Synthetic, Natural, or Bioidentical Hormone Replacement Therapy?

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Types Of Hormones Demystified

Most of us are familiar with the synthetic versions of medications; after all these are developed by pharmaceutical companies. They are ubiquitous and seen in advertisements on TV, in magazines, or conveniently placed on just about every object in a physicians’ office.

Many synthetic medications are derived from natural chemicals, which are then manipulated by the addition and subtraction of other molecules. This process allows pharmaceutical companies to patent and sell them to the general public.

What does this mean for you?

Synthetic Hormones

Well it means that you body must metabolize these foreign entities before they can be properly utilized. It’s like saying your car needs gas, but instead your going to give it oil. Oh yea, and by the way, the oil will be broken down to gas and in this process will cause damage to your car.

Does that make any sense?  An example of this is Provera, a synthetic form of progesterone called a progestin. The process of metabolizing Provera has been shown to have many deleterious side effects as have many other synthetic medications.  This is why we often see synthetic prescriptions being pulled off the market several years after their approval.

Don’t Fall For “It’s Natural” Either

Another form of taking hormone replacement therapy is with “natural” hormones. However, “natural” does not always mean that a specific medication is “natural” to the human body. Take Premerin for example. Premerin contains many forms of estrogen, all which are “natural”, however most, such as equilin, are “natural” only to horses and not humans. So once again we are being fed foreign molecules that must be broken down by the body to forms of estrogen that are identical to the human body.

What Bioidentical Means

So if our bodies are low on estrogen or testosterone than why don’t we simply add identical forms of estrogen and testosterone to our bodies? Simple enough right? This is common sense and one of the main benefits of natural bioidentical hormone replacement. Bioidentical hormones are derived from plants, such as yams and soy, and duplicate the exact structure of hormones found in our bodies. Therefore, we don’t have to do the extra work of breaking down and dealing with byproducts of foreign molecules. This breaking down process places strain on the body. In fact there are many studies that show that bioidentical hormone replacement therapy are not only safer than other forms of hormone replacement, but also provide many additional health benefits.

So why are synthetic and “natural” medications the ones that are being prescribed?

Well, identical and pure forms of our bodies own hormones cannot be patented as easily and thus are less lucrative. This makes them less attractive to companies looking to make a profit. After all the CEO’s and boards of these companies need to make sure that their stock rises.

So when pharmaceutical companies “create” medications they are often the synthetic or altered versions we discussed.

And who funds most of the studies for medications?

You guessed it; pharmaceutical companies provide much of the funding for universities to do studies on their medications. They also fund the FDA and give kickbacks to the insurance companies to be on their formulary. Now before you think that I’m becoming an iconoclast and hopping on the Michael Moore bandwagon, or getting ready to pitch him an idea for his next movie, think again. We are not saying that all medications are all bad. There are many medications that are helpful and make a big difference in people’s lives.

The point is that money speaks volumes and can cause us to only receive one side of the story. This is why it is important for you, the consumer, to do the research and know you sources.

So do your research, and stay tuned next week as we break down bioidentical hormones in more detail. For more information check out the links in this blog, the articles below, and contact Vitali-T Medical Clinics to find out if hormone replacement is right for you.

Article References:

A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks.  Alternative Medicine Review 2006 Sep; 11(3): 208-23. Moskowitz. D.  http://www.ncbi.nlm.nih.gov/pubmed/17217322

The bioidentical hormone debate: are bioidentical hormones (estrodiol, estriol, and progesterone) safer or more effiacious than commonly used synthetic versions in hormone replaement therapy? Postgrad Med 2009 Jan; 121 (1) : 73-85. Holtorf. K.   http://www.ncbi.nlm.nih.gov/pubmed/19179815

Point/Counterpoint: The Case for Bioidentical Hormones. Journal of American Physicians and Surgeons Volume 13: 43-46 Summer 2008 Number 2. StevenF. Hotze., Donald P. Ellsworth.   http://thefansproject.com/images/fckuploads/File/CaseForBioidentical(1).pdf

Money Talks: A Look At The Women’s Health Initiative

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The Truth About The WHI Study

Does your doctor know what’s best for you when it comes to hormone replacement therapy?

Most of us automatically assume that they do, but the truth is many physicians don’t take the time to read through all the reports and recent studies. Physicians are often very busy, and the information they receive is what’s most readily available.

This is why it is important for you to be an informed consumer so you don’t fall into a trap of “the blind leading the blind.”  

This brings us to the Women’s Health Initiative (WHI) study on hormone replacement therapy released in 2002. This highly publicized and well-funded study initially reported that hormone replacement therapy can result in an increased risk of coronary heart disease, breast cancer, stroke and pulmonary embolisms.

As fear set in, doctors and their patients panicked and the number of women on hormone replacement therapy plummeted by the tens of millions, but was this drop justified? Have you or your physician really taken an in-depth look at the WHI studies? Well today we are going to delve a bit deeper and clarify a few facts which have received minimal attention.

WHI Study: Two Parts

The WHI study had two parts referred to as “arms.” Patients in the first arm of the WHI study were prescribed a medication called Prempro. Prempro consists of two medications taken orally; Premerin and Provera. Premerin is a “natural” estrogen (derived from conjugated female horse urine).

However, notice that we have natural in quotes. Premerin is “natural” because it contains natural forms of estrogen, but natural forms to whom? Equilin and Equilenin are two of the main hormones found in Premerin. These hormones are specific to horses, but foreign to humans. Therefore, our bodies must break down these foreign estrogens into ones that are endogenous to humans, such as estrodial.  Provera, the other medication in Prempro, is a synthetic progestin, which means that it is chemically altered in a lab. Provera is used to treat abnormal menstruation or irregular vaginal bleeding (many people are familiar with the injectable form of Provera called Depo-Provera which has been used as a contraceptive).

Over the past several decades Provera has been taken off of the market in several other countries because it is considered to be carcinogenic, yes carcinogenic!

Even here in the United States there has been trepidation about known side effects prior to its use in the WHI study. So it is not surprising that this study resulted in many harmful side effects.

Follow Up Study (Second Part)

How about the follow-up studies? Well WHI released the second “arm” of their hormone replacement study in 2004.  In this study, participants on hormone replacement therapy received Premerin only. Results indicated that participants did not show an increase in breast cancer or many of the negative side effects associated with the first part of the study. Interestingly enough, we have heard little about these results.

Therefore, it does not take a genius to figure out that it is Provera that caused many of the deleterious effects reported in the first study. The unfortunate part is that when this news broke, the findings were generalized to all types of hormone replacement therapy, and the idea that hormone replacement therapy is harmful spread like wildfire.

Since this time there has been minimal coverage regarding the results from the second “arm” of the WHI study.  There have also been limited reports on studies pointing to the positive effects of bioidentical hormone replacement. So before you take your next trip to the doctor’s office and ask about hormone replacement therapy, make sure you do your research and know the facts.

For more information and additional articles, please see the links below, and check back next week as we explore the difference between synthetic, natural and bioidentical hormones.

Article Resources:

http://www.ncbi.nlm.nih.gov/pubmed/12626212

Climacteric. 2002 Dec;5(4):332-40. Combined hormone replacement therapy and risk of breast cancer in a French cohort study of 3175 women.de Lignières B et al.

French Cohort Study.

http://www.womentowomen.com/breasthealth/estrogenbreastcancer.aspx

Causes of Brea6t Cancer- the Estrogen Controversy, Dixie Mills MD

http://content.nejm.org/cgi/content/short/356/25/2591

Estrogen Therapy and Coronary-Artery Calcification. NEJM Volume 356:2591-2602  June 21, 2007  Number 25. JoAnn E. Manson, M.D., et al.

http://www.ncbi.nlm.nih.gov/pubmed/15989413

J Womens Health (Larchmt). 2005 Jun;14(5):410-7. Effects of hormone replacement on progression of coronary calcium as measured by electron beam tomography.Budoff MJ, et al.

http://jama.ama-assn.org/cgi/content/abstract/288/3/321
Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women
Principal Results From the Women’s Health Initiative Randomized Controlled Trial
Writing Group for the Women’s Health Initiative Investigators JAMA. 2002;288:321-333. First Arm.

http://jama.ama-assn.org/cgi/content/full/291/14/1701
Effects of Conjugated Equine Estrogen in Postmenopausal Women With Hysterectomy
The Women’s Health Initiative Randomized Controlled Trial.  JAMA. 2004;291:1701-1712. Second Arm. This is the Second Arm of the Study. Premarin Only.

http://www.ncbi.nlm.nih.gov/pubmed/16841178  Effects of estradiol with micronized progesterone or medroxyprogesterone acetate on risk markers for breast cancer in postmenopausal monkeys.Wood CE et al. Breast Cancer Res Treat. 2007 Jan;101(2):125-34.

http://www.time.com/time/magazine/article/0,9171,1002897,00.html

The Truth About Hormones Monday, Jul. 22, 2002 Time Magazine. By CHRISTINE GORMAN AND ALICE PARK

http://breast-cancer-research.com/content/7/3/131
The protective role of pregnancy in breast cancer. Jose Russo et al.Breast Cancer Research 2005, 7:131-142doi:10.1186/bcr1029

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17257424
Hormone-induced protection of mammary tumorigenesis in genetically engineered mouse models
Lakshmanaswamy Rajkumar et al.Breast Cancer Res. 2007; 9(1): R12.

http://www.annclinlabsci.org/cgi/content/abstract/28/6/360

Progesterone inhibits growth and induces apoptosis in breast cancer cells: inverse effects on Bcl-2 and p53.  B Formby and TS Wiley. Annals of Clinical and Laboratory Science, Vol 28, Issue 6, 360-369

Lossing Muscle Mass With Age?

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Age-Related Protein Decline Is Reversible

When most people think of the signs of aging, more often than not they think of wrinkling skin and maybe decreased bone density. But there are numerous other physiological changes that happen in our bodies as we age, one of the biggest being a decrease in muscle mass.

This symptom typically comes as a side-effect of the alteration of nine proteins naturally found within the blood. Luckily, a recent study has found that testosterone treatment can slow and even reverse these protein alterations, allowing for better retention of muscle mass well into one’s golden years.

Boston University Protein Study

The combined study out of Boston University School of Medicine and the University of Texas Medical Branch compared protein levels in multiple samples from two groups of healthy men – one group between the ages of 18-35, and the other between the ages of 60-75 – to see how they differed between the young and the old.  The results indicated that seven of the nine proteins were all at much lower levels in the older men. These proteins were linked to maintenance of muscle, as well as regulation of the immune system.

The same study also found that, with testosterone treatment, lean muscle mass levels increased in both groups, while also increasing two key proteins (PIIINP and IGF-1) in the young men, with similar results in a small group of the older men.

Talk With Your Doctor

The researchers noted that while testosterone therapy showed very promising results in treating these decreases in protein levels, they stress that it is not a one size fits all solution, and that you should consult a professional before undergoing any treatments.