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I just finished Suzanne Somers new book that claims that hormones
can keep you young and beautiful forever. What are bioidentical
hormones and are they good for everyone? EB, Billings, MT
Dear EB,
The hormone therapy discussed by Ms. Somers refers
to DHEA, testosterone, 3 types of estrogens (estradiol,
estrone, estriol),
progesterone and growth hormone. For many years health practitioners
interested in a concept called life extension, have been using
different combination of these hormones. While there are some benefits to
the use of combination hormone therapy for some individuals, I think it is
overrated, expensive, and unsafe for some individuals. Naturopathic physicians have been using bioidentical hormones for 20 years. At the Yellowstone Naturopathic Clinic we
have been recommending and prescribing this type of hormone therapy for 14
years. I appreciate that Ms. Somers
celebrity status has brought this important option for women to the
attention of the general public.
It’s important to realize that the idea that “one-size-fits-all”, in
regards to any therapy, is ineffective and unsatisfactory for most
individuals. Our experience in
treating women in the climacteric period (peri-menopause,
menopause and post-menopause) is that each woman needs a different
approach, depending on many factors.
We work with women to help them identify the treatments that are
available and to sort out what factors to consider in making their
decisions. We offer the bioidentical hormones, as one option, for women to consider. While we often use different types of
laboratory tests to assess an individual’s specific processing (metabolism)
of hormones, the use of lab tests to repeatedly re-evaluate a given dose of
a hormone is impractical and expensive for most individuals
Certainly it is not a
simple subject and deciding what to do about hormones is difficult for many
women. When the information we do
have is presented in a simple straightforward manner, in the context of
each individual, most women feel the confidence to choose what is best for
them. While we do see positive
effects with the appropriate use of hormones, I think it is an
oversimplification to assume that most problems after 50 are related to
hormone deficiency. It is not
unusual to develop a hormone regimen for an individual, based on lab
results, and find that it is either ineffective or that it causes unwanted
side effects.
Assuming that hormone
deficiency is the cause of not feeling well may result in missing what is
truly responsible for a lack of vitality. There is still much that is
not known about the long-term effects of hormone therapy after menopause,
therefore it is wise to be cautious.
In the last couple of
years the reports from large research projects, such as the HERS, WHI,
etc., have called into question some practices regarding hormone therapy,
and for good reason. Some of the
commonly used pharmaceutical estrogens and progestin (synthetic
progesterone) had not been widely studied and were used without sufficient
scientific data regarding safety, because of their effectiveness for
symptoms and bone health. Bioidentical hormones are made from sterols or fats
extracted from wild yam or soy. They
are considered safe because they have the same biochemical structure as the
estrogens, progesterone, and testosterones made and used in our own
bodies. Use of these hormones after
menopause also needs to be studied more extensively. (We have attempted to
use the bioidentical estrogens and progesterone
for an osteoporosis study here in Billings,
but without the resources of the pharmaceutical companies it has been
extremely difficult to get any sizeable study off the ground.)
As Naturopathic
physicians we know that the question of long-term safety does not rely
solely on the type of hormone used but in the ability of a woman’s body
to process and dispose of hormones efficiently. There is a growing body of scientific
knowledge that is recognizing the link between breast cancer and many other
factors beyond hormone therapy. Here
are some recent studies reported in respected scientific journals. “Use of antibiotics is associated with
increased risk of incident and fatal breast cancer.” JAMA Feb, 18,2004. “Alcohol use was associated with the risk of
lobular cancers and hormone receptor-positive tumors more that any other
type of breast cancer.” Cancer Epidemiol
Biomarkers Prev, Oct 2003.
“A reduced incidence of
breast cancer was found with the highest average lifetime activity for pre
and post menopausal women. MJA
Dec2003. It is known from the WHI
study that hormone therapy may reduce the incidence of colon cancer by
37%. Exercise is also
associated with a 30% reduction of the incidence of colon cancer. Combined with flaxseed, the risk of colon
cancer can be reduced equal to the reduced risk from hormone therapy. This is an example of information that
can help a woman to make an informed choice based on her concerns and
personal risk factors.
Last week Dr. Angersbach
discussed the role of the liver in the breakdown and elimination of
hormones, whether they are taken into the body or made internally. The colon has a large impact on this
process in that unhealthy bacteria in the gut make enzymes that interfere
with the removal of hormones and allow for recycling and increased
concentration of the hormones in hormone sensitive tissue. Research continues to indicate that
lifestyle factors such as healthy nutrition, exercise and emotional health
have a substantial impact on the need for hormone therapy and how safely
these therapies are tolerated.
This is the information we consider when we are consulted regarding
the use of bioidentical hormones. It is important to
recognize our biochemical individuality and address the whole person in making
important decisions such as the use of any type of hormone therapy.
Yellowstone Naturopathic
Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655
ync@180com.net
Dispensary
406·254·9682
dispensary@yncnaturally.com
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