Hormone menubar
Estrogens - The Female Hormones
estrogen hrt_not_necessary
Conventional hormone replacement therapy (HRT) - NOT necessary / causes harm
The irony. Some physicians are prescribing
estrogens to treat a presumed hormone deficiency
others are prescribing drugs that block
estrogen production
Studies have found that conventional HRT, using
synthetic estrogen
and progestins increase
risk of breast cancer >30%, heart attack, blot clots, stroke.
Dr. Lee, the break-through pioneer
in bioidentical hormone therapy suggests 3 rules for HRT.
Rule 1. Give hormones only to those who are truly deficient
in them.
Rule 2. Use bioidentical hormones rather than synthetic hormones.
Rule 3. Use only in dosages that provide normal physiologic
tissue levels.
DR. JOHN R. LEE'S THREE RULES FOR HORMONE
REPLACEMENT THERAPY
The estrogen replacement regime assumes that women are
estrogen deficient
after menopause
Drs. John Lee and Ray
Peat say this assumption is false
Ovarian estrogen
production naturally tapers off as a woman's egg supply is exhausted.
It ceases to be delivered to the uterus each month, however:
"Even with ovaries removed, women make
estrogen , primarily via
aromatase enzyme in body fat
and breasts that converts the adrenal hormone, androstenedione ,
into ESTRONE. Women with plenty of body fat can
make more estrogen after menopause than skinny women
make before menopause . Breast cancer specialists are so concerned about all
the estrogen women make after menopause that they
now use drugs to block the aromatase
enzyme."
- Dr. John Lee
After careful review, Dr. Lee
determined, along with other authorities, that over 2/3 of women up to age 80 continue
to make all the estrogen they need
in their tissues. And the evidence continues to build
. . .
Blood hormone levels do NOT directly represent organ/tissue
concentrations. Tissue is
abundant, and conversely, in the absence of
PROGESTERONE , tissues
retain estrogen even with little circulating
estrogen .
MELATONIN
▼ levels decrease when
estrogen ▲ increases.
This occurs sharply at puberty and again at menopause. PROLACTIN (stimulated
by estrogen ) increases around puberty, and often
increases at menopause ▲. Its increase is associated with osteoporosis
and other age-related symptoms. Aromatase ▲ (required
to produce estrogen )
increases with aging - present in many tissues including breast and endometrium;
Women who have had
their ovaries removed are usually told that they
need to take estrogen, but animal experiments consistently
show that removal of the gonads causes the tissue
aromatases to increase
- The loss of PROGESTERONE and
ovarian androgens is probably
responsible for this generalized increase in the formation of
estrogen. In the brain,
aromatase
increases under the influence of estrogen
treatment.
DR. JOHN R. LEE'S THREE RULES FOR HORMONE REPLACEMENT THERAPY
From Dr. John Lee's official web-site:
http://www.johnleemd.com/store/news_bhrt.html
Use a sprinkle of common sense
and a dash of logic.
by John R. Lee, M.D.
The recent Lancet publication of the Million Women Study (MWS) removes
any lingering doubt that there's something wrong with conventional HRT (see Million
Woman Study in the UK, Published in The Lancet, Gives
New Insight into
HRT and Breast Cancer for details). Why would supplemental estrogen and a progestin
(e.g. not real PROGESTERONE ) increase a woman's risk of breast cancer by 30 percent
or more? Other studies found that these same synthetic HRT hormones increase one's
risk of heart disease and blood clots (strokes), and do nothing to prevent Alzheimer's
disease. When you pass through puberty and your sex hormones surge, they don't make
you sick—they cause your body to mature into adulthood and be healthy. But, the
hormones used in conventional HRT are somehow not right—they are killing women by
the tens of thousands.
The question is—where do we go from here? My answer is—we go back to the basics
and find out where our mistake is. I have some ideas on that.
Over the years I have adopted a simple set of three rules covering hormone supplementation.
When these rules are followed, women have a decreased risk of breast cancer, heart
attacks, or strokes. They are much less likely to get fat, or have poor sleep, or
short term memory loss, fibrocystic breasts, mood disorders or libido problems.
And the rules are not complicated.
Rule 1. Give hormones only to those who are truly deficient in them.
The first rule is common sense. We don't give insulin to someone unless we have
good evidence that they need it. The same is true of thyroid, cortisol and all our
hormones. Yet, conventional physicians routinely prescribe estrogen or other sex
hormones without ever testing for hormone deficiency. Conventional medicine assumes
that women after menopause are estrogen-deficient. This assumption is false. Twenty-five
years ago I reviewed the literature on hormone levels before and after menopause,
and all authorities agreed that over two-thirds
(66 percent) of women up to age 80 continue to make all the estrogen they need.
Since then, the evidence has become stronger. Even with ovaries removed, women make
estrogen, primarily by an aromatase enzyme in body fat and breasts that converts
an adrenal hormone, androstenedione, into estrone. Women with plenty of body fat
may make more estrogen after menopause than skinny women make before menopause.
Breast cancer specialists are so concerned
about all the estrogen women make after menopause that they now use drugs to block
the aromatase enzyme . Consider the irony: some conventional physicians are
prescribing estrogens to treat a presumed hormone deficiency in postmenopausal women,
while others are prescribing drugs that block estrogen production in postmenopausal
women.
How does one determine if estrogen deficiency exists? Any woman still having
monthly periods has plenty of estrogen. Vaginal dryness and vaginal mucosal atrophy,
on the other hand, are clear signs of estrogen deficiency. Lacking these signs,
the best test is the saliva hormone assay. With new and better technology, saliva
hormone testing has become accurate and reliable. As might be expected, we have
learned that hormone levels differ between individuals; what is normal for one person
is not necessarily normal for another. Further, one must be aware that hormones
work within a complex network of other hormones and metabolic mediators, something
like different musicians in an orchestra. To interpret a hormone's level, one must
consider not only its absolute level but also its relative ratios with other hormones
that include not only ESTRADIOL, PROGESTERONE and TESTOSTERONE, but cortisol and
thyroid as well.
For example, in healthy women without breast
cancer, we find that the saliva PROGESTERONE level routinely is 200 to 300 times
greater than the saliva ESTRADIOL level. In women with breast cancer, the saliva
PROGESTERONE /ESTRADIOL ratio is considerably less than 200 to 1. As more
investigators become more familiar with saliva hormone tests, I believe these various
ratios will become more and more useful in monitoring hormone supplements.
Serum or plasma blood tests for steroid hormones should be abandoned—the results
so obtained are essentially irrelevant. Steroid hormones are extremely lipophilic
(fat-loving) and are not soluble in serum. Steroid hormones carry their message
to cells by leaving the blood flow at capillaries to enter cells where they bond
with specific hormone receptors in order to convey their message to the cells. These
are called "free"hormones. When eventually they circulate through the liver, they
become protein-bound (enveloped by specific globulins or albumin), a process that
not only seriously impedes their bioavailability but also makes them water soluble,
thus facilitating their excretion in urine. Measuring the concentration of these
non-bioavailable forms in urine or serum is irrelevant since it provides no clue
as to the concentration of the more clinically significant "free"(bioavailable)
hormone in the blood stream.
When circulating through saliva glands, the "free"non-protein-bound steroid hormone
diffuses easily from blood capillaries into the saliva gland and then into saliva.
Protein-bound, non-bioavailable hormones do not pass into or through the saliva
gland. Thus, saliva testing is far superior to serum or urine testing in measuring
bioavailable hormone levels.
Serum testing is fine for glucose and proteins but not for measuring "free"steroid
hormones. Fifty years of "blood"tests have led to the great confusion that now befuddles
conventional medicine in regard to steroid hormone supplementation.
Rule 2. Use bioidentical hormones rather than synthetic hormones.
The second rule is also just common sense. The message of steroid hormones to
target tissue cells requires bonding of the hormone with specific unique receptors
in the cells. The bonding of a hormone to its receptor is determined by its molecular
configuration, like a key is for a lock. Synthetic hormone molecules and molecules
from different species (e.g. Premarin, which is from horses) differ in molecular
configuration from endogenous (made in the body) hormones. From studies of petrochemical
xenohormones, we learn that substitute synthetic hormones differ in their activity
at the receptor level. In some cases, they will activate the receptor in a manner
similar to the natural hormone, but in other cases the synthetic hormone will have
no effect or will block the receptor completely. Thus, hormones that are not bioidentical
do not provide the same total physiologic activity as the hormones they are intended
to replace, and all will provoke undesirable side effects not found with the human
hormone. Human insulin, for example, is preferable to pig insulin. Sex hormones
identical to human (bioidentical) hormones have been available for over 50 years.
Pharmaceutical companies, however, prefer synthetic hormones. Synthetic hormones
(not found in nature) can be patented, whereas real (natural, bioidentical) hormones
can not. Patented drugs are more profitable than non-patented drugs. Sex hormone
prescription sales have made billions of dollars for pharmaceutical companies Thus
is women's health sacrificed for commercial profit.
Rule 3. Use only in dosages that provide normal physiologic tissue levels.
The third rule is a bit more complicated. Everyone would agree, I think, that
dosages of hormone supplements should restore normal physiologic levels. The question
is—how do you define normal physiologic levels? Hormones do not work by just floating
around in circulating blood; they work by slipping out of blood capillaries to enter
cells that have the proper receptors in them. As explained above, protein-bound
hormones are unable to leave blood vessels and bond with intracellular receptors.
They are non-bioavailable. But they are water-soluble, and thus found in serum,
whereas the "free"bioavailable hormone is lipophilic and not water soluble, thus
not likely to be found in serum. Serum tests do not help you measure the "free,"bioavailable
form of the hormone. The answer is saliva testing.
It is quite simple to measure the change in saliva hormone levels when hormone
supplementation is given. If more physicians did that, they would find that their
usual estrogen dosages create estrogen levels 8 to 10 times greater than found in
normal healthy people, and that PROGESTERONE levels are not raised by giving supplements
of synthetic progestin such as medroxyPROGESTERONE acetate (MPA).
Further, saliva levels (and not serum levels) of PROGESTERONE will clearly demonstrate
excellent absorption of PROGESTERONE from transdermal creams. Transdermal PROGESTERONE
enters the bloodstream fully bioavailable (i.e., without being protein-bound). The
PROGESTERONE increase is readily apparent in saliva testing, whereas serum will
show little or no change. In fact, any rise of serum PROGESTERONE after transdermal
PROGESTERONE dosing is most often a sign of excessive PROGESTERONE dosage. Saliva
testing helps determine optimal dosages of supplemented steroid hormones, something
that serum testing cannot do.
It is important to note that conventional HRT violates all three of these rules
for rational use of supplemental steroid hormones.
A 10-year French study of HRT using a low-dose ESTRADIOL patch plus oral PROGESTERONE
shows no increased risk of breast cancer, strokes or heart attacks. Hormone replacement
therapy is a laudable goal, but it must be done correctly. HRT based on correcting
hormone deficiency and restoring proper physiologic balanced tissue levels, is proposed
as a more sane, successful and safe technique.
Other Factors
Hormone imbalance is not the only cause of breast cancer, strokes, and heart
attacks. Other risk factors of importance include the following:
Poor diet (excess sugar and refined starches, trans fatty acids, lack of
needed nutrients such as omega-3 fats, full range of essential amino acids,
vitamins, minerals, etc.)
Environmental xenoestrogens and hormones not removed by water treatment.
(Be sure that your home water filter will remove hormones.).
Insulin resistance.
Stress.
Lifestyle problems such as excess light at night (poor sleep, melatonin
deficiency), alcohol, cadmium (cigarette smoking), and birth control pills during
early teens.
Men share these risks equally with women. Hormone imbalance and exposure to these
risk factors in men leads to earlier heart attacks, lower sperm counts and higher
prostate cancer risk.
Conclusion
Conventional hormone replacement therapy (HRT) composed of either estrone or
ESTRADIOL, with or without progestins (excluding PROGESTERONE ) carries an unacceptable
risk of breast cancer, heart attacks and strokes. I propose a more rational HRT
using bioidentical hormones in dosages based on true needs as determined by saliva
testing. In addition to proper hormone balancing, other important risk factors are
described, all of which are potentially correctable. Combining hormone balancing
with correction of other environmental and lifestyle factors is our best hope for
reducing the present risks of breast cancer, strokes and heart attacks.
A much broader discussion of all these factors can be found in the updated and
revised edition of What Your Doctor May Not Tell You About Menopause and
What Your Doctor May Not Tell You About Breast Cancer.
