Evidence Based Medicine
Doctor you may be hesitant to prescribe hormone replacement therapy (HRT) due to fear generated by the WHI (Women’s Health Initiative) Study which demonstrated an increased risk of breast cancer, heart disease and stroke in women who were treated with the SYNTHETIC hormone combination of Premarin and Provera. What you don’t understand is that this study does not apply to bio identical hormones which have different molecular structures, metabolites and biological effects than the hormones studied in the WHI. This dissimilarity is not understood by many physicians, journalists and the lay public. Women are living longer lives and deserve to live free of bone loss, heart complications and Alzheimer’s disease. Don’t fear estrogen. Fear the loss of estrogen. Christine Boss is a Master Clinical Fitness Trainer and Licensed Pharmacist at the Firm U. Besides her years of formal education in biochemistry, medicinal chemistry and human physiology, she has intensely studied advanced hormone replacement directly under world renowned hormone expert Dr Neal Rouzier. She is welcome to share with you his incredible bibliography of peer reviewed journals in every specialty of medicine so you will be able to review the safety, efficacy and benefits of bio identical hormones based on the medical literature.Cardiologists will see how testosterone, estrogen and thyroid are good for the heart. Internists will be shown that thyroid insufficiencies are not always uncovered by TSH tests, and how thyroid may even help a “healthy” patient. To the doctors looking down their noses at natural hormones, the justification is present in your own medical journals and literature. The data for natural hormones and against synthetic hormones is scientific, peer reviewed evidence based in the medical literature. When a client presents their lab work to us and asks to discuss hormone deficiencies we provide consultation that is not opinion based, nor is it fluff without foundation. Each hormone discussed and its application to longevity medicine is well grounded with clinical backing. Click on KPRC Channel 2 Houston Feature story on The Firm U.
The following is a quote from triple board certified plastic surgeon Dr Douglas Dedo MD:
“Patients find they can surgically reverse the effects of gravity and aging through facelifts, eyelifts, and liposuction. These procedures certainly make them look better, but cannot halt the internal aging process. When I prescribe HRT to a patient before surgery, they heal faster and feel better postoperatively. If the patient continues the natural hormone supplements post operatively, two wonderful things happen. First they will probably never need a second tuck or facelift. Second, they will begin to feel good with increased energy, libido, skin texture, muscle-to-fat distribution and improved mental clarity. Most of all I give my patients a choice in how they age after their cosmetic surgery!”
As we grow older, a little supplementation of familiar hormones is all it takes to feel healthy again.
REFERENCE ARTICLES FOR VARIOUS HUMAN HORMONES
(This is just a small selection from Dr Rouzier’s collection & his comments)
The following is a sample of articles for your review. Although the primary hormones (Estrogen, Testosterone, Progesterone and Thyroid are highlighted, there are other hormones that are important to youthfulness and beneficial to health when optimized as well. These are DHEA, Melatonin, Pregnenolone and Oxytocin. We have scientific information on these hormones as well when you are interested.
“There is an impressive large collection of biological data and observational studies indicating that postmenopausal HRT protects against heart disease and stroke. Vascular biologists are convinced of estrogen’s role in protecting against cardiovascular disease by estrogen’s role in protecting against the development of atherosclerosis.” Circulation 2001; 104:499-503 (Estrogen should be taken by all women starting at menopause and continued indefinitely. The term estrogen denotes bio identical estrogen)
“This manuscript presents a protocol for hormone replacement with natural estradiol, progesterone, testosterone, DHEA, and melatonin. This is inexpensive therapy that gives relief of symptoms, is well tolerated, provides minimal side effects, protects the endometrium, and results in excellent compliance.”
Infertility and Reproductive Medicine Clinics of North America; 1995 October; Vol.6 (4);653-675
(This article was one of the first of many to appear in medical literature that researched the efficacy and superiority of bio identical hormones. It is a classic article demonstrating the importance of natural hormones and the harm and side effects of synthetic hormones. Although many people have an appropriate fear of HRT, this comes from media hype and the medical studies demonstrating the harm of the synthetic hormones. This study provides credence that it is the synthetic hormones that cause the harmful effects not the natural hormones.)
“Fear of breast cancer is the strongest factor limiting postmenopausal hormone use. The most powerful study to date definitively demonstrated that estrogen does not cause as increased risk for cancer. The increased risk was associated only with taking the progestin (Provera) and not estrogen.”
“North American Menopausal Society (NAMS) position statement: The WHI results do not apply to the majority of women. The WHI trial does not negate 40 years of study demonstrating HRT benefit. Five recent studies demonstrate overwhelming evidence that HRT prevents atherosclerosis” Family Practice NEWS 2003 Oct:1-2
“Bone density is rapidly lost when HRT is stopped. HRT should be continued indefinitely.”
JAMA 2002 August; Vol. 288 No 7:880-887
“Estrogen lowers cortisol which in turn reduces abdominal fat.”
Female Patient April 2001;26;18-24
(Estrogen, testosterone, DHEA- all lower cortisol levels, thereby reducing abdominal fat, thereby reducing diabetes and heart disease)
(HRT provides positive effects for women such as improved mood, improved sense of well-being, relief of urogenital atrophy and improved bone density.)
“Multiple medical studies have demonstrated estrogen’s protective effects against Alzheimer’s, memory loss, loss of cognition.
Estrogen decreases colorectal cancer
Estrogen decreases cataracts and macular degeneration
Estrogen prevents tooth loss and gingivitis
Estrogen prevents urogenital atrophy, painful intercourse and stress incontinence”
Biomedical Jan 2000 Vol. 3(1);6-9
Men need estrogen as well as women. Typical estradiol level in a young adult male is 75pg/ml. Estradiol is raised in men through testosterone supplementation.
ESTROGEN IS PROTECTIVE BUT ONLY WHEN CERTAIN SERUM LEVELS ARE MAINTAINED.
WHERE WOULD YOU LIKE YOUR LEVELS TO BE ??
“Testosterone lowers fat, improves body composition, protects against diabetes and heart disease” International Journal of Obesity and Metabolic Disorders 1992 Dec;16(12);991-7
(There is no medicine or therapy that protects us as well as testosterone)
“Low testosterone levels are associated with as increased risk of diabetes, heart disease and carotid atherosclerosis” Diabetes Care 2003 June; Vol. 36 No 6; 20-30
(Testosterone treatment should begin at age 40 to prevent these illnesses from progressing.)
“Loss of testosterone causes decreased muscle mass and strength, increased fat, decreased libido, erectile dysfunction, depression, osteoporosis, decreased energy, decreased well being, decreased protection from heart disease and bone loss. Replacement improves energy, muscle and bone strength, libido, frequency of sexual function and ejaculation. Synthetic oral testosterone raises cholesterol and lowers HDL. Don’t confuse this with bio identical testosterone, which lowers cholesterol and raises HDL. Testosterone does not increase prostate volume or PSA levels to cause prostate cancer” Archives of Family Medicine; 1999; Vol. 8:252-263
“Development of prostate cancer does not depend on levels of testosterone. High levels of testosterone do not increase risk of prostate cancer” RR J Cancer 1999 June;80(7): 930-4
(All medical journals acknowledge that testosterone does not cause prostate cancer)
“None of the 12 longitudinal population based studies, such as the “Physician’s Health Study” found any increase risk of prostate cancer in men with higher levels compared with men with lower levels of testosterone” New England Journal of Medicine 2004;350;482-92
(If there is anyone who still imagines that testosterone causes cancer, then they remain ignorant of the world literature)
“Testosterone administration in the highest dosage resulted in increased sexual activity, pleasure and orgasm in women. There was an increase in sexual fantasies, masturbation and frequency of sex. There was an improvement of well-being and mood.” New England Journal of Medicine 2000;343;682-88
(These are quotes from the most prestigious medical journal in the world)
“Testosterone replacement in women significantly decreases carotid atherosclerosis and cardiovascular disease” American Journal of Epidemiology 2002;155;437-445
(It doesn’t make any difference if you are a man or a woman, both need optimal testosterone levels for cardiovascular protection and long term health)
“Low testosterone levels adversely affect women’s health. Testosterone improves women’s energy and well-being. Treatment should begin when a women’s testosterone drops below mid-range of normal. Testosterone administration has many benefits and no risks. This is cutting edge work.” JAMA May 2004;Vol 283(20):2463-64
(The second most prestigious journal recommends treatment with testosterone even if hormone levels are normal. They found optimum was best)
“Higher testosterone levels increase cognition and memory” Neurology 2005 Mar 8;64-5;866-71
(And people wonder what they can do for their memory?)
“Testosterone decreases cholesterol and raises HDL” Atherosclerosis 1996 Mar;121(1);35-43
(What drugs can do this and make you feel good too? Every cardiologist should be prescribing testosterone for their patients. Do you know any that do?)
“Symptoms of low testosterone may occur due to decreased serum levels or reduced receptor site sensitivity. In spite of normal blood levels patients still feel and function better when testosterone is prescribed” Medical Crossfire 2001 Jan; Vol. 3 No 1:17-18
(This is a perfect example of what most physician’s do not understand. Even if a patient’s hormone levels are normal, they may suffer from deficiency symptoms. This is due to poor stimulation of receptor sites. This results in symptoms that can be corrected only by hormone replacement. This applies to ALL hormones. Many physicians will refuse to prescribe hormones based on normal lab values. Physicians interpret normal lab values to mean patients do not need hormones. Nothing could be farther from the truth. There is overwhelming evidence that proves that patients feel and function better when taking hormones, particularly when taking thyroid and testosterone. Physicians are simply not trained in these concepts, even though documentation is provided throughout the medical literature)
RAISING TESTOSTERONE LEVELS TO OPTIMAL OFFERS HEALTH PROTECTIONS AND OVERCOMES THE HORMONE RESISTANCE TO ONCE AGAIN FEEL NORMAL.
WHERE WOULD YOU LIKE YOUR LEVELS TO BE ??
“The main reason women discontinue HRT is due to side effects. Synthetic progestins (Provera) cause many side effects: Breast swelling and tenderness, uterine bleeding, depression and mood disturbance, weight gain, bloating and edema. Natural progesterone has no side effects” Female Patient 2001 Oct;19-23
Natural progesterone is preferential to synthetic progestins. Natural progesterone produces excellent blood levels without the unwanted side effects such as fluid retention, weight gain, breast tenderness and depression of the synthetic progestins.)
“Progesterone should be administered to all women, hysterectomy or not.” Infertility and Reproductive Medicine Clinics of North America: 1995 Oct;Vol6(4);653-673
(This is another landmark study demonstrating the benefits of progesterone and the harm of synthetic progestins)
“Synthetic progestins (medroxyprogesterone) cause depression, bloating, breast swelling, excessive bleeding, and are not tolerated by many women. Natural progesterone has none of these side effects. In fact an unexpected improvement in well-being was observed when progesterone was added to estrogen” American Journal of Obstetric Gynecology; 1992 Jan;180;42-48
(Still think there is no difference? Even the OB-GYN journals mention this! )
“Estrogen and progesterone are neuro-protective against cerebral damage. These beneficial effects were blocked by MPA (medroxyprogesterone) National Academy Science USA;2003 Sept 2;100(8)10506-11
(Progesterone protects; Provera causes damage)
“Estrogen prevented cardiovascular disease. Adding medroxyprogesterone (Provera) increased risk of cardiovascular disease and negated beneficial effects of estrogen. Progesterone and estrogen decrease foam cell formation (plaque) whereas progestins (Provera) increase foam cell formation (plaque)” Circulation 1999 Dec;100:2319-25
(Another study demonstrating that estradiol and progesterone together protect against heart disease)
“Progestin, (Provera) dramatically increases risk of breast cancer 8 times” JAMA 2000;203:485-91
(This is exactly how hormones get bad press. The Media reported that progesterone causes breast cancer. This is absolutely wrong! Medroxyprogesterone causes breast cancer, not progesterone. Doctors and media chop off the prefix medroxy, thereby referring to medroxyprogesterone as progesterone. Medroxyprogesterone is completely opposite of progesterone) Perhaps these doctors need to go back to chemistry class.
“The estrogen-only arm of the WHI trial demonstrated no increased risk of breast cancer with estrogen. This study therefore demonstrates that the breast cancer increase was due to medroxyprogesterone (Provera) and not due to estrogen” Family Practice News 2004 March 15;1-3
(Isn’t it amazing that when we lose a hormone that protects against breast cancer (progesterone), we replace it with a hormone that significantly increases the risk of breast cancer [medroxyprogesterone] ?)
“Progesterone raises good HDL cholesterol, whereas MPA (Provera) lowers good cholesterol. Progesterone increases estrogen’s beneficial effects. MPA reverses estrogen’s benefits. Progesterone has no side effects, whereas MPA has many.” Obstetrics Gynecology 1989;73:606-611
“This study demonstrates that maximal reduction in breast stimulation occurs when progesterone is at its peak levels during pregnancy or late in the monthly cycle. Medroxyprogesterone increases mitotic (cancer-causing) whereas progesterone decreases mitotic activity. Climacteric 2002 Sept;5(3); 229-35
“Progesterone decreases breast stimulation 400% and down regulates breast receptor sites, thereby protecting against breast stimulation.” Fertility Sterility 1998;69:963-69
“Adding a progestin (Provera) increased risk of breast cancer 29%” J National Cancer Institute 2000;92(4):328-332
“Natural progesterone, but not MPA, decreases myocardial ischemia and causes vasodilation of coronary vessels” Journal American College of Cardiology;2000 Dec; 36(9):2154-59
(By now one should perhaps get the impression that progesterone and medroxyprogesterone (MPA) are opposite of each other, and indeed they are: Progesterone decreases heart disease, MPA increases heart disease. Progesterone lowers cholesterol, MPA raises cholesterol. Progesterone prevents plaque formation, MPA increases plaque formation. Progesterone is synergistic with estrogen, MPA negates estrogen’s benefits. Progesterone administration raises serum progesterone levels while MPA has a different chemical structure that does not raise progesterone levels. Progesterone makes women feel better while MPA cases depression, bloating, bleeding. Progesterone is progestational (maintains pregnancy). MPA is a teratogen that causes birth defects and is absolutely contraindicated in pregnancy.)
PROGESTERONE IS PROTECTIVE BUT ONLY WHEN OPTIMAL SERUM LEVELS ARE MAINTAINED.
WHERE WOULD YOU LIKE YOUR LEVELS TO BE ??
“Fibromyalgia is frequently seen in hypothyroidism. There is now evidence to support that fibromyalgia may be due to thyroid hormone resistance “ Medical hypotheses 2003 Aug;21(2):182-89
(In this study, even though thyroid blood levels did not factor into the treatment, high doses of thyroid were used to treat symptoms)
“Combined T4 and T3 therapy resulted in improved symptoms, well-being and weight loss in comparison with straight T4 therapy. A decrease in weight resulted from using higher T3 levels” J Clinical Endocrinol Metab 2005 May;90(5):2666-74
(This is another classic article demonstrating T3 makes patients feel and function better. Physicians will continue to believe that only T4 is required, whereas the good studies in major medical journals demonstrate that adding T3 is necessary for physiologic improvement. This study proved as more T3 was prescribed, the better the results)
“Long term high doses of thyroid had no adverse effect in causing osteoporosis or fractures.” “Over 40 studies prove that thyroid replacement does not lower bone density or cause increased risk of fracture” Cortland Forum 2001 July;85-90
(Another study reviewed over 40 studies and none found any evidence that thyroid hormone has any significant effect on bone density; as these were studies of patients not on any hormone therapy except for thyroid. What this means is that the medical community cannot assert that thyroid hormone causes bone loss. Doctors are always afraid that prescribing thyroid causes osteoporosis. It doesn’t and over 40 studies prove so. Low hormone levels cause bone loss, not optimal levels.)
“Long term thyroid replacement with high doses has no significant effect on bone density or fractures.” Lancet 1992 Jul 4;340(8810:9-13.
“Thyroid levels should be raised to the upper normal range for a young person. This results in optimal cognition, memory and cerebral function.” Journal of Gerontology;1999 Vol. 54:109-115
“Low T3 levels are associated with increased heart disease and decreased cardiac function. Replacing T3 increases clinical performance and cardiac output. Adding T3 increases exercise tolerance and quality of life” CVR&R 2002;23:20-26
“Decreased T3 levels result in increased cholesterol and heart disease. Treating with T3 improves the lipid profile.” Preventive Cardiology 2001;4:179-182
“Low levels of free T3 in patients resulted in increased disability, depression, decreased cognition, energy and increased mortality.” JAMA Dec 2004;Vol 292(2c) 500-504
(All Hormones have health benefits. When we lose our hormones we lose health; thereby increasing morbidity and mortality, and thyroid is no different. There are no studies that demonstrate that optimal thyroid levels are harmful. There are many studies indicating that suboptimal or low normal levels are detrimental. Therefore the goal of physicians should be to optimize thyroid as well)
“Low normal thyroid levels result in increased cholesterol, increased heart disease, fatigue, low energy, depression, and memory loss. Thyroid replacement eliminates these risks. No study has shown any harm or adverse effect of treatment. Consultant 2000 Dec; 2397-2399
(Most physicians incorrectly and unfortunately prescribe only T4, whereas the studies demonstrate that adding T3 resulted in weight loss and an improvement in energy and a decrease in symptoms. There was no [or little] improvement in symptoms or well being on T4 alone (Levoxyl or Synthroid).
Alone or with all the other hormones, optimal levels of T3 work best. Optimal levels of all hormones are beneficial and thyroid is no different. For healthy memory, metabolism, cholesterol, hair, skin and nails, optimal hormone levels are necessary; normal levels are detrimental)
WHERE WOULD YOU LIKE YOUR LEVELS TO BE ??
OTHER ARTICLES PERTAINING TO DESICCATED THYROID
DESICCATED THYROID IS A SAFE ALTERNATIVE Thanh D. Hoang, DO, staff endocrinologist of the Walter Reed National Military Medical Center in Bethesda, Md., told Endocrine Today at ENDO 2013.
A HEALTHY THYROID PRODUCES A ROUGH EQUIVALENT TO 3-5 GRAINS OF DESICCATED THYROID A few years ago, we found detailed medical info that revealed this, explaining why so many of us ended up in that range. This article states: Estimates of average normal secretion for euthyroid humans are 94-110 µg T4 and 10-22 µg T3 daily (300).\
see paragraph 4 under section PROTEOLYTIC CLEAVAGE OF THYROGLOBULIN
Don’t be afraid to use dessicated thyroid.
PERTAINING TO T3 THYROID HORMONE
HEART ISSUES FROM T4-ONLY TREATMENT
: The Journal of Clinical Endocrinology & Metabolism has reported that long-term levothyroxine replacement therapy in young adults is associated with cardiovascular abnormalities. http://jcem.endojournals.org/cgi/content/abstract/93/7/2486 2008 COMMENT: Of course, thyroid patients have known this a long time as they watched their cholesterol and Triglycerides rise while on T4-medication, and some end up with heart problems. But this finally gives some research on a FACT.
T3 IS NOT ONLY ANTI-CANCER IN YOUR LIVER, BUT CAN HELP YOUR LIVER TO REGENERATE
: From the American Association for Cancer Research, this research study shows that T3 can not only be anti-cancer, but actually help your liver to form new cells: http://cancerres.aacrjournals.org/cgi/content/abstract/60/3/603 COMMENT: This article shows that T3 REDUCES liver nodules, and you can wonder what T3 might do against cancer elsewhere in your body.
THYROID HORMONES AFFECT HAIR
This research explains how insufficient T4 and T3 can affect hair follicles. http://www.ncbi.nlm.nih.gov/pubmed/18728176
SUPPRESSIVE TSH RESEARCH:
This PubMed article from 2005 is about research which shows that even suppressive doses of T4 does not negatively affect bone mineral density. http://www.ncbi.nlm.nih.gov/pubmed/16269872 And this one from 1993: http://www.ncbi.nlm.nih.gov/pubmed/8252740If bone suppression is a worry to doctors we often suggest ordering a urine NTX for your patience to set your fears to rest.
The Society for Endocrinology in the UK in 2010 did research which revealed that having lower TSH levels while taking Thyroxine replacement is not detrimental to health, and that low level was .004 to .4 !! Blog post concerning this http://www.sciencedaily.com/releases/2010/03/100315230910.htm
See this Big Daddy of references from Thierry Hertoghe, MD of Belgium concerning thyroid hormones in diverse age-related diseases.