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.

May
10
2014

The Full Story About Testosterone

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014

Dec
14
2013

Pollution And Soaring Lung Cancer Rates

In early 1900 lung cancer was unheard of. This was before the cigarette industry started to mass-produce and market cigarettes.

However, ever since the arrival of the industrial revolution air quality has suffered. In China poor air quality has now reached such enormous values that the specialized cancer agency of the World Health Organization, the International Agency for Research on Cancer (IARC) has labeled poor air quality as one of the causes of lung cancer.

When you rank countries by average air pollution measurements, one sees that Europe, the US and South America overall have good ratings, whereas the Middle Eastern countries, China and India have poorer ratings.

However, when the pollution index of cities where the population is much denser than in the countries at large, are tabulated a much different picture emerges: Cities in Iran, India and Pakistan stand out as particularly bad followed by cities in China, Eastern Europe, Paris, London, Berlin, cities in California (the populous State), Chicago and New York.

Pollution does not stay local, but travels through the stratosphere around the globe. The result is that now 10 to 15% of lung cancer in the US occurs in patients who never smoked. This translates into 16,000 to 24,000 deaths annually of never-smokers in the US.

In certain cities such as Beijing the lung cancer rates have doubled in 9 years between 2002 and 2011. As this article shows lung cancer in never smokers can be caused from exposure to radon, to second-hand tobacco smoke, and other indoor air pollutants can also cause such cancers. But the outdoor air quality has been a problem ever since the industrial revolution, which started around Europe in the 1800’s and first part of the1900’s. In the latter half of the 1900’s much of the industrial wave has migrated to the Middle East, to India and China. But the air quality of the whole world has suffered as the jet stream and other air currents carry pollution in the stratosphere all around the globe.

Pollution And Soaring Lung Cancer Rates

Pollution And Soaring Lung Cancer Rates

History of pollution in various regions

1. In Germany’s  Ruhr district (“Ruhrgebiet”) in North Rhine-Westphalia, a highly populated industrial area, pollution reached a peak in the late 1950’s. From 1963 onward many of the coal mines, iron ore mines and other mineral mines closed down. 50 years ago the German Chancellor, Willy Brand was concerned about the environment and promised that blue skies would return to the Ruhr district again.  A special task force was initiated and maximally allowable limits were established for industries’ pollution emissions and enforced by the German government. Government and industry were co-operating in developing anti-pollution measures, which have cleared up a lot of the pollution since. With regard to car emissions lead free gasoline was introduced and carburetors ensured more complete burning of exhaust gases. This is now common and accepted anywhere except for diesel fume exhaust, which nobody wants to address despite proven carcinogenicity.

Now Germany is one of the leaders in green technology, which is also important for tourism.

2. England has its own legacy of pollution in soil and air from the industrial revolution. The soil of moorland, which soaked up acid rain for decades, is more acidy than lemon juice and it will take a long time despite industrial complexes having closed long time ago, before the soil quality will be returned to normal.

3. Hamilton in Ontario/Canada has had a longstanding pollution problem, which I witnessed from 1976 until my departure in 1978. It is well known that Stelco, the local steel plant downtown Hamilton is sending polluting emissions into the air. In 1976 a vising professor from Australia gave an interesting talk about a study that was done at that time regarding the risk of developing bronchogenic carcinoma (a synonym for lung cancer) in the immediate surroundings of the Stelco plant. He said that this was one of the first studies to show that the distance of people’s houses from the source of pollution mattered as that determined how concentrated the air pollution was (the closer the more polluted the air). This  affected cancer rates: they were much higher in the immediate surrounding of Stelco when compared to the average rate in the rest of Hamilton. This difference was very significant within a radius of 1 kilometer (= 0.62 miles) from the Stelco plant.

Just in May of 2013 the local cancer agency of Hamilton announced that the lung cancer rate in Hamilton was higher than elsewhere in Ontario because of a combination of poor air quality and of a higher percentage of people smoking. Then in August 2013 the city of Hamilton announced a new air pollution bylaw for stricter pollution measures to improve the air quality in the downtown area. It is just a pity that Hamiltonians had to wait until 2013 before the city approved an anti-pollution bylaw that could have been passed 50 years earlier like in Germany’s Ruhr district!

4. In 2008 Pittsburg, a former steel manufacturer town like Hamilton, Ont. outdid Los Angeles with regard to small particle air pollution.

Lung cancer prevention by the authorities

As mentioned before up o15% of lung cancer is caused by environmental exposure. So, we ourselves can only prevent 85% of lung cancer by not smoking and not exposing ourselves to industrial emissions or to smoke from incense. However, in many cities around the world you will get exposed to air pollutants that are well above the safe limits, so the risk of getting lung cancer from just breathing the air there can be much higher than in rural areas where there is no industry.

Technologies to control air pollution are widely available. We need to exert pressure on politicians to show leadership around the world. Government regulations to lower emission rates need to be put into place and inspectors need to ensure the rules and regulations are adhered to. Without reducing emissions of cancer producing gases and chemicals right at the source (open burning of cuttings in orchards or burning cut trees), cutting emissions of cars, planes, ships, diesel cars, locomotives, electric generator plants etc. the air quality will not improve. Despite some costs involved industry, governments and individuals have to work together to make clean air happen.

The residents of those countries that have low pollution values will not benefit, if pollution continues to occur in other parts of the world as it just travels in the stratosphere around the globe until it arrives right here at home! We need an international pollution police. Satellites can be used to monitor where pollution occurs and this can be followed up through the local regulatory bodies with penalties and remedial actions.

What can I do personally to prevent lung cancer?

1.The most obvious step is to quit smoking and ask smokers who come to your place to smoke outside (not in your home).

2.Consider moving away from the city, if the air quality is unacceptable to a place where there is low air pollution.

3.Vitamin D3 has been shown to prevent colorectal cancer, but as there are vitamin D receptors found on the surface of various cells in tissue around the body including the lungs, many researchers feel that this vitamin in higher doses (2000 IU to 5000 IU) has probably a wider applicability in preventing cancers, even lung cancer.

4.Cutting out sugar and adopting a Mediterranean type diet is a prudent thing to do; also cutting down your calories to the maintenance you need (mildly ketogenic diet). If you bought body composition scales, it would display what your daily calorie consumption is and you should not exceed this, or else you’ll gain weight. An aging man who is overweight will experience hormone changes as fat is being metabolized and the enzyme aromatase contained in fatty tissue will turn male hormones (testosterone, DHT, androstenedione) into estrogen. Estrogen (particularly estradiol) is a known carcinogen that has been proven to cause breast cancer in women and prostate cancer in men. However lung cancer is also being promoted in women by estrogen as discussed in this link. In men one needs to remember that lung cells have estrogen receptors and there is concern in aging men with higher estradiol levels that this can promote cell divisions in existing lung cancer. So, it is important to maintain a normal body mass index between 21 and 24 (well below 25.0 and well above 18.5, which are the official accepted limits). This way there is no problem with insulin resistance (too high an insulin level), and other metabolic substances (cytokines, growth hormone like factors and tumor necrosis factor-alpha from body fat) that are cancer promoting.

5. If testosterone deficiency is present, which is common in older men, testosterone will have to be replaced with bioidentical hormones. It is a myth that testosterone would cause prostate cancer. Testosterone in males is necessary to maintain a normal metabolism including the immune system, which then can fight lung cancer and any other cancers.

6. Exercise and reducing beef consumption are also often mentioned in terms of preventing lung cancer.

7. Here are several recommendations from the LifeExtension Foundation that I found very useful in terms of lung cancer prevention. This link shows that antioxidant vitamins such as vitamin C, alpha tocopherol, the minerals selenium and zinc are also helping to reduce the lung cancer rate. Drinking green tea has also been shown to be effective in a dose-response curve manner (more tea protecting more from lung cancer). Vitamin B12 and folate have been shown to reduce abnormal bronchial cell growth in smokers as shown by repeat bronchoscopy studies.

8. Those who have been smokers in the past and those who have been around heavy smokers for more than 10 years in the past should consider having a preventative bronchoscopy done by a lung specialist (also called respirologist or pulmonologists). This way any suspicious areas with precancerous lesions can be biopsied during the procedure and attended to.

Hopeful research for new lung cancer treatments

Lung cancer is a disease that is best prevented. Once a person gets lung cancer, the prognosis is still very poor. However, cancer researchers are getting close to newer treatments involving genetically modified T-cells (killer cells) as was recently achieved for leukemia. Similar research is going on regarding ovarian cancer, melanoma, lung cancer and pancreatic cancer.

More information about lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/

Conclusion

It is not acceptable to let pollution take its course , the way politicians around the globe have handled this in the past 6 decades with a few notable exceptions mentioned. We all suffer a higher risk of getting lung cancer, even if we have been life-long non-smokers. Right now up to 15% of lung cancer in most populations are of this type. However, in Beijing this number is already much higher. The technology is available; Germany has led the way in the Ruhr district in the 1960’s and beyond. In my opinion the G8 meetings should have this high on their agendas and send technological aid to all the regions that have higher than the average world pollution index under the mandate of a special UN commission. This should be supported by the major industrial players with the knowledge that they will prevent the death of millions of potential consumers down the road, which will on the long-term pay off the relatively minor investment of installing pollution controls, before lung cancer levels rise even more.

Last edited Nov. 7, 2014

Aug
10
2013

Bioidentical Hormone Replacement

In many previous blogs I have mentioned that bioidentical hormone replacement prolongs life. Here is a more detailed look at what such hormone replacement looks like for both women and men. Before I get into details I want to stress that I am talking about replacing what is missing and replacing only with natural hormones, not some artificial hormone derivative produced by a drug company. The reason this is immensely important is that hormone receptors in the body are distributed all over our vital organs including bones, blood vessels and the nervous system. If there is no lock and key fit (bio-identical hormone fitting the hormone receptor), there is trouble as the Women’s Health Initiative in 2002 has shown. Unfortunately they had used synthetic hormones for HRT that were not fitting the hormone receptors, and this caused many problems (heart attacks, strokes, osteoporosis, cancer).

Physiology of aging

As we age, we gradually produce fewer hormones in our hormone glands, but the various hormone glands deteriorate in their functions at different rates. Beyond the age of 30 we produce less melatonin and less growth hormone. As a result our sleep pattern may change, as melatonin is necessary for a deep sleep. The decreasing growth hormone production means that we are losing some of our muscle mass and accumulate more fat in the subcutaneous tissues. Our adrenal glands produce less DHEA at the age of 35 to 40, a hormone that is a precursor to our sex hormones in males and females. The gonads (testicles and ovaries) also produce fewer hormones, a process which already starts 5 years before menopause and about 5 years before andropause (the male menopause equivalent).

Typically a woman will get into menopause at the age of 45 to 55 at which time the periods stop and postmenopausal symptoms are interfering with her well-being.  Men get into andropause (the male equivalent of menopause) at the age of 55 to 65 at which time erectile dysfunction occurs and often the individual will become the “grumpy old man”.

Other hormones such as thyroid hormones are also affected by the slow down. Hypothyroidism is common in people above the age of 50.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Baseline laboratory tests

In order to know what is going on, the physician or naturopath needs to order a number of tests to assess whether there is inflammation, how your key hormone levels are; the cardiovascular system markers should also be checked, the liver enzymes and vitamin D3 level. Inflammatory markers are fasting insulin levels and C-reactive protein (CRP). Fasting cholesterol and subfractions (HDL, LDL, VDLP, small LDL) and fasting triglycerides are also measured. Thyroid hormones (T3 and T4, TSH) are measured to rule out over or under function. Typically hypothyroidism is found, which would have to be rectified by taking Armour (a mix of T3 and T4 thyroid hormones).

At this point I need to explain that long time ago the research by Dr. Lee has shown that progesterone hormone levels are notoriously unreliable when blood tests are done. All of the other sex hormones, and cortisol are also not that reliable with blood tests. For this reason the saliva hormone tests have been invented that conveniently report a panel of 5 hormones from one saliva sample: DHEAS (which is the storage form of DHEA), estradiol (the major estrogen in a woman), progesterone, testosterone and cortisol. The saliva hormone tests correlate very well with the actual tissue hormone levels. You can order the saliva tests through Dr. Lee’s website. Another longstanding lab in the US is Dr. David Zava’s lab. In Canada the Rocky Mountain Analytical Lab can process your saliva tests.

Women’s hormone replacement

Let us assume that a woman is getting postmenopausal symptoms and bioidentical hormone replacement is being discussed. The physician will want to first rule out that insulin resistance is not present by ordering a fasting insulin level. If this is normal and the other baseline tests are normal as well except for missing estrogen and progesterone, the physician will usually start to replace progesterone first using a bioidentical hormone cream to be applied once or twice per day. If estrogen levels were also low, the next step in 4 weeks or so is to add Bi-Est, a bioidentical estrogen replacement cream. After 8 weeks of hormone replacement the saliva hormone test is repeated to see whether the estrogen and progesterone levels have come up and also, whether the ratio of progesterone to estrogen is at least 200 or more. Dr. Lee has extensively researched this and found that women with a ratio of less than 200 to 1 (progesterone/estrogen ratio) were more prone to breast cancer. He also stated in this link that there are 3 basic rules with regard to bioidentical hormone replacement:

1. only replace hormones, when they were measured to be low.

2. use only bioidentical hormones (never synthetic hormones) and

3. only replace with low doses of bioidentical hormones to bring hormone levels to physiological levels (body levels that were experienced to be normal before).

Many women who are not replaced in menopause have estrogen dominance meaning that the progesterone/estrogen ratio is less than 200:1, which puts these women at risk of developing breast cancer. Women who are overweight or obese also are estrogen dominant (from estrogen produced in excess through aromatase in the fatty tissue, explained further below), which makes them more prone to breast cancer, uterine cancer and colon cancer. Without bioidentical hormone replacement inflammatory processes take place in the joints (causing arthritis), in the nervous system (causing Alzheimer’s and dementia) and in the blood vessels (causing heart attacks and strokes). Rebalancing your hormones to a youthful state by paying attention to the hormone levels and the hormone ratios mentioned will remove the inflammatory reactions and reduce the risk for cancer.

Men’s hormone replacement

Males enter andropause 10 to 15 years later than women are entering menopause. Typically testosterone production slows down leading to hair loss, erectile dysfunction, loss of muscle mass, osteoporosis and Alzheimer’s/dementia. Blood tests (bioavailable testosterone) or saliva tests are both reliable in determining a deficiency. Replacement with bioidentical hormone creams once per day is the preferred method of treatment. Overweight and obese men produce significant amounts of estrogen through an enzyme localized in fatty tissue, called aromatase.

Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Estrogen causes breast growth, weakens muscles, and leads to abdominal fat accumulation, heart disease and strokes.

Similar to women, where the progesterone/estrogen ratio is important, there is another ratio for men, called testosterone/estrogen ratio. This should be in the 20 to 40 range for a man to feel good and energetic. Unfortunately many men above the age of 55 have testosterone/estrogen ratios much smaller than 20. This makes them more prone to heart disease and prostate cancer (Ref.1).

However, a male also does need a small amount of estrogen and normal thyroid hormones as well as all of the other hormones for his “hormonal symphony” (mentioned in Ref. 2) to function at his best.

Safety of hormone replacement

There are still otherwise reputable websites that state that bioidentical hormones are not safer than standard synthetic hormones. This confuses the consumer and does not serve the public well. I much prefer the text of the Wikipedia, which is a more thorough review regarding safety of hormone replacement and explains what the issues are.

In the US there is a collective experience of about 25 years on thousands of patients, but there have not been any randomized studies, as Big Pharma that would have the money to finance such studies is not interested in proving that bioidentical drugs would be safer than their distorted synthetic hormone copies that will not fit the body’s hormone receptors. There are some noble exceptions as Big Pharma is producing bioidentical insulin and human growth hormone that had toxicity studies done and showed safety. 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.

The FDA is contributing to the confusion of the public as can be seen from this publication. One example where the FDA is confusing the consumer, is the progesterone product Prometrium, a bioidentical micronized progesterone capsule that can be taken by mouth. By law the manufacturer had to put a warning label on the package identical to progestin, which is the synthetic, non-bioidentical hormone having been shown to have severe side effects. As is explained in this last publication Prometrium should not have been required to have a warning label in it ; the paper explains what I have already stated above, namely that bioidentical hormones are the safest form of hormone replacement and administered in the right ratios will actually prevent cancer and prevent premature cardiovascular and joint deterioration. In other words, bioidentical hormone replacement can add many years of useful life when started early enough before permanent organ damage sets in from the aging process (which would be due to missing hormones).

Why bother about hormone replacement?

Nature has a plan of “knocking us off” to make room for the next generation. The only way that you can change nature’s plan of killing us prematurely through cardiovascular disease, arthritis, dementia and loss of your sexual life is by bioidentical hormone replacement. Of course you also need the other ingredients of known life prolongers such as healthy (preferably organic) foods, exercise and detoxification. Many women are scared to treat the hormone deficiencies that cause their menopausal symptoms because of the Women’s health Initiative results with synthetic hormones. Men who would benefit from testosterone are often anxious that they may get prostate cancer, when in reality it is the exact opposite: testosterone prevents prostate cancer (Ref.3).

Conclusion

I wrote this blog about bioidentical hormone replacement in order to clarify this often-misunderstood topic. Don’t get confused by the FDA, by highbrow medical websites (such as the likes I mentioned). Big Pharma has a powerful lobby that attempts to keep the medical profession in the belief that their products are better than those that nature has provided (I call it “defend your patent rights”). We are still in a flux state where anybody who tells the truth about hormones gets much criticism. In another few decades it will be an accepted fact and people will wonder why the Women’s Health Initiative was done without a control with bioidentical hormones. With bioidentical hormone replacement you can add about 20 years of youthful life without disabilities to the normal life expectancy. Exercise, detoxification and organic food with avoidance of wheat, starch and sugar can add another 5 to 10 years to your life. The baby boomers are lucky that they have this new tool to prolong life. I wonder whether they will put it to good use.

More information about bioidentical hormone replacement: http://nethealthbook.com/hormones/anti-aging-medicine-women-men/

References:

1. John R. Lee: “Hormone Balance for Men – What your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation”, © 2003 by Hormones Etc.

2. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

3. Abraham Morgentaler, MD “Testosterone for Life – Recharge your vitality, sex drive, muscle mass and overall health”, McGraw-Hill, 2008

Last edited Nov. 7, 2014

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Dec
11
2012

What a Wonderful World

Recently I traveled from Palm Springs to the Caribbean and back. There were connecting flights and there was waiting at various airports, so I had lots of time to watch people and to observe what was happening around me.  Louis Armstrong’s song (1967) “What a Wonderful World“ came to mind , and I thought that this would be a fitting title for this Blog. Earlier we had come from Canada escaping the winter. The deep blue sky of Southern California and the sight of palm trees (instead of pine trees) is something that makes our hearts beat faster. The desert is a special place. We had friends join us for a week and we had visited Joshua Tree Park with the grotesque looking rock formations. During the flight it was interesting to see the landscape, as we crossed the desert areas of Arizona and New Mexico, seeing what difference people make when large areas are irrigated and the desert transforms into lush, green areas. It is also very visible, where the desert has taken back the land that no longer is irrigated.

We came to Dallas Fort Worth and the sky was clear. We traveled on to Miami and the sky was showing signs of pollution, although it was a sunny day. After our take-off from Miami we saw the ocean. I have flown over that region many times before, but this time I detected oil slicks on the surface of the ocean of the Gulf of Mexico, leftovers from previous oil spills. So, the Armstrong song of a “wonderful world” came back to me in a different context. I looked at the landscape and what industries can do to it. Erroneously we had just seen several BP commercials while waiting for our plane at the airport where BP was congratulating itself for the role it plays in cleaning up the environment having spent several billion dollars. But there are still oil slicks…

What a Wonderful World

What a Wonderful World

I looked at the people around me in the plane. More than 35% of them were obese; many of their faces looked sagging and prematurely aged, particularly in women. Males, even middle aged ones looked like they were pregnant (abdominal fat) and often their hair was receding, thinning on top and quite a few were bald. All of the texts I had read about anti-aging medicine came back to me. Too bad that people were eating the wrong foods and obviously did nothing to counter their built-in aging clock from depleting hormones as we age. I looked at the menu of the airline (I won’t mention the name of the airline, but I can assure you that 10 different airlines would have almost the same menus), but there would only have been one chicken salad that I could have eaten. In the past I tried to order this and I was told that due to popular demand this item was sold out. Instead they wanted to offer me potato chips, cheese and crackers. My wife and I had anticipated this scenario and we had bought a chicken salad and water before we boarded the plane. We also had packed healthy organic energy bars and a trail mix consisting of nuts and raisins to use as snacks during the trip. While travelling we stuck to the same principal of cutting out starches, bread, rice, pasta and only eating fresh vegetables, salads and lean meat (chicken, grass fed beef, ribs, lean pork and veal), which we always do since the fall of 2001.  We also avoid all alcoholic beverages and sugar containing sodas. When we returned to Southern California we were delighted to see that our body compositions when measured with the body composition scales were identical to what they were before the trip.

I think we can all contribute to this wonderful world, if we participate in whatever we can do such as these steps.

  1. End wars because on the long-term they do not lead anywhere to solve conflicts (in my lifetime I am thinking about the Vietnam war, long-winded Ireland crisis, the Korean war and the German reunification at the end of the Cold War). Right now there is the Middle East conflict, which screams for a peaceful solution. As we are conscious about the devastation that is caused by wars, we have to start with ourselves. We have to resolve our own conflicts that may be present in our own lives. Tolerance, acceptance and forgiveness are the tools.
  2. Pollution needs to be addressed by the US and all of the world’s countries (including Canada where I live most of the time). This means that anti-pollution devices need to be installed in industrial plants and chimneys. Recycling needs to be done on a larger scale. China and India and other emerging market countries need to be taught how these new anti-pollution measures work. This is an ongoing project, but we need more co-operations between government, industry and countries all around the globe. Also we have to start with our own behavior: we can become more aware of reusing and recycling instead of creating more waste in our landfills.
  3. What can we do to make us part of this wonderful world? We need to become better caretakers of our bodies. Instead of looking at quantity we must look at quality in choosing  natural food wherever possible. Growing up in Germany after the Second World War in the 1960’s and early 1970’s made me witness that high consumption of fat, sugar and starchy foods (potatoes, pasta and bread) caused people to age prematurely and get heart attacks, strokes, high blood pressure, arthritis, obesity, diabetes and cancer. At that time the “Wirtschaftswunder” (translated into English it means “economic miracle”) had propelled Germany into a nation of  high consumers. During the war they had been poor and often went hungry, they were slim and heart attacks were at an all-time low. After the war they made up for times of deprivation and overindulged:  pretzels, buns, bread, butter, French fries, sweets, cakes, cookies, jams, chocolates, pralines-everything was consumed with gusto!  What happened to Germany in the 1960’s and 1970’s is happening again right now in front of our eyes with the obesity wave in the US, Canada and all the other civilized countries around the world. Food companies have been very successful with their advertizing through the media. Already kids get hooked to the wrong foods! Hyperinsulinism will ensure that we get hungry every two or three hours. Refined carbs and extra calories are turned into fatty acids by the liver and stored as fat. It shows that we have to resist the wrong food temptation and cut out all refined carbs. It is healthier to stick to salads and vegetables like broccoli, cauliflower, asparagus, and spinach and eat a small piece of lean meat with it. Have probiotics as plain yoghurt (0% to 2% fat). If you need a sweetener, use a small amount of Stevia, which is a natural sweetener that leaves your body chemistry untouched. Have some fruit as a dessert like blueberries, cherries or strawberries. Eat an apple, the occasional grape. Drink lots of purified water or mineral water.
  4. Buy ORGANIC food whenever possible. Most of the vegetables and fruit have been treated with insecticides, which contain residuals in them. When these are ingested, they act like estrogenic substances causing breast cancer in women and prostate cancer in men. The safest in our society is to stick to organic foods. More expensive, but the best insurance against future disease. Question politicians whenever possible to make yourself heard. You want unadulterated food and water. And as I’m writing about water, have a water filter under the kitchen sink with a carbon filter or have reversed osmosis to get rid of chloride or fluoride from the city water. This is what you use to cook your food. You may want to take an iodine tablet once or twice a day to counteract the negative effects of chlorine from having a bath or shower (chlorine gets absorbed through the skin). Why? Because chlorine and fluoride can displace the iodine of the thyroid hormones and make you hypothyroid.
  5. Exercise every day. Nobody gets fit in their muscles from sitting in front of the TV for hours or from spending hours and hours of computer work. If you have to, counterbalance this with an exercise program of 1 hour per day. Walk 30 minutes on a treadmill and do 30 minutes of weights or use specific exercise machines in a gym to strengthen your upper and lower extremity muscles.
  6. Did I mention hormones? Yes, I did above when I mentioned depleting hormones as we age. It is known now for some time that each hormone of the body has its own peak in life and then it declines in production as we age. Or should I rather say, we age when these hormones decline? I like the latter way of wording it, because we can measure hormone levels and when one of the hormones is too low, we can replace it with a bio-identical hormone and the person’s energy comes back and whatever function was missing is restored. This is in essence what anti-aging medicine does. Many conservative physicians and clinics do not like to hear this. Big Pharma does not like to hear this, as I am talking about replacing hormones in the body with bio-identical hormones, not with patented cheap copies that are mass manufactured, sold at inflated prices, but are no fit to the hormone receptors in the body and therefore are dangerous. The artificial drugs cause heart attacks, strokes and cancer as the Women’s Health Initiative has shown in 2002.
  7. What should have been done with the people I watched on the plane? They should have been hormone tested by their physicians. Many of the overweight or obese patients would likely have had high fasting insulin levels. The extra fat does not just sit there; it is a hormone producing factory for inflammatory compounds and estrogen-like substances. This causes heart attacks and strokes in women. It causes prostate cancer and hair loss in males as well as impotence (“erectile dysfunction”). What I said under point 3, 4 and 5 would help these people that I met. When fat is lost through changes in the diet and when an exercise program is started, the body mass index slowly comes down as fat melts away. The estrogen production comes down, the inflammatory substances abate. The person feels more energetic and may even think straighter. One special test is a saliva hormone test that looks at 5 steroid hormones: DHEA-S (storage form of DHEA), testosterone, estradiol, progesterone and cortisol. Every man and every woman needs a certain balance between these hormones and this test should be done when there is a change in energy or appearance (hair loss) somewhere when we are 35 to 40 years. In women it is important that the progesterone level is 200 times fold higher than the estradiol level (progesterone/estradiol ratio) or she is at risk of developing breast cancer and other cancers (ovary, colon etc.). In a man it is important that his testosterone to estradiol ratio is higher than 20 to 1. This protects him from cancer of the prostate or other cancers. Whatever is missing can be prescribed by the physician or a knowledgeable naturopath who is familiar with the use of bio-identical hormone creams. This program can prevent diseases like osteoporosis, diabetes, cancer and arthritis. It also prevents disabilities.

So with a view towards a new year (2013) and with a sense of leaving 2012 behind, I am looking forward to the time when more people can see Louis Armstrong’s vision of a “Wonderful World”.

More information on:

1. Pollution: https://www.askdrray.com/protecting-yourself-from-environmental-toxins/

2. Obesity: https://www.askdrray.com/stop-obesity/

3. Processed food: https://www.askdrray.com/caution-processed-food-ahead/

Last updated Nov. 6, 2014