Medical Dictionary

Case History
Heavy metal toxicity: A man in his 60’s had a severe rash. It was very itchy and was like small sores or ulcers especially on his arms and legs. (more)...
An engineer in his 40’s had brain fog so severe he had trouble forming sentences. (more)...
A 40 year old professional with tingling, burning, and numbness in her limbs (more)...
45 year old woman with relentless severely itchy hives had been evaluated and treated for allergies with no relief. (more)...
A 48 year old woman had had sleeping difficulties since the birth of her child at age 38 (more)...
Administration
Bioidentical Hormones

    Background:  Many women have now heard about bio-identical hormones from the interviews and books of Suzanne Somers (“Ageless” and “The Sexy Years”).  These are two excellent books about the use of “natural” estrogen and progesterone for menopause.  She also has chapters on the use of “natural” testosterone for men in andropause.  Suzanne Somers gives the additional perspective of a woman who has chosen to use these hormones in spite of her history of breast cancer.  Another excellent book on this topic is by Jonathan Wright, M.D. (“Natural Hormone Replacement”).  Dr. Wright is the one who in 1982 researched the issue of alternatives to Premarin by looking into the estrogens, their kinds and amounts, that healthy menstruating women produced.  He found that normal women produce three kinds of active estrogen hormone:  estradiol, estrone, and estriol.  He then had his compounding pharmacist put these three estrogens into a blend which later came to be called triple-estrogen, or “tri-est”.  For more details this history can be found on page 41 of his book.  Dr. John Lee in the late 1970’s had begun to research and prescribe bio-identical progesterone as well, so the use of these hormones now goes back 25 years or more.  Unfortunately none of this is taught to medical doctors in their training.

 

    Important points:  There are several important things that should be considered once you have decided that bio-identical hormone replacement is right for you.

 

  • You will need to have a practitioner to measure the levels of all the hormones that you are using.  The three kinds of estrogen, progesterone, testosterone, DHEA, and in some cases pregnenelone.  There are three ways to test:  blood samples, urine and saliva.  There are pitfalls to the use of all those measurements but an experienced practitioner will be aware of these.  This is important both to minimize cancer risk (high levels of estrogen are associated with cancer), and to be sure that your body is absorbing the hormones so they can be used for osteoporosis prevention, brain health, etc.

 

  • Estrogen is also broken down into waste products and these should also be measured.  This has come to be known as “estrogen ratios”.  The levels of the mild estrogen breakdown product (“2-hydroxyestrone” and the potent/strong estrogen breakdown product (“16-hydroxyestrone”) are measured and compared.  You should be producing at least twice as much mild as strong estrogen waste product, as the waste products can contribute to cancer risk as well.  This is explained further in the book “HRT:  The Answers”, by Pamela Wartian Smith, M.D., M.P.H. in the chapter called “Estrogen Metabolism”.

 

  • If levels of estrone are found to be too high (estrone is a very potent form of estrogen and is felt to be related to an increased risk of breast and perhaps uterine cancer), Lugol’s iodine can be used to lower it.  The use of Lugol’s iodine is described in the book “Iodine” by David Brownstein, M.D.

 

  • If levels of the strong estrogen waste product (“16-hydroxyestrone”) are found the levels can be decreased with the use of Indole-3-carbinol (I-3-C) or Diindolemethane (DIM) which are extracts of cruciferous vegetables.