Jun
13
2015

Preserving Our Energy

We are all aging, and as we do we are gradually losing energy until we reach our last breath. Here I like to review where our energy comes from and what we can do to preserve our energy. When we preserve our energy we are in fact also slowing down the aging process and this in essence is the approach to anti-aging.

Mitochondria are power packs of energy

Each of our body cells has many mitochondria to give us energy. Some organs are more demanding. They are the main players in our body like the brain, the heart, the liver or the kidneys. Their cells have thousands of these energy packages. Without the mitochondria there would be no energy available to these key organs to perform all the work they do. They allow us to think and produce brain hormones, to contract our heart muscle and pump the blood through our arteries. They are organs like the liver that are in charge of all of the major metabolic reactions or the kidneys that filter our blood for impurities and eliminate them in urine. Mitochondria can be likened to our power bundles that give our organs and us energy to get through life.

Get enough sleep

Sleep is an energy rebuilder. But it has to be deep enough and long enough, and there has to be enough REM sleep to give us the feeling that we had a refreshing sleep. As we age some of our hormone production slows down. One of those substances is melatonin. It is crucial for good and restful sleep. If our body is not producing enough, we can supplement with small dosages like 3 mg orally to help our body to initiate sleep. It is not an addictive substance. It is the body’s own hormone. Should you wake up later in the night, you could take another 3 mg of melatonin. There is no risk either to feel tired or “hung over” after taking melatonin.

Exercise regularly

The cheapest energy you can get is by exercising regularly. When you exercise on a treadmill, go jogging or go for a brisk walk you condition your heart, improve your lungs; in short you develop cardiovascular fitness. At the same time your muscles are strengthened with isometric exercises. You are optimizing your energy flow. In the process of exercising you create a stimulus for your mitochondria to multiply in the affected tissues. This applies as much to your muscles as it does to your heart and to your lungs. You will find that your muscle strength increases. With exercise you spend energy, but you feel more energetic from it because your body is being tuned up.

Manage stress

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Lifestyle

You need a lifestyle that is conducive to keeping your energies. Listed here are several factors that interfere with energy production.

  1. Smoking: If you smoke, you burn up energy with every cigarette you consume. You interfere with the oxygen transport through your lungs, but the chemicals that poison your system also poison the mitochondria of the cells. By smoking you are destroying your power packs. Pollution damages your lungs in a similar fashion as smoking does, but it is a slower process. There are a number of big cities with severe air pollution and they may not be worthwhile visiting.
  2. Sugar and starchy foods: Back in the 1970’s based on the Framingham Heart Study it was thought that hardening of arteries would be due to an accumulation of cholesterol from fat in the diet. Saturated fatty acids were accused to be the culprit. A low fat diet was supposed to be the solution. But the end result was the obesity and diabetes wave that we still see now. There had to be another explanation of where hardening of the arteries came from. Banning fats did not lead to better statistics. The new observation was that a low carb/medium fat diet was associated with low heart attack rates, low stroke rates, and even low cancer rates. Researchers also found the real culprit: They are sugar, starchy foods and processed foods. Sugar and starchy foods are metabolized in the liver into LDL cholesterol, triglycerides and they also oxidize LDL cholesterol. This starts a vicious process of inflammation of the lining of the arteries with fat deposits into the wall of the arteries. By eating the wrong foods we interfere with our body chemistry to the point where free radicals are produced that attack everything in us including our mitochondria. I have blogged about this many times before. You can read about it here.
  3. Alcohol: the famous one glass of red wine for women and two glasses of red wine for men is supposedly keeping us younger for longer. This is true for the resveratrol in the red wine, which is a powerful antioxidant. But to say that alcohol itself would prolong your life is a white lie. Alcohol is a nerve and cell poison; it robs you of energy. I take the resveratrol as a supplement from the health food store to protect my system. I stay away from alcohol.

Keep the arteries open

We need healthy arteries to pump blood through all of the branches and deliver oxygen and nutrients to the body cells. Unfortunately, as we age our arteries tend to get deposits that make them more narrow, and this could also raise our blood pressure. The end result is that less nutrients and oxygen will reach our body cells. We perceive that something is wrong by not feeling as energetic as usual. Simple lifestyle changes as mentioned below can improve our circulation and lower our blood pressure. Chelation therapy has also been shown as helpful in the TACT study.

Get rid of inflammation

Dr. Paul Ridker found that approximately 50% of patients with heart attacks had a normal cholesterol level. He was looking for a more meaningful screening test and found it in the C-reactive protein. If the test result was higher than 3 there was a high probability that there was inflammation somewhere in the body, but a test result of less than 1 was normal. In the meantime scientists have learnt that the C-reactive protein is a very sensitive tool to measure inflammation in the body, but it is not specific for heart attacks. It is also positive in people with arthritis, cancer, and autoimmune diseases. Chronic inflammation is also destroying immune cells: this explains the development of cancer as the end stage of chronic inflammation.

Chronic inflammation robs you of energy. We can do a lot with natural anti-inflammatory supplements to quench inflammation.

Preserve your immune system

We can strengthen our immune system by exercise, taking vitamin C regularly and by taking vitamin D3 supplements to just name a few. DHEA, the precursor hormone from the adrenal gland also helps stimulate the immune system.

Balance your hormones

As we age we loose hormones one by one. With melatonin this starts happening after the age of 20, with DHEA and growth hormone after you are in your mid thirties. Women start to get into menopause at the age of 45 to 55, but this can occur earlier or later. Men are going through their hormone change (andropause) at the age of 55 to 60. Both, women and men know when they are entering their hormone change because of a lack of energy and a few other unpleasant symptoms. Women get hot flashes. Men get grumpy, have erectile dysfunction, a lack of sex drive, week muscles and slower thinking. If you feel those symptoms, seek the help of a naturopath who is knowledgeable on bioidentical hormone replacement. Chances are that your regular doctor will want to prescribe synthetic hormones unless you can find an anti-aging physician. If your blood tests show deficiencies in the sex hormones, you will need to get a bioidentical hormone prescription. They are usually dispensed as creams, which you apply to your chest wall or non-hairy forearms in the morning. After 4 weeks your energy will be back, and your body will function normally again. All the body functions that you thought were gone forever just needed that extra stimulus from the missing bioidentical hormones.

Organic, GMO free food

I was tempted to just write “good food”. But this may be confusing to people. It is difficult anywhere in the world to get good food. Often insecticides and pesticides contaminate fruit and vegetables, which function as xenoestrogens blocking hormonal receptors. These residues are toxic for your body, and they are destructive to your energy. Organic food with the USDA certification or any independent certification is the best way to ensure that you get a good food product. I take this seriously and pay the extra dollar. We do not need plates heaped with foods. Small helpings of good quality foods are more important for our well-being.

Treat depression and mental disease

People who are depressed will complain of a lack of energy. Their brain circuits are constantly in overdrive being busy with negative thinking. Cognitive therapy can help depressed patients to face their negative emotions. It is a learning process of thinking step by step to distinguish what is real and what is magic thinking. It is important to seek qualified help. Depressed patients distort the way they think, but cognitive therapy sets their thinking straight (Ref.1). When the thinking is normalizing, the drained energy returns, people sleep better again and they can use the energy to move forward.

Positive thinking

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or by getting caught up in needless anxiety. Worrying does not get us anywhere, but it depletes our energy.

Preserving Our Energy

Preserving Our Energy

What can we do to prevent aging?

It follows from all that I said that anything that preserves energy would also prevent premature aging.

As mentioned, it is important to exercise regularly (gym, swimming, dancing, fast walking, jogging etc.). Have good, balanced nutrition, preferably organic food. Some supplements are also helpful: resveratrol, Co-Q-10; pages 100 to 103 of my book contain more vitamins and supplements (Ref.2). Here is a link to my website NetHealthBook, which also addresses vitamins and supplements (scroll down to table). Avoid sugar and starchy foods to avoid oxidizing LDL cholesterol. Use bioidentical hormones to replace what is missing. Get your 7 to 8 hours of sleep and don’t forget relaxation. Detoxify to get rid of toxins that would slow you down. Infrared saunas are one way to detoxify. It is helpful to consider chelation treatments. Last but not least have a positive outlook on life.

Conclusion

Our energy that we feel tells us whether we are staying healthy or whether we are at the verge of getting sick. It is best to maintain your energy at all times by doing a combination of things outlined above. You will retain youthful energy; you prevent cardiovascular disease, Alzheimer’s and even cancer. Most of all you have the energy to do the things you want and love to do.

I prefer to work on staying well and in the process I have the energy to do the things I want to do. Part of it is blogging, part of it is writing books, and part of it is dancing. The key is that I like what I am doing. I invite you to do what will keep you energized. Listen to your body.

 

References:

1. David D. Burns, MD: “feeling good – the new mood therapy” 1999, Harper Collins.

2. Dr. Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling

May
23
2015

Treating Menopausal Symptoms

There has been a lot of confusion since the Women’s Health Initiative that was prematurely abandoned because the women in the group that were treated with PremPro developed heart attacks, strokes and breast cancer. The clinical trial was supposed to confirm that hormone replacement therapy (HRT) with synthetic hormone supplementation would be heart protective, but it did the opposite.

I have addressed the problem of menopause and andropause in another blog.

Here I will review what can be done for a woman who enters menopause, has symptoms of hot flashes, lack of energy, sleep disturbances etc., but wonders whether not something could be done without introducing any risks as mentioned above. The answer is yes. I will review first what bioidentical hormones do and then discuss a bioidentical hormone replacement plan.

Hormones

The normal hormone action in a woman gets regulated through a complex interactive cycle between the stimulatory releasing factors of the hypothalamus that release pituitary hormones, which in turn stimulate the ovaries to produce estradiol and progesterone in a cyclical fashion. When salivary hormone levels are measured, there is a hormone ratio of 200:1 of progesterone to estrogen. According to Dr. Lee who researched this in detail in his books estradiol is potentially cancer producing in the breast and in the lining of the uterus. However, when the ratio of 200:1 (progesterone to estradiol) or more is found in a woman’s saliva the carcinogenic estrogen effect is neutralized by progesterone (Ref. 1 and 2). When a woman approaches menopause, less progesterone is being produced by the ovaries, as there can be anovulatory cycles. This means that a corpus luteum is not developing and progesterone is missing (Ref. 3 and 4). The change of cyclical hormone changes causes the pre- and postmenopausal symptoms.

There are a lot of effects that estrogens are having: estradiol is involved in neutralizing free radicals that age your cells; it maintains libido, supports bone health, prevents Alzheimer’s, prevents cataracts and skin wrinkling, prevents hot flashes and much more. Progesterone on the other hand keeps your hair from falling out, protects from blood clots, has an antidepressant effect, protects myelin sheaths (prevents multiple sclerosis), reduces cholesterol, prevents diabetes and much more. A table with all of the properties of these two hormones can be found here (scroll down).

Testosterone is also necessary in women for normal libido. However, the dose is much smaller than in the male. These traces of testosterone are produced in the adrenal glands and in the ovaries. These can be tested in either blood or saliva.

Safety of hormone replacement

Immediately when hormone replacement is discussed, the question of safety comes up. I have discussed this in detail here. Briefly, there is a 25 year collective experience in the US with bioidentical hormone replacement with no case of breast cancer, uterine cancer or other complications. In Europe bioidentical hormones have been used since the 1960’s, on a larger scale since the 1970’s. So the European experience of safety of bioidentical hormones is presently about 40 to 50 years. Again no breast cancer, uterine cancer, blood clots, heart attacks or strokes have occurred.

In contrast the synthetic hormones promoted by Big Pharma and approved by the FDA have caused the problems of the Women’s Health Initiative.

There has been a review of the Women’s Health Initiative in Postgraduate Medicine 2009 that clearly described that only bioidentical hormones are safe.

Bioidentical hormone replacement

Basically, what is missing should be replaced with the same hormones that were in your body all along. The reason for this is that each cell of your body has specific hormone receptors. There is a key/lock fit with regard to the hormone and the fitting hormone receptor in the cell that will stimulate necessary biochemical reactions to sustain cell function in every corner of your body. Why would you use a false key (synthetic hormone) that does not fit? Just because a regulatory body, Big Pharma and a physician who was influenced by Big Pharma say so? This does not make sense. Your body requires the bio-identical hormone that your body used to make when you were younger. With the gentle replacement of bioidentical hormones that youthfulness will come back. Based on hormone tests, the first hormone that usually needs to be replaced is progesterone, which can be applied as a skin cream or can be taken as Prometrium, a tablet that can be taken by mouth. After two to three months the hormone levels can be repeated and the ratio of progesterone to estradiol can be calculated (as stated above should be greater than 200:1). If testosterone levels are missing and this is clinically verified by symptoms, a small amount of testosterone cream can be applied as well. DHEA levels, cortisol and thyroid levels are also determined and what is missing is replaced. Fasting insulin is often also measured, particularly in a person who may be overweight or obese. A naturopathic physician or an anti-aging physician (A4M) can help you with the management of bioidentical hormone replacement.

New consensus rules

In 2012 a new HRT consensus statement was published allowing postmenopausal symptoms to be treated for 5 years. It was endorsed by 15 agencies. But when you read this with an open mind, it has NOT changed the synthetic hormones, but argues that up to 5 years of treatment would be relatively safe. There is no clear distinction made between natural progesterone and the synthetic progestins, which produce clots, heart attacks and strokes. Bioidentical hormones have been with women all their lives; when menopause sets in, there is a lack of progesterone, and estrogen dominance causes cancer problems. In Europe postmenopausal women can use bioidentical hormones as long as they feel they need it, in North America there is a consensus statement that postmenopausal women should not use  HRT with synthetic hormones from Big Pharma for longer than 5 years. This does not make sense! Why still synthetic hormones? I smell influence peddling worn out on the shoulders of postmenopausal women.

Treating Menopausal Symptoms

Treating Menopausal Symptoms

Conclusion

A lot of women have been unnecessarily scared by hormone replacement because of the Women’s Health Initiative, which was just a confirmation that synthetic hormones are noxious substances for the body. The recommendations from the consensus statement did nothing to clarify the situation.  All their lives women have been under the influence of their own bioidentical hormones produced by their hormone glands. So replacement with bioidentical hormones (structurally identical to the natural hormones in women) is safe and will bring back the vitality of the past, remove all postmenopausal symptoms and help women live a longer life without Alzheimer’s, heart disease or cancer (Ref.5). I agree with the European studies, the studies presented at many of the A4M conferences I have attended and the Postgraduate Medicine article mentioned above that stated that bioidentical hormone replacement is safe.

 

References:

Ref.1: Dr. John R. Lee, David Zava and Virginia Hopkins: “What your doctor may not tell you about breast cancer – How hormone balance can help save your life”, Wellness Central, Hachette Book Group USA, 2005. On page 256 and 257 Dr. Lee describes how progesterone can be used as a cream to treat PMS.

Ref. 2: Dr. John R. Lee: “Natural Progesterone- The remarkable roles of a remarkable hormone”, Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

Ref. 3: Dr. John R. Lee and Virginia Hopkins: “Hormone Balance Made Simple – The Essential How-to Guide to Symptoms, Dosage, Timing, and More”. Wellness Central, NY, 2006

Ref.4: Dr. John R. Lee, David Zava and Virginia Hopkins: “What your doctor may not tell you about breast cancer – How hormone balance can help save your life”, Wellness Central, Hachette Book Group USA, 2005. Page 29 – 38 (Chapter 2): Risk factors for breast cancer. Page 360 to 374 explains about xenohormones and how they cause estrogen dominance. Pages 221 to 234 (chapter 12) explains why Tamoxifen is not recommended and bio-identical progesterone is more powerful in preventing breast and uterine cancer

Ref.5: Dr. John R. Lee: “What your doctor may not tell you about menopause: the breakthrough book on natural hormone balance”. Sept. 2004.

Feb
20
2015

Hormone Changes With Burnout

At the 22nd Annual A4M Las Vegas Conference in mid December 2014 Dr. Thierry Hertoghe, an endocrinologist from Belgium gave a lecture on “Burnout: A multiple hormone deficiency syndrome”, in short: hormone changes with burnout. I have heard him speak on several congresses before. He is always very thorough and extremely knowledgeable. I decided to use this topic as a separate blog.

He said that burnout is common in teachers, soldiers, emergency room physicians (who have to deal with life and death situations) and firefighters. In essence they burn out their hormones. In burnout several hormones are affected, with the cortisol axis being the main one (low cortisol readings and flattening of the diurnal hormone curve), but at the same time other hormone glands are affected as well. As a result endocrine glands age prematurely and symptoms of fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness develop.

When hormone levels are measured, there is a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone/estrogen and progesterone deficiency and oxytocin deficiency. Holocaust survivors were found to have lower 24 hour cortisol levels. With burnout already the morning output of the adrenal glands is reduced. The health care provider must check prolactin levels, because if prolactin is not high, cortisol will work; however, if prolactin levels are high, cortisol will be ineffective and high prolactin levels have to be addressed first. There is a questionnaire that has been originally developed for teachers (teacher’s burnout scale) to monitor whether burnout is imminent. Soldiers who return from combative situations will also benefit from being assessed with the teacher’s burnout scale; they often suffer from burnout or from PTSD. In suspected cases hormone laboratory tests give concrete answers about hormone deficiencies.

In men growth hormone, melatonin, thyroid, testosterone, cortisol, DHEA and aldosterone have to be replaced to bring the hormone balance back to normal. Instead of aldosterone (a adrenal gland hormone) fludrocortisone is used. In women missing hormones are replaced by bioidentical progesterone and estradiol, but small doses of testosterone are also required.

Dr. Hertoghe discussed cortisol deficiency and its replacement at some length, as this is the main stress hormone that is deficient with burnout. Different treatment protocols for cortisol replacement are used as dosing varies for different degrees of burnout. Other hormones must also be replaced as necessary, possibly for a prolonged period of time, if not life long. Supportive counseling sessions have been shown to elevate cortisol levels and several studies were discussed. A counsellor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Balanced hormones are necessary on a cellular level to regulate the metabolism of every cell in the body.

Hormone balance and symptoms of various deficiencies

Cortisol is placed on one side of the scales and is balanced by androgens (DHEA), estrogens in women and testosterone in men, growth hormone and melatonin on the other side of the scales. When fainting is part of the burnout, it is because of extremely low aldosterone from the adrenal glands. The best treatment for this is fludrocortisone, which will bring the blood pressure up and remove the hazardous symptom of fainting. Symptoms of “slow thinking, slow moving” and tiredness are often from hypothyroidism. The best treatment for this is T3/T4 (Armour thyroid) treatment. Many physicians still use either T3 or T4, which is not physiological. Symptoms of “poor resistance to noise” are due to DHEA deficiency. In addition there often can be moderately poor resistance to stress and joint aches (arthralgias).

When permanent fatigue is present it is time to measure sex hormone levels. If deficiencies are found in a woman, bioidentical estrogen (Bi-Est) is given transdermally from day 5 to 25 of the cycle, and progesterone transdermally from day 15 to 25 of her cycle. Depending on how severe the hormone deficiency is hormone replacement doses in women range from 2.5 to 5.0 mg for bioidentical estrogen and from 100 mg to 150-200mg for bioidentical progesterone per day.

Sports fatigue

In this age of exaggerated sports activities a new entity of burnout, the sports fatigue has emerged. A low free testosterone/cortisol ratio is a reliable marker for overtraining. When this ratio shows a decrease of 30% or more, it shows that there is a temporarily incomplete recovery from intensive training. In the lab often an increase in the sex hormone-binding globulin (SHBG) can be measured, which leads to a lack of free testosterone. In a study of Chinese over-trained soldiers there was a complete recovery from this sports fatigue with multi-vitamins and a liposomal testosterone gel.

Sleep abnormalities

Restless, non-restorative sleep can be a symptom of melatonin deficiency and happens more often in people above the age of 50 as there is a natural hormone decline with age in the older generation. Treatment consists of replacement, which is easily achieved either with sublingual tablets (mild: 0.05mg, moderate: 0.15 to 0.5 mg, severe: 0.5 to 1mg). Oral melatonin doses are more problematical as there are average absorbers and poor absorbers. For mild, moderate to severe symptoms of insomnia the dosages are for average absorbers 0.2mg, 1 mg, 2mg and for poor absorbers 0.3mg, 1.5mg and 10mg. One should use the lowest effective dose of melatonin as it opposes cortisol and when melatonin is overused, adrenal gland weakness can be the result.

Exhaustion

An overpowering feeling of exhaustion can be due to growth hormone (GH) deficiency. This is diagnosed by taking insulin-like growth factor-1 (IGF-1) levels. When these are low, daily subcutaneous injection of low-dose human growth hormone is given. Depending on how severe growth hormone deficiency is, different GH doses are administered. The patient self-injects with an insulin injector. Mild GH deficiency requires 0.05 mg (1 click) per day, moderate deficiency 0.1 mg (2 clicks) per day and severe deficiency 0.15 mg (3 clicks) per day.

Adrenaline deficiency

Dr. Hertoghe pointed out with the help of a publication where runners had developed overtraining syndrome that adrenaline deficiency can be part of burnout. Laboratory tests on these runners showed that overnight catecholamine (metabolized adrenaline) excretion was only 50% of healthy runners. Often this is associated with thyroid deficiencies (in males and females) or with estrogen deficiency in women. Treatment consists in rectifying the thyroid and sex hormone deficiencies (estradiol and progesterone treatment in women).

Hormone Changes With Burnout

Hormone Changes With Burnout

Treatment of burnout

Dr. Hertoghe suggested a 5-step treatment protocol.

  1. Improve the diet

This involves the removal of sugar and starch as both lower the levels of essential hormones. He specified that sweets, chocolate drinks, soft drinks, milk, bread, pasta, commercial mueslis and high temperature cooked meats need to disappear from the diet plan.

The consumption of animal protein is desirable, but the food should be cooked at low temperatures. Fresh vegetable and fruit consumption should be increased. I like to add that these foods are best consumed as organic foods. These foods will increase your natural hormones and produce energy in your cells (ATP, NADPH).

  1. Improve your sleep

This requires a dark bedroom at night and day light exposure in the morning. Avoid TV’s, electrical alarm clocks, i-phones, computers at the bedside (EMF can disturb your sleep). If your environment is noisy, you may require ear plugs to shut out the noise. In case of hormone deficiency, it may be necessary to replace missing melatonin, growth hormone, see hormones above (especially progesterone in women), and oxytocin.

  1. Treat adrenal deficiency, if present
    The missing hormones here to be replaced are cortisol, DHEA and often aldosterone, which is replaced with fludrocortisone.
  2. Treat other associated hormone deficiencies

The other hormones, which are often overlooked, are growth hormone, thyroid hormones, estradiol/progesterone in women and testosterone in men.

  1. Treat nutritional deficiencies

The most common missing minerals and vitamins are iron, magnesium, folic acid, vitamin B12, vitamin E and others. Replacement of these along with the missing hormones is essential for normal cell function.

Conclusion

In an attempt to add to our physical fitness we may overlook our limits and run into a burnout situation without noticing it. Your medical care provider should think about multiple hormone and nutritional deficiencies that can be treated, although treatment can be multifaceted. If in doubt ask for a referral to an anti-aging physician.

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Dec
16
2014

Straight Talk About Menopause

In men andropause, the equivalent of menopause is easy to spot and treat. With them it is about a lack of testosterone, which is confirmed with a blood test and treated with testosterone until the blood level comes back to normal and the symptoms disappear (lack of drive, loss of erections).

In women symptoms of menopause are more subtle, but more profound when they have fully developed. Unfortunately there is a lot of misinformation out there including in the media, so often women do not get treatment that would turn their lives around and make the next phase of life more livable. To my way of thinking this is simply not acceptable in a time when help is readily available. Read what I am writing here first and discuss this with your gynecologist or primary care provider. If you notice that there is a prejudice towards using synthetic hormones, go for a second opinion from a naturopathic physician. I will explain why later.

Confusion from the Women’s’ Health initiative in 2002

A discussion about menopause and hormone replacement therapy (HRT) would be incomplete without mentioning the Women’s Health Initiative. I have discussed this study in a previous blog.

Briefly, the use of Premarin and Provera as HRT caused heart attacks, strokes, breast cancer, uterine cancer and osteoporosis, not exactly what women wanted to see as side-effects from a hormone replacement therapy! This happened because the hormone receptors in the hormone-derivative, Premarin (an estrogen-like substance) and Provera (a progesterone-like substance) did not fit like a key and lock. The study was intended to show how useful Premarin and Provera would have been as hormone replacement therapy; the authors hoped to show that the treatment group would live longer, have less cancer of the breast and of the uterus, have less strokes and heart attacks and would suffer less osteoporosis. But because in this study the wrong ingredients were used to do the study, this should not be a discouragement to continue to look for the original goals of helping women to live longer, have less postmenopausal symptoms, less cancers (uterine and breast) and no osteoporosis. The solution is simple: in Europe many women have been treated for decades with bioidentical hormones and were shown to have no postmenopausal symptoms, no premature cardiovascular disease or cancers. Here is a 2010 review that mentions some of today’s confusion, but also points out several large European studies that did not use Premarin or Provera, but showed no increased risk of heart disease, no increased risk of cancer or osteoporosis.

Diagnosis of menopause

Symptoms of hot flashes, night sweats and vaginal dryness have all been found to be strong predictors of menopause as I reviewed here. FSH and LH hormones are above the normal range when a woman is in menopause and this is a very reliable test for menopause that your doctor can order. Usually in menopause it is the progesterone that is no longer produced by the body because the woman stopped ovulating and her ovaries do no longer produce progesterone in the missing corpus luteum that would have followed ovulation.

Progesterone depletion is best measured with a saliva hormone test rather than a blood test as progesterone in tissues accumulates to many times the value of blood tests. Only saliva tests correlate with the tissue levels of progesterone as Dr. John Lee has shown in the past.

On the other hand, estrogen levels are usually still in very good supply (in 65 to 80% of women in menopause) as the ovaries, the adrenal glands and the fatty tissue continue to produce estrogen in sufficient quantities for years to come.

Straight Talk About Menopause

Straight Talk About Menopause

Bioidentical hormone replacement (BHT)

The main principle of replacement with bioidentical hormones has been stated by Dr. John Lee and is still valid. Only replace the hormones that are missing and replace them in the lowest possible concentration, but in the natural form (called ”bioidentical”). Most women in menopause will only need progesterone. This comes in many FDA approved versions, as Prometrium (100 mg capsules) taken orally, or as bioidentical progesterone cream which is applied to the skin. The end point of treating is the lack of hot flashes, night sweats and vaginal dryness and the normalization of the FSH/LH blood levels. Saliva tests are expensive, but if they are taken when the other symptoms have subsided, they will also be in the normal range.

If you have problems getting these tests done and getting a prescription of the appropriate bioidentical hormone replacement, seek the advice of a naturopathic physician who is usually familiar with this type of treatment. Quite a few of the primary care physicians and gynecologists are starting to take an interest in bioidentical hormone replacement, but many of them are 20 to 30 years behind when it comes to treatment of menopause.

Conclusion

Bone mass density can be increased by 15% over 3 years with progesterone replacementHeart attacks can be prevented by replacing missing hormones with bioidentical ones. Apart from progesterone or testosterone levels, melatonin often is also depleted and has been found useful in attaining a better quality of sleep and in cancer prevention. The key is to not be one-sided, but to check for all your key hormones. Replace what is low with bioidentical hormones using moderation. You will have less symptoms, live healthier and live longer.

Last edited Dec. 16, 2014