Hormone Replacement Therapy; the options, risks, benefits: who, why, and where to go for help?
Bio-identical Hormones (BHRT) v. Non-bio-identical hormones (HRT)
- Both used to alleviate symptoms of hormonal imbalance
- Bio-identical Hormone Replacement also used to correct the imbalance causing the symptoms
Bio-identical Hormone Replacement (BHRT) – what are they? Why all the HYPE?
- Bio-identical means that it is an exact copy of the hormones made by you naturally since birth.
- The body knows what to do with the hormone because the BHRT is “fully” recognized by the body.
- Balance of these hormones is important for optimal function, health and vitality.
- They are easy to measure before administering hormone intervention using creams, capsules, pellets and other, and then re-measure to monitor, thus improving the desired outcome.
What are Non Bio-identical Hormones or frequently called “synthetic” hormones?
- Slightly different molecules from what your body makes
- The slight difference gives a very different response by the body
- The slight difference also allows the drug companies to patent their molecule.
- They are known to cause cancer
- Not easily measured and therefore not monitored by health provider
- Not used to correct imbalance because they are not normally found in the body and therefore they can only help to treat the symptoms of an imbalance
Men and Women need balance
Balance of all hormones in order to enjoy maximum vitality and wellness.
- And MANY othes
Signs and symptoms of hormone imbalance
- Mood Changes
- Loss of energy
- Change in mental acuity
- Decreased muscle mass
- Increased Fat mass
- Decreased Endurance
- Sleep Disturbances
- Hot Flashes and Night Sweats
- Decreased sexual desire
- Premenstrual Syndrome (PMS)
BHRT and HRT Basics
- Most people (including doctors) use the words Progestin and Progesterone interchangeably. The truth is they are VERY different.
- Progestins are non bio-identical “synthetic” hormones that have been shown to cause cancer more than non bio-identical estrogens alone (WHI study)
- Progesterone a bio-identical “natural” hormones have been shown to have cancer protection (many studies)
- Hormones such as estrogen, progesterone, testosterone, and DHEA are prescribed in many different forms (ie. Capsule, cream, drops, pellets, injectable and other).
- The different vehicles are used to customize the doses and effects. Example: progesterone cream may be given to help a woman with PMS re-establish balance because it has a strong affect on the lining of the uterus. Where a capsule may be used in the case where a women with low Progesterone has trouble sleeping since its metabolites seem to have a calming and mildly sedating affect on the brain
Testosterone – both Men and Women
- Testosterone in men is essential for optimal function, vitality and quality of life. Replacing a man’s Testosterone when low most often has a very positive effect on both quality of life and physiology and disease prevention
- Testosterone is necessary for normal brain, heart, and bone health. Cholesterol, blood sugar and body composition often improves when the Testosterone level is restored.
- In women, Testosterone is very important to brain, heart, bone health as well as libido, energy and general sense of wellbeing. Testosterone replacement in women has many very positive effects.
- Most physicians trained in BHRT monitor levels 2-4 x a year to maintain balance and optimal result.
Who, why, where?
Men and women of all ages experiencing symptoms should be evaluated for hormone imbalances and may be candidates for some combination of BHRT
- Not just menopausal women and very old men
- Hormones are restored to optimal levels to restore health, wellness and vitality
- Make sure health care practitioner has been trained in the evaluation and treatment of hormonal imbalances using BHRT – www.bodylogicMD.com
- Synthetic Progestins, prescribed orally to balance estrogen replacement has been found protective against uterine cancer BUT shows a significant increase in breast cancer and cardiovascular diseases
- Natural Progesterone given to balance estrogen has been shown to protect against uterine cancer, breast cancer and cardiovascular disease.
- Breast cancer is often receptor negative, meaning that; the cancer is not thought to be caused by hormones.
- There is literature world wise that support the safe use of BHRT when prescribed and monitored by an expert.
- Hormone imbalance may be much more dangerous than properly administered BHRT
- There are decades of research of both estrogen only and estrogen/progestin HRT. Estrogen replacement has been shown to relieve menopausal symptoms, improve bone and skin health and diminish long-term morbidity from cardiovascular disease.
- However, when non-bioidentical hormone replacement is used, these benefits are accompanied by increased risks of breast cancer, blood clots, gallbladder disease, and endometrial overgrowth and cancer.
- Addition of a progestin mitigates against endometrial problems but increases other risks, as demonstrated conclusively by the results of the WHI trial and other studies.
- Patients have become increasingly aware of hormone replacements with bioidentical hormones and are coming to their physicians on a daily basis with questions about this more natural BHRT option.
- Patient must seek a physician training in BHRT to get more complete information regarding pros, cons and treatment options – www.BodyLogicMD.com
- We shouldn’t hedge and turn our backs on patients suffering from hormonal deficiencies while we wait for large trials to be conducted.
- Moreover, we are not sure if large trials will be conducted or who will fund them, since bioidentical hormones are not patentable.
- We should go back to first principles, think for ourselves, incorporate what we have learned from more than 30 years of steroid hormone research, and make our best call.
- We have good indications from the literature about what types of estrogens we should use (estradiol and estriol), and we realize that transdermal delivery of hormones often offers advantages over oral delivery.
- There is evidence that we should avoid certain progestins, and there is strong evidence to support both the oral and transdermal use of bioidentical progesterone.
- Through testing modalities such as saliva, we are able to more closely monitor the delivery of hormone to tissue.
- With good follow-up, good clinical judgment and good laboratory back-up, we have enough information about hormone replacement to offer BHRT as a viable option
- As time goes on, we need to analyze new information and modify our approach as indicated.
- Addressing the body as a whole to optimize total function is the primary concern of a Functional Medicine Physician. Hormones are a tool to this end. Diet and targeted supplementation are also valuable and necessary tools to optimizing the bodies function.
A MUST FOR PREVENTION:
I see people regularly in my practice that are over the age of 50 and have not yet had their colonoscopy screening. When I ask them why, they tell me that they don’t have any family history of colon cancer, or they have no bowel problems, or they are afraid of having cancer, or even that they simply mistrust the medical community – this is happening more frequently. Most of them have been asked by their Primary Care Doctors to have the screening test done, but it seems it was never properly explained to them WHY. I find that patient compliance is directly related to understanding WHY.
So… here is WHY:
First let me say that Colonoscopy is disease surveillance. Surveillance is necessary because colon cancer is silent and is often detected early via colonoscopy. Please also know that there are many ways to prevent colon cancer. One of the most important and easiest ways to lower your colon cancer risk is to optimize your vitamin D level. A vitamin D levels can be checked by a simple blood test. If you are deficient or less than optimal, you can increase your level of Vitamin D by either spending more daily time in the sun or by oral daily supplementation. It is important to monitor your Vitamin D level by getting tested every 6-12 months if taking high doses (above 2000iu) of orally supplemented Vitamin D3.
So… here is WHY having a screening Colonoscopy is so important:
- Colon cancer is very slow growing and can be seen early by colonoscopy
- By having a screening colonoscopy, changes in the colon can be detected before a cancer is formed. If these changes are detected early, the small precancerous growth(s) can be removed at the time of the screening procedure without additional intervention. Or if cancer is detected it can often be treated effectively.
- There are likely NO symptoms of colon cancer until the growth is large enough to cause complications and even death. Colonoscopy is a tool that is used to visualize these changes, thus allowing for early intervention of treatment.
- Screening Colonoscopy saves MANY lives.
Talk to your doctor about when you should have your screening colonoscopy. When you have your colonoscopy is determined by your age, your family history, general state of health and any symptoms you might be having, Signs and Symptoms that you experience that need to be evaluated by a physician and may require a colonoscopy.
- Change in bowel habits for more than a few weeks – constipation (less than three stools per week), diarrhea, thin stools
- Abdominal pain with bowel movement
- Rectal bleeding or blood in your stool
- Sensation that you “still” need to go after having a bowel movement
- Persistent cramps, gas, pain
- Iron deficiency anemia in a male or non-menstruating female
- Unexplained weight-loss
There are typically NO signs or symptoms in early colon cancer, which is why colonoscopy is ESSENTIAL. Pap Smears are necessary to diagnose “silent” cervical cancer, as colonoscopies are necessary to detect “silent” colon cancers. Both cancers are highly preventable and treatable.
Prevention strategies include drinking plenty of fresh clean water, eating whole fresh food, appropriate exercise, stress reduction and restorative sleep. In an earlier post you will find a list of “great” healthy foods. Try to have your diet consist primarily of the these foods to lower your risk of all disease.
Broccoli may reduce cancer risk!
But what if you don’t like broccoli?
Johns Hopkins University and many other academic institutions have been studying the anti-cancer effects of broccoli. The active ingredient in cruciferous vegetables that is thought to have these anti-cancer properties is Sulforaphane. The studies show that Sulforapahne may boost cell enzymes that protect it against molecular damage from cancer-causing chemicals. Sulforaphane had also been shown to mobilize natural cancer protection resources, thus reducing the risk of malignancy.
Broccoli (as compared to other cruciferous vegetables) has a particularly powerful type of sulforaphane, which the researchers believe gives broccoli, its particular cancer-fighting properties. It appears that broccoli contains the necessary ingredients to switch ON genes that prevent cancer development, and switch OFF other ones that help it spread.
What might be Even Better Than Broccoli?
- Small quantities of fresh broccoli sprouts contain as much cancer protection as larger amounts of the mature vegetables, according to previous research at Johns Hopkins University. These sprouts are sold in food markets or can be grown at home.
- Just 5 grams (0.17 ounces) of sprouts contain concentrations of the compound glucoraphanin (a precursor to sulforaphane) equal to that found in 150 grams (5.2 ounces) of mature broccoli.
- You can grow broccoli sprouts at home quite easily and inexpensively, and as you can see, a small amount of spouts go a long way. Another major benefit is that the sprouts don’t smell since you don’t have to cook them. They are eaten raw, usually as an addition to salad.
Below are a few recommendations for how to reduce your risk of developing cancer:
- Optimize your Vitamin D level with appropriate sun exposure or nutritional supplementation. It is best to monitor your Vitamin D level with a simple blood test ordered by your doctor.
- Control your insulin levels. Make certain that you limit your intake of processed foods, and eat an abundance of whole fresh foods.
- Get appropriate exercise. One of the primary reasons exercise works is that it drives your insulin levels down. Controlling insulin levels is one of the most powerful ways to reduce your cancer risks.
- Get appropriate amounts of Omega 3 fatty acids such as fish oil, and reduce your intake of omega-6 oils.
- Consume freshly ground flaxseeds and raw almonds daily.
- Consume fresh vegetable juice daily – including one small tomato (lycopene).
- Eliminate sugar as much as possible as it’s been shown again and again that sugar feeds cancer.
- Eat broccoli sprouts, cauliflower sprouts, and brussel sprouts. Or take a sulforaphane nutritional supplement daily. This can be found on the www.AgeExpert.com website as “ChemoProtect 1 EP”
- Practice Stress management and stress reduction techniques
- Get enough high-quality sleep
- Reduce your exposure to environmental toxins and sources of heavy metals.
- Boil, poach or steam your foods, rather than frying or charbroiling
Reconnecting with our food source:
Food is information and NOT just for pleasure
We have lost touch with our food source! We as a society have been “sold” on nutritionally empty foods because they “taste good”. The fact is that these foods dictate to and change our bodies in such a way that addictions are established and cravings occur.
We have been taught to focus on the gratification aspect of food and NOT the importance of food as information to the body. Did you know that our ancestors were drawn to foods for their nutritional value and healing properties?
Foods were chosen and combined with a specific purpose in mind. For example: Sushi is served with pickled ginger and wasabi because ginger and wasabi are digestive aids and natural anti-parasite agents. Most of us don’t realize that there is a specific purpose to that chosen food combination, we will often eat sushi without combining these “condiments” because we prefer the taste of the fish when dipped “naked” in the sauce that is provided.
We used to understand our food and have a healthy respect for the way in which our bodies utilize food to meet nutritional need and to protect us from our environment. We have LOST TOUCH with our food source and now focus on quantity and taste without regard to quality and purpose.
We have all heard the phrase “you are what you eat” But did you know that you are also what you are eating EATS! The information that your food provides your body dictates your state of health, productivity and general sense of wellbeing. The food you put in your mouth is responsible for turning on or off genes that cause or prevent cancer… your food is the building blocks necessary for your body to product brain chemistry, and energy necessary for every function. Whole fresh food is purposeful and essential to optimal health, wellness and a pleasurable productive life.
Choose a natural diet…. But what is a Natural Diet? One that is loaded with whole fresh foods such as fruits, vegetables, lean protein, nut, seeds, legumes, and healthy oils and fats.
Follow these guidelines to get started.
- Wash fruits and vegetables well!
- Are you eating real, unadulterated foods, or are you eating chemical concoctions, pressed and mashed and artificially flavored to give the appearance of being food? It may even say “healthy” on the package.
- Are you eating foods that are loaded with antibiotics and hormones? Choose free range and wild caught animals.
- Are you eating foods that contain ingredients that are genetically modified?
- Even though we live lives that are far different from those of our ancestors, you can still benefit from their traditional diets by using them as dependable roadmaps to good health.
- Eat at least 1/3 of diet raw (fruits, veggies, nuts, oils)
- Avoid processed foods and all artificial flavorings, colorings, and artificial sweeteners. Instead, seek out locally grown and raised foods that are in-season
- Enjoy fermented foods like kefir and cultured veggies
- Make sure you eat enough healthy fats, including those from animal sources like omega 3, and reduce your intake of omega-6 from vegetable oils
- Drink plenty of pure, clean water
- Limit exposure to toxins– eat whole fresh foods – no boxes, bags or cans
- Eat organic as often as possible
- Below is a list of great foods!
Following these guidelines is a powerful way to avoid premature aging and disease of all kinds.
Dr. Beth-ism: Eat whole, fresh foods…. NO BOXES, BAGS OR CANS Allowed. Food is information to your body. Get as close to what nature intended as possible.
- Bell Peppers
- Brussel Sprouts
- Collard Greens
- Green Beans
- Green Peas
- Mustard Greens
- Romaine Lettuce
- Sea Vegetables
- Squash, summer
- Squash, winter
- Sweet Potatoes
- Swiss Chard
- Turnip Greens
Beans & Legumes
- Black Beans
- Dried Peas
- Garbanzo Beans (Chick Peas)
- Kidney Beans
- Lima Beans
- Navy Beans
- Pinto Beans
Nuts, Seeds and oils
- Almonds, raw
- Cashews, raw
- Flaxseeds, raw
- Olive Oil, extra virgin
- Pumpkin seeds, raw
- Walnuts, raw
- Coconut oil, extra virgin
- Cold press nut oils
- Almond butter, unsweetened
- Coconut oil, extra virgin
- Extra virgin olive oil
Spices & Herbs
- Black Pepper
- Cayenne Peppers
- Chili Peppers, dried
- Cilantro / Coriander Seeds
- Cinnamon, ground
- Cumin Seeds
- Mustard Seeds
- Blackstrap Molasses
- Cane Juice
- Local Honey – not for children
- Pure Maple Syrup
Poultry, Lean Meats and fish
- Beef, lean and organic (100% grass fed)
- Chicken, organic – no antibiotics or hormones
- Turkey, organic – no antibiotics or hormones
- Wild Caught Salmon
- Green Tea
- Braggs Amino Acids
- Apple Cider Vinegar
Milks and cheeses
- Goat milk
- Goat milk cheeses
- Almond Milk, unsweetened
- Rice Milk, unsweetened
- Coconut milk, unsweetened
Environmental Estrogens can be divided into two catagories: Man Made and Naturally Occurring:
Phytoestrogens – are weak estrogenic compounds found in naturally occurring plants such as soy and black cohosh. Virtually all plant based foods we eat; grains, seed oils, berries, fruits, vegetables and roots – contain phytoestrogens
Xenoestrogens – are Man Made chemical compounds that mimic the effect of estrogen on the human body. These estrogen mimickers interfere with our bodies’ natural circulating estrogens and disrupt hormone balance and menstrual cycles, affect prostate and breast health, contribute to problems with endometriosis, fibroid tumors, uterine cysts and polycystic ovarian syndrome. They also interfere with sperm and ova, thus affecting fertility.
So instead of feeling overtaken by the enormity and pervasiveness of the problem, start making choices to make changes to things you can control right now. That would include switching to non-toxic and natural soaps, lotions, cleansers, and all things you use on your body, around your home and in the yard
In future posts I will be offering advice regarding product alternatives and other helpful advice.
- Stop using insecticides, pesticides and chemical lawn-care products. You can find natural, non-xenoestrogenic replacements for these products. Most insecticides and pesticides have xenoestrogenic effects.
- Stop eating any product that contains BHA (butylated hydroxyanisole). This is a common food preservative found in processed foods and it is a xenoestrogen.
- Consider switching to organic meats. Many of the hormones used to help turkeys, pigs, chickens and cows grow bigger and faster (and produce more meat) include xenoestrogens. Organic meat does not. This can be a difficult step, as organic meat is extremely expensive compared to meat at traditional, mainstream grocery stores.
- Don’t heat any food in the microwave in a plastic bowl or with plastic wrap on it. Softer plastics leach xenoestrogens into the food. Use a glass bowl or container, or consider heating food in a stainless-steel pot on the stove top.
- Avoid PCBs (polychlorinated biphenyls) in paints and oils.
- Avoid sunscreen that contains 4-MBC, a xenoestrogen.
- Remove paraben-containing lotion from your routine.
Multi Tasking While Eating can lead to weight gain!
Texting, talking on the phone, checking emails, tweeting, watching TV, and many other “multitasking” past times are causing health problems. It has been well studied that people who participate in these activities have an increase in health risk. Not only do sedentary activities take time away from more active alternatives, but researchers are finding that many “multitaskers” eat while doing these tasks. They eat mindlessly and therefore tend to eat almost 100% more food than if they had been sitting peacefully with their meal… chewing mindfully and slowly. Snacking while distracted was increased to unto 100% more as well. They eat without the brain registering satisfaction and therefore with a very delayed response to satiety or the feeling of being “full”.
It really doesn’t matter the activity, but it is rather the distraction that takes away from the full experience and therefore leads to overeating without complete satisfaction. In fact, eating was such a mindless event, that many people can’t even remember what they ate.
- Do NOTHING during mealtime except eat! Savor every bite and be grateful.
- Take several deep breathes during meal time. Use this time to nourish your body and your mind by just sitting with your meal. You will feel more satisfied and more full.
- Noticing the colors and the texture of your food will actually send healing signals to your brain and aide in improving physical and emotional health.
- Invite your family to quiet mealtimes. Children need time to pause and to learn an appreciation for food