"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Sunday, September 16, 2012

We have far to go in educating people about biodientical hormones:

(and yes, I get that I am somewhat on a rant today...funny how these issues come up in batches!)

Many of you know, either from remarks I have made on this board, or from reading my Needle Notes blog, that I am a knitter. I never have less than three projects on my needles at any one time (right now it's a scarf, another scarf, a man's sweater, and I am using my very limited crochet skills on a baby blanket for a friend's grandchild) and I have used knitting not only as a way to pass time and be involved in a hobby, it is often very good meditative therapy for me. I have knit to manage pain (if I am absorbed in my knitting I can relax a little more and my back pain seems not so overwhelming), to manage stress, and I have met some great people through knitting groups.

I'm a member of an online knitting group called Ravelry, it's a social media site for knitters, crocheters, and fiber artists of all kinds. Some people refer to it as Facebook for Knitters, but it's not set up like Facebook, there are all sort of groups you can join (or not join) and it's a great source for education, patterns, connecting with others of similar interests, etc. There are groups for nearly any interest you can think of, political, demographic, fiber interests, religion, non religion, and so on.

I'm not going to name the board that this was on, but I was alerted to the post and asked to respond. This is what the post said (there has been an ongoing discussion of the problems with menopause, hot flashes, getting older, etc. and I have detailed my experiences with bioidenticals numerous times--in fact, my Ravelry name is Holyhormones....not surprising, I am sure):

My husband is an endocrinologist. He says that bio identical hormones have exactly the same effects, pro and con, as any other sort. In other words, your body responds to estrogen in the same way whatever its source. There are lots of bio identical adherents, but there are no good evidence based studies that support it. HRT is HRT and the risks are as great. I wouldn’t take the risk (but then, full disclosure, I didn’t have hot flashes), but it certainly wouldn’t hurt to get a second opinion from an endocrinologist, or from a GYN who specializes in menopausal problems (as opposed to someone who mostly does OB)
Recent true story: Last month I saw my very sweet, female dermatologist to get a renewal on all my prescriptions, and a skin check. One of my Rx has to be compounded by the pharmacy, which Walgreens will do. She mentioned that if I had trouble getting it she could refer me to a compounding pharmacy and I replied that I had used one near my home. She suddenly looked very alarmed and asked why I was going to a compounding pharmacy, and was relieved that the answer was to get an antibiotic for my cat, who needed a human drug in a chicken broth suspension. Her response was that she was relieved, and had been concerned that I was using bioidentical HRT which could have been the cause of my thinning hair. Yet another reason to be wary!

Those of us who have researched and experienced bioidentical hormone optimization know that this statement is simply not true. Premarin and Prempro are not hormones, they are drugs, and as such, have significant risks and side affects associated with their use. These are the drugs that were used in the infamous 2002 WHI study that is often cited by healthcare professionals who argue that ALL hormones are dangerous. Why Premarin and Prempro are still being used is beyond me, but that's a discussion for another day. I found it also interesting that the endocrinologist only addressed the issue of estrogen, when in fact hormone balance is not just estrogen, but also progesterone and testosterone. If your doctor is just slapping an estrogen patch on you to get you out of his office (the estrogen/estradiol in the patches is bioidentical), think about getting another doctor who is an expert in hormonal balance.

Bioidentical hormone optimization is simply replacing what was in our bodies that we lose as we age, and we are replacing it with hormones that (while synthesized in a lab) are molecularly identical to what is in our bodies. Huge difference! In very simplistic terms, we (especially women, but men also) develop a myriad of health issues as our hormone levels decline....mood swings, hot flashes, depression, sleep disruption, loss of libido, (and I am one of those people who thinks sexual health is vitally important) thinning bones, elevated cholesterol, increase of abdominal fat, heart problems and I could go on. Doesn't it make more sense to simply replace what was lost in our bodies than to prescribe a myriad of expensive, toxic drugs to simply mask symptoms or manage the illnesses brought on/exacerbated by hormonal imbalances? As my doctor is fond of saying when he hears me raving about another person I know who has been put on antidepressants for hot flashes "She doesn't have a Prozac deficiency, she has a hormone deficiency!" I could also do a lengthy post about how many side effects there are in the drugs used for many illnesses/conditions that could be helped by hormone optimization, and I likely will at some point, but that too is for another day.

I know what I'm talking about because I have been on both sides of the drug/hormone issue. When I moved to North Carolina (and before I met Dr. Carr and my pain managment physician Dr. Hines) I was on so many drugs I filled up a large Ziploc bag. Two kinds of blood pressure meds, antidepressants, Concerta for ADD, Provigil to wake me up, anti anxiety meds, anti-inflamatory meds and on and on.......and at 320 pounds, it was pure luck I hadn't developed diabetes or a heart condition (yet). I also had osteopenia, the precursor for osteoporosis, even more dangerous for me because I was prone to falling (and looking back, I think some of it was from being unbalanced on all those medications). How I managed to get out of bed and function on all the meds I was on is absolutely beyond me (and my doctor). I was in a fog most of the time, had zero energy, and oh, yes, my pharmacy bill between me and my insurance company was over $700 per month.

Once I got on the hormone optimization protocol, I was able to eliminate 6 medications within 6 months. Now all I take by prescription (besides my bioidentical hormone creams) is thyroid hormone (my previous physician kept telling me my thyroid was normal, but now I know there is a big difference between normal and optimal), and medication for my back. Everything else is supplements, I take about 8 different supplements daily, including Vitamin D3 (5000 ius). My energy level is far better than it ever was, my osteopenia is completely resolved, my lab values come back right on the money, my cognitive functioning is way improved, and my quality of life is far better than life before BHRT. Oh, and an interesting point, I used to have very cystic breasts, which is thought to be a risk factor for breast cancer. My breasts were so lumpy that getting a breast exam with any new practitioner took forever because they were concerned they had found a problem. Within three months of starting the progesterone, my breasts had almost completely smoothed out, the difference in doing self exams now is remarkable.

Another interesting point regarding the thinning hair: my hair since being on the bioidentical hormones (especially the progesterone, that's the one I started with and the others were introduced gradually) is (without modesty) GORGEOUS! I wear my hair short, but it is thick, healthy, shiny and hold my style beautifully. Even Dr. Carr has commented that most women my age would kill to have the bounce in my hair that I do, which of course makes my stylist very, very happy. My nails have never been stronger or healthier (and I am tough on my hands)----I rarely break a nail, and they do not split or bend the way they used to.

I plan to respond to the comment posted in a thoughtful, reasonable post (as soon as I stop grinding my teeth). I know that I am doing what is healthy for me, and I am blessed to have a doctor who cares enough about his patients to think for himself and want the best for his patients (and in case you are wondering, Dr. Carr takes bioidentical hormones himself and has for years).