Naturone

Recent Articles on Menopause

Here are a few Articles recently published for you to read for yourself : -

Closing Dates Over Christmas and New Year

To you all
Thank you for your support during 2009.

Here's wishing you a wonderful festive season
and may the
NEW YEAR 2010
bring all your desires to fruition.

The office will be closed from Friday 18th Dec 2009 - Wednesday 6th 2010. (Last orders on 17th please)
Please make sure your customers are aware of this and do stock up for Xmas !
For emergencies please contact Sally on slongden@naturone.com.

From us all at MAILWORK
Sal, Fi, Jeanette and Pip

Eating your way to strong bones?

LEE-ANN VAN DEN BERG, BSC (FOOD SCIENCE), DIP CLIN NUTR, is a food scientist and obtained her Graduate Diploma in Clinical Nutrition in 2007 through the International Academy of Nutrition in Australia. She runs a private practice in Fairland, Johannesburg, and is a member of the South African Association of Nutritional Therapists (SAANT � www.saant.org.za). With a passion for nutrition and living holistically, Lee-Ann is dedicated to assisting clients to live a life of quality and consults across the spectrum of all health ailments. Her mantra is �Eat to live and not live to eat�, and she helps clients to make informed food decisions, listen to their bodies and achieve balance in body, mind and spirit. Contact her on 083-417 8241.

Did you know that women have a higher risk of dying from hip fractures resulting from osteoporosis than from breast cancer?
Osteoporosis is a common condition, affecting 1 in 4 women and 1 in 8 men worldwide, across all ages.¹

Your skeleton is living tissue and is constantly being worn out and rebuilt. Cells called osteoclasts dissolve old bone, leaving tiny spaces into which cells called osteoblasts move and build new bone. When you have osteoporosis, bone cells are being broken down faster than new bone cells are being created and the supporting structures of the bone deteriorate.

Osteoporosis is defined as �a skeletal disorder characterised by compromised bone strength which puts a person at an increased risk of fracture�. It is the fractures that make the disease so deadly. In general women have a 1 in 6 lifetime risk of a hip fracture, whereas the risk of breast cancer is 1 in 9. Of women who suffer a hip fracture, 50% become dependent on others and at least 20% need long-term care.

The major factors contributing to osteoporosis include poor nutrition, lack of exercise and progesterone deficiency.

signs of osteoporosis
�� Curvature of the spine
�� Severe back pain
�� Loss of height.

Prevention of osteoporosis
Osteoporosis may be prevented or delayed by:

A balanced diet, rich in bone-building nutrients � calcium, magnesium, vitamin D, vitamin C, vitamin K, silica, manganese, phosphorus and boron.
Daily weight-bearing exercise or activity.
Not smoking.
Limiting alcohol intake.
Using natural progesterone cream. According to Patrick Holford, natural progesterone cream has proved four times more effective than synthetic oestrogen hormone replacement therapy (HRT) in restoring bone density.²

The importance of diet
Diet is strongly related to increased or decreased risk of osteoporosis and may explain why many cultural groups have no osteoporosis at all. For example, the Bantu tribes of Africa have an average calcium intake of 400 mg a day (well below the recommended intake for postmenopausal women) and virtually no osteoporosis, while the Inuit, who consume vast amounts of calcium, have an exceptionally high incidence² that may in fact be attributable to too much dietary protein.

The roles of calcium and protein in preventing osteoporosis
Research into what causes calcium loss is ongoing. Oestrogen levels are a significant factor in calcium loss and osteoporosis in women, who are at highest risk during and after menopause, when oestrogen levels have decreased.

Various studies have shown that diets high in protein cause calcium to be lost through the urine � but how exactly does this happen? Protein-rich foods are acid forming. The body cannot tolerate substantial changes in acid (pH) levels in the blood and therefore neutralises this effect through two main alkaline agents, sodium and calcium. When the body�s reserves of sodium are used up, calcium is taken from the bones to help restore the blood to its normal pH. So the more protein you eat, the more calcium you require.² In essence, 1 mg of calcium is lost in the urine for every 1 g rise in dietary protein. Red meat proteins generate more acid than poultry and fish, while vegetable proteins generate the least.

However, it is important to bear in mind that a diet totally devoid of protein is not the answer. A large study showed that both elderly men and women who consumed the most animal protein had the lowest rate of bone loss, whereas those who consumed little protein had much higher rates of bone loss.³ Other studies have shown that bone density in older men and women may be improved by increasing protein intake as long as they meet the currently recommended intakes of calcium and vitamin D.⁴ If your diet is insufficient in protein your body will put bone rebuilding low on its list of priorities, which is just as detrimental to bone density as a diet too high in protein. Diets low in protein hamper recovery from fractures and also put the body in a catabolic state, where it cannibalises muscles for protein and produces lower amounts of anabolic, bone-building hormones such as testosterone, oestrogen and growth hormone.

You therefore need a diet rich in both protein and calcium for healthy bones.

It makes sense that maintaining a diet rich in calcium can go a long way in helping to prevent osteoporosis, since the body stores 99% of its calcium in bones and teeth.⁵ Foods rich in calcium include low-fat yoghurt, milk, cheese, sardines with bones, broccoli and green leafy vegetables such as collard, bok choy and spinach. It is important not to rely solely on dairy products for calcium, because many adults are unable to digest lactose.

If you already have osteoporosis you need to make sure you eat foods with all the nutrients that the bones require, which include not only calcium but magnesium, boron, silica, zinc, manganese and copper and are found in products such as tempeh, tofu, dark-green leafy vegetables, broccoli, seaweed, salmon, sardines, beans and almonds.

Ways to increase calcium absorption
There is increasing evidence that protecting your bones depends on absorbing and retaining calcium rather than the amount you consume. Reseacher Roberto Civitello, MD, maintains that eating foods rich in lysine such as poultry, fish, dairy products, legumes and nuts may increase absorption of calcium.⁶Vitamin D is important in helping prevent bone loss because it helps the body absorb calcium and deposit it into the bones. Vitamin D is essential to calcium absorption in the intestines � without it all the calcium in the world would be useless! The recommended daily intake is 400 international units (IU). Good food sources include fortified milk and foods such as liver and organ meats, fatty fish and egg yolks. In addition, sunshine on the skin for as little as 15 minutes a day helps the body maintain sufficient vitamin D levels.¹In contrast, diets high in fat and sugar may reduce bone strength. High dietary fat decreases calcium absorption as fatty acids form calcium soaps, while sucrose may increase urinary calcium losses.⁷�

The role of nutrients
Vegetables and herbs can improve bone metabolism, and juicing is an excellent way to help make fresh vegetables a major part of your diet. Research has also shown a major link between fruit and vegetable intake and increased bone density, but no such effect for dairy products.

As mentioned earlier, minerals in our bones serve as a buffer against all the acid foods we ingest. After a lifetime of buffering, the acid load from eating diets rich in grains�� causes a gradual loss of minerals in the bones, resulting in bone loss.

Two nutrients that may help with the necessary buffering are magnesium and potassium, both abundant in a variety of whole, unrefined foods, including fruits and vegetables. Studies have indicated that potassium helps the kidneys retain calcium and also prevents urinary losses of magnesium, while low potassium intake results in increasing losses of calcium in the urine. Magnesium is required for the activation of alkaline phosphatase, an enzyme involved in forming calcium crystals in the bone, thereby strengthening the bone structure and helping to prevent fractures. As a person ages, the prevention of urinary losses of calcium is key to the prevention of osteoporosis, so a diet rich in potassium and low in sodium is of the utmost importance. Vegetable juicing is not only one of the best ways in which to normalise high blood acidity but also ensures a high intake of vitamin K, which is necessary for the production of osteocalcin, a protein that functions as a foundation for calcium to construct bone and has been associated with reduced urinary calcium excretion. The best food source is dark green leafy vegetables, but as an added insurance you can take a vitamin K supplement providing 150 - 500 mcg a day.

Manganese is another nutrient that helps to build bone. Food sources include whole grains, nuts, seeds and leafy vegetables, but unfortunately modern farming and food processing techniques may strip manganese from the food, and food additives are known to block its absorption. �

Other dietary considerations
Diets high in carbohydrate and fibre can decrease bone density. Dietary fibre has been shown to depress serum androgens, which increase bone density. A number of studies have shown that there is a positive correlation between salt intake and osteoporosis, so keep your salt consumption down.

In terms of beverages, caffeine should be avoided and alcohol restricted. Caffeine may increase urinary and faecal calcium loss and the risk of hip fractures through decreased bone minerals, while alcohol has been reported to cause osteoblastic dysfunction resulting in diminished bone formation and demineralisation.⁹

The importance of EXERCISE
Although this article focuses on the prevention of osteoporosis through diet, the importance of weight-bearing exercise must be mentioned. Astronauts who live for just a few weeks in a gravity-free environment, with little or no push-and-pull on their bones, lose bone mass! The body operates on a �use it or lose it� basis, and if you�re sedentary your body will soon realise that it does not need strong bones or muscles. Weak bones and muscles increase susceptibility to fractures. Weight-bearing exercise is an ideal way to put enough stress on the skeleton to keep bones strong. Besides weight lifting, calisthenics such as deep knee bends, biking, jogging or tennis will do the trick.�

CONCLUSION
A diet rich in calcium, magnesium, potassium, manganese and protein and low in sodium will help prevent osteoporosis. In addition the acquisition of vitamin D from sunlight and regular weight-bearing exercise are important.

References

Preventing osteoporosis using natural methods. www.healingdaily.com
Holford P. New Optimum Nutrition Bible. London: Piatkus, 2004; 223-225, 466-477.�
Hannan MT, et al. Effect of dietary protein on bone loss in elderly men and women: The Framingham Osteoporosis Study. J Bone Miner Res 2000; 15: 2504-2512.
Heaney RP. Protein and calcium: Antagonists or synergists? Am J Clin Nutr 2002; 75: 609-610.
Medtronic. Preventing osteoporosis. www.imaginis.com.com
Fischer R. Some recent research and food suggestions to help prevent or reverse osteoporosis. www.foodandlife.com
Weisser NM, et al. Absorption and Malabsorption of Mineral Nutrients. New York: Alan Raliss, 1984: 15.
Effect of vegetables on bone metabolism. Nature 1999; 401: 343-344.
Diamond T, et al. Ethanol reduces bone formation and may cause osteoporosis. Am J Med 1989; 86(3): 282-288.

Avoid Routine Mammograms if You are Under 50

According to updated guidelines set forth by the U.S. Preventive Services Task Force, women in their 40�s should not get routine mammograms for early detection of breast cancer.

The group's previous recommendation was for routine screenings every year or two for women age 40 and older. They now recommend that before having a mammogram, women ages 40 to 49 should talk to their doctors about the risks and benefits of the test, and then decide if they want to be screened.

While roughly 15 percent of women in their 40�s detect breast cancer through mammography, many other women experience false positives, anxiety, and unnecessary biopsies as a result of the test, according to data.

The Obama administration distanced itself from the new standards, saying government insurance programs would continue to cover routine mammograms for women starting at age 40.

Sources:

CNN November 16, 2009

New York Times November 18, 2009

Dr. Mercola's Comments:

A new recommendation from the U.S. Preventive Services Task Force is stirring up controversy in the conventional medical community, where the long-held advice was for women to get a mammogram every year or two after age 40.

Now the Task Force has revised their recommendation, saying that women in their 40s should not get routine mammograms.

The new advice is a small step in the right direction, but many are up in arms, fearing a decrease in mammograms will put women�s lives at risk from breast cancer, or that insurance companies will stop covering the procedure until a woman reaches age 50.

What is being completely overlooked by the majority of media outlets, however, is the reason WHY the Task Force decided to trim their mammogram recommendation. The prior advice was given in 2002, before a host of new research came out showing the problems of overdiagnosis, including false positives.
Back in 2001, around the time that U.S. health officials widened the use of mammograms to included women over 40 (previously it was only women over 50), a Danish study published in The Lancet revealed some startling data.
The study concluded that previous research showing a benefit was flawed and that widespread mammogram screening is unjustified.
That mammograms are still recommended at all speaks volumes about the state of modern medicine.

Decades ago in 1974, the National Cancer Institute (NCI) was warned by professor Malcolm C. Pike at the University of Southern California School of Medicine that a number of specialists had concluded "giving a women under age 50 a mammogram on a routine basis is close to unethical."

Why is Routine Mammography �Unethical�?

For starters mammograms expose your body to radiation that can be 1,000 times greater than that from a chest x-ray, which poses risks of cancer. Mammography also compresses your breasts tightly, and often painfully, which could lead to a lethal spread of cancerous cells, should they exist.

Dr. Samuel Epstein, one of the top cancer experts, stated:
�The premenopausal breast is highly sensitive to radiation, each 1 rad exposure increasing breast cancer risk by about 1 percent, with a cumulative 10 percent increased risk for each breast over a decade's screening.�

Dr. Epstein, M.D., professor emeritus of Environmental and Occupational Medicine at the University of Illinois School of Public Health, and chairman of the Cancer Prevention Coalition, has been speaking out about the risks of mammography since at least 1992. As for how these misguided mammography guidelines came about, Epstein says:
�They were conscious, chosen, politically expedient acts by a small group of people for the sake of their own power, prestige and financial gain, resulting in suffering and death for millions of women. They fit the classification of "crimes against humanity."�
Not surprisingly, as often happens when anyone dares speak out against those in power, both the American Cancer Society and NCI called Dr. Epstein�s findings �unethical and invalid.�
But this didn�t stop others from speaking out as well.

� In July 1995, The Lancet again wrote about mammograms, saying "The benefit is marginal, the harm caused is substantial, and the costs incurred are enormous ..."

� Dr. Charles B. Simone, a former clinical associate in immunology and pharmacology at the National Cancer Institute, said, "Mammograms increase the risk for developing breast cancer and raise the risk of spreading or metastasizing an existing growth.�
� "The high sensitivity of the breast, especially in young women, to radiation-induced cancer was known by 1970. Nevertheless, the establishment then screened some 300,000 women with Xray dosages so high as to increase breast cancer risk by up to 20 percent in women aged 40 to 50 who were mammogramed annually,� wrote Dr. Epstein.

Mammograms Often Give False Positives

Aside from the radiation risks, mammograms carry a first-time false positive rate of up to 6 percent. False positives can lead to expensive repeat screenings and can sometimes result in unnecessary invasive procedures including biopsies and surgeries.
Just thinking you may have breast cancer, when you really do not, focuses your mind on fear and disease, and is actually enough to trigger an illness in your body. So a false positive on a mammogram, or an unnecessary biopsy, can really be damaging.

Not to mention that women have unnecessarily undergone mastectomies, radiation and chemotherapy after receiving false positives on a mammogram.

What about Breast Self-Exams?

The revised U.S. Preventive Services Task Force recommendations also discourage doctors from teaching breast self-examination (BSE).

BSEs have long been recommended as a simple way for women to keep track of anything unusual in their breasts. However, studies have found that such exams do not reduce breast cancer death rates, and actually increase the rate of unnecessary biopsies.

So the problem with breast self-exams is that it typically forces women into a conventional, and potentially dangerous, diagnostic model, as if you do find something unusual, you will typically be brought in for a mammogram.

A Safer Breast Screening Option

Most physicians continue to recommend mammograms for fear of being sued by a woman who develops breast cancer after he did not advise her to get one. But I encourage you to think for yourself and consider safer, more effective alternatives to mammograms.

The option for breast screening that I most highly recommend is called thermographic breast screening.

Thermographic screening is brilliantly simple. It measures the radiation of infrared heat from your body and translates this information into anatomical images. Your normal blood circulation is under the control of your autonomic nervous system, which governs your body functions.

Thermography uses no mechanical pressure or ionizing radiation, and can detect signs of breast cancer as much as 10 years earlier than either mammography or a physical exam!

Whereas mammography cannot detect a tumor until after it has been growing for years and reaches a certain size, thermography is able to detect the possibility of breast cancer much earlier.

It can even detect the potential for cancer before any tumors have formed because it can image the early stages of angiogenesis -- the formation of a direct supply of blood to cancer cells, which is a necessary step before they can grow into tumors of size.

More men�s lives could also be spared from the disease as mammography is not frequently used on men, which leads to most men with breast cancer being diagnosed at a very late stage
Visit Dr. Mercola's Thermography Diagnostics Center NOW
Top Breast Cancer Prevention Tips
Women have a one in eight chance of developing breast cancer during their lifetime. In fact, breast cancer is the most common cancer among women -- except for skin cancers -- and the second leading cause of cancer death in women, exceeded only by lung cancer.

The American Cancer Society estimates that over 192,000 new cases of the disease will be diagnosed in women in 2009, and over 40,000 will die from it.

While screening tools can help you to detect breast cancer, they obviously do nothing to help prevent the disease, and this latter strategy is the best one for avoiding cancer.
Researchers estimate that about 40 percent of U.S. breast cancer cases, or about 70,000 cases every year, could be prevented by making lifestyle changes.

A healthy diet, physical exercise, optimized vitamin D levels and an effective way to manage your emotional health are the cornerstones of just about any cancer prevention program.
It�s also important to make sure you�re getting sufficient amounts of animal-based omega-3 fats such as krill oil.

Two studies from 2002 offer explanations for how omega-3 fats can protect against breast cancer. BRCA1 (breast cancer gene 1) and BRCA2 (breast cancer gene 2) are two tumor suppressor genes that, when functioning normally, help repair DNA damage (a process that also prevents tumor development).

Earlier research had discovered that women who carry mutated versions of these two genes are at higher risk of developing both breast and ovarian cancer than women who do not have these genetic mutations. Currently, women with BRCA1 mutations account for about 5 percent of all breast cancer cases. Omega-3 and omega-6 fats have been found to influence these two genes.

Omega-3 fats tend to reduce cancer cell growth while highly processed and toxic omega-6 fats have been found to cause cancer growth.

Three additional steps that can lower your breast cancer risk as well include:
� Not drinking alcohol, or limiting your drinks to one a day for women
� Breastfeeding exclusively for up to six months
� Watching out for excessive iron levels. This is actually very common once women stop menstruating. The extra iron actually works as a powerful oxidant, increasing free radicals and raising your risk of cancer.

All you need to do is measure your ferritin level and if it is above 80, donate blood, which will reduce the amount of iron that you have and thereby lower your cancer risk.

Related Links:
Stop! Read This BEFORE You Get that Mammogram�
Why Mammography is NOT an Effective Breast Cancer Screen
Major Confusion on How to Do Breast Checks

Bioidentical Hormone Research Shows Heart Benefits

Kenna Stephenson MD

Interview with KENNA STEPHENSON, M.D.

Dr. Kenna Stephenson presented the first-year results of her CHOIICE (Compounded Bioidentical Hormones: Immune, Inflammatory, and Cardiovascular Biomarker Effects) study to the American Heart Association Scientific Sessions. Dr. Stephenson did her research under the auspices of the University of Texas Health Science Center. She has had a distinguished academic career that includes clinical research and professional publications on women�s health, cardiovascular pharmacology, aging, prevention, and holistic medicine. She is a Fellow in the American Academy of Family Physicians, and is board certified in Family Medicine. She appears as the health expert for the local CBS television affiliate, KYTX, in Eye on Health and is a sought after speaker on the subject of natural hormones in clinical practice. Stephenson is currently an Associate Professor of Family Medicine at The University of Texas Health Science Center in Tyler, Texas.

The following is an interview done by Virginia Hopkins for Women in Balance with Dr. Kenna Stephenson about her research with bioidentical hormones and their effects on heart health, and is republished here with permission of Women in Balance.

WIB: Taking on a study like this involves an enormous commitment of time, energy and fund raising. What inspired you to take on this task?

KS: I started using compounded [bioidentical] hormones in clinical practice about a decade ago and observed an oftentimes dramatic benefit and very few side effects or problems. I wasn�t entirely comfortable prescribing them because of the paucity of clinical studies, especially long term, with specifically compounded hormones. I wanted to make up for that deficit in the U.S. research literature in a prospective, 36-month, long-term study to look at clinical outcomes with the compounded hormones as well as potential for harm.

I was really spurred on after the Women�s Health Initiative [WHI] when all hormones were condemned equally. My thinking in looking at the clinical literature, epidemiological studies and experimental studies is that hormones are not all equal as it relates to their pharmacology and physiology, and that there are distinct differences with the compounded hormones. This needed to be explored further instead of just saying, �Hormones are dangerous, hormones are bad, we can�t use them anymore, we�ve got to look at non-hormone therapies for hormone-related symptoms.�

We started recruiting for the CHOIICE study in 2005. The second arm of the WHI, the Premarin-only study, was halted in 2004. I think the timing was good in that there were women who had been off hormones for awhile because of the fear-based knee jerk response by a lot of physicians and patients, and yet women were suffering and looking for relief.

WIB: What were the criteria for women entering the study? Did you choose women suffering from specific menopausal symptoms?

KS: We did not seek out women that were having menopausal symptoms. We looked at women who were perimenopausal and postmenopausal, between the ages of 30 and 70, and who were free of any severe chronic diseases. They could not be on a statin or other cholesterol-lowering drugs, they could not be on a COX-2 inhibitor, they could not be on any hormones, and had to be cancer-free for five years. Those are the inclusion/exclusion criteria. We documented their symptoms at baseline and on followup. There were a few women that did not have hormone-related symptoms because that was not an inclusion criteria, but part of our hypothesis is that if women have depleted levels of sex steroid hormones, and those levels are vital to multiple systems in the body, then it would benefit them to have those levels restored. Maybe they don�t feel it as it relates to having a hot flash or a night sweat, but does it reflect on say, cardiovascular markers? Does it behoove them perhaps in a preventive way, in a proactive way, to have their hormones evaluated and then restored if they�re deficient?

WIB: How many women total are in the study?

KS: Seventy-five in the interventional group, and then 75 in the control group. The control group are women in the clinics at our facility that are receiving conventional care. They�re ethnic and age-matched controls. Those women are receiving, let�s say, statins, antidepressants, anxiolytics [drugs for anxiety] and conventional hormone therapy from their providers. This is a three-year study. The data that we reported at American Heart Scientific Sessions last month [November 2008] was the 12-month data.

WIB: What were the markers that you chose to measure?

KS: Our high interests were in thrombotic [stroke/blood clot] factors because there is a large body of clinical and experimental evidence demonstrating that conventional hormone therapy does increase thrombotic risk when given orally. Then there have been statements by entities such as the North American Menopause Society that progesterone should be inferred to have the same thrombotic risk as medroxyprogesterone acetate [e.g. Provera], yet there�s not evidence of that�but again there was no lack of evidence either.

We had a high interest in what was happening with hemostatic [blood clotting] factors. We looked at factor VII, factor V, factor VIII, antithrombin III, fibrinogen activator inhibitor and fibrinogen. These factors may be reduced or elevated in patient populations and then lead to risk of stroke or heart attack, pulmonary embolism or venous thrombosis.

Both the PremPro arm and the Premarin arm of the WHI were stopped early because of increased thrombotic risk, so we measured all of these factors and did not see any significant changes that would be pro-thrombotic, and we saw, with several of the factors, a statistically significant beneficial change. That change was most pronounced in the postmenopausal women.

We also looked at other biomarkers for cardiovascular disease: the inflammatory factors such as C-reactive protein [CRP] and we looked at clinical measures of systolic blood pressure, diastolic blood pressure, pulse pressure, fasting blood glucose, fasting insulin, fasting triglycerides.

Then we looked at a mood scale for depression, anxiety, as well as the Greene Climacteric Scale, a numerical index that scores 21 menopausal symptoms. We looked at a depression and anxiety scales scale because of data from the POWER study and the ATTICA study�both demonstrate that when women have a mood state of anxiety or depression, they have an increase in both pro-thrombotic and proinflammatory factors irrespective of whether they�re on psychotropic drugs, they smoke, or their BMI [body mass index, or weight]. A woman�s emotional state will affect these biomarkers, so it was important for us to quantify that.

WIB: How did you decide which hormones to put the women on?

KS: For each patient that met the strict inclusion/exclusion criteria and entered the study, we performed baseline hormone profiles. We looked at estrogen, progesterone, testosterone, DHEAS, and we also looked at their cortisol circadian rhythms. We used saliva testing, which our research team feels is the best measure of bioavailable hormones. Then, if the patients had sub-optimal levels of progesterone they were given progesterone during the first eight weeks. If they had sub-optimal levels of both estrogen and progesterone they were given both of those for the first eight weeks. The first eight weeks did not include any androgens [male hormones].

Then we retested the patients and at that point if they had low androgens we added in androgen therapy. All of our hormones were given transdermally [through the skin, via cream]. There is a myth out there that androgens are harmful to women, but some of that may come from the fact that very high doses of oral synthetic androgens have been shown to have adverse effects. And of course that�s distinctly different than the transdermal low dose compounded androgens that were given to our patients.

WIB: How did you decide the amounts of hormones to give them?

KS: We used the formulary for health care professionals that�s published in my book, Awakening Athena. I used that formulary in clinical practice for nearly a decade. Then the prescriptions were titrated to physiologic reference ranges because women have different responses to hormone therapy. Some women may be rapid metabolizers, some slow metabolizers, so that�s why it was important that we monitor and retest them. One patient may need 20 mg of progesterone to get her to target, and another may need 40 mg or 60 mg. We�ve looked at the patients collectively as it relates to risk and benefit and the type of hormone therapy. But as far as the dosing, women have to be treated individually, and they need individual dosing. It is not good enough to just categorize them based on their uterine status or symptoms. Each patient received her specific hormone dose based on her saliva test profile results. It sounds complex but it�s really not, and it sure saves a lot of time in the long run.

WIB: And the women sure feel better!

KS: We proved that I think. Our hypothesis was that we would not see the elevated thrombotic factors, but we were very surprised to see this global benefit in all domains. We felt that we would see some, but it was quite surprising to us to see the statistically significant beneficial changes across the board.

WIB: Very exciting. Would you give us a general overview of the results?

KS: Cardiovascular disease is the leading cause of death and disability in American women. Our concern is that there are hormonal factors involved, and our research suggests that if we address those hormonal factors primarily, then there�s a downstream effect on the cardiovascular biomarkers showing a benefit. The WISE [Women and Ischemic Events] studies by the NIH Heart, Lung and Blood Institute and others over the last decade suggest that there is a gender-specific pathophysiology as it relates to cardiovascular disease. This clustering effect in peri-menopausal and post-menopausal women of an elevated fasting glucose, elevated triglycerides, elevated CRP and elevated pulse pressure, all contribute strongly to cardiovascular disease risk, along with psychosocial factors of anxiety and depression. We saw benefit in all of these domains both at eight weeks and at 12 months. We saw improvement in their depression and anxiety scores, we saw a decrease in fasting glucose and fasting triglycerides, we saw a decrease in CRP, we saw a decrease in systolic pressure and pulse pressure.

WIB: Do you plan to continue to follow these women when the study is over?

KS: Funding is the issue. It�s been quite a struggle to do this study on a shoestring. We�re competing with Big Pharma studies that are very generously funded, where there�s want of nothing. We�ll probably survey the women, but I don�t know that we�ll be able to afford much more than that.

WIB: Do you have any insights that you can share from your own clinical practice?

KS: I think the most compelling thing that I can share as it relates to women�s health and assessing women in this age group, is that when they are pre-hypertensive and prediabetic, by clinical criteria, it is vital to know their hormone profile. Starting treatment with pharmacotherapy [drugs] to lower blood pressure, triglycerides or blood sugar may create problems with drug interactions or side effects, or not have a global protective effects. By knowing a woman�s hormone profile and her hormone status, and by testing that first, you may see a significant improvement in her blood pressure, her lipids and her glucose.

WIB: So doctors can use a treatment that�s safe and effective, is replacing what�s depleted, and addresses the whole body, rather than treat specific symptoms with a pharmaceutical drug approach. You�re treating an underlying cause rather than a symptom.

KS: Yes. That is what I try to emphasize with the medical students and the residents. Metabolic syndrome is so prevalent and is increasing in this patient population. Hormone factors are the priority.

WIB: How do you treat women whose cortisol is out of balance and indicating tired adrenals?

KS: First I want to know what�s happening with her progesterone. If the progesterone is low, then I prescribe transdermal progesterone along with nutritional and lifestyle counseling. That�s my primary approach.

WIB: Does the nutritional/lifestyle counseling include getting more sleep, eating less sugar, stress management and exercise?

KS: Yes. We counsel women with low adrenal function to pay attention to the glycemic indices of food, to take the time to restore and recharge. Even if she�s working two jobs. Some of my patients are working three jobs. They need to find somewhere, even if it�s just a twenty-minute break, to help de-stress. Maybe she can take 30 minutes on an hour lunch break to do some yoga work or aerobic type exercise. That�s what I counsel the patients initially. And then if the adrenal depletion is more profound or severe, I will oftentimes have them take supplements.

WIB: What types of supplements do you recommend?

KS: I primarily use James Wilson�s protocols and supplements.

WIB: Thanks so much for your time and attention, Dr. Stephenson. This is a beautifully thought-out and executed study, and it will change how doctors approach women�s health.

BREAST CANCER RATES DROP DRAMATICALLY

Women kick the PremPro habit and live to tell the tale.

In November 2006, research was released by cancer centers around the U.S. showing that breast cancer rates have dropped dramatically since 2002. Most doctors and researchers agree that the drop was created when millions of women suddenly stopped using hormone replacement therapy (HRT) after the Women's Health Initiative (WHI) study group announced, in the summer of 2002, that HRT users had an increased risk of breast cancer, stroke and heart disease. Estimates are that as many as 50 percent of women using HRT stopped taking it within six months after the WHI results came out.

How large was the drop in breast cancer? It depends on who's reporting the statistics and how they're interpreting the numbers. Most of the data came from the National Cancer Institute's (NCI) cancer registry.

Here's How Dramatic It Is

o�� There was a 2.5 percent drop in breast cancer cases in 2002, and a 7 percent drop in 2003.

o�� If you just look at estrogen-driven cancers (the most common kind and the kind caused by HRT), in the months between August 2002 and December 2003, there was a 15 percent drop in breast cancer cases.

o�� If you just look at women between the ages of 50 to 69, when women are most likely to be using HRT, there was a 12 percent drop in breast cancer cases in 2003.

o�� A northern California group led by Kaiser and Stanford University combined their own numbers with the NCI numbers and reported a 10 to 11 percent drop in breast cancer cases between 2001 and 2003.

Preliminary numbers for 2004 show the decline is continuing. Suffice it to say that no matter which way you crunch the numbers, breast cancer rates have dropped significantly for the first time since 1945.

Thousands of Lives Saved

According to the American Cancer Society, in America, breast cancer is the most common major cancer in women. This amounts to about 200,000 cases of invasive breast cancer each year. If you do the math (these are very crude estimates, but it gives a sense of the magnitude of this decline), a 7 to 15 percent drop in breast cancer cases represents between 14,000 and 30,000 women a year who won't be getting breast cancer.

When we look at breast cancer mortality (women who die from breast cancer), the numbers get a bit more muddled because women may die from the side effects of radiation and chemotherapy, but that may not be counted as dying from breast cancer. Most estimates are that 40 to 50 percent of women with invasive breast cancer die from it within 20 years. If we crunch the numbers again, at the current rate of decline, in one year between 5600 and 15,000 women's lives will be saved. Wow!

Putting Out the Breast Cancer Fire

Most breast cancers take seven to ten years to develop from a few cells to a lump detectable by mammogram or breast exam. So how did this decline show up so quickly after the WHI results were announced? There is some evidence that adding conventional HRT (e.g. PremPro) to an already existing breast cancer can cause much more rapid growth, and some theories that it may stimulate otherwise "quiet" cancers to grow. In other words, adding PremPro to an already existing cancer may be like throwing gasoline on the fire.

I'd hazard an educated guess that in addition to the millions of women who dumped their PremPro, the decline is also related to the millions of women who have switched to natural hormones since the late 1990s and as a result have actually prevented breast cancer altogether.

Two large and well-done French studies following women for 9 to 20 years who were taking estradiol (a natural estrogen) and an oral progesterone, found no increased risk of breast cancer and in fact even a slight decrease in breast cancer in one.

Marin County Breast Cancer Cause is Found

Back in 2002 my friend and co-author, the late Dr. John Lee, was scheduled to give a talk in Marin County in Northern California near where he lived, an area with very high rates of breast cancer. In the December 2002 issue of the John R. Lee, M.D. Medical Letter he wrote, " It's the estrogen, stupid! That was my first reaction to a newspaper headline I read this morning: �Researchers say pollution not cause of Marin County breast cancer.' No, it's not the power lines, it's not the styrofoam cup factory, and it's not the quarry. It's the estrogen!"

But of course at the time Dr. Lee got "no respect" from most of his colleagues on this insight, so I was tickled to read the following in a New York Times article (12/15/06) by Gina Kolata:

"The heaviest users of hormone therapy were women in affluent places like Marin County, where high breast cancer rates had long troubled women and researchers. Women in those areas also largely abandoned the treatment after the 2002 report and their cancer rates declined accordingly, Dr. Clarke said. Dr. Marcia Stefanick, a professor of medicine at Stanford University and chairwoman of the steering committee for the Women's Health Initiative, said she found the hormone argument persuasive and felt it helped clear up the mystery in Marin County. Everyone kept saying, 'What is it? What's in the environment?' she said. Now, she said, 'it is becoming clear. The best explanation is hormone therapy.'"

Does the connection between conventional HRT and breast cancer apply to natural hormones?

The best way to answer that is to again quote Dr. John Lee, in answer to that very question:

"Not at all. What I recommend is first measuring saliva hormone levels to find if there is a hormonal imbalance. Then, if necessary, correcting the imbalance using natural hormones in physiologic doses, which means ordinary doses that the body would naturally produce itself. (Please read one of our "What You Doctor May Not Tell You..." books for details.)

Another way to look at this is, from puberty until menopause, a healthy woman's body is making its own natural hormones in synchrony and balance, without giving her cancer, heart disease or strokes. What I recommend is attempting to regain this natural balance as closely as possible.

Conventional HRT not only fails to measure hormones and use physiologic doses, it uses synthetic, not-found-in-nature, "hormones that are foreign to the human body and cause a long list of unwanted side effects."

References
Data came from the American Cancer Society, the National Cancer Institute, the Centers for Disease Control, and the Journal of Clinical Oncology (Clarke et al, Vol 24, 33:Nov 20 2006)

French Studies:
de Lingnieres et al, Climacteric 2002
Fournier A et al, Int J Cancer 114:2005

Cancer and brain damage from plastics in food.

New Report:

Bisphenol-A: a cancerous estrogenic toxin, found in the lining of tinned food can and babies bottles

Everybody is exposed to environmental hormones, called xenoestrogens: The January 2008 edition of Toxicology Letters, published a report that showed that a type of plastic called polycarbonate, when heated, releases an environmental xenoestrogen called bisphenol-A. This xenoestrogen causes brain damage and hormone sensitive cancers (especially breast and prostate cancer). This type of plastic is contained in babies� bottles and the inside-coating of every can of tinned food you eat (By the way, tinned food is cooked inside the tin, so there is plenty of heat to release biphenol-A from the inner coating, into the food, as was reported by the Environmental Working Group in the USA in March 2007). As a result of this report, the Canadian government has already banned polycarbonate from baby�s bottles and is investigating banning its use in tinned foods. No such ban exists in South Africa where polycarbonate is still used in babies� bottles, and still coats the inside of every single can of food.

You are also exposed to hormones in the food we eat. Most cows and chickens are given growth and sex hormones to make them grow faster and bigger. These are stored in the fat of the animal for its entire life. You then consume these when you eat meat or drink milk. Pollution from exhaust fumes, as well a pesticides used on fruits and vegetables, and in your home, also all contain a type of estrogenic substance that increases cancer risk in both men and women.This risk of cancer is greatly increased if you have a family history of cancer, are on hormone replacement therapy (even the oral contraceptive), or if you smoke, or if are overweight.

CANSA (The Cancer Association of South Africa) is also concerned about environmental estrogens:

CLICK HERE to listen to an SA fm radio interview with Professor Carl Albrecht, head of research at CANSA. Recorded on 2 July 2008, Monica Fairall interviews Professor Albrecht who explains CANSA�s concerns over environmental toxins that are in our food and water, and how these cause brain damage and increase the risk of cancers in both men and women.

Cancer protective nutrients:

There are known plant extracts that help protect men and women from cancer. These include two cruciferous vegetable extracts (found in broccoli, cauliflower and Brussels sprouts), known as I3C (indole-3-carbinol) and DIM (di-indole-methane).These help block the effects of cancerous estrogens and xenoestrogens in your body. Another nutrient known as curcumin (obtained from turmeric spice) stimulates phase II liver metabolism. This means it flushes these estrogens and xenoestrogen from your body. There are other cancer protective nutrients too, such as quercetin, selenium, resveratrol, EGCG (from green tea), lycopene, co-enzyme Q10 and folic acid.

(6) Environmental Working Group; A Survey of Bisphenol A in U.S. Canned Foods; March 5, 2007; http://www.ewg.org/reports/bisphenola&l ...

Cholesterol Drugs and Breast Cancer

Cholesterol lowering drugs are among the most profitable on the planet. After the community of MDs has been brain washed to think that they can prevent heart disease by lowering cholesterol, most everyone with a high lever of cholesterol is prescribed these drugs. Well proven alternatives, such as nutritional approaches (as vitamin B3, or Dr. Clark's liver flush) are not used.

Research now indicates that the benefit from these drugs to reduce heart attacks is not only minimal, but they may pose a serious threat to the health of the people taking them.

Journalist Shane Ellison reports: "In a study published in the Journal of the American Medical Association (JAMA), Thomas B. Newman MD, MPH and co-workers show that all cholesterol-lowering drugs, both the early drugs known as fibrates (glofibrate, gemfibrozil) and the newer drugs known as statins (Lipitor, Pravachol, Zocor), cause cancer in rodents at the equivalent doses used by man."

He goes on to state: "Evidence from the cholesterol-lowering drug trial [in humans] known as CARE (Cholesterol And Recurrent Events) showed that Pravachol� (a cholesterol-lowering drug made by Bristol-Myer Squib) reduced the chance of suffering from a heart attack by an absolute reduction rate of 1.1%. This miniscule benefit was accompanied by a 1500% [sic!] increase in breast cancer among women taking Pravachol. An increase in cancer rates among Pravachol users was also shown in the drug trial known as PROSPER."

For the full article, go here: http://www.newswithviews.com/Ellis on/shane14.htm

Christmas Close Down

The DISTRIBUTION OFFICE will be closing on Friday 19th Dec and reopening on January 5th 2009.

Please make sure your orders are placed before this date

Remember Xmas and New Year are stressful periods; even though it is "good" stress the body will need help with hormonal balancing because THE STRESS HORMONES drain the PROGESTERONE LEVELS.

We all wish you a very happy festive season and may 2009 be your best year yet!

HOW CORTISOL LEVELS AFFECT THYROID FUNCTION AND AGING

Interview with David Zava, Ph.D.

Originally published in the John R. Lee, M.D. Medical Letter

David Zava, Ph.D. is a biochemist, breast cancer researcher, a much-published author of professional research papers, and the laboratory director of ZRT Laboratory in Portland, OR, which does state-of-the-art saliva hormone assay and blood spot testing. He is also the co-author of What Your Doctor May Not Tell You About Breast Cancer, and a sought-after speaker on the topic of hormones and saliva hormone testing.

JLML: Cortisol is needed for nearly all dynamic processes in the body, from blood pressure regulation and kidney function, to glucose levels and fat building, muscle building, protein synthesis and immune function. You�ve been specifically studying the effects of cortisol on thyroid function.

DTZ: Yes, one of cortisol�s more important functions is to act in concert or synergy with thyroid hormone at the receptor-gene level. Cortisol makes thyroid work more efficiently. A physiologic amount of cortisol�not too high and not too low�is very important for normal thyroid function, which is why a lot of people who have an imbalance in adrenal cortisol levels usually have thyroid-like symptoms but normal thyroid hormone levels.

JLML: Would you explain this thyroid-cortisol relationship in more detail?

DTZ: One way to understand the synergy of cortisol and thyroid is to think of trying to turn on a big round valve with one hand, as opposed to two hands where you can really grip it and turn it on. Both thyroid and cortisol have to be there in the cells, bound to their respective receptors at normal levels, to efficiently turn the valve on and get gene expression. So, when cortisol levels are low, caused by adrenal exhaustion, thyroid is less efficient at doing its job of increasing energy and metabolic activity.

Every cell in the body has receptors for both cortisol and thyroid and nearly every cellular process requires optimal functioning of thyroid.

JLML: And what happens when cortisol levels get too high?

DTZ: Too much cortisol, again caused by the adrenal glands� response to excessive stressors, causes the tissues to no longer respond to the thyroid hormone signal. It creates a condition of thyroid resistance, meaning that thyroid hormone levels can be normal, but tissues fail to respond as efficiently to the thyroid signal. This resistance to the thyroid hormone signal caused by high cortisol is not just restricted to thyroid hormone but applies to all other hormones such as insulin, progesterone, estrogens, testosterone, and even cortisol itself. When cortisol gets too high, you start getting resistance from the hormone receptors, and it requires more hormones to create the same effect. That�s why chronic stress, which elevates cortisol levels, makes you feel so rotten�none of the hormones are allowed to work at optimal levels.

Insulin resistance is a classic example. It takes more insulin to drive glucose into the cells when cortisol is high. High cortisol and high insulin, resulting in insulin resistance, are going to cause you to gain weight around the waist because your body will store fat there rather than burn it.

JLML: This would certainly be a significant effect when it comes to creating balanced hormone levels.

DTZ: When cortisol is high the brain also is less sensitive to estrogens. That�s why you can have a postmenopausal woman with reasonable amounts of estrogen, but when you put her under a stressor and her cortisol rises, she�ll get hot flashes, which are a symptom of estrogen deficiency. She really doesn�t have an estrogen deficiency, the brain sensors have just been altered. If you then drive the estrogen levels up with supplementation to treat the hot flashes, she�ll start getting symptoms of estrogen dominance like weight gain in the hips, water retention, and moodiness. And the hot flashes usually don�t go away.

This is why you often can�t effectively treat someone with hormonal imbalance symptoms such as hot flashes by simply adding what seems to be the missing hormone, be it thyroid, progesterone, estrogen or testosterone. If your cortisol is chronically high you�ll have overall resistance to your hormones.

JLML: What percentage of the saliva tests for cortisol are high?

DTZ: I�d say it�s as high as ten to twenty percent, but you have to remember that the population that�s sending in saliva hormone tests tends to have health problems. It also depends on the time of year and what�s happening in the world. I saw a lot of high cortisol in the saliva samples that came in after 9/11. Around the winter holidays, cortisol skyrockets, and then after the holidays it takes a nosedive. The adrenals were keeping pace with the holiday stressors and then they collapse because they�re exhausted. That�s a very common pattern. It�s no different with other stressors like exams or war. Most of us can remember how we made it through the stress of exams only to get sick shortly thereafter. Adequate levels of cortisol are necessary to acutely activate the immune system when we are exposed to viruses and when the adrenals are just too tired to make any more cortisol we are vulnerable to viral infections.

Stress is what both high and low cortisol have in common. Stress hits the adrenals and in response they either collapse in fatigue and do not produce enough stress hormones, resulting in a functional thyroid deficiency, or they can go in the other direction where they�re pouring out cortisol and it�s causing overall hormone resistance, including thyroid resistance. Either way, low or high cortisol, and thyroid hormones become inefficient.

JLML: Let�s talk about the good and bad aspects of cortisol.

DTZ: Most people with cortisol problems, high or low, are in the gray zone, meaning that they are outside of a normal physiological range necessary for optimal health. Cortisol helps maintain blood glucose levels by activating gluconeogenesis, the breakdown of tissue protein to amino acids and then to glucose. That�s a good thing, but not in excess. Too much cortisol, caused by stressors, over a prolonged period of time, results in excessive breakdown of all structural tissues of the body including muscle, bone, skin and brain, causing accelerated aging.

In bones, high cortisol activates nearly every biochemical pathway involved in bone resorption. Cortisol specifically inhibits osteoblast activity, or bone building; it suppresses the production of androgens [male hormones] in the gonads [androgens build bone]; it activates osteoclasts which causes bone to be resorbed faster; it decreases mineral absorption in the gut, so you won�t be absorbing the calcium and magnesium you need to build bone; and it increases renal [kidney] tubule spilling of calcium. Calcium supplementation and alendronate-type drugs used to inhibit bone resorption, such as Fosamax, will always fight a losing battle to high cortisol. I frequently see women reporting continued bone loss, despite use of pharmaceutical bone resorption inhibitors, when salivary cortisol levels are very high.

With saliva testing we see that when people have very high cortisol and low androgens they tend to have bone loss even when their progesterone and estrogen are normal. I see the most bone loss in women who have had a total hysterectomy.

JLML: What is the relationship between cortisol and melatonin, yet another hormone?

DTZ: Cortisol is released from the adrenal glands in a rhythmic pattern throughout the day. It�s high in the morning, which energizes you. If you don�t have enough cortisol in the morning you have a hard time getting out of bed. It�s at its lowest levels at two a.m. when melatonin is high. Melatonin and cortisol are inversely related, so when cortisol is down and melatonin is up you�re regenerating your body.

When your cortisol stays high you also won�t produce enough growth hormone or thyroid-stimulating hormone, which are important anabolic [tissue building] hormones. This is why a good sleep is so important. People with high salivary night cortisol levels are usually complaining of sleep problems.

JLML: What are normal saliva cortisol levels for a perimenopausal woman?

DTZ: At ZRT Laboratory a normal morning saliva hormone level for cortisol for a perimenopausal woman is 3 to 8 ng/mL, and by 10 at night it�s 0.5 to 1.5 ng/mL, which is a big drop. Very early in the morning when you�re in a deep sleep it goes even lower, so if you�re not sleeping properly and resting, your cortisol rhythms will be thrown out of balance. This is where progesterone plays an important role because it�s the only natural hormone that actually competes with cortisol for the glucocorticoid receptors. It can counter the stimulating effects of cortisol at night when you need to be sleeping.

JLML: You�re offering this new technology of blood spot testing which is available to the lay consumer�what is it and what can you test with it?

DTZ: It involves a nearly painless finger prick to get a very small amount of blood that is dried on filter paper and mailed back to us with a completed questionnaire. Right now we can test IGF-1, an index of growth hormone activity, a thyroid panel including TSH, free T3, free T4, and thyroid peroxidase (TPO), FSH and LH. In the next month or so we will launch a male panel, which includes PSA, testosterone, and SHBG.