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Ask Dr. Mike: Nosebleeds Caused by Spicy Food, Youthful Hormone Levels PLUS Where Should You Get a Blood Test?

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans. Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

When I eat spicy foods, I often get nosebleeds. Is this an allergic reaction?

Actually, eating spicy food is associated with nosebleeds. Doctors aren't really sure why this happens to some people and not others. Dr. Mike thinks it's a neurodegenerative response, and it's completely normal. However, if nosebleeds are happening constantly when you're eating certain foods, or if you get them quite frequently, then you might want to talk to your doctor.

Where is the best place to get a blood test?

The first place you should always start is with your doctor. Your doctor could help write a prescription to get any necessary test(s) done.

Tell me, what supplements do you take?

Dr. Mike takes the core foundational supplements: multivitamin, vitamin D, CoQ10, omega-3 oils, DHEA, curcumin, vitamin K2, and a probiotic.

What do you mean by "youthful hormone levels"?

Before you start taking any hormones, it's extremely important to get a blood test. What Dr. Mike means by youthful hormone levels is having the same hormone profile as you did in your 20s and 30s.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it. or call in, toll-free, to the LIVE radio show (1.844.305.7800) so he can provide you with support and helpful advice.

RadioMD Presents:Healthy Talk | Original Air Date: May 8, 2015
Host: Michael Smith, MD

Radio MD. It's time to ask Dr. Mike. Do you have a question about your health? Dr. Mike can answer your questions. Just email This email address is being protected from spambots. You need JavaScript enabled to view it. or call now 877-711-5211. The lines are open.

DR MIKE: Alright, so I have an interesting first question here.

"When I eat spicy foods I often get nose bleeds. Should I take this matter seriously or might this just be an allergic reaction?"

Now this may sound weird to some people. Eating spicy food is actually associated with nose bleeds. Now, we don't really know what happens but we do believe that a spicy pepper for instance, causes a release of what are called catecholamines from the adrenal glands. This is the epinephrine and norepinephrine and I think most people don't know the fact that spices and stuff, especially really spicy stuff--spicy peppers--boost metabolism. I did a whole show on that one. So in capsaicin, cayenne extracts, they boost metabolism. They're thermogenic, they raise what is called the sympathetic response in the body, that's your flight or fight nervous system.

And when that happens, the charge of neuro transmitters and hormones that are released often will cause a dilation, a dilatation of the small vessels in the entering portion of the nose, because it's such a thin skin there, they can actually bleed and that's the nose bleed. I don't know, I'm kind of just trying to put it together. I don't know if anybody really knows but I think that's a pretty good theory of how spicy foods cause nose bleeds. It's a neuroendocrine response to the thermogenic effect of the spice.

It's pretty good. You didn't think I had an answer for that one, did you? It's not an allergic reaction. When the body has an allergy to a food, it's reacting to a protein, what we call an antigen. So, I don't believe that's what's going on here. That would be more hives, itchy skin, that kind of stuff. I do have a friend when she eats spicy curry dishes she gets this red looking weird stuff around her lips and nose. That's more allergy. This nose bleed thing, it's not an allergy. It's not a side effect. It's just the result of a thermogenic response by the spice. Interesting though, part of this question is, "Should I take this matter seriously?"

No. If it only happens when you eat spicy foods, it's okay. The concern would be is if the nose bleeds are happening a lot. They don't seem to be associated with anything. If you have other bleeding issues going on, easy bruising, that kind of stuff, then you might want to get a work up. You might want to look at a complete blood count with a differential.

Make sure we're not missing some sort of leukemia type stuff. That does happen because platelets drop in those cases and that's why you're bleeding. Those are rare but that's when you get more concerned. But if you really have associated the nose bleeding with spicy food, don't worry about it. Just eat spicy food by yourself.

Okay, so that was number one. Number two. Next question here.

"Where is the best place to take a blood test to determine what supplements I should be taking?"
I think this is a question I had because I talked about the importance of blood testing recently with hormones. I can't remember the guest but I had a guest on where we talked about the power of prevention with blood testing. So, that's probably where this is coming from.

Well, you've got to start with your doctor, right? Your doctor would have to give you a diagnosis code, write you the prescription for the blood test, then you take it to whatever lab you go to. The problem is when it comes to a lot of the anti-aging blood testing, when it comes to maybe some of the blood testing that's not part of a disease work up or a general work up, they're not covered by insurance. And your doctor is not going to order it. Your doctor is going to be like, "Why do you want that blood test? I didn't diagnose you with anything like that. I don't think you have that.

Why do you want that?" And then you might say, "Well, because I listen to Dr. Mike and he talks about DHAE being important. It's a hormone important for anti-aging. So, I want to know what my level is." Then you get in this big fight and then I get blamed. There are companies out there, Life Extension is one of them.

There are other companies out there where you can order a blood test through . You have to pay out of pocket. It's not covered by insurance but, basically, you can get any blood test you want, if you're willing to pay. Insurances will only pay for certain things that your doctor has listed that your doctor thinks you have.

So, the insurance is only going to cover blood tests that are related to basic work up and a disease work up or a follow up from a disease or treatment. But you can get any test you want. You can get an advanced cholesterol test, you can get a hormone profile, you can get a fancy inflammatory profile, you can do a genetic...You can do anything you want.

You're just going to have to pay because insurance is not going to cover it because there's no doctor giving a reason for it. So, you have to pay out of pocket in a lot of these cases but it can be done and then when you have the result often these companies like Life Extensions have doctors that you can call.

They're not going to diagnose anything from it but they can help you understand the results and make some nutrient suggestions, at least. So, really just start with your doctor. If you have a doctor that will work with you, just tell him what you want.

You'll be fine. If the doctor doesn't want to do that stuff then you're going to have to go to some of these third party companies that offer this blood testing and you will have to pay out of pocket. Most of them offer these tests at a pretty significant savings, too.

Okay, there is a question here. Let me see how I'm doing on time. I guess I'll do this one. It's more about what I take and I shy away from these questions.

"I've been listening to your show on podcast over the past year. Thank you for all the wonderful health and wellness information."

You're welcome.

"Tell me, what supplements do you take?"

I take the core foundational supplements. I call them the "foundational supplements" in my book, The Supplement Pyramid. I take a multivitamin, I take extra vitamin D, I take CoQ10, I take Omega-3 oils, I take a probiotic, I take DHEA, I take curcumin...I have to remember now...That's pretty much it.

There may be some other ones here and there. I do a...there's a product called Berry Complete on the market that's just a collection of different types of dark fruits and vegetables. I don't do that all the time but I do take that on occasion. I take vitamin K-2 separately. I do that one. That's pretty much it. I stick to the basics. And it seems to work pretty well for me. So that's just my quick little list there.

Next question: "What do you mean by youthful hormone levels?"

I had a conversation again on, as a matter of fact, I think on several past shows about hormones and replacing hormones. I've talked about testosterone, DHEA--all of the steroid hormones. But before you start taking any hormone, especially, if you're going to do it on your own like over the counter DHEA or progesterone or pregnenolone, you don't need prescriptions for those. It's important to get a blood test.

And I talk about, sometimes, I say the word "youthful" or "optimal hormone levels". What I mean by that and I think what most longevity doctors mean by that is simply if you took your hormone profile when you were in your twenties, mid-twenties like 25, 26, 27, something like that, the level of those steroid hormones at that time in your life, that's optimal.

When it comes to hormone levels, when it comes to repair and regeneration of healthy tissue and muscle tissue, if it wasn't for the fact that we overeat and don't exercise in this country, we would be at our optimal health at that stage. So, when I talk about youthful hormone levels or optimal hormone levels, I'm simply trying to get people to rebalance their hormones like when they were in their mid-twenties to upper twenties, that's all. So, that's what I mean by that terminology and to understand that you just have to work with a doctor who knows what those levels are.

This is Healthy Talk on Radio MD.

I'm Dr. Mike. Stay well.