Category Archives: Alternative Medicine

The Hormone Replacement Therapy Debate

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Bioidentical Hormones vs. Synthetic Hormones

Now that more and more women are becoming educated on preventative medicine and anti-aging, the debate is heating up and the very bioidentical hormones that have been used safely for decades across the world are coming under fire in the US. Proponents of bioidentical hormones claim that they are safer than comparable synthetic and non human versions of Hormone Replacement Therapy. Of special concern is the fact that the FDA, big Pharma, state medical boards, and the media claim there is little or no evidence to support claims that bioidentical hormones are safer or more effective.

The term “bioidentical HRT” refers to the use of hormones that are exact copies of endogenous human hormones, including estriol, estradiol, and progesterone, as opposed to synthetic versions with different chemical structures or nonhuman versions, such as Conjugated Equine Estrogens. Bioidentical hormones are also often referred to as “natural hormones,” which can be confusing because bioidentical hormones are synthesized, while some estrogens from a natural source, such as equine urine, are not considered bioidentical because many of their components are foreign to the human body.

Women who had lost their quality of life because of Tubal Ligation Syndrome, hysterectomies, or hormone imbalances associated with aging, report getting their lives back with the use of bioidentical hormones. Many who complained of insomnia, weight gain, depression, memory problems, low libido, aging skin, were able to resolve these issues without anti-depressants, benzodiazapines, or sleeping pills. Those who discovered BHRT described a light bulb going back on and getting their lives back. So, if America is a free country, and a woman can choose whether she wants to use synthetic chemicals such as Prempro or Birth Control Pills, have an abortion, or use bioidentical hormones, why is she being denied the right to choose the latter? Why are physicians being threatened not to prescribe BHRT in the state of Louisiana and being forced to send their patients to Texas for treatment? Why are natural forms of Estriol being banned in America? It would appear that our governing bodies and the media are willing to sacrifice women’s health in the interest of protecting big pharma.

Menopause

Just this morning, Dr. Nancy Snyderman, the medical commentator on the Today Show, instructed all menopausal women not to take any Hormone Replacement Therapy. She cited the very negative outcomes that was seen with the Women’s Health Initiative. This was a vast clinical trial involving more than 100K women and looked at the effect of estrogen and progestin therapy. The study was stopped when it was recognized that women taking Prempro were at a 25% increased risk of developing invasive breast cancer and heart disease. Snyderman went on to express concerns about all forms of Hormone Replacement Therapy including bio-identical hormone replacement because according to her there was “no evidence” to support the claim that they are safer than commonly used synthetic hormones.

Studies Show Bioidentical HRT to be Safe

In actuality, there are hundreds of studies showing the safety of bioidentical hormone replacement therapy which would make one question the honesty of Dr. Snyderman and why she would purposely withhold the truth from women. Furthermore, the US Food and Drug Administration (FDA) have ordered pharmacies to stop providing estriol, stating that it is a new, unapproved drug with unkown safety and effectiveness. This is the same FDA that has approved the use of synthetic birth control pills in 14 year olds to control acne and the use of the depo-provera shot for birth control in young women, which contains the same synthetic progestin as Prempro. Whose side are they on?

Nevertheless, estriol has been used for decades without reported safety concerns and is a component of medications approved for use worldwide. The FDA has acknowledged that it is unaware of any adverse events associated with the use of compounded medications containing estriol, and US Congress is considering a resolution (HR342) to reverse the FDA’s decision to restrict its use.

The definitive article on Bio-Identical Hormones versus Synthetic has been written by Kent Holtorf, MD published in Postgraduate Medicine, Volume 121, Issue 1, January 2009, which evaluates the evidence comparing bioidentical hormones, including progesterone, estradiol, and estriol, with the commonly used nonbioidentical versions of HRT for clinical efficacy, physiologic actions on breast tissue, and risks for breast cancer and cardiovascular disease.
Dr. Holtorf in his work did an exhaustive literature search and reviewed an array of Journal articles and published papers documenting human clinical studies, animal studies, and in vitro experimental work that compared bio-identical and non-bioidentical hormones as well as focusing on the physiological and biochemical aspects of the hormones.

Results showed that patients reported greater satisfaction with HRT’s that contain progesterone compared with those that contain a synthetic progestin. Bioidentical hormones have some distinctly different, potentially opposite, physiological effects compared with their synthetic counterparts, which have different chemical structures. Both physiological and clinical data have indicated that progesterone is associated with a diminished risk for breast cancer, compared with the increased risk associated with synthetic progestins. Estriol has some unique physiological effects, which differentiate it from estradiol, estrone, and conjugated equine estrogens. Estriol would be expected to carry less risk for breast cancer, although no randomized controlled trials have been documented. Synthetic progestins have a variety of negative cardiovascular effects, which may be avoided with progesterone.

Progesterone

                                                  Natural Progesterone

The effect of progesterone compared with Progestin, medroxyprogesterone acetate (MPA) included a 30% reduction in sleep problems, a 50% reduction in anxiety, a 60% reduction in depression, a 30% reduction in somatic symptoms, a 25% reduction in menstrual bleeding, a 40% reduction in cognitive difficulties, and a 30% improvement in sexual function. Overall, 65% of women felt that HRT combined with progesterone was better than the HRT combined with synthetic progestin, MPA.

In conclusion, physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including lower risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT.

Pamela Egan, DNP, CDE
Doctor of Nursing Practice
MS, Metabolic & Nutritional Medicine
Fellow, Metabolic Medical Institute
MN, Gerontology Mental Health
Certified Diabetes Educator

She can be reached at 985-892-3031 or www.pamelaegan.com.

Vitamin D3 and Probiotics Can Help Fight Acne

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Vitamin D3, Probiotics are Powerful, Natural Acne Remedies

Acne can result from such factors as hormonal disharmony, bacterial overgrowth, improper eating habits, chronic constipation, heredity and excess oil in the body. Although often overlooked, a direct link exists between Vitamin D and the skin.

Who would have ever thought that Acne was related to an imbalance of flora in the gut or a low Vitamin D level?

If you don’t know me by now, I try to find the cause of symptoms and disease rather than prescribing synthetic medications to cover up symptoms, especially complex acne medications like antibiotics, steroids, and accutane.

Accutane has been linked to Chron’s Disease. Not only does this drug dry up the face, it dries up the whole body. Many times once antibiotics are stopped, acne comes back raging. Sometimes, we just need to take a step back and look at natural remedies that worked in the past.

Vitamin D3 Helps Prevent Acne

Let’s review some simple facts regarding Acne:

Why are more and more adolescents suffering from severe acne? Is it something we’re eating, something we’re taking?

Over the years, our children have received more and more antibiotics for minor ailments. I myself am guilty of demanding antibiotics for my four children when they were younger. My youngest son lived on antibiotics prior to receiving ear tubes. Interestingly, he is the one who has suffered the most with acne.

Many adolescents are treated with antibiotics such as Doxycycline or Minocycline for their acne. The trouble with antibiotics is that while they will indeed kill off the bacteria that may be causing infection, they are non-discriminatory and so will attack the friendly flora in the digestive tract that actually work to keep us healthy. My patients act surprised when I tell them that many elements of the immune system are based the gut.

In a healthy gut, the good bifidobacteria that make up about a third of the gut flora naturally produce antimicrobial agents, which kill off or inhibit the more harmful micro-organisms. When this balance is disrupted and the harmful bacteria are allowed to thrive, they can bind to the gut wall where the damage they cause includes intestinal permeability problems. We fail to absorb the good nutrients, vitamins & minerals and allow the wrong toxins through our intestines. This can lead to nutritional deficiencies, allergies, acne, and auto-immune disease.

The over-prescribing of antibiotics is one of the most common causes of this imbalance. However, supplementing the diet with a good quality probiotic will help re-balance the intestinal system and put those good bacteria back in control. Whenever you are prescribed antibiotics you need to take a probiotic with at least nine strains to counter the negative effects on your digestive system. It is important to note that not all probiotics are created equal. I often prescribe a pharmaceutical strength probiotic with Vitamin D3 for my acne patients.Probiotics Supplements

Even if you suffer from a serious skin condition such as acne, you will likely notice a dramatic improvement to your skin if you take a probiotic supplement. This is because acne has been linked in some studies to intestinal health with researchers reporting increased blood levels of toxins absorbed from the gut in acne sufferers. These toxins come from those pathogens or bad bacteria that take over our intestinal tract. It has been shown that in about 50% of cases of acne, the natural balance of the gut bacteria has been disrupted and the bad bacteria are multiplying faster than the good bacteria. This is referred to as dysbiosis- the disturbance of the natural balance, which is an underlying cause of acne. Probiotics really can make a dramatic and positive difference on your skin.

Although a Vitamin D deficiency does not directly result in acne, obtaining sufficient Vitamin D can help resolve acne by making the skin and body healthier as a whole. Because the sun provides the most potent source of the nutrient, make sure you get enough exposure to the sun to improve your chances of having well-nourished skin. Of course, too much exposure to sun can also cause its own problems, so use your discretion. If your Vitamin D3 levels are low, synthetic forms of the nutrient used in supplements can help with the treatment of several common skin conditions, including acne.

Many clinics are now offering LED Light Therapy which also diminishes inflammation within the sebaceous gland to prevent propions-bacterium (P-acne) from reproducing.

Pamela Egan, NP, ABAAHP Diplomat, CDE is a board certified Adult & Family Nurse Practitioner, American Board of Anti-Aging Health Practitioner, Certified Diabetes Educator, Clinical Specialist in Mental Health can be reached at 985-892-3031.