Human hormones for human women

Is there any reason for a human woman to use non-human hormones?

Premarin is the prototypical example, a mixture of around 30 different compounds, some of which resemble human estrogens (estradiol, estrone, estriol), many of which do not.

What conceivable reasons could there be to use a non-human form of a hormone over the human form? There are several theoretical reasons:

--The non-human form has been shown to be superior in some way

--The non-human form is cheaper to produce, reducing the cost

--Human women prefer the non-human form

Have any of these potential reasons ever played out in real life? NO, absolutely not.

There's one reason why non-human forms of hormones may be preferred over human forms that I've not listed: Non-human forms are more profitable and/or possess greater patent protection.

Well, that might explain it all.

The battle over progesterone

I was talking with a hospital nurse recently who told me about her lack of energy, blue moods, and other assorted complaints. At age 49, she was exasperated. So I suggested that she ask her gynecologist about progesterone cream.

The gynecologist advised her, "You don't have a uterus. You don't need progesterone." He went on to explain that the only reason to take progesterone was to prevent uterine cancer caused by estrogen.

What about progesterone's weight loss benefits? It's effects on increased energy, improved mood, deeper sleep? These benefits, of course, have nothing to do with the uterus.

I've witnessed these benefits in women many times, both in the peri-menopausal period (which starts around your late 30's) and menopause.

I tracked down vocal progesterone advocate, Dr. Nisha Jackson. Dr. Jackson is a proponent of “bio-identical” hormone replacement, replacement of estrogen, progesterone, and other human hormones using natural human forms of replacement.

Dr. Jackson has several books available, including "The Hormone Survival Guide to Perimenopause."

I asked Dr. Jackson for her thoughts on several questions:

Q: What are the advantages of bio-identical hormone replacement as compared to synthetic hormones?

Dr. Jackson: If you have been prescribed drugs containing synthetic hormones, even if you use the medications as directed, chances are the results haven't been what you had hoped. Your hot flashes may be gone, your periods may return to regularity, but you’re also likely to experience a spectrum of negative side effects, including irregular bleeding, bloating, sore breasts—and weight gain.

Like millions of American women, you have been prescribed powerful hormone medications by healthcare practitioners who have no way of knowing your hormone levels! You are getting a one-size-fits-all treatment that does not address the list of maladies that can accompany hormonal imbalances.

This long list includes depression, weight gain, exhaustion, acne, insomnia, facial hair, food cravings, fuzzy thinking, bloating, joint pain, and loss of sex drive. Although some peri-menopausal women tolerate synthetic hormones, others experience mild to severe side effects that can be more annoying or debilitating than the symptoms they are meant to relieve.

Instead, if your provider ordered a complete hormone panel, it will often reveal that a woman's hormone levels are either low or out of balance. Knowing a woman's estrogen, progesterone, testosterone, DHEA (dehydroepiandrosterone), and thyroid levels would not only allow for a customized treatment plan to relieve symptoms, but also provide a baseline to observe changes as she moves through peri-menopause to menopause. Testing allows an accurate prescription for safe, quick relief of symptoms. Without testing it's a guessing game at the patient's expense.

Q: What is the basic blood panel you recommend at the start of a hormonal assessment?

Dr. Jackson: The basic blood levels that we recommend for women considering hormone replacement are: estrodiol, estriol, estrone (fractionated estrogen levels); progesterone; free testosterone; DHEA-S; TSH, free T4, and free T3 (thyroid hormones). These should be obtained in the last half of your menstrual cycle, or about 18–21 days after the first day of your period. For women without menses, these levels can be drawn any time.

Q: Why aren’t bio-identical hormones used more frequently? Shouldn’t they be the standard of practice for hormone replacement?

Dr. Jackson: The reasons why hormone testing and prescribing natural hormones are not standard of care has more to do with patent law and the pharmaceutical industry than anything else. There is also the fact that most medical schools have, until recently, ignored natural hormones as an option for treating women's hormonal imbalances. We therefore have a medical establishment out of tune with bio-identical hormone replacement.

But let's go back to the drug companies. Natural hormones cannot be patented and marketed as exclusive products. Even though safe, bio-identical natural progesterone and estrogen are readily available, pharmaceutical companies rarely use them. Instead they use lab-formulated synthetic progestins and estrogens to make their hormone-replacement therapies. These preparations are patentable and profits can therefore be protected. (Ironically, the recent discrediting of synthetic hormones is beginning to propel the drug companies in the direction of using bio-identical hormones).

Personally, having witnessed many women who have been transformed with using natural human progesterone, I have become totally convinced that it is a huge boon to health for women, far greater than estrogen.

CardioChek home cholesterol device

Say you want to monitor your own cholesterol values. Say, for instance, you make a specific change in diet or lifestyle and would like to know if it has exerted any effect on cholesterol values like HDL, LDL, or triglycerides. Can you assess the effect without involving your doctor?

It has become increasingly easy with home cholesterol testing. The only hand-held at-home device that I'm aware of is the CardioChek.

The CardioChek is a hand-held device that measures total cholesterol, HDL cholesterol, and triglycerides that you can purchase for home use. It requires a finger prick to obtain a drop of blood for testing.

This is a really neat concept: a device that can be used by just about anybody that yields immediate results. Nothing needs to be mailed to a laboratory, no wait for results. It also yields more than just a total cholesterol. All other home test kits I could find tested only total cholesterol and the sample had to be mailed to the laboratory.

However, having used the device several times, some comments:

1) The company is not very good about telling you that each test--total cholesterol, HDL, and triglycerides--require a separate fingerstick and a separate test strip. It means that, for every panel of total cholesterol, HDL, and triglycerides, 3 fingersticks have to be performed and 3 test strips used.

2) The first couple of tests will be cumbersome. Even my nurses had a bit of difficulty following the instructions, though they were quite clear and concise. (They do provide a helpful online video.)

3) LDL will need to be calculated, just as your laboratory does. (LDL = total cholesterol - HDL - triglycerides/5).

How about costs? The device can be obtained for as little as $79 at Walmart and The tests strips come in separate boxes, purchased separately. A set of 3 total cholesterol test strips costs between $12 and $15; similar prices for HDL and triglycerides. Thus, each run of total cholesterol, HDL, and triglycerides will cost you about $12-15 (3 test strips), provided there are no fumbles (which are somewhat common, particularly at first.)

Availability is a bit of a difficulty. The CardioChek website lists CVS, Walgreen's, and Walmart as retailers, along with several online distributors that I've never heard of. I bought a device at CVS for $99, test strips for $14.95 each for HDL and total cholesterol. However, after stopping at 5 different CVS locations, 3 Walgreen's, and one Walmart, none carried triglyceride test strips, which therefore have to be purchased online. Also, none of the Walgreen's or Walmart even carried the device itself, despite the website's claims.

Despite the hurdles, the CardioChek device is a useful and practical tool if you are interested in monitoring your own cholesterol values. With a bit of practice, you can get quite facile at performing this on your own with an accuracy close to that of your doctor's office or laboratory.

DHEA for osteoporosis

One fairly clear-cut benefit of supplementation of the adrenal gland hormone, DHEA, is increased bone density.

Here's one study showing very persuasive effects of DHEA supplementation, 50 mg per day for 12 months, on bone density: Effects of Dehydroepiandrosterone Replacement Therapy on Bone Mineral Density in Older Adults: A Randomized, Controlled Trial

70 men and 70 women were given DHEA 50 mg per day vs. placebo with pre- and post- measures of bone density made.

From Jankowski CM et al. J Clin Endocrinol Metab 2006 Aug;91(8):2986-93.

As you can see, the women responded more vigorously than the men.

From Jankowski CM et al. J Clin Endocrinol Metab 2006 Aug;91(8):2986-93.

To achieve these results, women increased DHEA blood levels to 225-300 mcg/dl, while men increased DHEA blood levels to 300-400 mcg/dl.

This study corroborates findings made by a Washington University group and that of a University of California group that also showed increased bone with DHEA supplementation.

Perfect cholesterol values without statins

Who is better off?

John takes Crestor, 40 mg per day:

LDL cholesterol 60 mg/dl
HDL cholesterol 60 mg/dl
Triglycerides 60 mg/dl
Total cholesterol 132 mg/dl

Or Sam:

LDL cholesterol 60 mg/dl
HDL cholesterol 60 mg/dl
Triglycerides 60 mg/dl
Total cholesterol 132 mg/dl

who obtained these values through vitamin D normalization (to increase HDL); wheat elimination (to reduce triglycerides and LDL); and omega-3 fatty acids (to reduce triglycerides).

Believe the drug industry motto--If some statin is good, more statin is better--then John is clearly better off: He has obtained all the "benefits" of statin drugs. They refer to the "pleiotropic" effects of statin drugs, the presumed benefits that extend outside of cholesterol reduction. The most recent example are the JUPITER data that demonstrated 55% reduction in cardiovascular events in people with increased c-reactive protein (CRP). Media reports now unashamedly gush at the benefits of Crestor to reduce inflammation.

However, on Sam's program, elimination of wheat and vitamin D both exert anti-inflammatory effects on CRP, typically yielding drops of 70-90%--consistently, rapidly, and durably.

So which approach is really better?

In my experience, there is no comparison: Sam is far better off. While John will reduce his cardiovascular risk with a statin drug, he fails to obtain all the other benefits of Sam's broader, more natural program. John will not enjoy the same cancer protection, osteoporosis and arthritis protection, relief from depression and winter "blues," and increased mental and physical performance that Sam will.

If our goal is dramatic correction of cholesterol patterns and reduction of cardiovascular risk, for many, many people statin drugs are simply not necessary. In fact, they may be inferior to what is achievable without them applying effective nutritional strategies.

Go wheat-free to reduce LDL cholesterol

TV ads, media conversations, magazine articles, even advice from the American Heart Association and USDA (a la Food Pyramid) all agree: eat more whole grains, get more fiber.

What happens when you follow this advice?

Look around you: People gain weight, they become pre-diabetic and diabetic. Abnormal lipids and lipoprotein patterns emerge: increased triglycerides and VLDL, reduced HDL, increased (small) LDL. Blood sugar goes up, inflammatory responses are ignited. You feel crumby, cancer risk is increased.

"Official" agencies have urged us to eat more grains, get more fiber and most Americans have complied. We now have a nationwide health disaster that will eventually lead to more people with coronary plaque, more heart disease, more heart attack, more heart procedures.

This is why I've been urging patients to go wheat-free. It has proven an extraordinarily and surprisingly effective strategy for:

1) rapid and profound weight loss
2) raising HDL and reducing triglycerides, VLDL, and LDL (small)
3) reducing blood sugars, pre-diabetes and diabetes

Yes, as crazy as it may sound, elimination of wheat products reduces LDL cholesterol--dramatically. And it reduces the small type of LDL specifically, the type that is most likely to cause heart disease.

Here's a sampling of the comments I've received on another blog of mine, the Heart Scan Blog, regarding elimination of wheat to reduce LDL cholesterol and obtain other health effects:

Barbara W said:

It's true! We've done it. My husband and I stopped eating all grains and sugar in February. At this point, we really don't miss them any more. It was a huge change, but it's worth the effort. I've lost over 20 pounds (10 to go)and my husband has lost 45 pounds (20 to go). On top of it, our body shapes have changed drastically. It is really amazing. I've got my waist back (and a whole wardrobe of clothes) - I'm thrilled.

I'm also very happy to be eating foods that I always loved like eggs, avocados, and meats - without feeling guilty that they're not good for me.

With the extremely hot weather this week in our area, we thought we'd "treat" ourselves to small ice cream cones. To our surprise, it wasn't that much of a treat. Didn't even taste as good as we'd anticipated. I know I would have been much more satisfied with a snack of smoked salmon with fresh dill, capers, chopped onion and drizzled with lemon juice.

Aside from weight changes, we both feel so much better in general - feel much more alert and move around with much greater flexibility, sleep well, never have any indigestion. We're really enjoying this. It's like feeling younger.

It's not a diet for us. This will be the way we eat from now on. Actually, we think our food has become more interesting and varied since giving up all the "white stuff". I guess we felt compelled to get a little more creative.

Eating out (or at other peoples' places) has probably been the hardest part of this adjustment. But now we're getting pretty comfortable saying what we won't eat. I'm starting to enjoy the reactions it produces.

Weight loss, increased energy, less abdominal bloating, better sleep--I've seen it many times, as well.

Dotslady said:

I was a victim of the '80s lowfat diet craze - doc told me I was obese, gave me the Standard American Diet and said to watch my fat (I'm not a big meat eater, didn't like mayo ... couldn't figure out where my fat was coming from! maybe the fries - I will admit I liked fries). I looked to the USDA food pyramid and to increase my fiber for the constipation I was experiencing. Bread with 3 grams of fiber wasn't good enough; I turned to Kashi cereals for 11 years. My constipation turned to steattorrhea and a celiac disease diagnosis! *No gut pains!* My PCP sent me to the gastroenterologist for a colonscopy because my ferritin was a 5 (20 is low range). Good thing I googled around and asked him to do an endoscopy or I'd be a zombie by now.

My symptoms were depression & anxiety, eczema, GERD, hypothyroidism, mild dizziness, tripping, Alzheimer's-like memory problems, insomnia, heart palpitations, fibromyalgia, worsening eyesight, mild cardiomyopathy, to name a few.

After six months gluten-free, I asked my gastroenterologist about feeling full early ... he said he didn't know what I was talking about! *shrug*

But *I* knew -- it was the gluten/starches! My satiety level has totally changed, and for the first time in my life I feel NORMAL!

Feeling satisfied with less is a prominent effect in my experience, too. You need to eat less, you're driven to snack less, less likely to give in to those evil little bedtime or middle-of-the-night impulses that make you feel ashamed and guilty.

An anonymous (female) commenter said:

My life changed when I cut not only all wheat, but all grains from my diet.

For the first time in my life, I was no longer hungry -no hunger pangs between meals; no overwhelming desire to snack. Now I eat at mealtimes without even thinking about food in between.

I've dropped 70 pounds, effortlessly, come off high blood pressure meds and control my blood sugar without medication.

I don't know whether it was just the elimination of grain, especially wheat, or whether it was a combination of grain elimnation along with a number of other changes, but I do know that mere reduction of grain consumption still left me hungry. It wasn't until I elimnated it that the overwhelming redution in appetite kicked in.

As a former wheat-addicted vegetarian, who thought she was eating healthily according to all the expert advice out there at the time, I can only shake my head at how mistaken I was.

That may be a record for me: 70 lbs!!

Stan said:

It's worth it and you won't look back!

Many things will improve, not just weight reduction: you will think clearer, your reflexes will improve, your breathing rate will go down, your blood pressure will normalize. You will never or rarely have a fever or viral infections like cold or flu. You will become more resistant to cold temperature and you will rarely feel tired, ever!

Ortcloud said:

Whenever I go out to breakfast I look around and I am in shock at what people eat for breakfast. Big stack of pancakes, fruit, fruit juice syrup, just like you said. This is not breakfast, this is dessert ! It has the same sugar and nutrition as a birthday cake, would anyone think cake is ok for breakfast ? No, but that is exactly the equivalent of what they are eating. Somehow we have been duped to think this is ok. For me, I typically eat an omelette when I go out, low carb and no sugar. I dont eat wheat but invariably it comes with the meal and I try to tell the waitress no thanks, they are stunned. They try to push some other type of wheat or sugar product on me instead, finally I have to tell them I dont eat wheat and they are doubly stunned. They cant comprehend it. We have a long way to go in terms of re-education.

Yes. Don't be surprised at the incomprehension, the rolled eyes, even the anger that can sometimes result. Imagine that told you that the food you've come to rely on and love is killing you!

Anne said:

I was overweight by only about 15lbs and I was having pitting edema in my legs and shortness of breath. My cardiologist and I were discussing the possible need of an angiogram. I was three years out from heart bypass surgery.

Before we could schedule the procedure, I tested positive for gluten sensitivity through I eliminated not only wheat but also barley and rye and oats(very contaminated with wheat) from my diet. Within a few weeks my edema was gone, my energy was up and I was no longer short of breath. I lost about 10 lbs. The main reason I gave up gluten was to see if I could stop the progression of my peripheral neuropathy. Getting off wheat and other gluten grains has given me back my life. I have been gluten free for 4 years and feel younger than I have in many years.

There are many gluten free processed foods, but I have found I feel my best when I stick with whole foods.

Ann has a different reason (gluten enteropathy, or celiac disease) for wanting to be wheat-free. But I've seen similar improvements that go beyond just relief of the symptoms attributable to the inflammatory intestinal effects of gluten elimination.

Wccaguy said:

I have relatively successfully cut carbs and grains from my diet thus far.

Because I've got some weight to lose, I have tried to keep the carb count low and I've lost 15 pounds since then.

I have also been very surprised at the significant reduction in my appetite. I've read about the experience of others with regard to appetite reduction and couldn't really imagine that it could happen for me too. But it has.

A few weeks ago, I attended a party catered by one of my favorite italian restaurants and got myself offtrack for two days. Then it took me a couple of days to get back on track because my appetite returned.

Check out Jimmy Moore's website for lots of ideas about variations of foods to try. The latest thing I picked up from Jimmy is the good old-fashioned hard boiled egg. Two or three eggs with some spicy hot sauce for breakfast and a handful of almonds mid-morning plus a couple glasses of water and I'm good for the morning no problem.

I find myself thinking about lunch not because I'm really hungry but out of habit.

The cool thing too now is that the more I do this, the more I'm just not tempted much to do anything but this diet.

Going wheat-free, along with a reduction in processed sugary foods like Hawaiian Punch, sodas, and candy, is the most direct path I know of to lose weight, obtain all the health benefits listed by our commenters, as well as achieve the cholesterol corrections we seek, like reduction of LDL cholesterol (small LDL particles) and increase in HDL.

Do-it-yourself osteoporosis treatment

Debbie did not want to take the osteoporosis drugs prescribed by her primary care doctor for mild osteoporosis (T score -2.7) identified by a DEXA scan (x-ray densitometry).

He'd offered her the choice of Fosamax, Actonel, or Boniva. But Debbie was concerned about some of the reports of side-effects, including irreversible damage to the jaw bone requiring reconstructive surgery ("mandibular necrosis"). He'd warned her about the long-term risks of fractures, especially of the hip, if her osteoporosis progressed. So she committed to trying it on her own with an all-out effort.

At 56, Debbie was skeptical. So she put together her own osteoporosis prevention program:

Vitamin D--using a dose sufficient to raise her 25-hydroxy vitamin D blood level to 60-70 ng/nl.

Vitamin K2--Borrowing from the Japanese experience, in which vitamin K2 is used as a prescription "drug" for treatment of osteoporosis (Glakay, Eisai Pharmaceuticals), she started 1000 mcg of a mixture of K2 forms, MK-7 and MK-4.

Magnesium--Based on evidence that magnesium strengthens the bonds in bone tissue, she started magnesium glycinate, 400 mg per day (200 mg twice a day), a form that is well-absorbed and causes little or no loose stools.

Progesterone--Debbie added natural topical progesterone cream formulated for her by a compounding pharmacy, 60 mg twice a day.

The one interesting agent she did not add was strontium, despite evidence of benefit.

Debbie also added twice weeekly strength exercises for 20 minutes in addition to her walks.

14 months later, a second DEXA result: A T score of +1--complete reversal of her osteoporosis.