Why More Tampa and St Pete Residents are Using Low Dose Naltrexone, LDN

Posted by Anne Hermann on Wed, Apr 25, 2012 @ 02:07 PM

Anne Hermann, MD

Low Dose Naltrexone, or LDN, is a small dose of a medication called Naltrexone that was FDA approved for treatment in opiod addiction in 1984.   Naltrexone is believed to increase our body’s production of endorphins, which boosts the immune system.

Within a year of hitting the market, some physicians noticed that very low doses of naltrexone reduced decline rates in HIV and cancer patients.

Currently, multiple research centers, including Stanford, Penn State University, University of California, San Francisco and University of Utah performed small studies that demonstrate that LDN is beneficial for:

  • Multiple Sclerosis
  • Chronic Fatigue Syndrome
  • Crohn’s Disease
  • Autoimmune skin disorders
  • Ovarian cancer
  • Pancreatic cancer

In general, LDN is safe and tolerated very well.  It may enhance treatment of many autoimmune diseases.  While studies are small, they are all positive and since the medication is safe, it can make a big difference to a lot of people.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your consult, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

ALCAT vs IgG Antibody Testing for Food Sensitivities: From Tampa and St Pete’s Medical Nutrition Expert

Anne Hermann, MD

Food sensitivities are mild allergies that can cause migraine, fatigue, weight gain, gas, bloating, joint pain and rashes.   If you have food sensitivities, you will feel much better when you eliminate the foods you are allergic to. So how do you find out which foods are causing your symptoms?   We offer both IgG antibody and ALCAT testing for food sensitivities.  ALCAT is more effective than the IgG antibody testing.  ALCAT measures the total amount of inflammation in whole blood that you have to a food, while IgG antibody testing measures antibodies, but not inflammation.

ALCAT is the gold standard for food allergy testing because it is the only lab that has been shown to have 83.4 % accuracy with food and 96% accuracy with food additives in double blind trials.  The level of accuracy with IgG diagnosis of food allergies is much lower.

Prices for ALCAT testing vary based on how many foods and additives are being tested.  The range is between $450 and $1100.  IgG testing is much less because the insurance will often pay a portion.  Typically, IgG cost is between $80 to $250 depending on how much insurance covers.

Even though the ALCAT is the better test, I also carry the IgG testing because it costs less than ALCAT and still gives us some information about foods that people might be allergic to.  Also, if cost is an issue, I offer elimination diets, which cost nothing and can help you determine whether you have a food sensitivity.  To learn more about IgG testing and elimination diets click this blog: http://www.doctorhermann.com/blog/bid/129091/How-to-Treat-Food-Allergies-in-the-Tampa-St-Pete-Area.

To schedule your appointment with Dr. Anne Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Why You Should Take Vitamin K from Tampa and St Pete’s Medical Nutritionist, Anne Hermann, MD

Posted by Anne Hermann on Mon, Apr 16, 2012 @ 05:28 PM

Anne Hermann, MD

The buzz in the nutrition world is that Vitamin K2 (menaquinone) is more important that we ever realized.  Vitamin K2 has always been recognized
for its crucial role in blood clotting.  Here are a few new recent findings about Vitamin K2:


Adding K2 to Vitamin D and Calcium reduces risk of fracture by 25%.  Vitamin K Supplementation for the primary prevention of osteoporotic fractures: is it
cost-effective and is future research warranted?  Gajic-Veljanoski O, Byoumi AM, Tomlinson G, Khan K, Cheung AM.  Osteoporosis Int. 2012 Mar 8

Vitamin K reduces heart disease.  High dietary menaquinone intake is associated with reduced coronary calcification.  Beulens JW. Bots ML, Atsma F, Bartelink ML. Atherosclerosis. 2009 Apr; 203(2):489-93

People with higher dietary Vitamin K2 intake have lower rates of death from cancer. Dietary vitamin K intake in relation to cancer incidence and mortality:  results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition.  Am J Clin Nutr. 2010 May, 91(5):1348-58.

With all these benefits, I recommend that patients take 125 mcg of vitamin K2 per day.  For bone health, I recommend a preparation of Vitamin D and Vitamin K2.  Sources of vitamin K include kale, and other leafy green vegetables.  If you would like to have your vitamin K level checked, we do this through Spectracell Labs.

If you are on a blood thinner, you will need to talk to a physician about the safe amount of K2 for you.

Anne Hermann, MD, is a board certified physician nutrition specialist.  To schedule your appointment with Dr. Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Is Natural Progesterone Cream Safe and Effective? Learn from Tampa and St Pete’s Expert

Posted by Anne Hermann on Fri, Apr 13, 2012 @ 04:39 PM

Anne Hermann, MD

Bioidentical hormones are exactly the same molecule as those produced in our own bodies.  Most standard hormones are chemically different than the hormones made by our bodies.  Progesterone is a hormone that is also converted to other hormones in our bodies.  So, when we take the bioidentical form, we are not only replacing progesterone, but also the other hormones that are made with progesterone.  Standard, synthetic progesterone cannot be converted into other hormones in our bodies.

As early as the late 1990’s, I saw patients who used natural progesterone cream for menopausal symptoms.  At that time, most doctors had no knowledge about the difference between standard hormone therapy and bioidentical hormones.   When I spoke with one expert in the field, he told me that “in order to absorb enough progesterone through the skin, you would have to wear a progesterone patch the size of a vest”.  I knew this could not be correct as my patients were having real benefit from the progesterone creams they were using.  I set out to perform a study to determine how much natural progesterone is absorbed from the creams.  At Bassett Hospital, a Columbia University Hospital, where I did my residency, I worked with two clinical pharmacologists, Joe Bertino, PhD and Ann Nafsiger, MD.  They helped me develop a protocol to compare the FDA approved oral natural progesterone, Prometrium to over the counter progesterone cream.  The results were surprising to many (but not to me):  40 mg of progesterone cream twice a day gives same blood value of progesterone as 200 mg per day of Prometrium!

Because we already know that prometrium is effective against endometrial cancer, we can say that progesterone cream is equally effective at this.  The cream provides additional benefit because it does not yield as many by-products as the oral form.  Now, research is leaning towards bioidentical progesterone as being less likely to cause breast cancer than synthetic progesterone.

All progesterone use should be used under medical supervision.

For more blogs on bioidentical hormones, check out http://www.doctorhermann.com/blog/?Tag=Bioidentical+Hormone+Therapy.

To schedule your consult with Dr. Anne Hermann, call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Bioidentical Hormone Therapy from Tampa and St Petersburg’s Own Expert!

Posted by Anne Hermann on Wed, Apr 11, 2012 @ 04:10 PM

Anne Hermann, MD

What You Need to Know about Bioidentical Hormone Therapy from Tampa and St Petersburg’s Own Expert!

This article focuses on female hormone therapy.  On my blog, I also post articles focused on male hormone therapy.  As an author of nationally recognized research on bioidentical hormone therapy, I have been treating men and women for 9 years in Tampa Bay.  I recommend hormone replacement therapy when non-hormonal and natural therapies do not work in treatment of menopausal symptoms including:

  • hot flashes
  • weight gain
  • sleep disturbance
  • “brain fog”
  • poor libido
  • vaginal dryness
  • skin changes

The medical community is learning that some forms of hormone replacement, called bioidentical hormones, have less side effects and less danger than standard hormones.  Less risk does not mean no risk, and I always discuss these pros and cons with my patients.

Hormone therapy is not recommended for women with the following:

  • · Current or past history of breast cancer (standard hormone therapy increase risk of breast cancer)
  • · Coronary heart disease especially if older than 60 or went through menopause more than 10 years ago
  • · A previous blood clot, heart attack, or stroke (standard therapy increase risk of blood clots and stroke)
  • · Women at high risk for these complications


  • Reduces the risk of bone fracture caused by osteoporosis.
  • Lowers risk of colon cancer
  • Make women with menopausal symptoms feel better

The North American Menopause Society, the Endocrine Society, the International Menopause Society, and guidelines from the European Menopause and Andropause Society for the management of menopausal women all favor the use of bioidentical forms of hormone replacement in women with high risk of blood clots.  Unlike standard estrogen treatment, bioidentical estradiol does not increase risk of blood clots or stroke (doses ≤ 50 μg).  Bioidentical progesterone also has less risk of blood clots and breast cancer than standard therapy. Based on these data, which are now included in the guidelines, the use of transdermal estradiol and micronized progesterone could reduce the excess risk of blood clots, stroke, and possibly even breast cancer associated with hormone use.  Simon JA. What’s new in hormone replacement therapy: focus on transdermal estradiol and micronized progesterone. Climacteric. 2012 Apr;15 Suppl 1:3-10.

I was the first author in the study that demonstrated that the bioidentical form of progesterone cream is absorbed as well as progesterone pillsOver-the-counter progesterone cream produces significant drug exposure compared to a food and drug administration-approved oral progesterone product.  Hermann AC, Nafziger AN, Victory J, Kulawy R, Rocci ML Jr, Bertino JS Jr.J Clin Pharmacol. 2005 Jun;45(6):614-9.  Look out for my blog on this topic in the future.

Anne Hermann, MD is double board certified in Internal Medicine and as a Physician Nutrition Specialist. To schedule your consult, please call 813-902-9559.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

MIC B vs B12 Shots for Weight Loss in Tampa and St. Petersburg

Posted by Anne Hermann on Wed, Apr 04, 2012 @ 12:46 PM

Anne Hermann, MD

Why MIC B Shots are Better than B12 Shots for the Best Weight Loss

We are often asked if we do B 12 shots for weight loss.  To be accurate, there are better shots for weight loss than B12.  We recommend and use a MIC combo shot that provides a combination of amino acids and vitamins to aid in weight loss.

B12 shots (which we do offer for B12 deficiency) contain very high concentrations of B12, but do not have any other vitamins in them.  Before we give either shot, we usually check your blood level of B vitamins.   If you are low in B12, then you will feel better with the concentrated B12 shot.  If your B12 level is normal to high, adding more B12 will not make you feel any better or aid in weight loss.

So, for people with normal B12 concentrations, we recommend the MIC combo which has:

  • Methianine, Inositol and Choline: Amino acids that aid in the maintenance of muscle tissue
  • Vitamin C to boost immune system and skin health
  • Methylcobalamin, pyridoxine, niacin, riboflavin and thiamine, which are B vitamins that help prevent fatigue while you are on a calorie restricted diet.

Our formula also contains lidocaine to ensure that the injection is comfortable.  If you are receiving B shots for weight loss, please ask your provider if you are getting B12 or a B complex.  If it is just B12, be sure that the doctor monitors your blood levels so that you do not get too much.

For more information, we offer consults at 813-902-9559 or 727-278-3992.  Anne Hermann, MD is double board certified in Nutrition as well as Internal Medicine.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.

Best B12 Shots in Tampa St. Petersburg

Posted by Anne Hermann on Wed, Apr 04, 2012 @ 01:00 PM

Anne Hermann, MD

Learn why we have the best B12 shots in Tampa and St Pete: Methylcobalamin vs Cyanocobalamin

B12 shots are given to people with low levels of B12.  A reputable weight loss clinic may use a B complex shot for weight loss, but should only use B12 if you have bloodwork that shows low B12 levels.  For more on B shots for weight loss: http://www.doctorhermann.com/blog/?Tag=B12

The other name for B12 is cobalamin and the best form of B12 injection is methylcobalamin or mythyl B12.

Most clinics use cyanocobalimin, or cyano B12, which has very small traces of cyanide attached to the B12.  In order for the more common, cyano B12 to be used by the body, our own metabolism must break the ‘cyano’ particle off from the B12.

Methylcobalin is a natural form of vitamin B12 and can be used much more easily by the body.  Be sure to ask your doctor which form they use before you start injections.

If you are looking for B12 for weight loss, make sure the doctor checks your level first.  If your B12 levels are already middle to high, you should have a B shot that gives less B12 and more other B vitamins such as folate, niacin, thiamine and sometimes amino acids that help maintain muscle.

Things that B12 helps with are:

Bell’s Palsy: methyl B12 reducesed the recovery time in Bell’s palsy. Jalaludin MA. Methylcobalamin treatment of Bell’s palsy. Methods Find Exp Clin Pharmacol 1995;17:539-544.

Diabetic Neuropathy  Alternative Med Review. 1998 Dec;3(6):461-3.

Heart Disease:   in one subgroup study, people with high B12 levels given additional B12 had a 34% reduction in stroke, death and heart attack.  Spence JD, Bang H, Chambless LE, Stampfer MJ.  Vitamin Intervention for Stroke Prevention Trial: an efficacy analysis. Stroke. 2005, 36(11): 2404-2409.

Anemia: B12 deficiency causes pernicious anemia and the only treatment is B12 shots

Fatigue:  Because we need B12 to prevent anemia and nerve damage, low B12 causes fatigue

To schedule your consultation with Dr. Hermann, please call 813-902-9559 or 727-278-3992.  Anne Hermann, MD is double board certified in Nutrition as well as Internal Medicine.

This post was written by Anne Hermann. Follow Anne Hermann on Google, Facebook, Twitter & Linkedin.