BHRT making controversy through Oprah’s show
January 30th, 2009The purpose of this blog post is to give you information. Please read through all material and make an informed decision. It’s your health.
A week ago, Oprah featured a segment on her show regarding hormone replacement therapy and the controversy between synthetic and bioidentical. You can go to Oprah.com to read some of the show’s excerpts. I can understand the controversy from the stand point of lack of knowledge on both sides (pro and con). I’ve made my decision to stick with BHRT with my patients based upon the Women’s Health Initiative Study.
On May 31, 2002, the WHI study of conjugated estrogens 0.625 mg/day, plus medroxyprogesterone acetate 2.5 mg/day in postmenopausal women was stopped after a mean of 5.2 years of follow-up because the test statistic for invasive breast cancer exceeded the stopping boundary for this adverse effect and the global index statistic supported risks exceeding benefits.
Three years after stopping hormone therapy, women who had taken study pills with active estrogen plus progestin no longer had an increased risk of cardiovascular disease (heart disease, stroke, and blood clots) compared with women on placebo.
Source: FDA website
The estrogen-alone study was stopped at the end of February 2004 because the hormone increased the risk of stroke and did not reduce the risk of coronary heart disease, a key question of the trial. The study was to have ended in March 2005.
Many Medical Doctors and the FDA are standing up to refute claims against BHRT products claiming that BHRT is “a marketing term not recognized by the FDA.”
And the Endocrine Society issued this position statement back in October 2006, expressing concerns about these products: ” ‘Bioidentical hormones,’ particularly estrogen and progesterone, have been promoted as safer and more effective alternatives to more traditional hormone therapies, often by people outside of the medical community. In fact, little or no scientific and medical evidence exists to support such claims… Additionally, many ‘bioidentical hormone’ formulations are not subject to FDA oversight and can be inconsistent in dose and purity.”
Source: Washington Post.com
At the end of the article, they state that testing for hormones through saliva is not as accurate as serum. But there are numerous studies that refute that claim:
Direct assay for progesterone in saliva: comparison with a direct serum assay.
Webley GE, Edwards R. Ann Clin Biochem (1985) 22:579-585.Study compares direct serum and saliva assays for sensitivity, precision and recovery. Twenty women in various stages of their menstrual cycle were compared using serum and saliva. Conclusion: Saliva showed a significant correlation (r=0.71, P<0.001) compared to serum with the added advantages of convenience and reduced stress (no needles).
Hormones in Saliva.
Vining RF and McGinley RA. Critical Reviews in Clinical Laboratory Sciences. (1986) 23(2):95-146.An excellent review article looking at the constituents of saliva. Conclusion: “Saliva flow rate does affect saliva pH and the concentration of many salivary ions. This has led many clinicians to assume that it would also affect all salivary steroid levels. This is not the case—a number of clinically important steroids, such as cortisol, testosterone, estriol and progesterone, have salivary concentrations which are not appreciably affected by saliva flow rate. However, the conjugated steroids (e.g., DHEAS) and some unconjugated (e.g., cortisone) may exhibit marked flow rate dependence.”
One of the big reasons why most MDs disagree with the use of salivary hormone testing and bioidentical hormones comes from how they’re trained in terms of ‘healthcare.’ Modern day medical schools teach the best techniques in emergent care. We have the best emergent care doctors on the planet. Modern day medical schools, however, lack the proper instruction on functional wellbeing and solving issues of chronic disease. Don’t get me wrong here, if I’m having a heart attack or was in some serious traumatic incident, I’m going straight to a medical doctor. If I’m suffering from a chronic illness, I’m seeing a functional medicine practitioner. Functional medicine practitioners like Dr. Mark Hyman, Dr. Jeffrey Bland and myself are trained to look at all aspects of the body not just your ‘digestive system’ or your ‘nervous system.’ Remember the song: “the hip bone’s connected to the knee bone…” It’s all connected.
We’ve developed a healthcare system of specialists, which has been our downfall. It’s like running into a burning building, but only looking in one room that’s not on fire and saying ‘nothing wrong here.’
So back to the subject at hand: if synthetic HRT was the answer, then we would not have the hormonal issues in our society as we do today. I state that BHRT is a better choice than synthetic HRT, but I do agree with the FDA and most OB’s that you need to do your research.
- First you need to understand the pros and cons of synthetic HRT (please visit the Women’s Health Initiative study).
- Secondly, understand why your hormones are out of balance.
- Thirdly, get your hormones tested. In my opinion, I’d do serum, saliva and urine just to cover all bases.
- Fourthly, find a functional medicine practitioner to work with you on rebalancing your hormones. Remember, it’s not just about your hormones, but you have to look at how the entire body is functioning. Are you in adrenal gland fatigue? Do you have some type of impaired detoxification mechanism? Are you laden with chemical toxins that can act as hormones (xenoestrogens)? So as you can see, there’s more to it than just getting your blood drawn. Figure out the cause and eliminate it. That’s how you achieve wellness.
Links of interest:
Hormone replacement therapy webcast
Labrix resource page on hormone balance
North American Menopause Society
Harvard Medical School: what are bio-identical hormones?
Bio-identical hormones: sound science or bad medicine?
Mayo Clinic: bio-identical hormones: are they safer?
Dr. John Lee’s website on natural hormonal therapy
If you have any questions, feel free to contact me or leave a comment below. You may also schedule a complimentary 15 min phone consultation with me via phone 949-559-7999.
