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Chuck Fulmer, R.Ph., FIACP 672 Lanier Park Dr.
Gainesville, GA 30501
770-536-CARE (2273)
Fax: 770-536-2635
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The Bioidentical Hormone Debate
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Kent
Holtorf, MD, is a leading authority in the field of hormone replacement
therapy, and is also a board examiner for the American Board of
Anti-Aging Medicine. Dr. Holtorf talked to Sunday Magazine about HRT on
February 15, 2009. Click here to listen to the interview.
In
January 2009, Dr. Holtorf also published an article entitled "The
Bioidentical Hormone Debate: Are Bioidentical Hormones (Estradiol,
Estriol, and Progesterone) Safer or More Efficacious than Commonly Used
Synthetic Versions in Hormone Replacement Therapy?" We have provided an
overview, but you can click here to read the entire article.
The
use of bioidentical hormones for hormone replacement therapy (HRT) "has
sparked intense debate. Of special concern is their relative safety
compared with traditional synthetic and animal-derived versions." Dr.
Holtorf's recent review concluded: "Physiological data and clinical
outcomes demonstrate that bioidentical hormones are associated with
lower risks, including the risk of breast cancer and cardiovascular
disease, and are more efficacious than their synthetic and
animal-derived counterparts."1
Bioidentical hormones such as
progesterone, estradiol, and testosterone have a chemical structure
identical to human hormones but are made from precursors found in soy
and yams. Nonbioidentical hormones are not structurally identical to
human hormones and may either be chemically synthesized, such as the
synthetic progestin medroxyprogesterone acetate (MPA), or derived from
a nonhuman source, such as conjugated equine estrogen (CEE) which comes
from horse urine.
Synthetic progestins are mainly prescribed
for women who are receiving estrogen replacement therapy to prevent a
buildup of the tissue lining the uterus (endometrial hyperplasia) that
can lead to uterine cancer. Synthetic progestins and the human hormone
progesterone have essentially the same effect on endometrial tissue.
However, in other body systems, "natural progesterone has properties
that are very distinct from the synthetic progestins. Within the
nervous system, the neuroprotective and promyelinating effects of
progesterone are promising, not only for preventing but also for
reversing age-dependent changes and dysfunctions... The actions of
progesterone in peripheral target tissues including breast, blood
vessels, and bones are less well understood, but there is evidence for
the beneficial effects of progesterone."2
The Women's Health
Initiative (WHI) was a large government sponsored study that
demonstrated that the synthetic progestin MPA significantly increased
the risk for breast cancer. In contrast, progesterone has shown
protective benefits with regard to breast cancer.3
Conventional
HRT has been shown to result in an increase in heart attack and stroke
in large prospective clinical trials. In sharp contrast, experimental
data reveals favorable effects of estradiol and progesterone on
vascular biology and physiology. Kenna Stephenson, M.D. et al., of the
University of Texas Health Center at Tyler, conducted a prospective,
case-controlled study to determine the effects of low dose daily
transdermal progesterone and estradiol therapy on mood, quality of
life, and cardiovascular disease. Dr. Stephenson found that therapy
using these bioidentical hormones decreased hormone-related symptoms,
systolic blood pressure fasting blood glucose, and triglycerides
without a negative effect on clotting factors.4
Topical
progesterone cream does not increase clotting factors in postmenopausal
women. Progesterone maintains and enhances the protective effects of
estrogen, thus decreasing the risk for heart attack and stroke.
However, the synthetic progestin medroxyprogesterone acetate and other
synthetic progestins generally negate the positive effects that
estrogen has on cholesterol and lipids.5
A primary reason for
the confusion encountered when reviewing studies of efficacy, safety,
and side effects of various forms of HRT is that most studies have
grouped all forms of estrogen under the title "estrogen replacement
therapy", and the various progestins as well as progesterone under the
name "progesterone", and often have failed to distinguish the specific
type of hormone that was used in the study.
We
welcome your questions! Our compounding professionals work closely with
patients and their physicians to customize hormone replacement therapy
by prescription, to meet each woman's unique needs.
We
utilize hormones that are pure chemicals obtained from many of the same
suppliers used by pharmaceutical manufacturers. Patient monitoring
using saliva or blood spot testing to optimize therapy and avoid
excessive levels is encouraged.
1,3,5 Postgraduate Medicine. 2009 Jan;121(1):1-13.
2 Endocr Rev. 2007 Jun;28(4):387-439.
4 Circulation 2007;115;e214-e301 (this abstract is on page e277)
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As compounding pharmacists, we are
problem solvers. If you have friends with problems (hormones, chronic
pain, foot, nail, gynecologic, etc.) that are not being solved with
conventional therapy, forward this email to them for FREE confidential
consultations on their problems. If we can help, they will each
receive $15.00 off their first prescription and you will receive a
$15.00 credit on your next refill.
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Partners in Care, Inc.
Compounding Pharmacy
672 Lanier Park Dr.
Gainesville, GA 30501
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Bring us your medication problem, and if we can help, you will receive a
$15 CREDIT on your first new compounded prescription.
Print this email
and present at Partners in Care, and add the name of the friend who
referred you to receive this credit.
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Offer Expires: 06/30/09 Friend's Name _________________________________________________
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We offer private consultations in Pain Management and Bio-Identical Hormone Replacement Therapy. Please call to schedule an appointment.
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Order your prescription refills online 24 hours per day at http://picrx.com/refillrequest.htm! |
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