BIO-IDENTICAL HORMONE REPLACEMENT THERAPY

By Lawrence Wilson, MD

Revised © 2007, LD Wilson Consultants, Inc.

More and more physicians agree that synthetic hormone replacement therapy is fraught with problems. A growing number of holistic doctors, however, offer the less toxic bio-identical hormone replacement therapy.

In our experience, bio-identical hormone replacement is better than the synthetic hormones. However, there are still a number of critical problems with it. For these reasons, elaborated below, we only recommend it for short-term therapy and certain exceptional cases as mentioned later in this article.

For most people, no hormone therapy is needed and it can be quite harmful, in fact, despite the products being “natural” substances. They are still powerful chemicals and somewhat toxic in their own right.

Thus we approach this subject with extreme caution, far more than is exercised by most natural doctors or conventional ones. Here are some concerns with hormone therapy that one should consider:

BIO-IDENTICAL HORMONE THERAPY PROBLEMS

1. Hormone therapy can cause cancer. I mention this as a warning, even about natural products such as glandular extracts used by nutritionists and holistic doctors. They should be avoided at all cost if one has a diagnosed cancer and even in some instances if one strongly suspects a full-blown cancer, even if it has not been diagnosed.

Cancer is probably the biggest danger of many types of artificial and even natural hormone therapies is that it can increase the risk of cancer. This applies specifically for hormone-related cancers such as breast and prostate cancer.

The reason prostate and breast cancer are so prevalent, in part, is that we are exposed to hormone “replacement” products all day. These include plastics, or so-called xenoestrogens. These function like estrogens in our bodies. Also, dairy products and meat naturally contain hormones, which is why they are avoided often in early treatment for cancer. Avoiding them altogether for long periods of time, however, is usually not as helpful.

Other sources are hormones injected into livestock, poultry and other animals that we either eat outright or use products made from these animal bodies. Many processed and prepared foods contain flavorings and other animal-based products that vegetarians are even unaware of. The only way to avoid them is to eat at home all the time of fresh, organic foods.

Other natural sources of hormones are found in certain plant-based foods such as most soy products unless they are fermented. Other sources include wild yam, sea vegetables (but not kelp and certain others), cactus-derived products and, in fact, many other foods in smaller amounts. Most do not pose a problem. However, for the cancer patient they certainly can pose an added risk.

This is one reason wer recommend stricter diets for people, and why we love the near infared or far infrared sauna to help remove thousands of toxic plastics and other chemicals from the body quickly and efficiently with few side effects. This efficiency is only possible when the sauna is used enough, and in the correct way. For much more information about saunas, see our articles or preferably our book, Sauna Therapy.

2. Hormone replacement upsets the delicate hormone feedback systems in the body. This is especially true of the steroid hormones (DHEA, pregnenolone, estrogen, progesterone, cortisone, androsterone and testosterone).

We have found that hormone replacement may do much more harm than good by upsetting the delicate feedback mechanisms. Giving a hormone affects others and may affect many areas of physical functioning. The feedback systems are exceedingly complex. It is difficult to monitor and figure out exactly how to regulate hormones, especially adrenal hormones.

3. Hormone therapy is often not needed if chemistry is balanced. We find that if one corrects the diet, toxic metals, the oxidation rate and other imbalances through nutritional balancing science, many hormonal problems go away without the need for any hormone replacement. If nutrient therapy is not sufficient, herbal therapy and other natural therapies are also often excellent.

4. Hormone therapy rarely addresses the cause of health problems. Instead, it mainly treats symptoms. Causes of hormone imbalances are nutrient deficiencies, toxic metal excesses, toxic chemicals and the effects of radiation, emotional imbalances and stress from other causes. The only time hormone replacement addresses the cause is when the organ that produces the hormone is irreparably damaged so that it cannot function.

For example, at menopause or after a hysterectomy with oophorectomy, the adrenal glands should produce enough estrogen and progesterone to prevent hot flashes and other symptoms. Millions of women do just fine without hormone replacement if their adrenal glands are functioning normally. Improving the adrenals and thyroid activity and balancing body chemistry often suffices to prevent and correct hot flashes and other symptoms associated with menopause. In some cases, however, supplementary progesterone, in particular, may be helpful.

For diabetics, Type 1 diabetes may require insulin. However, many Type 2 diabetics can lower their blood sugar with dietary and lifestyle changes.

5. Hormone replacement therapy masks underlying problems. One may receive relief from hot flashes, exhaustion or other annoying symptoms with natural hormone therapy. However, underlying problems such as heavy metal toxicity, nutrient deficiencies or chemical toxicity continue unrecognized and unaddressed. This can and does lead to more serious problems in the future.

6. One cannot provide the correct dosage of replacement hormones. Not only does natural hormone secretion vary every minute of the day and night in everyone. Hormone secretion also depends greatly on each person’s specific lifestyle and activity schedule.

Replacement therapy substitutes a rigid routine for the delicate balancing act the body performs all day and all night long. This can have severe adverse consequences on body systems.

A very important determinant in natural hormone secretion is one's lifestyle. Exercise, rest, mental versus physical activity, emotional ups and downs, eating patterns, illnesses and other biochemical factors all affect natural hormone secretion on a moment-to-moment basis.

7. A hormone's metabolic effect is what is most important, not its serum, urine or saliva level. However, serum, urine or saliva are how they are usually measured. This is particularly a problem with thyroid and adrenal hormone monitoring.

Their metabolic effect depends less on the level of circulating hormone and more on how much enters the cells and is metabolized properly within the cells. For this reason, cellular tests such as hair mineral testing often reveal a very different picture than blood, urine and saliva tests that measure circulating hormone levels.

8. Even bio-identical hormones are toxic. This is most evident with insulin. Every physician is familiar with the care that must be used in administering insulin, technically a bio-identical hormone, to avoid often-fatal insulin shock.

Even using extreme care and sophisticated delivery systems, insulin still always causes side effects and cannot prevent the adverse effects of many diabetic complications.

Estrogen, even natural estrogen, is also extremely toxic. Many believe it is the primary carcinogen. Studies of menopausal women on estrogen replacement would tend to support this.

Some toxicity of DHEA, pregnenelone, testosterone, growth hormone and others is also well-known. Yet often these are prescribed casually with little consideration of possible toxic effects.

Less important, but nevertheless true, is that a product from outside the body, even bio-identical estrogen, progesterone or others is not always identical to the internal substance. For example, manufactured products are usually not perfectly fresh or pure as those within the body.

See number 10 below on the differences between hormones and vitamins from outside the body, for example. Vitamins and minerals in our food are often cooked, salted, preserved and more and are still very good for the body.

This is not true of hormones, however, which must be absolutely fresh to be really bio-identical. In practice, this is very difficult to achieve, so there is always some toxicity for this reason as well as others listed above.

9. Hormone replacement therapy is costly. The cost includes not only the substance itself, but costly repeated testing required to prescribe them in a responsible fashion.

Yet another cost is the need for long-term therapy. Since they do not address causes, one is usually forced to remain on the replacement hormones for life.

In addition to the financial burden, one becomes dependent on tests and doctors that in itself extracts a human cost. While this is better than dying of diabetes or Addison's disease, there are often better ways to handle these conditions discussed below.

10. Hormone therapy is not in the same class of therapies as vitamin and mineral supplements at all. The latter are found in foods, whereas hormones are produced inside the body for the most part.

Hormones are among thousands of internal chemicals that must react and balance each other on a moment-to-moment basis. Food components like vitamins are designed to be ingested safely in average or rough amounts at irregular times during the day, as occurs daily during mealtime.

This is an extremely important difference between supplements of vitamins and mineral therapy versus hormone therapy. Yet most holistic and naturopathic doctors think that natural hormones are just like natural minerals and vitamins. They could not be more wrong!

It is true we ingest a tiny amount of hormones from food products, but most of this is extremely harmful. For example, dairy animals today are quite high in some estrogens due to cattle breeding and drugs given to the cattle to produce more milk or fatten them. These hormone residues find their way into our food today, making it far less healthful.

Soy and a few other foods contain genistin and other compounds that bind to estrogen binding sites in the body. Once again, many scientists believe this is not a good thing, except perhaps for menopausal women, a rather small subgroup of the population.

Another source is tap water that is contaminated with synthetic hormones fed to animals or humans. These do not break down in time and circulate in the water supplies. America and Western European nations, in particular, are experiencing this problem with their tap waters.

Finally, some pesticides and plastic materials contain hormone-like toxic chemicals that can mimic estrogens. These are very common today, unfortunately, and also quite harmful.

So most of our food-based hormone sources are decidedly negative for health. This is totally unlike vitamins and minerals, in which the general principle is that more is better in the food supply.

11. Finally, hormones are always secreted in constantly-changing combinations. They are never secreted in an isolated way, which is how most hormone supplements are prescribed.

Even if the doctor prescribes a combination of replacement hormones, it is always arbitrary. In fact, the combination is always changing from moment to moment.

In reality, hormone replacement involves taking an average amount that is not in the correct moment-to-moment dosage or combination for the body’s needs.

In contrast, our bodies are designed to take in a lot of calcium at one meal, a lot of potassium at the next meal and so forth. In other words, the body has complex buffering systems to prevent an overload of any nutrient at a meal and to make up for missing nutrients in a particular meal or day. This is not the case with hormones.

Once again this is the reason why exercising extreme caution with hormone therapy of any kind is warranted and hormone replacement is nothing at all like vitamin and mineral supplementation therapies. Far too many of my patients have been harmed by well-meaning physicians who use bio-identical hormones without understanding this fact.

EXCEPTIONS -

INSULIN REPLACEMENT

Diabetics on insulin may still suffer many complications of diabetes including vascular disease, blindness, infections, premature aging and much more. I consider it unfortunate to put most diabetics on insulin without first addressing nutritional and other factors possibly related to glucose intolerance.

Many type 2 diabetics in particular have iron and at times vanadium toxicity. Lead, cadmium, mercury and other toxic metals are also very commonly present. They may also have chromium, zinc and manganese deficiencies. Their cell permeability is often reduced. Their diets are often high in carbohydrates, and many use stimulants such as coffee or colas that worsen nutritional imbalances. They are often low in other nutrients such as selenium, iodine, vitamins and others.

Simply eliminating most carbohydrates from the diet often has a dramatic glucose lowering effect. Combining this with a nutrition program and detoxification with sauna therapy can reduce blood sugars often in a matter of a few weeks or less. There are many cases of doctors who have enabled even long-term insulin users to reduce or even eliminate their insulin shots in quite a short period of time.

Nutritional balancing is just one of many methods that may assist diabetics to regain their true health and not need to be on insulin for the rest of their lives. However, it is needed until the body can manufacture its own insulin and until the body can properly metabolize it, in the case of Type 2 diabetics.

I believe one reason insulin will be around for a long time is that many people simply will not adhere to a strict diet of fruits, vegetables and lean meats that is needed and can correct even chronic, stubborn cases of diabetes slowly over a period of months or even years if needed. For much more information about diabetes, read the article on this website entitled Diabetes. Also, many other articles on this website discuss carbohydrates in the diet, sugars in the diet and other topics related to diabetes.

THYROID HORMONE REPLACEMENT

Thyroid hormone replacement with natural thyroid hormone is another good use of hormone replacement therapy when no other solution will work. The reason is the feedback system for thyroid hormone production is simpler than the feedback system for the steroid hormones. Only two hormones are involved, and their metabolism is relatively simple. Therefore, thyroid hormone replacement is less harmful and, indeed, helpful at times for thousands of people whose health is not good.

However, many of the same problems arise as a result of thyroid hormone therapy as with the replacement of other hormones. It often masks deeper imbalances, and it does not address factors such as copper, mercury or fluoride toxicity which can affect the thyroid and pituitary glands.

Adrenal weakness often contributes to thyroid imbalance as the thyroid gland seeks to compensate. Exhaustion of the sympathetic or fight-or-flight nervous system also contributes to thyroid imbalance. Adrenal exhaustion even contributes to hyperthyroid conditions or Grave's disease. This is revealed on hair mineral tests that often reveal low cellular thyroid effect. In these individuals, cell permeability is impaired and the thyroid gland compensates by secreting more hormones, causing symptoms of hyperthyroidism.

Most people diagnosed with hyperthyroidism in my experience are also pushing themselves with exercise or other activities, which aggravates the hyperthyroid condition. Copper and particularly mercury toxicity are also important factors in almost all cases. The solution is not to destroy the thyroid gland or replace hormones, but to correct the biochemical imbalances and lifestyle.

If one must replace thyroid hormones, most patients do better on natural thyroid (Armour thyroid, Naturethroid or Westhroid), which contain all the hormones and nutritional factors as well.

For more information about thyroid problems and natural approaches to solving them, see the article on this website, Thyroid Healing.

PROGESTERONE AND TESTOSTERONE

Of the natural hormones, progesterone for women only and testosterone for the men are among the safer ones. We have seen fewer bad effects from these than from the use of hormones such as DHEA, pregnenelone, corticosteroids, estrogens and some others. However, we use them only as a last resort when we cannot correct the hormone imbalances in other ways.

WHEN HORMONE REPLACEMENT IS HELPFUL

Here are the only times I recommend short-term hormone replacement therapy with any type of natural or bio-identical or animal-based hormones. Synthetic one such as Synthroid and progestins are usually the worst, by the way.

1. Natural progesterone is helpful for some PMS and other women’s issues, provided that one cannot correct the problem with nutritional balancing methods first. These approaches are described elsewhere on this website in articles such as Premenstrual Syndrome.

2. Thyroid hormone replacement with natural hormones is helpful for those who cannot function without it, assuming that nutritional balancing methods are not enough to correct a serious problem. Synthetic thyroid hormones are a disaster in too many cases and should be avoided at all costs.

3. Birth control pills, used today for acne, avoiding pregnancy, premenstrual problems and perhaps other women’s problems, are harmful for one’s health. However, they can be used if one realizes how much one is compromising one’s future on this earth.

The side effects, which include increased incidence of cancer, brain tumors, strokes, heart attacks, depression and much more are too often completely ignored by prescribing people.

4. Insulin is necessary for some diabetics, at least until they decide that the side effects are not worth the effort and they will correct their eating and living habits enough to remove the need for insulin altogether or reduce the amount they use. fatigue, long-term use is not recommended in most cases unless it is the only other option available. This is not true in most cases, in our clinical experience.

5. Hormone replacement is absolutely necessary if a key organ has been so damaged or destroyed by surgery, radiation or illness that it will never produce enough hormones. This does not apply to removal of the ovaries, however, as these hormones can be made in most cases by the adrenal glands and other sites in the body.

However, in some cases, ovary removal, which should be done only rarely in the case of overwhelming pathology, can render some women so unwell that hormones may be the only answer for a while, until they improve their overall health. Then they should not be needed at all.

6, Cortisol or cortisone replacement therapy is needed very rarely in true cases of Addison’s disease. This is quite rare, however, in my experience. Most who are given this diagnosis really have adrenal exhaustion. One can read much more about this rather common condition by clicking on Adrenal Burnout Syndrome. This website also have other articles about adrenal insufficiency because this is such an important problem today.

The side effects of even low-dose cortisone therapy are so devastating that its use should be only if all else fails.

7. Topical hormone therapy, for example, for dermatitis and other skin problems, is far less toxic than ingesting corticosteroids. However, it will eventually thin the skin if used repeatedly. Therefore, it should be used only occasionally, if at all.

8. Hormones for aging, such as DHEA, pregnenelone, HGH (human growth hormone) and others, perhaps, are fraught with problems. These issues have been mentioned earlier.

However, some people benefit from them, without a doubt. We prefer the natural methods of healing, which actually restore health at far deeper levels. So this is just a caution to beware of, although if one is old and ill, anything to help should be considered and we are still researching when these might be beneficial, especially for those who cannot or will not undertake a total cleansing and healing diet, lifestyle, supplement and sauna program.

9. Hormones for beauty are fine if they are topical, such as those in skin creams. However, avoid corticosteroids like cortisone, as it will age the skin. This approach to beauty has some merit, but one must realize it is only skin deep, so to speak.

10. Melatonin. This is a hormone secreted by the pineal gland. It is helpful for many people to promote restful sleep. It can be used short-term without problems. Some studies indicate it can even prevent or mitigate cancer in some animal studies.

We prefer not to use it because, like all hormones, it is toxic. However, it is fine for occasional use to help one sleep. Especially if one has traveled on an airplane across time zones and feels disoriented, melatonin before bed for several days can be most helpful.

11. Testosterone. This hormone may be needed in men who are middle-aged, usually, or older, if their testosterone levels are low and they are not willing or able to embark on a nutritional balancing program. In these cases, one may supplement with a natural replacement hormone.

I do not recommend it as much for women, where it seems to cause a few more side effects and could engender cancer, one of the biggest dangers with hormone replacement in general.

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