Are Bio-identical Hormones Safe? | The Riordan Clinic

Are Bio-identical Hormones Safe?

by Ron Hunninghake, MD

When I was a young teenager,?it never crossed my mind that I?and my fellow adolescents had?extremely high hormone levels.?Then . . . and now, no doctor,?parent, high school athletic?coach, or girlfriend/boyfriend?would question the safety of my?hormones.

We did not get ?hormone-related?cancer.? At worst, we suffered from?some testosterone-related acne?and hormonal over-impetuosity.?Ah . . . wouldn?t it be great to?have some of that pubescent energy back again! I could eat a lot and still maintain a muscular?physique. Hormones were definitely a ?good thing.? Too bad, as commented on by Mark Twain,?that ?youth is so wasted on the young!?

Now, as many of us enter our elder years we hear about HRT, or Hormone Replacement Therapy.?We hear great stories of restored healthiness and wonder if this approach could give us back?some of that lost vim and vigor of our youth.

Yet, many elders have an uneasy fear of hormonal therapy. The big ?C? word lurks directly behind?what conventional doctors consider the risky promise of hormone replacement. This fear haunts?the menopausal female (fear of breast cancer from?estrogen replacement therapy) and to a lesser degree?the andropausal male (fear of prostate cancer from?testosterone ?low T? therapy).

The medical rationale for hormone replacement is not?unreasonable. Doctors give thyroid when the thyroid?gland fails. Insulin is ?replaced? in Type 1 or advanced?Type 2 diabetes. Addison?s disease occurs when the?adrenal glands stop working, thus giving rise to the need?for cortisol?a life saving hormone for that condition.?Testing for vitamin D has become commonplace. D3?is a hormone-like vitamin, the deficiency of which can?cause many degenerative conditions which can be?prevented with ?vitamin D3 replacement therapy.?

In this brief article I would like to shed light on what?appears to be a blatant incongruity: how can something?that is so life enhancing in our youth be so potentially ?dangerous in our elder years. How can hormone?replacement, which is practiced in many other areas?of medicine, turn sinister when the sex hormones are?replaced in aging women and men?

?THE CHANGE?

What happens to many women when their ovaries?stop producing estrogen and progesterone??Menstruation stops, of course. Hot flashes, night?sweats, sleep disturbance, vaginal atrophy, mood?and memory dysfunction, accelerated heart?disease, osteoporosis, macular degeneration, colon?cancer, arthritis, and more rapid skin, hair loss and?nail deterioration occurs. Granted, these manifestations of menopause do not occur in every?woman, or occur only mildly, resolving over time thanks to their adrenal glands ?taking over? and?producing the menopausal estrogen?estrone. So some women handle ?the change? quite well.?For many others, it can be devastating.

Men too can suffer from a male climacteric, though the changes are often more subtle and?slower to develop. Loss of muscle mass, lower motivation and libido, depressed mood, altered?sleep, nocturnal urinary frequency, belly fat, insulin resistance and cholesterol elevation (with?increasing cardiovascular risk) are possible manifestations of an overall loss of ?quality of life.???I?m just getting old and over-the-hill? is the thought process that often accompanies diminishing?male testosterone levels. (Women can suffer from loss of testosterone as well.)

The use of testosterone for male andropause is a more recent phenomenon. However, the?use of HRT for women had been an established medical standard for decades. Why? HRT?helped to attenuate the well known phenomenon of a?women?s increased risk for heart disease with the onset?of menopause. It is well established that cardiovascular?disease is by far the #1 killer of menopausal women. All?the major HRT observational studies showed a relative?reduction in heart disease in women taking estrogen.?This is the ?heart protective? effect of estrogen at work.

One major exception to this research finding now exists?that drastically changed that ?standard of care.? This one?highly publicized study changed the course of medical?care for menopausal women everywhere. Because of this?study, doctors and their female patients silently hold a?great fear of breast cancer whenever the topic of HRT is?mentioned. How could just one study be so influential?

THE WOMEN?S HEALTH INITIATIVE

The Women?s Health Initiative (WHI) was a large NIH sponsored hormone study of 27,000 women?begun in 1993 that was prematurely terminated when a surprising increase in breast cancer?and heart disease showed up in 2.5% of the enrollees. Suddenly, doctors everywhere began?pulling their female patients off of the Premarin and Prempro hormones that were used as the?replacement hormones in the WHI women.

I would like to make three cogent comments on?WHI that are believed to be responsible for the?change of standards and the mainly negative bias?and fear surrounding the modern use of HRT:

1) The average age at time of enrollment in WHI?was 63. The increased cardiac risk that did?occur was in the 1st year of treatment which?then greatly diminished in subjects remaining?in the study. The younger enrollees (ages 50?59) experienced reduced cardiovascular risk.?(Their relative risk ratio was 0.56 compared?to controls.) This strongly suggests that the older?enrollees already had emerging cardiovascular?disease that could not be attenuated by the ?too?late? estrogen replacement.

2) The Prempro hormone used in the WHI is part?Premarin and part Provera. Premarin is derived from?pregnant horse urine (equine estrogen) and Provera?is a synthetic progestin, a patented alteration of?native progesterone. These two molecules are?clearly NOT ?bio-identical? female sex hormones.?Furthermore, progestin added to estrogen is a?known cause in both animal and human studies of?increased breast cancer.

3) Finally, these NON-bio-identical hormones were given?by the oral route. This invites ?first pass? changes by?the liver with multiple adverse consequences which?added to the negative results in WHI:

a. increased SHBG (sex hormone binding globulin) with resultant decreases in the protective?availability of the hormones at the cellular level

b. increased clotting enzymes with increased risk of stroke and thrombosis risk

c. increased gallbladder disease (similar to what occurs with birth control pills)

d. increased triglyceride levels which is associated with increased numbers of the small/?dense, more atherogenic LDL particles in individuals who consume too much sugar/high?glycemic carbs

IDEAL HORMONE REPLACEMENT THERAPY

While the majority of doctors and researchers came to the conclusion that HRT was unsafe,?many alert medical practitioners realized that the findings of WHI pointed to a need to ?clean?up? the methodology of HRT. The following changes in the way sex hormones are prescribed?and monitored suggests a safer and more effective HRT is available to women (and men) who?understand that nothing in this world is ?risk free,? but that through the use of better standards?of care, these risks can be lowered so that the benefits of HRT can be realized in those individuals?who truly need it.

1) Use hormones that are exact chemical replicas of what is produced by the body.(Bio identical?hormones are NOT ?natural? in the strict sense. They are synthetically converted sterols from?yams and soy that are converted in the lab to biologically identical molecules.)

2) Start replacement therapy as near to menopause (or andropause) as is reasonably possible?before the hormonal deficiency creates adverse degenerative changes in the patient.

3) Use a route of absorption besides oral (apply topically to either skin, vaginal mucosa, buccal?mucosa using troches, or even anal mucosa in men.)

4) Carefully monitor blood levels after initiation of therapy to ensure that the hormonal levels?remain in the same, safe physiologic?range as was existing in the body prior?to ?the change.?

ORTHOMOLECULAR PRINCIPLES

These new standards of a more ideal?hormonal replacement methodology reflect?key orthomolecular principles first elucidated?by Nobel Laureate Dr. Linus Pauling in his 1968?article in Science. Keep in mind that ?ortho? is?a prefix that means ?right? or ?correct.?

a. The right molecule: using molecules?that naturally occur in the body and are?essential to healthy biochemical and?cellular processes. The lack of these?molecules create deficiency diseases.

b. The right dose: using dosages of?these ortho-molecules that actually?correct dys-regulated or diseased?conditions within the body (rather than?simply suppressing symptoms of the?condition) .

c. The right dosing: using dosages of?the ortho-molecules that reflect appropriate physiologic timing, route of entry, and optimal?metabolic processing and elimination pathways.

d. The right professional usage: using ortho-molecules appropriately to correct specific
conditions in unique individuals based upon careful clinical selection, laboratory testing,
and the professional training and experience of the practitioner, with special emphasis on
the balance of safety and effectiveness for each patient seeking this kind of medical care.

Please note that ?orthomolecular? includes synthetically produced molecules such as synthetic?vitamin C. Bio-identical hormones are synthetically made in a way that produces molecules that?precisely match what is normally present in the human body.

It would be impractical, overly expensive, and aesthetically untenable to attempt to obtain?enough human urine to extract ?natural? hormones for use in every human seeking treatment.?It is, however, of historical interest that in the middle ages the Chinese collected the urine of?young people, evaporated it in the sun, and then gave the resulting residue to the elderly with?impressive healing results. This was mankind?s first foray into HRT!

THE RELATIVE RISKS OF BREAST CANCER

Breast cancer in women is on the rise in modern times. This may be a reflection of earlier detection?due to screening or it could be due to epigenetic factors that increase risk. What are these risk?factors?

One way of determining the risk of developing breast cancer is to look at a simple comparison?between an experimental group and a control group, where the experimental group reflects a?behavior (such as alcohol usage), an ?event?, or some other independent factor. Relative risk (RR)is expressed according the following definition:A relative risk of 1 means there is no difference in risk between the two groups.

RR of < 1 ?the event is less likely to occur in the experimental group than in the control group.
RR of > 1 ?the event is more likely to occur in the experimental group than in the control group.
While gender, age, and family history are major risk factors for breast cancer, the following chart shows several additional risk factors that need to be factored into any risk assessment:

Experiment Group ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?Relative Risk
WHI Study users of Prempro ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?1.26
Greater than 13 years of education ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?1.79
Greater than 14 alcoholic drinks per week ? ? ? ? ? ? ? ? ?1.70
Body Mass Index exceeding 30.7 kg/m ? ? ? ? ? ? ? ? ? ? ? 1.60
Left handedness ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 1.42
Nulliparity (never pregnant) ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?1.40
Night shift worker ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?1.36
Composite risk calc. from 39 studies of ERT users ? ? 1.20

To see how these Relative Risks affect your Absolute Risk, use the following chart to multiply anyone of the Relative Risks times the percentage of your Absolute Risk to see how this ?event? or?characteristic affects your current Absolute Risk.

Age Category ? ? ? ? ? ?Absolute Risk ? ? ? ? ? ?Percentage

30-39 ? ? ? ? ? ? ? ? ? ? ? ? 1 in 233 ? ? ? ? ? ? ? ? ? ? ?0.43%

40-49 ? ? ? ? ? ? ? ? ? ? ? ? 1 in 69 ? ? ? ? ? ? ? ? ? ? ? ? 1.4%

50-59 ? ? ? ? ? ? ? ? ? ? ? ? 1 in 38 ? ? ? ? ? ? ? ? ? ? ? ? 2.6%

60-69 ? ? ? ? ? ? ? ? ? ? ? ? 1 in 27 ? ? ? ? ? ? ? ? ? ? ? ? ?3.7%

70+ ? ? ? ? ? ? ? ? ? ? ? ? ? ? 1 in 8 ? ? ? ? ? ? ? ? ? ? ? ? ? ?12%

CONCLUSIONS

There is no absolute way to escape the risk of breast cancer. Absolute safety does not exist. The?use of estrogen in replacement therapy as a Relative Risk factor does have a minor additional?risk associated with it. But if used according to orthomolecular principles, this minor risk may?be attenuated with the attending benefits of a greater quality of life, less heart disease, less?bone disease, better sleep, mood, cognition, and a host of youthful characteristics we cherish as?normally being reserved only for ?the young.?

?

Source: http://www.riordanclinic.org/2013/are-bio-identical-hormones-safe/

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Laura Cococcia: 'The First Sounds Ever Heard on Earth': A Conversation With Soundscape Artist Bernie Krause

Like most pioneers, both literal and figurative, cutting-edge soundscape artist Bernie Krause spent a long time laying the groundwork for what has become widespread success. In the case of this sound engineer, coming to mainstream recognition has involved extensive time spent experimenting with technology and listening to nature. While we might not automatically consider these two activities to be complementary, the resulting work is fascinating. Timely and interdisciplinary, simultaneously bold and intricate, Bernie's work exists at an intersection of technology, design, and nature that he has energetically fashioned himself.

Bernie has long been an innovator in the field of music and sound recording. He began his career in the 1960s as an electronic musician and synthesizer player with the likes of The Doors and Stevie Wonder. In the late '60s and onward, his focus shifted to recording and researching natural soundscapes throughout the world in a technologically advanced and thoughtful way. In 1968, Bernie founded Wild Sanctuary, an organization that exists to archive the sounds of pristine environments globally.

In June, I had the opportunity to hear Bernie speak at TEDGlobal in Edinburgh, and after the conference, we had a wide-ranging conversation regarding our mutual interests in education, technology, and the artistic process. Specifically, we discussed his evolution as an avant-garde artist, as well as the human evolution as both listeners and music makers.

Laura Cococcia: You responded to and began creating music at a very early age. What are some of your first memories of playing music and of the joys of creating sound?

Bernie Krause: Because I don't see very well, my world is primarily informed through what I hear. There was always some limited kind of classical music on the radio in the house when I was growing up in the 1940s in the Midwest. And, most importantly, there were the bird, insect and frog soundscapes coming from the fields outside my bedroom window, the fields that surrounded our house before the Detroit building boom late into the Second World War destroyed them. Those were the signature ambient sounds I heard passively. Then I discovered that I could create my own acoustic environment, beginning with violin early in my life. Composition followed, and later, as a teenager, guitar. It was always fun to elicit a positive listener response from a well-played musical line.

Cococcia: The 1960s were an incredible time to be making avant-garde music, and you were at the forefront of electronic music during its formative years. Was there anything you learned about the artistic process then that was ahead of its time?

Krause: The synthesizer, which my late music partner, Paul Beaver, and I helped introduce to the fields of pop music and film, freed composers and musicians to explore beyond Western academic and popular musical genres. The synthesizer brought us back to the roots of sonic structure. Synthesizers, like the Moog, required programmers and performers to have at least a passing understanding of audio building block fundamentals, especially if we wanted to create, say, a violin, trumpet, clarinet, a percussive or even a helicopter sound. Once we had that knowledge, we learned to organize our material more organically, kind of like things happen in natural world environments. We reinstated structures that had been lost in our effort to be more culturally avant-garde. In fact, we needed to be more derri?re-garde to actually move forward.

Cococcia: Much of your recent work has centered on soundscapes. Can you expand on the soundscape concept and talk about what goes into creating one?

Krause: The soundscape concept, and the word, was brought into the lexicon in the late 1970s by a Canadian composer and naturalist, R. Murray Schafer. When he first proposed it, the word meant all of the sound that reaches our ears -- from whatever source. In my field, soundscape ecology, the definition needed to be a bit more precise, so I, with the help of colleague Stuart Gage, divided Schafer's idea into three basic sources. The first is the geophony, the non-biological sources that spring from naturally wild habitats, such as the effect of wind in the trees, water in a stream, waves at the ocean shore, movement of the Earth. Geophonic sounds are likely the first sounds ever heard on Earth. The second component is the biophony, the collective and organized sounds produced by organisms in a given habitat at a given time of day, night, or season. And the third is made up of all the sounds we humans produce; it's called anthrophony. Some of this is controlled sound, like music, theater, or language. But a far larger percentage of human-produced sound is chaotic or incoherent, referred to by many of us as "noise." The special and quantifiable relationships between all of these sources gives us wonderful tools by which to measure the health of habitats in very efficient and precise ways across the entire spectrum of life.

Cococcia: What is your favorite natural setting to record in, and why?

Krause: That would be a location that is relatively noise-free and as far away from human endeavor as possible. That said, my wife and I live an hour north of San Francisco, in a rural area. Twenty minutes from our house there are habitats where I can record for an hour or more without interruption, and a dozen or more habitats within a 90-minute drive.

Cococcia: Figuratively and literally, what do you think the relationship is between music created by humans and the sounds we hear in nature?

Krause: Originally, when humans lived much more closely connected to the natural world around them, there was an explicit and direct connection between the forest sounds and music. As we became more isolated from the natural sources of our lives, though, our music (along with language and other cultural expressions) reflected that shift by becoming more insular and self-referential. A few remaining groups, however, like the Ba'Aka from the Central African Republic, actually consider the biophonies of the rain forests around them as a natural karaoke orchestra with which they sing and dance. No distinction is made between the music of the forest and that which they perform. The link is direct and profound.

?

Follow Laura Cococcia on Twitter: www.twitter.com/lauracococcia

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Source: http://www.huffingtonpost.com/laura-cococcia/the-first-sounds-ever-hea_b_3548211.html

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I love the Mac Pro. I love its simplicity and its ingenious engineering. And I would like it even more if it were encapsulated in glass, like in these 3D renderings created by our friend Martin Hajek, who painstakingly modeled its guts following Apple's transparent prototype displayed at WWDC 2013.

Of course, there a couple practical issues here. Glass is, in general, an insulator. It would not be good for what's basically a very powerful portable heater. On the other hand, there is glass with special formulations that can conduct heat, so maybe that can be worked out.

The main problem, however, would be a visual one. Your glass Mac Pro would look like crap in a few months. As anyone who has opened a computer knows, electronics attract dust. Sometimes, they get even worse things. I still remember this fly that got stuck into my original Apple 23-inch Cinema Display, made of transparent lucite. It died and stayed inside one of its hollow legs for days, until I was finally able to remove it. Gross.

This was, in fact, one of the problems with the candied iMacs, including the original Bondi iMac, but especially with the fully transparent ones. They would start to gather dust and would end up looking like crap after a year.

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Source: http://gizmodo.com/this-awesome-mac-pro-glass-is-all-i-want-660518723

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