September 2001 Newsletter
Dear Friends and Patients:
We at the Center hope you had a great Summer. We appreciate your referrals and patronage. As an introduction to this issue on Anti-aging therapies and HRT (hormonal replacement therapies), I’d like to share a true story.
Sarah (not her real name) was a bubbly lady in her early 50′s who came to see me last year complaining of loss of memory. She had seen a number of other physicians for her problems and was told that her memory loss and fatigue were “just part of getting older” and she would just have to “learn to live with it.” She was taking all sorts of vitamins and supplements that didn’t really help that much, including Gingko Biloba. After careful questioning, she was also suffering from chronic constipation, severe fatigue, abdominal bloating, vaginal dryness and osteoporosis. She had previously undergone a hysterectomy and was placed on Premarin (a synthetic estrogen) and had also seen her gynecologist who tried different natural hormones which did not help her symptoms. Sarah was also taking Synthroid for hypothyroidism.
After initial consultation and evaluation were completed, Sarah was taken off Synthroid and was placed on a natural thyroid hormone along with a thyroid nutritional supplement. Her synthetic estrogen was replaced as well with natural, bio-identical estrogens (Estradiol and Estriol). Natural progesterone and testosterone were also added. Her supplements were checked for compatibility by Contact Reflex Analysis and those that were unnecessary or were not being absorbed were eliminated. Special whole food supplements were added.
Within four months her brain fog completely resolved, but her fatigue, although improved, was still present. A hair analysis was taken and showed elevated hair mercury and a subsequent urine test confirmed this and showed lead as well. Sarah decided to have her mercury amalgams removed from her teeth and later took an oral chelating agent to remove the lead and mercury from her body. Her supplements were also adjusted to support the detoxification process. Within a few months she was back to “normal” and today she not only is full of energy and looks wonderful, but feels wonderful as well.
Your Hormones and Aging
Sarah’s story is an example that one can’t have a satisfactory life if one doesn’t have satisfactory hormones. As we go from youth and health to aging and disease, hormonal changes are the single most important transforming factor. If you would like to stay healthy far into old age, full of energy and vitality, retaining youthful levels of your major hormones is like keeping the foundation of your house intact. Hormones are the fuel of youth. They fight infection, heal injury, cause you to grow, permit a good night’s sleep, balance the level of minerals in your body, adjust the burning of fuel for energy, help you deal with stress, and, of course, underlie your sex drive.
Fortunately, due to modern science and with the help of your compounding pharmacist, most hormones can be replaced with natural, bioidentical (i.e., identical to what your body produces as opposed to a synthetic drug) hormones in most cases. Some of the major hormones include estrogen, progesterone, insulin, adrenaline, DHEA, thyroid hormone, melatonin, HGH (human growth hormone), pituitary hormones, and hypothalamic hormones.
From the 1940′s to the 1960′s, menopause was seen as an estrogen deficiency condition, and all women were treated with estrogens. In the 1970′s and 1980′s, although menopause was still considered an estrogen deficiency state, progestins (synthetic progesterone compounds) were introduced to control the problems that were occurring from estrogen treatment alone. We now know that the story is more complex and that there can be deficiencies in progesterone, the different estrogens, DHEA or testosterone. Menopause is currently being promoted almost like a disease state, rather than just another step in the path of life when a women stops menstruating. So there is a lot of confusion about what, if anything, that needs to be done to reduce risk factors and improve quality of life. The most common way of evaluating a women’s hormonal status is through measuring hormone levels in the blood or saliva.
Statistics show us only about 20% of menopausal women are on HRT. The biggest reason that more women are not using hormones is the fear of developing breast cancer. There is confusion both in the lay and medical press from “hormones” being treated as a single entity. The body produces three different types of estrogen — estradiol, estrone, and estriol. Synthetic hormones such as Premarin or Provera are very different than the hormones the body makes. Natural, bio-identical hormones are just that – identical on a molecular basis to what a woman’s body produces. Another reason many women are not on HRT is because they have experienced side effects from improperly adjusted hormonal therapies. At the Center, Dr. Erickson uses both lab tests and Contact Reflex Analysis to customize each women’s HRT based on her body’s needs. These custom formulations can be in the form of capsules, liquid drops, trouches (lozenges that go under the tongue) or creams, and are made by a special, compounding pharmacist. Let’s look at some of the facts.
Estrogens are the dominant hormone produced by the ovaries. Like testosterone in the male, estrogens are anabolic (muscle building) steroids, only much weaker. Many of the physical characteristics of femininity are, of course, made possible by this hormone. Men also produce a small amount of estrogen, and as they get older, an enzyme called aromatase converts a certain portion of testosterone into estrogen. If this conversion is in excess, health problems and sexual performance problems can arise. At the Center we evaluate not only a man’s testosterone levels, but also his estrogen levels.
In women, estrogen protects the cardiovascular system. This is why women, prior to menopause, have a much lower incidence of heart disease and heart attacks than men. A large scale study called the PEPI study, showed menopausal women who were placed on estrogen lowered their risk of heart disease by 50%. If estrogen and natural progesterone were used together, the risk dropped to 75%. But if a synthetic progesterone (Provera) was used, the heart risk actually increased. This is significant information because almost half of all women die of cardiovascular disease after the age of 55. In another study done in the Kaiser Permanente health system almost 500 women were followed for 17 years, half of whom were on estrogen replacement. It was discovered that the death rate from all causes was lower by 44% in the women on estrogen.
It has been clearly demonstrated that estrogen replacement therapy reduces the incidence of osteoporosis by approximately 50%. Estrogen probably does not build up bone (progesterone and testosterone do), but it slows the rate at which bone is lost. Bone loss begins in a women’s mid-thirties and the rate of bone loss can increase ten-fold after menopause. Many women have lost a third of their total bone mass by age 60. One fifth of osteoporosis patients are men, and their problems generally show at a latter age. So taking calcium by itself will not do the job. Proper hormone levels are critical.
Estrogen is critical for proper brain function in both men and women. As a women’s estrogen levels decline, so does brain function – memory and mental sharpness lie under a fog, just as in Sarah’s case. In men, this is less of a problem because of the aromatase enzyme being so abundant in a man’s brain tissue, converting testosterone into estrogen. Researchers at the University of Southern California wanted to know if administering estrogen to postmenopausal women would prevent Alzheimer’s disease. They found women on estrogen were less than half as likely to develop Alzheimer’s. This has been confirmed in other studies as well.
Estrogen and Breast Cancer Risk
This is an area of controversy in medicine There is an increased risk of breast cancer with prolonged, excessive estrogen stimulation to the breast tissue, especially with synthetic estrogens and also xenoestrogens (estrogen-like compounds that pollute our environment from pesticides, plastics, etc.). These compounds and their metabolic
by-products can occupy estrogen receptor sites in the breast tissue and other areas of the body.
My personal belief is there is a big difference physiologically using natural, bioidentical estrogens such as Estradiol or Estriol which are identical to what a women’s body produces, and introducing a synthetic estrogen such as Premarin that is made from horse urine and is foreign to the human body. For one thing, the metabolic by-products will be completely different. An interesting viewpoint and one that I happen to agree with is one held by a nationally known research scientist by the name of Dr. David Zava. Dr. Zava worked at NIH (the National Institute of Health) for 12 years studying thousands of breast cancer biopsy specimens. What he found was in all cases of breast cancer, estrogen occupied the estrogen receptor sites in the breast tissue, but there was also no or very little progesterone occupying the progesterone sites in the breast tissue in these same patient’s. Dr. Zava stated he never saw breast cancer in a women with normal amounts of progesterone in the breast tissue. His viewpoint is that because progesterone regulates how much estrogen goes into tissues, it is the lack of progesterone that increases the risk of breast cancer in women by allowing elevated, unopposed levels of estrogen, including xenoestrogens, into the breasts. Unfortunately, some doctors have been taught that Progesterone replacement is needed only if a women has an intact uterus, and so a significant number of women who have had hysterectomies are placed on estrogen alone. In my opinion, this is dangerous. I am often asked about soy products reducing cancer risk. Soy products have isoflavones (very weak estrogenic substances) that work to reduce cancer risk by allowing estrogen receptor sites to be occupied by a very weak estrogen, preventing the site to be occupied by a stronger cancer-causing xenoestrogen. The incidence of breast cancer in Japan is very low, where high soy intake is prevalent. Interestingly, when Japanese women immigrate to the U.S. and eat a typical American diet, their breast cancer risk and incidence goes up.
If one looks at the facts, 1.5% of women over the age of 55 die of breast cancer, while 50% die from cardiovascular events such as heart attack or stroke. One in two women will have a fracture due to osteoporosis by age seventy. So the decision to take estrogen is a risk-benefit issue that each women needs to make for herself. To get more information on this subject I would suggest picking up a copy of Natural Hormone Replacement by Jonathan V. Wright, M.D. In the upcoming issues of the newsletter I will deal with some of the other hormones that we evaluate and treat patient’s for at the Center.
Vitamin B12 – Does It Work?
Would you like to boost your energy naturally? No, it’s not downing a steaming cup of coffee to start the day. It’s a B12 shot, a neglected but extremely valuable therapy that increases energy, improves mood, and sharpens memory. In patient’s with a prolonged B12 deficiency, pernicious anemia and permanent neurological damage can result if not corrected. B12 is also critical to reduce levels of homocystine that contribute to hardening of the arteries and heart disease. Early symptoms of B12 deficiency include fatigue, memory loss, confusion, depression, and nerve problems such as numbness, tingling, unsteady gait and burning. In the elderly, B12 deficiency can mimic Alzheimer’s disease with impaired mental function. B12 deficiency is a lot more common than we think. As we get older, we lose both stomach acid and a substance called intrinsic factor that is in our stomachs that allows us to absorb B12, so taking oral B12 may not work. B12 is commonly found in organ meats and eggs. However, food levels of B12 have changed significantly. Eggs, for instance, have 800% less Vitamin B12 than they did 4 decades ago. At the same time our needs for B12 have increased due to the changing of our environment with more pollution in the air, water, and foods. I have never seen a mercury toxic patient at the Center that was not also B12 deficient. Going to your dentist and getting a little nitrous oxide gas for a dental procedure will wipe out most of your B12 in one visit. B12 is a critical vitamin in the detoxification pathways of the body and without it, waste products and toxins cannot be effectively removed.
B12 levels are commonly measured by a blood test, but this may not reflect low levels in the tissue or the body’s ability to convert cyanocobalamin into active B12 (about 25% of B12 deficient patients have a conversion problem). We use a special, preservative-free compounded B12 called Methylcobalamine, rather than the common cyanocobalamin that is commercially available. We find that because it does not require conversion
by the body into a more active form, it works better.
Sauna Program Update
In a previous mailing I discussed the Center’s Medical Infra Red Sauna Detoxification program. Our first two patient’s have successfully completed the Center’s sauna detoxification program and the results have been dramatic. The first was a patient who had undergone multiple surgeries and was feeling very fatigued, agitated, and mentally cloudy. She was a professional person and her work was demanding. She was concerned about all the anesthesia and prescription drugs she had been exposed to in the past. After undergoing 4 weeks of intensive sauna therapy she is now full of energy and the mental fog is gone for the first time in years. The second patient was a complicated case involving 57 year old man who had seen numerous physicians. Terry had fatigue to the point he could not work and would lie on the couch much of the day. He was having daily heart palpitations that were unexplained by his cardiologist, even after undergoing a cardiac catheterization and full work up. He was also depressed. Terry had documented mercury toxicity but was so sick he could not tolerate the medicine to remove the mercury from his body. He also had Wilson’s Syndrome with low thyroid system function, further compromising his ability to excrete toxins, but taking T3 therapy didn’t seem to help. He had also previously been exposed to numerous chemical toxins, including pesticides such as DDT where as a young boy he would ride his bicycle behind mosquito spray trucks. I felt that Terry’s body had bioaccumulated so many toxins, that unless these were removed no amount of supplements or medication would help him. After 4 weeks of intense sauna therapy he is back to work full-time and his energy is back to normal 75% of the time. He will continue to improve as his nutritional therapies can now work effectively.
The sauna we use at the Center is much different that the typical health club lava rock sauna. It is an infra-red low heat sauna that has a penetrating heat that warms up the person rather than the air, so it is much better tolerated for longer periods. Infra red heat penetrates the tissue 1-2 inches to mobilize toxins that are trapped in the fatty tissues. This same type of technology is used in Europe (hyperthermia therapy) to activate a person’s immune system to treat cancer. The sauna detoxification program is an intense, medically supervised 4 – 6 week program using vitamins, minerals and salts, special oils, and exercise to release and remove toxins that have accumulated in the body tissues over a life-time. It is a life-changing experience for many people.