gonna have less heart disease or whatever. Two, is that a lot of the data originally was from serum levels, just epidemiologic data. You know, if you had a higher level of this you might have a decreased risk or increased risk or whatever. I understand the logic, but I don't understand in the part where you get the baseline to go forward. And they're different camps. A saliva person will have totally different doses than a serum person, than a urinary person. And so I think that makes the field very confusing in a way. Even as a practitioner, you know, and I do salivary testing. I do a lot of it.
DR. JAY MEAD: Uh-huh.
KIRK HAMILTON: Because I'm a low dose person. Just by common sense to me is that I want to give the lowest dose possible to get whatever benefit. But I know that's a long-winded kind of shotgun question but it's the one that permeates my mind the more I go because I just interviewed Dr. Holtorf who wrote an excellent article on bioidentical hormone safety in Postgraduate Medicine, and yet saliva to him is something that's very inaccurate unless it's just for baseline. And so it's confusing. So I know I just asked six questions at once and I apologize for that. If you want to make a comment on a couple of them, I can -
DR. JAY MEAD: Well certainly. Well first of all, I'd like to say that bioidentical hormone safety studies are not necessary. We know it helps with, what the levels of hormones are in healthy people. And we know that healthy people perform better, they feel better and they look better. And so what the goal is with trying to rebalance somebody is actually give them more youthful hormone levels. Now what we have to think about now is the difference between empirical medicine and a double-blind placebo controlled trial. In empirical medicine, which is the foundation of all the practice we do in medicine, double-blind placebo controlled trials are a drug company derived concept which has merit, but it only has merit if you're trying to test something that may work or barely works, and you want to compare it to something may work or barely works. And that's what they do. They're drugs that they produce are synthetic, not natural, and they're looking for effects and then they're looking for an effect of a new drug compared to an old drug, for example, and so they do their double-blind placebo controlled trials. But I'm here to tell you there's never been a double-blind placebo controlled trial done on insulin, morphine, quinine, penicillin or aspirin. And you may ask why, but it's intuitive isn't it. It's because they work. And that's what I would say about these bioidentical hormones. And I suspect in your experience, I know you're a very thoughtful practitioner and I appreciate that, and I see some of your work and you get responses and you get good responses and your patients improve. And that's what empirical medicine is. You try something, it works, you try it again and it works, and you do that a few times and by golly you start instituting that into your clinical practice.
KIRK HAMILTON: Well let me - let‘s hold on just for a second there. I agree with you and I think most integrative medicine practitioners that do hormone therapy do some kind of level of assessment whether it be serum, saliva or whatever and then they shoot from the hip on symptoms for the rest of the time, most of the time. That's been my experience and almost all the clinicians, they'll pick out their favorite pet thing to start with and then they'll shoot from the hip of symptom reduction. But you can get symptom reduction from putting a pellet in somebody with a very high dose of estrogen to sometimes a small amount of a cream.
DR. JAY MEAD: Uh-huh.
KIRK HAMILTON: But the long-term effect of that, I don't think we have a honest to God, I mean I don't think we have a long-term perspective of that and there's so many different bioidentical hormone level of dosages that it's like, I don't know how anybody can do it with confidence. Like for example, your salivary data base levels comes from the salivary labs, and yours in particular, because I don't know of any long-term study that uses salivary hormones that say if you get to this level you have a decreased risk of heart disease, or Alzheimer's disease or increased, you know, decreased bone density. See what I'm saying. So you - the salivary people in my opinion take maybe a study that says a low level of a serum hormone is increased risk to X and then they you know they try and bump it up with their normals, but I don't know how those are connected sometimes. Are you getting my drift a little bit?
DR. JAY MEAD: Yeah, well I think so. Maybe I can help. Let's go back to the basic science. The level of hormones that the body produces, and we're speaking of steroid hormones which are fat soluble hormones and they won't want to be in water. So they're carried through our blood, water, in one fashion or another that protects them. And that protection is either proteins that are the body has designed to carry that particular hormone such as cortisol-binding globulin or sex hormone-binding globulin, etc., or lipid membranes on the cells. And the red blood cells account for about 40% of the blood volume. So there are plenty of choices for the steroid hormone to attach to and then get carried to the target organ. And only a very small percentage, less than 3% of the hormone is bioavailable to the target organ. So when you measure a serum level of a hormone, you're measuring the total hormone level in most cases. Now there are "free levels," in quotes, that you can get for let's say testosterone, which is actually a calculation. And it's calculated based on the total testosterone level in the serum and the amount of sex hormone-binding globulin in the serum, and there's a formula for that calculation. And I know Quest Labs does that calculation in their free hormone level, testosterone level of calculation. So it's very difficult to measure that small amount of free hormone. The salivary gland is an amazing organ in that it acts like a sieve and it removes from the media that you're testing all the proteins, all the red cells, and so you're actually getting a fluid that is filtered as it were and is - and you're now looking as closely as you can look at any free bioavailable level of an analyte you're seeing it in the saliva. Saliva, however, is limited again to the steroid hormones which are the sex hormones and the cortisol as I mentioned earlier. Now what is happening with the folks who use serum now that they've - so they've measured baseline, so let me go back - I need to digress for a moment. So when you actually look at hormone production in an individual and you compare their serum to saliva, there is a correlation. Absolutely there's a correlation. If the hormone's high even if it's total because, that will make the free level higher, it's higher in saliva. And so you can see a nice correlation between hormone levels in serum and the free levels you're seeing in saliva. There's absolutely a correlation with that. You have the science is there for that, and that's why we as salivary testers believe that it's a very useful test, those of us who also practice and use saliva testing know that it's actually the best way to measure. Again, because we're measuring the free levels. So where the disparity comes in and the confusion, is when a provider starts using topical hormones to correct the deficiency that they're measuring in serum.
So we're going to talk about a serum doctor now. Or a urine doctor. Same concept. The serum or urine doctor gets their baselines and they say okay, we're going to give this individual testosterone, for example, a male and we're going to put it on topically. Well in order to get a serum level, a therapeutic serum level using topical hormone, you have to dose it 10 times more than you would use the same topical dose to get a therapeutic level in saliva.
KIRK HAMILTON: Hold there just for a second. That's - because I want to hang on this point. So that therapeutic range in the saliva - how do you know that that's as effective, and this is the argument, and Holtorf came up with the reverse argument, in that his experience was that when he gave topical transdermal progesterone the target tissue, for example the uterus, didn't change but the saliva level went sky-high and the serum level was virtually not changed. And the target tissue didn't change. So I guess what I'm saying is, I understand that you're saying, but I don't understand the correlation. Just stay with the testosterone thing because this is really the debate because this is where everybody gets confused. And because I've been to a seminar where someone gives 200 mg of testosterone cream topically because he's gonna drive that serum level up and then I've been up to another seminar where salivary testing is the norm and it's somewhere between 10 and 25. And I've done enough saliva testing to know that you can't go above 25 (mg of testosterone) or you're gonna blow it (level) sky-high.
DR. JAY MEAD: Right. Actually the starting dose is around 5 to 10.
KIRK HAMILTON: Correct. Keep going. I don't want to - I interrupted you but I want to keep-
DR. JAY MEAD: We've hit the meat of the topic now. Here's my position and this is what I've observed and what Dr. John Lee observed, and I can show this on anybody. If I put a topical hormone, testosterone for example, if I put 5 mg of testosterone on an average sized male I will get a therapeutic level in saliva and I will get a clinical response. And the therapeutic level in saliva will - has been established based on using topical hormones in clinical practice over the years. So it's an historical perspective and it's established by the usual and customary method of measuring or establishing a reference range which is to take an individual on that form of therapy and doing two standard deviations, get a mean, and so forth. So that's the way that you get that reference range. But if I measure that same individual with a therapeutic level in the saliva and I measure their serum level they're not gonna see a change which is what you're reference to that other physician mentioned. So he notices that. He puts on a bunch of progesterone on the skin and it doesn't see a significant level in the serum, but he sees a huge level in the saliva. Now where he is mistaken and I will debate him any time he would like, is that that progesterone does alter the endometrium.
KIRK HAMILTON: Well that's the question, and I am interjecting, but I agree with you. And his study said something I've heard you say, just the reverse of. Part of the problem is there's never a conference where all three of the different group of people are up there at the same time so someone can ask an intelligent question. You know, there'll be a urine seminar and then you'll only get urine answers, and then you get the serum seminar and you only get the serum doses, and that's the frustrating part for me as a clinician. Now stay on that same one, though. But see here's where - you give 5 or 10 milli - Well let me put it this - you give 5 or 10 mg of testosterone on the skin and I know the body produces somewhere between 6 and 10 mg a day of testosterone, so physiologically that makes sense.
DR. JAY MEAD: Right.
KIRK HAMILTON: I don't get the hit that you get. I mean maybe I'm using a different cream. And especially if someone has been on, and usually we get don't naive males. I get people that have been on 50 to 100 mg and then you try and wean them off. That's a hard pill to try and swallow because they got some hit from that 50 to 100 mg of testosterone and you try and back them off...I understand where your reference ranges come from. I'm not debating those. But I'd say a lot of people would say you give 5 to 15 mg of testosterone and you say you're getting results and I - that's a little - I don't get as much symptomatic improvement. But also I have to work downwards sometimes. In other words, I have people that are on the higher doses.
DR. JAY MEAD: That has to do with receptor down-regulation, but I want to talk about that - but before I do that I want to make my point regarding the difference between that salivary level and that serum level and why you don't see a topical hormone appreciably in the serum unless you drive, unless you drive the dose up to saturation levels which turns out to be 10 times the topical dose that I would prescribe or others who use saliva prescribe. And that have to do with the capillary beds. These topical hormones are put on the skin. They're lipid soluble. They drop right through the skin into the capillary beds and the red cells, therefore, which are concentrated in the capillary system, the hematocrit or the concentration of the red cells in the capillaries is 60, 70%, much higher than it is in the general circulation. And the red cells they are concentrated and those red cell membranes are friendly to these hormones. And those hormones attach to the red cells and they get delivered to the tissue including the salivary gland and that's why we measure accurately topically applied hormones.
KIRK HAMILTON: So let me ask you then. Why - I've tried to wrap my head around this explanation so many times. I mean I've really tried. So you're saying that because it gets picked up at --the steroid part or the fat soluble part get picks up by the red blood cell. It doesn't go into the serum before it gets to the target tissue. I'm trying to understand that and I'm -
DR. JAY MEAD: No it's carried on the red cell. It gets into the general circulation. So it's - it gets delivered - the red cells go everywhere. But the hormone doesn't jump from a red cell into the serum. It stays on the red cell.
KIRK HAMILTON: Okay.
DR. JAY MEAD: And the laboratory then when the get the sample and you order a serum test, they spin it down and they throw the red cells in the rubbish and they measure the serum and they've missed the media that's carried that hormone. And if you could measure a whole blood level, and in another life and another laboratory I actually attempted to do this, and was successful enough to know that that hormone is on the red cells. And you can actually - I mean there's - there are papers in the medical literature that show that steroid hormones are on those membranes and I've got those references if you'd care to see them. So I know the red cells carry the hormone. That's the only explanation for this phenomenon that I see and that my colleagues, they also see it, but they make the wrong conclusion. So the individual who uses 200 mg of testosterone, alright that's 20 times or 30 times more than I would use and can get a clinical response and he sees the serum level go and up and he or she is happy with that. But they look at the salivary level and that is just through the roof and instead of thinking about this phenomenon and maybe they're overdosing the patient and to be as thoughtful as you are, to even understand that the testicles in a 20 year old male produced 6 mg a day. Why would we go to 200? Only if topical hormones weren't absorbed and they were very inefficient or if the topical transmission was very inefficient. Which we know is incorrect because when we measure in saliva we see these levels go up. So instead of reconsidering their dosing and what they're doing and the consequence, and the consequence goes back to the point we want to mention about using excess hormone and down-regulating receptors. Cell membranes lose receptors when hormones are saturated. You can think of it as, you know how your ears adjust when you're being screamed at or you're in a high noise level environment. You adjust down. You numb out to that experience. Well our cells are very similar to that. So you down-regulate the receptors and that's why when you go back and you try to do the right thing by the individual who's been overdosed that you don't get a good response because you have to let those receptors rebuild and once they rebuild, and this can take time and as you may know can take months. But as that happens the patient is not really happy and they're gonna go find someone who's gonna give them that excess dose again so they get the response that they did initially.
KIRK HAMILTON: Alright.
DR. JAY MEAD: And that is not the healthiest thing to do because you down-regulate those receptors, you're using too much hormone, and those hormones affect other systems. In a case in point, testosterone. Too much testosterone down-regulates those receptors. They get their symptoms back over time, and I see that routinely in the laboratory when we see someone who's been over-treated. Their symptoms come back because the receptors down-regulate and their estradiol levels because of conversion from testosterone, their estradiol goes through the roof, too. So it's a balance again and using physiologic dosing to get the clinical response which you mentioned very early on in this discussion.
KIRK HAMILTON: So let me - gosh, there's so many things I want to talk about. We could go on for hours and you know this really is a course and it's not clear. It's not being taught and so it gets confusing. So let me, if I can rephrase in my own simple little mind. The hormone binds onto the red blood cell. So, and then it gets sent to all the tissues and it's not going to be seen in the serum because it's got to be spun down, etc. Unless there's this overwhelming dose that you can't fit on the red blood cell anymore and it spills over to the serum. Is that -
DR. JAY MEAD: Right. Supersaturates, yes. Exactly. It saturates the system.
KIRK HAMILTON: Alright. So I think we've got that concept. Gosh, there's a whole lecture here. I have questions for days.
Let's just take that practical clinical example. How do you down-regulate this male whose come in to you? I just had it the other day. I got a guy who's been on hormone replacement at 150 mg, sometimes he does it daily, sometimes he does it every other day. He's 70 years old, doing wonderfully, and I'm coming in here and I'm gonna go well, I know the saliva test is going be sky-high, so it's like if I do that then he's gonna be all confused. He's feeling good. And I pop in and I go, and he had his great PSA so I'm not worried about that, so it's like okay, "I'm gonna put you on 10 mg." You know, it's a very, very difficult thing. Tell me how you'd deal with that person.
DR. JAY MEAD: Well they are difficult and there's no easy way out of dropping their dose. What I would do, I would go through this discussion that we're having and I would explain to him that this is not to his advantage to stay on that much testosterone and that we will be able to manage him but it's going to take some time and it may take several weeks or months for us to re-adapt him. And so you could cold-turkey him or - which is probably not going to be his favorite thing and it will probably drive him away from your practice. But if you can just start adjusting him down and I would certainly measure as I was adjusting him down. First thing I would do when he came in is I would measure him and I would show him his level is too high and I would tell him, because I am that saliva believer, and I would make my most convincing argument about saliva being his best method to test and that his level would be very high. And his estradiol level needs to be measured and I suspect his estradiol level is going to be very high also. Which is going to affect his risk of prostate cancer. And I'm gonna tell him about that and I'm gonna tell him the reason we want to lower you back down is to get all of this back into manageable physiologic levels. And if he agrees he's gonna go with me on this and we're gonna start adjusting him down and looking at his levels. And I would put him on progesterone absolutely. That's another topic for another session perhaps, but progesterone is absolutely indicated for these males to balance out that estradiol.
KIRK HAMILTON: We're talking to Dr. Jay Mead, president and medical director of Labrix Clinical Services. If you can share in this interview how can people really educate themselves about saliva testing, just what you told me, some of those common questions and answers, at least to have a fair balance. Because I go to all these conferences and unless it's a saliva conference you're not going to hear of this. And there is some legitimate questions I have, but we've started to open the door here. So how can someone who listens to this say, "Okay, well I've been doing serum and whatever, and my doctor says this or I'm using serum. But how can I go educate myself in a legitimate way to see the other side?" Your side?
DR. JAY MEAD: Well, you know, I think Dr. John Lee's books are very helpful. He speaks to many of these issues in his books, anyone of them. He passed away six years ago but his books are still most appropriate and full of extremely useful information. "What Your Doctor May Not Tell You About Menopause," "What Your Doctor May Not Tell You About Breast Cancer," he's even written a monogram about - for males - "What Your Doctor May Not Tell You About Prostate Cancer."
So those are available. And then, "Slim, Sane and Sexy" which you mentioned early on has some of this information in it, certainly for the lay public. "Slim, Sane and Sexy" would be a very good start. And for a novice physician it would also be a good read. It opens the doors to these concepts that we're talking about. And then I would challenge them to try saliva testing and try these concepts out. But I would take patients who are not on hormones, because the patients you have that come in with these high doses are really challenging. But you take somebody fresh who hasn't been on hormones and those are the people that I get and that I treat and I get these responses from. That's what I would say to someone looking for this information. There are conferences that are - that speak to this. They're few and far between and the Dr. John Lee Institute puts on a conference annually. We didn't get to one this year, but we will be having one perhaps in the spring and these are the things that we address.
KIRK HAMILTON: Is there a place on your website for Q and A's, and you want to give out your website to the lab? I think there is, isn't there?
DR. JAY MEAD: Yeah, there is, definitely. Yeah, there's definitely a website. It's Labrix.com. It's very simple. And we have webinars. We actually do webinars on these topics. We do them live. We have them recorded so we have the education on line for individuals who want to take advantage of that.
KIRK HAMILTON: Okay. Well, I'm gonna have you back. This is a hard topic because really it's more than a weekend seminar to answer all the questions that I have. No really, you know, because I've played with this stuff. I've played with it all and I have colleagues who do things totally different than I do and I respect them very much both in my practice and also around the country that I have people I respect and they come out with totally different answers and I think the problem is that number one, you're trying to make bioidenticals a credible approach, and two is, the problem is every practitioner uses a different level of dosage and it makes no sense when you step back and if you're looking from the outside and being critical, you'd be really critical because you'd say well how come that expert says one dose and I've done this. I've gone to a seminar where I asked the urine person, the saliva person and the serum person what would be your starting dose and they were all different, I mean way different.
DR. JAY MEAD: Uh-huh.
KIRK HAMILTON: So and I think that discredits the attempt to try and balance hormones with hormones that are the same chemical structure your own, which is the whole bioidentical definition and to move forward and to use those these appropriately.
So Dr. Mead, thanks for spending the half hour with me. We'll have you back I promise and I'll give you more time to delve into these things. Thank you for coming.
DR. JAY MEAD: It was my pleasure. Thanks for inviting me.
KIRK HAMILTON: And I want to thank you, the audience, for this edition of Staying Health Today Radio. And until next time, Stay and Be Well.
No part of this interview may be copied or reprinted in any form, electronic or print, without written permission from Prescription 2000, Inc.
© copyright 2010, Prescription 2000, Inc.
www.prescription2000.com
