Is Hormone Replacement Safe?

Did you know that unless your doc puts in time to do their own research they are running off of information that’s 10 to 20 years behind on average?

Some docs like Dr. Johnathan Wright, ND say the “standard of care” aka “science” is 200 years behind. 

Either way it’s nuts!

Continuing education on bio-identical hormone replacement therapy is widely available and all doctors are required to do continuing education.

Plus there are plenty of books out there by MDs talking all about the latest research in the field of hormone replacement.

So why are so many doctors going off of outdated information?

Biases?  

Maybe. 

Sadly, in the medical field – once a concept is drilled in, it’s hard to change it, even if research proves otherwise. 

Every week I have a client that tells me their doctor won’t prescribe bio-identical hormones because of the cancer risk. 

Or I’ll have a doc try to take a patient of mine off their bio-identical hormones for outdated hormone versions they are familiar with because they are “safer”.

May doctors who prescribe bio-identical hormones promote them to their clients as a natural option. 

While bio-identical hormones are biologically identical to the hormones you have in your body, they are also synthetic.

Confusion is rampant. 

Sadly, the patient aka consumer suffers!

So are hormones safe or not?

I cannot say they are 100% without risk because humans have vices and exposures that can disrupt their hormones.

From chemicals you can’t control in your environment to those that you can limit your daily exposures to makeup, hygiene products, cleansers, food and water all have the potential to disrupt your hormones.

Pair all those exposures with hormones and it’s possible that you could ignite an estrogen positive tumor fire.

Have I had a patient on bio-identical hormones develop cancer?

Yes, once in my 18 years of practice.

Just before she was diagnosed, the DUTCH test (dried urine hormone metabolism test) came out and I had her do the test.

Turns out she was struggling to detox hormones through the liver and the cells. 

Unfortunately, she came to me on a dose of estrogen replacement therapy that was double the standard dosage and she was still having hot flashes, despite her dosage being increased. 

I adjusted her dosage down, used herbs to help with cortisol and hormone detox over the course of 6 months. 

Then she found a lump in her breast. 

She was drinking to self soothe PTSD from her military experience.

She wasn’t much for cooking, relied on snack foods for meals and ate out often. 

I don’t think the circumstances that led to her cancer were 100 percent the hormones.

Her breast tumor was estrogen positive, it was caught early but some lymph nodes also tested positive. 

She did not test positive for any tumor genetics such as BRCA or HER2/Neu. 

She had a lumpectomy and the positive nodes were removed. 

I know she had chemo and radiation but after a year she moved with her husband as he was in the military and I never heard from her again.

Her case is always in the back of my mind as I recommend and prescribe bio-identical hormones.

I believe bio-identical hormones have great benefits when they are used with caution.

For every patient of mine that desires hormones I will do a full blood panel that includes blood hormones as well as a urine hormone metabolism test with saliva hormones so I can look at one’s hormone data from every angle. 

If there’s family history of first degree relative with breast cancer I will recommend genetic testing for cancer.

I evaluate diet and lifestyle factors to educate the patient on their individual risk factors. 

Before taking bio-identical hormones you want to know…

• how your body detoxes hormones via the liver and cells
• if you have any genetic risk
• how your diet and lifestyle may impact your hormone use
• your plan to monitor effectiveness with labs and your own charting over time

It’s not uncommon for me to test hormones every few months the first year to ensure we’re on the right track for dosage. 

After that I recommend at least once a  year testing. 

If your hormones are topical, saliva hormone testing is crucial to monitor dosing.

In my opinion blood and saliva labs combined can be useful for monitoring. 

I don’t use urine hormone metabolism for monitoring like it is recommended.

The urine metabolism testing is useful for understanding hormone metabolism in the liver and cells and for monitoring if a patient isn’t seeming to respond to hormones. 

My goal with any patient is to use the least amount of hormone necessary to get results.

How long can you use hormones?

For life.

This is another mis-conception.

If you want to use them beyond countering peri-menopause, menopause or andropause symptoms you can.

Hormones have more benefit than just making the hormone transition easier.

The anti-aging effects are plentiful.

Estradiol has over 400 functions in your body from brain, heart, bone, vascular, skin, muscle, libido and gut health.

Estriol maintains your vaginal tissue lubrication and health, plus it helps with sexual performance.

Testosterone is useful to help maintain strength, muscle and energy levels.

Progesterone helps with sleep, calming anxiety, preserving hair growth and keeping rashes in check.

DHEA is the precursor to testosterone and estrogen as well as androgens, it’s quite helpful with energy boosting and libido.

Pregnenolone is the mother hormone to all of the hormones, including DHEA and has the potential to increase vitality in someone who’s been fatigued and worn down for a long time.

I encourage all my patients to talk with me about hormone replacement therapy and discuss all the pros and cons to make an educated decision.

The good news is once you start hormone replacement therapy you can stop at any time by lowering your dosage slowly. 

You can also micro-dose the hormones once you find you are past your symptoms. 

I’ve recently started to recommend women who are not symptomatic when they stop their hormones to take 1-2 days a week. 

What’s the best form of bio-identical hormones?

At this point I have to say it varies.

Some women do well with topical applications while others prefer patches, drops or oral films.

For men it’s a toss up between injection, oral film, drops and topical creams.

I don’t administer the BioTe pellet hormones but I’ve found them to be preferred once a dosage has been identified as once they are in, you are subject to that dosage for 3 months.

The only oral form of hormones I tend to recommend are the BiEst – combination of estriol and estradiol film and progesterone capsules.

Is compounded bio-identical therapy better than pharmaceutical?

I’ve found that the pharmaceutical patches for estradiol are quite effective. 

I prefer compounded extended release bio-identical progesterone capsules or compounded creams versus the pharmaceutical options. 

Ultimately, you may have to try a few things before you find what works best for you. 

Meeting up with a doc who will walk you through all the options so that you can determine what will work best for you and your lifestyle is key. 

Keep in mind that you do have a choice and it’s incredibly important to discuss all your options versus go with the first thing your doctor recommends.

Knowledge is power when it comes to anything health and in the case of hormones it especially applies. 

If your doc doesn’t seem to know how the different applications work and function it’s key to find someone who does and can help you find what suits you best.

Once you find a protocol to test out then it’s key to set up a testing schedule to ensure that all is going well once you start the protocol. 

At least every 90 days for the first year then twice a year thereafter is ideal. 

Keep notes as to how you are feeling once you start the hormones so that you can make a solid decision on progression and use of them over time.

I’ve seen the life changing benefits for many men and women who’ve tried bio-identical hormones.

While they are not for everyone, hormone replacement therapy has the potential to make an incredible impact on health and vitality. 

Here’s to happy healthy hormones,

Dr. J

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