Will You Be Ready If a Major Earthquake Strikes?

While I usually write to you about hormones or other topics directly related to Age Management Medicine, today I feel compelled to write about something very different.  Disaster preparedness.  Specifically earthquake preparedness, since much of my practice serves clients in California.

Last weekend I was at a medical conference where a presentation on disaster preparedness was aimed at doctors and our roles post disaster.  The data shocked me.

According to seismologists, California has more than a 99% chance of having a magnitude 6.7 or greater earthquake in the next 30 years.  The southern extension of the San Andreas Fault, which extends from Monterey County to the Salton Sea, is now capable of an 8.1 or greater magnitude earthquake.  According to Thomas Jordan, Director of the Southern California Earthquake Center, the San Andreas Fault is “locked and loaded.”

This means “The Big One” In California could happen anywhere between the next 10 minutes and the next 30 years.

The earthquake in Northern Japan on March 11, 2011 was 9.0 on the Richter Scale.  Ten days later, nearly 900,000 households were still without water and 250,000 households were without power. The estimated economic cost was US$235 billion dollars. Staggering statistics.

Despite the fact that there were some key differences, we learned some valuable lessons from that earthquake. One of the biggest lessons learned is that basic supplies shortages will affect areas far from the epicenter. Many of the things we take forgranted (food, water, shelter, transportation, communication) can be gone in a moment if a major earthquake hits.

Preparedness is Key

There are a number of suggestions that I’d like to pass along to you:

1. Have enough water.  1 gallon of water/day per person for drinking.  Store enough water for 30 days.  Also have a water purification kit or unscented liquid bleach (eight drops per gallon when water is first stored)

2. Maintain canned/non-perishable food supply (and a manual can opener) . Ideally, 2000 calories of food/day per person.  Canned beans, protein bars, canned meat, canned vegetables.  As with water, food may not be readily available for an extended period after a significant disaster.  Make your food supply count and emphasize nutrient dense choices.

3. Maintain a one month supply of critical medications. Pharmacy services as well as transportation of pharmaceuticals (and other goods) will very likely be disrupted.  Experts encourage you to have a 30 day supply of any necessary, life saving medications available.  Make sure you check the expiration dates and rotate your stored supply as necessary.

4. Create an earthquake kit or box containing, at the minimum:

  • First aid kit and handbook
  • Comfortable/practical change of clothes
  • Sturdy shoes
  • Blankets or sleeping bags
  • Portable radio and flashlight, with spare batteries
  • Extra pair of eyeglasses
  • Extra set of house and car keys
  • Toilet paper, toiletries and feminine hygiene items
  • Cash in small bills and small change
  • Small tool kit
  • Books, deck of cards, games

While this list may seem simple, most people don’t have even these basics on hand. Take some time this weekend to talk to your loved ones about a preparedness plan and to stock these necessities.

You can purchase self-contained earthquake kits online: http://www.earthquakestore.com/emergency-deluxe-kits.php

Here are some additional resources for more information and access to disaster preparedness information.  You and your loved ones are worth the investment of a bit of forethought when it comes to being prepared.



Leptin: The New Big Boss in Town









There’s a new kid on the hormone block and he’s kind of a big deal.

Even though we’ve only known about him for a very short while, he’s actually been controlling things behind the scenes this whole time.

The hormone we’re talking about is leptin.

Discovered in 1994, leptin is the major hormone that ultimately influences all other hormones in our body, and virtually controls all functions of the hypothalamus – the organ previously considered the grand master in charge of our hormonal output.

Leptin’s primary job is to tell the hypothalamus that you’ve got enough energy stored in your fat stores, and thus don’t need to eat or store more of it. It’s a close relation to insulin, your fat storage hormone, and the two are constantly in a dance together.

As such, leptin coordinates our hormonal, metabolic, and behavioral responses to starvation. Even though we’re not consciously aware of it, leptin is telling us how much to eat, how much of what we just ate to store as body fat, and how much to move or not move our bodies. It profoundly affects our emotions, cravings, and behavior and it determines how much fat is stored under the skin and around our organs.

Like I said, it’s kind of a big deal.

When your leptin levels are in balance, you feel good, you have appropriate appetite and good energy levels, and your weight is healthy and stable. When your leptin levels are too high, your appetite increases disproportionately, you energy levels tank, and your body goes into “starvation” mode, stashing away more and more fat for the rainy day that never comes.

There can be two reasons for leptin being out of balance:

1) leptin deficiency – there is simply not enough leptin to tell your brain you’ve stored enough fat

Or, what is much more common:

2) leptin resistance – there’s plenty of leptin circulating in your blood, but your hypothalamus isn’t getting the message, so your brain thinks you’re starving and responds appropriately

Much like insulin, chronically high leptin levels increase inflammation and, over time, lead to degenerative disease.

Here’s the kicker: the only thing that influences leptin levels is your diet. And in fact, no other hormonal imbalance in your body can be restored without leptin functioning properly.  Bio-identical hormones can help, but we must also work to maintain optimal endogenous hormonal balance – and managing leptin levels is key to doing so.

Here are 14 indicators that you may be resistant to this all-important hormone:

  1. Being overweight
  2. Fatigue after meals
  3. Presence of love handles
  4. High blood pressure
  5. Craving comfort foods
  6. Feeling consistently anxious or stressed out
  7. Feeling hungry all the time or at off hours in the night
  8. Having osteoporosis
  9. Being unable to lose weight or keep weight off
  10. Regularly craving coffee or other stimulants
  11. High fasting triglycerides
  12. Tendency to snack after meals
  13. Having problems falling or staying asleep
  14. No change in the way your body looks no matter how much you exercise

The take away?

There is no pill, exercise, or injection you can take that will ultimately get you to your health goals without also taking your diet into consideration. This is why nutritional optimization is a cornerstone of The Carragher Method, The Body Well’s Age Management Program, and it’s why we get the results we do.

Interested in optimizing your hormones and feeling like you did in your 20s no matter how old you are?  Contact us at (323) 874-9355 or email me at doctormike@thebodywellusa.com

3 Things You Need to Know About Inflammation: Cause. Effect. Prevention.

What Is Inflammation?

At some point in your life, you’ve probably had some sort of injury. You’ve either fallen, ending up with a scrape or bruise, or you’ve somehow cut yourself, I’m sure. You’ve also likely had some sort of infectious invader, like a bacteria or virus. And, it’s quite possible you’ve had a foreign body like a splinter or a bee sting.

Each of these assaults on your body triggers a physiological response called inflammation. Acute inflammation, to be precise. Basically, inflammation is a response that your body has to injury or insult. It’s a protective response your body initiates to eliminate the cause of cell injury, remove dead or dying cells and tissues, and begin the process of repair.  The acute inflammatory response is normally limited and self controlled – meaning, once the repair process if complete, the inflammation ends.

This is a good thing, right?  Well, it is good in the sense that it is necessary to heal.

But there is another kind of inflammation that happens in your body. And it’s not a good thing. This other type of inflammation is chronic, low-grade, and can cause progressive and serious injury to your body’s cells and tissues.  Worse still, it can be systemic, meaning it happens all over damaging tissues in multiple organ systems.

We have identified through research that your body has some of this chronic, low-grade inflammation present all the time.  But the degree of this inflammation is what makes it worse for you.  Meaning the more of this chronic inflammation you have, the more it damages your tissues and organ systems. It can also increase and intensify and cause a number of different problems as you age. Chronic inflammation has been linked to just about every degenerative disease, including:

  • Heart disease
  • Insulin resistance and Diabetes
  • Cancer
  • Stroke
  • Muscle loss
  • Alzheimer’s Disease
  • Osteopenia and Osteoporosis
  • Hypertension
  • Arthritis

So the next logical question you may have is: What causes chronic inflammation?

We have identified a number of causes of chronic, low-grade inflammation. The good news is, many of them you can eliminate. Here are some of them:

  • Suboptimal hormone levels
  • Oxidized LDL (“bad” cholesterol)
  • Weight gain and obesity
  • Many dietary factors
  • Lack of exercise or too much exercise
  • Smoking
  • Stress (mental or prolonged physical)
  • Periodontal disease

So How can I prevent low grade inflammation from happening, or at least keep it at bay?

Since many of the causes of chronic inflammation can be linked to your diet, exercise and lifestyle choices, the solutions can be found here as well.

  • Learn how and what to eat
  • Learn the right type and amount of exercise for your body
  • Improved self-care, and decreasing bad habits.

It’s a little bit easier said than done, but with the right information, you can profoundly decrease inflammation and improve not only the way you feel now, but decrease you risk for degeneration and disease down the road.


Why Can’t I Ever Seem to Keep the Weight Off When I Diet?

Dieting. It works!

Well…sort of.

You’ve tried dieting.  It works most of the time. Restrict what you’re eating and you’ll usually lose weight. Sometimes very quickly.

Juice cleanse du jour, Master Cleanse, The Biggest Loser, Fat Flush, The Zone, Atkins, Weight Watchers, Sugar Busters, South Beach, High Fat/Low Carb, Mediterranean. The list goes on.  They could open a bookstore devoted to diet books alone there have been so many. And the truth is, most of them DO work. Short-term.

But as time goes on, dieting becomes more difficult.  The same diet you did a few years ago doesn’t work as well the second, or third, or fourth go-around.  Or even if you’re not “dieting,” maybe you’re eating better than you ever have before. And you’re exercising more frequently and with more intensity than ever.


Well there’s a very good explanation. And it has to do with hormones.

You see, hormones play a large part in how your body responds physically as you grow older. As you age, your body produces less of the fat burning, energy producing hormones like thyroid, testosterone, estrogen, DHEA and growth hormones and tends to produce more of your fat storing hormones like cortisol and insulin. This result is overall weight gain and that dreaded fat around the middle that becomes so difficult to lose.

And one of the big problems with short-term, restrictive type diets is that they can increase the hormones you want to keep low (the fat storing ones) and decrease the hormones you want nice and high (the fat burning ones). So you’re often left in worse shape than when you started!

Optimizing your hormones can turn this around. Getting levels of key hormones back to where they were before they started declining (or rising, in the case of the potentially harmful ones) helps your body lose weight, burn fat, and increase your muscle density.


So where can you start? Begin by getting your hormone levels checked by a physician who specializes in Age Management & Hormonal Optimization.  And lose the weight. Safely. Sustainably.

Get the body and vigor that you had during your 20s and 30s back. Look and feel better than you ever have before.

Is Testosterone Going to Give Me A Heart Attack?

testosterone dr. mike carragher. hormones age management









Poor testosterone!

Many patients have been asking me recently about news reports mentioning a study that linked testosterone to an increase in heart attacks in men.  “Testosterone prescriptions linked to heart attack” was the headline in the Los Angeles Times on January 29, 2014.

Yikes!  Of course this headline grabbed my attention.

The news reports stem from an article published in the journal Plos One, titled ‘Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men.’

So I looked closer at the study.

Before I talk about the serious flaws in the study, the first thing I should mention is this: Testosterone therapy is not to be taken lightly.  With all the popularity of testosterone therapy these days, there are many doctors recklessly prescribing it without properly screening patients.  There are “Low T” clinics sprouting up in strip malls across the country.  This is has been, and continues to be, unsettling to me.  Testosterone (or any hormone therapy) should be properly prescribed and and monitored by a hormone specialist.  If you think you may benefit from testosterone, see a hormone specialist who will comprehensively evaluate you.  He or she should be well versed in the benefits and risks of therapy and the treatment of possible side effects for you to have optimal benefits from the therapy.

Now, as for the Plos One study, here are the important problems:


This is an observational study. These are the ones that typically make news headlines, as one can observe any outcome and draw erroneous conclusions from it. It is not a randomized trial.  Most of the randomized, controlled studies on testosterone demonstrate considerable cardiovascular protection (more later).  If you manipulate the data of any study long enough, you can get it show anything that you want.


The study did not assess testosterone levels of patients before and during therapy. It looked at men who filled a prescription for testosterone. Not even whether or not they took it, or took it correctly.  Without proper assessment of testosterone levels, it is impossible to tell if a patient is a good candidate for therapy or if they are tolerating the therapy well.  And without knowing if the men took their testosterone, or took it correctly, you need to be very wary of conclusions drawn. This is very basic stuff when if comes to research studies.


The biggest problem with this study has to do with the “control group.” The authors compared the groups of men who were prescribed testosterone therapy to men who were prescribed a class of drugs called PDE5 inhibitors.  You’ve heard of these drugs before by their brand names: Viagra and Cialis.  The authors  observed a lower risk of heart disease in the PDE5 inhibitor group. PDE5 inhibitors are drugs typically used to treat men with erectile dysfunction.  The authors state they used this group “as comparison” to the testosterone group so there would theoretically be an increase in sexual activity in both groups.

But they ignored an important fact!  PDE5 inhibitors have significant positive effects on the cardiovascular system. Two PDE5 inhibitors have even recently been approved for treatment of idiopathic pulmonary hypertension because of their ability to relax blood vessels. And a new study in the Journal of Cardiovascular Pharmacology and Therapeutics states that PDE5 inhibitors have potential as cardiovascular drugs in patients with coronary artery disease and in heart failure patients.

If PDE5 inhibitors can decrease the risk of heart disease and relax blood vessels in men with heart disease, how can the authors of this study possibly think that men on PDE5 inhibitors would be a good control group against the men placed on testosterone?

They can’t!

The results of the Plos One study run counter to an overwhelming amount of literature over 25 years that supports the use of testosterone as an important therapy that can lower cholesterol and blood sugar levels, reduce body fat and increase lean muscle mass.  These are all factors that reduce the risk of heart disease.

A new review article published in December 2013 in the Journal of the American Heart Association (JAHA) provides a comprehensive review of the clinical literature looking at associations between testosterone and cardiovascular disease. Over 100 studies were reviewed, and the authors concluded that low levels of testosterone are associated with increased rates of overall mortality, cardiovascular-related mortality, and higher rates of obesity and diabetes. And the severity of disease correlated with the degree of testosterone deficiency. Testosterone has been shown to relax coronary arteries and improve ability of patients with congestive heart failure to exercise. Testosterone lowers blood sugar in diabetics and lowers body mass index (BMI) in obese patients. Finally, studies have associated lower testosterone levels with thicker walls of major arteries, increasing risk of atherosclerosis. All of these factors point to the conclusion that optimal testosterone levels decrease the risk of cardiovascular disease.

The results of the current study, despite all the media coverage, are essentially meaningless. Testosterone therapy can be an excellent way to help men to improve their quality of life and decrease their risk of multiple diseases.  This is shown in the overwhelming majority of studies.

Again, be wary of news headlines.  Consult with a hormone specialist.

Show your doctor this blog post, especially if he or she tells you testosterone is going to increase your risk for heart attack.  The truth is, you probably know more than he or she does about this study after reading this.