3

votes

Bio-Identical Hormone Replacement Therapy Discussion

Commented on June 08, 2015
Created March 14, 2011 at 4:20 PM

I had never heard of BHRT until doing some research to find a paleo supportive physician. From my understanding, conventional medicine has a problem with the accuracy/necessity of various tests that are performed in order to prescribe a dose that is tailored to the individual and then the conflict of interest marketing that sometimes may accompany some practices.

Mark's Daily Apple has several pro BHRT posts, but I have not been able to find any other paleo-type bloggers discussing either pro or con.

http://paleohacks.com/questions/11050/hormone-replacement-therapy#axzz1GaOTsCop This question discusses HRT in general, but I am curious as to specific experiences with BHRT.

Have you/will you/do you use BHRT and why? (menopause, pre-menopause, aging etc)

E32abdc9a483de43def522faf81ed4e9

(0)

on March 25, 2014
at 02:37 PM

I am very interested in this because I began BHRT a year and a half ago. We're still tinkering with it--not sure what to do because I *definitely* felt better when I began the testosterone cream. I had to take a midday nap all the time, I was just so tired. I've been wondering if/when with Paleo I should perhaps try going without the cream? I've also heard of a product that's homeopathic which may help the body regulate its hormones (I laughed at the name and don't know what is in it yet--but it's called "Feminessence."

Just wondering if you have any advice on transitioning?

662a4ea915eb7c758bdd797d77ead7b6

(656)

on August 11, 2012
at 04:23 PM

Wow Heather, you sound like me. I am wondering about bhrt myself, but with all the breast cancer, mom, moms dad, and my own dad, I winder if I am doomed to have no sex drive, painful intercourse, and no energy......how do you stave it off naturally?

7e36094a0f7a2fbad24290225405220b

(2064)

on August 03, 2012
at 03:43 PM

Oestrogen is the UK spelling of estrogen.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:47 PM

Yeah.. probably was a good thing! sound like you had a good doctor!

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:45 PM

What is Oestrogen? Not sure about other countries but in the US there is most definitely synthetic estrogen and Bio-identical estrogen. I am on the latter in a cream.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:44 PM

how will someone's hormones be at an optimal level without HRT? Highly highly unlikely for someone past age 25 or so. Like Quilt says above... diet alone is not enough

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:42 PM

I have found all of Suzanne's books very helpful. Her latest, Bombshell is good. I also like this book by Jonathan Wright MD, Stay Young and Sexy with Bio_ID Hormone Replacement. Just ignore that they all have sex or sexy or something like that in the title!

C8b2136ef95ba6aac211825ff38cc0e9

(971)

on August 02, 2012
at 04:30 PM

I am all for increasing endogenous production whenever possible and staving off menopause through good health, but "menopause" is not just a term for getting older- there are effects that are very obvious if you are in it and feeling politically supportive of them doesn't make them more enjoyable. A decreased sex-drive, painful intercourse and vaginal dryness will never be on the table for me as a viable option. I love sex. I don't think lubricant is paleo either.

3e88219ad76dbcdb3d96d2a0788b83a0

(155)

on January 20, 2012
at 09:58 PM

Unfortunately, the women commenting on this thread are NOT post-menopausal. I wasn't a fan of HRT either until I started having rage attacks that I believe were a hormonal issue. Since I have been on bio-identical hormone replacement (no horse-pee, by the way), I am feeling like my "old self". I waited too long to start, so my body could not be coaxed into making my own estrogen again. Life is much better in that regard. Now, if I could only lose my belly fat!

9dd74d3941535d0aaa2c8d3cf454fb7e

on March 16, 2011
at 12:13 AM

Thanks Amanda. One way to keep bones mineralized is to run (sprint) occasionally - the impact of running signals the bones to uptake calcium. How frequently? I am not sure. Certainly its more complicated than just estrogen - the forward thinkers in the female arena think progesterone is as or more important.

03db20f160e58814827ae5a05a5c8792

(520)

on March 15, 2011
at 12:53 PM

PS: Everybody will age but not everybody has to become sick and crippled. Watch this: http://growingbolder.com/articles/sports/track-field/growing-bolder-grandma-us-decathlon-646381.html http://www.youtube.com/watch?v=Qvgj02fanO4&feature=related http://www.youtube.com/watch?v=0OR-6y-8-nM

03db20f160e58814827ae5a05a5c8792

(520)

on March 15, 2011
at 12:32 PM

Aging is not a CAUSE for hormone imbalance or diabetes or obesity or whatever. These are the diseases of western civilisation. Aging is not a desease like being female is not a disease. Period. If it were the whole paleo lifestyle gig would be a terrible waste of time. As Dr. Janet Lang says: Having symptoms of hormonal imbalances is NOT normal -at any age. It can be corrected. I totally agree.

Cfccbcf3450ac4919311ded8ef162d49

(2312)

on March 15, 2011
at 06:33 AM

Where are you located Dr K?

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 15, 2011
at 02:27 AM

+1 this! Encouraging endogenous production FTW. I'm assuming you aren't including all post-menopausal women in the not enough estrogen camp, right? Whatever the evolutionary reason(s) for menopause (Grandmother hypothesis or something else), I cringe when moving into post-reproductive time is characterized as simply an estrogen deficiency that needs to be fixed with HT or else every single lady goes straight from hot flashes to breaking hips left and right. It's so much more complicated...

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 11:10 PM

Also, there is totally a strong correlation between ED and obesity/metabolic syndrome that scientists are looking into that I assume Dr. K is referencing. http://www.ncbi.nlm.nih.gov/pubmed/19754871, http://www.ncbi.nlm.nih.gov/pubmed/18641413, http://www.ncbi.nlm.nih.gov/pubmed/19172551, etc etc etc

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 10:14 PM

PS--Again, I know next to nothing about this stuff and have had to watch many loved ones suffer over the years from breast cancer and strokes that are quite possibly attributed to HRT so I get a bit cranky about the issue, perhaps unnecessarily.

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 10:12 PM

Melissa--I guess I just don't get what benefits HRT brings to women who don't fit really specific categories like early menopause or something that outweighs increased risk of stroke, breast cancer, blood clots, and heart attack. Possible reductions in dementia and osteoporosis, sure, but I would think healthy lifestyle would do the same. I can see using it short-term for a particularly difficult menopause, but the Women's Health Initiative data leads me to believe that longterm usage is inadvisable in most cases.

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 09:50 PM

What? Dr. K can you translate to English? Or cite actual science?

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 09:49 PM

I'll do the research on which is better when the time comes.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 14, 2011
at 09:35 PM

Viagra is a symptom of bigger issues.....CVD atherosclerosis and andropause. And after sometime all humans get it no matter how good their diet is. It would behoove you younger paleo's to start reading a bit about it. The science meshes well with paleo living. I am proof of that and I have thousands of patients who also think so.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 14, 2011
at 09:33 PM

There is a huge difference between synthetic HRT and BHRT therapies.......huge.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 14, 2011
at 09:32 PM

I do this daily for my patients with bone issues. AS the paleo community ages they will definitely get a lot more into it. A good primer book is Ageless by Suzanne Sommers from 2006. Perimenopause and andropause can not be stopped just by diet alone. I know because I see hundreds of patients with it. From 22 yrs old to 84 over the last ten yrs.

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 06:58 PM

just because it's normal aging doesn't men we have to like it. Men have been treating "normal aging" too with viagra and whatnot.

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 06:57 PM

conventional HRT

D67e7b481854b02110d5a5b21d6789b1

(4111)

on March 14, 2011
at 06:10 PM

Andrea, Thanks for posting all of these links, can't wait to start reading.

D67e7b481854b02110d5a5b21d6789b1

(4111)

on March 14, 2011
at 06:09 PM

Melissa, do you know if they use bio-identical type replacements with tailored dosing or the conventional HRT?

100fd85230060e754fc13394eee6d6f1

(18706)

on March 14, 2011
at 05:39 PM

But what if the cause is ageing? Then not taking hormones would be a bit like not taking insulin if your pancreas stopped working.

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9 Answers

3
9dd74d3941535d0aaa2c8d3cf454fb7e

on March 15, 2011
at 01:40 AM

The most important thing to know about hormone supplementation is that it very frequently results in a reduction in the body's endogenous production. This can lead to issues particularly when hormones are normally secreted in a pulsatile pattern; applying a hormone transdermally, or in some cases enterically, will result in the hormone presenting to the body in a long slow wave - instead of a pulsatile pattern. Some key hormones that are pulsatile in nature include growth hormone and testosterone.

The best example of this is topical testosterone application - it always results in suppression of the hypothalmic-pituitary-testicular axis. This is because the hypothalmus senses the increased testosterone and then stops signaling the pituitary to make LH and FSH, messengers which tell the testis (adrenals in females) to produce more testosterone. Eventually the testis atrophy.

"Bioidentical" refers to the type of hormone used. For example, bioidentical testosterone matches what is in the body already, while testosterone enthanate, a synthetic form, does not.

After studying this for quite some time I'm convinced that a far more beneficial route is to encourage the body's own system to increase it's own endogenous secretion. The only exceptions should be when the body no longer produces the hormone - but that conclusion should only be reached after trying methods of stimulation first. A paleo diet high in saturated fat and cholesterol provides many of the building blocks for many types of hormone synthesis, as just one approach. Obviously, if your body won't make enough estrogen, that can be a significant issue as it can lead to bone demineralization.

9dd74d3941535d0aaa2c8d3cf454fb7e

on March 16, 2011
at 12:13 AM

Thanks Amanda. One way to keep bones mineralized is to run (sprint) occasionally - the impact of running signals the bones to uptake calcium. How frequently? I am not sure. Certainly its more complicated than just estrogen - the forward thinkers in the female arena think progesterone is as or more important.

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 15, 2011
at 02:27 AM

+1 this! Encouraging endogenous production FTW. I'm assuming you aren't including all post-menopausal women in the not enough estrogen camp, right? Whatever the evolutionary reason(s) for menopause (Grandmother hypothesis or something else), I cringe when moving into post-reproductive time is characterized as simply an estrogen deficiency that needs to be fixed with HT or else every single lady goes straight from hot flashes to breaking hips left and right. It's so much more complicated...

E32abdc9a483de43def522faf81ed4e9

(0)

on March 25, 2014
at 02:37 PM

I am very interested in this because I began BHRT a year and a half ago. We're still tinkering with it--not sure what to do because I *definitely* felt better when I began the testosterone cream. I had to take a midday nap all the time, I was just so tired. I've been wondering if/when with Paleo I should perhaps try going without the cream? I've also heard of a product that's homeopathic which may help the body regulate its hormones (I laughed at the name and don't know what is in it yet--but it's called "Feminessence."

Just wondering if you have any advice on transitioning?

2
Medium avatar

on March 14, 2011
at 05:18 PM

I've only ever heard bad things about HRT, specifically with regard to cancer rates increasing. I think it's wise to get a comprehensive endocrinological panel to see if the levels of everything are appropriate and then use that information for dietary decisions first. If micronutrient deficiencies are the cause of the imbalance, it's clearly preferable to address that problem before using exogenous hormones that will downregulate endogenous production and make the individual reliant upon the dosing forever. Organ meats are the most concentrated sources of micronutrients and might make a big difference.

1
9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 05:53 PM

I was very against HRT, because I have seen the negative effects of hormonal contraceptives. But most of the negative effects relate to child bearing. Once you are older and aren't worried about that, HRT has costs and benefits. Luckily about half the older women in my family has done it, while the other half hasn't...so it's like a mini-study of people genetically similar to me. The HRT group is more in-shape and active in general, so I'll probably do HRT. There is no cancer in my family.

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 09:49 PM

I'll do the research on which is better when the time comes.

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 06:57 PM

conventional HRT

D67e7b481854b02110d5a5b21d6789b1

(4111)

on March 14, 2011
at 06:09 PM

Melissa, do you know if they use bio-identical type replacements with tailored dosing or the conventional HRT?

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 14, 2011
at 09:33 PM

There is a huge difference between synthetic HRT and BHRT therapies.......huge.

0
99ac392257e444e014be6d4da6a900e4

(1036)

on August 02, 2012
at 09:21 PM

Do some research on the Wiley Protocol and go in for a consultation. I did just this past Tuesday. The doc I met with believes in healing yourself first with proper nutrition, then supplement if necessary. Everyone would benefit from having their hormones at optimal levels whether that be with HRT or without.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:44 PM

how will someone's hormones be at an optimal level without HRT? Highly highly unlikely for someone past age 25 or so. Like Quilt says above... diet alone is not enough

0
7e36094a0f7a2fbad24290225405220b

(2064)

on August 02, 2012
at 04:00 PM

As far as I know the difference between bio-identical HRT and conventional HRT is in the progesterone supplementation. Natural progesterone cannot be patented so there's no money to be made so the pharmacy companies change it ever so slightly and call it progestagen in the UK and progestins in the US. These changes are what can cause the hormones to be a problem.

When a woman reaches menopause oestrogen production declines but progesterone production stops altogether. The idea of bio-identical HRT is to supplement with natural hormones only if necessary and only in the small doses that nature would supply.

I use natural progesterone (I am 64) daily and oestrogen occasionally transdermally. (Oestrogen is a natural hormone anyway)

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:45 PM

What is Oestrogen? Not sure about other countries but in the US there is most definitely synthetic estrogen and Bio-identical estrogen. I am on the latter in a cream.

7e36094a0f7a2fbad24290225405220b

(2064)

on August 03, 2012
at 03:43 PM

Oestrogen is the UK spelling of estrogen.

0
1edb06ded9ccf098a4517ca4a7a34ebc

on August 02, 2012
at 03:47 PM

I am aware that it is mostly older individuals who do this, but let me relay my experience and perspective.

If you're considering HRT, I'd first makes sure if there aren't any diet/lifestyle factors that you could improve upon. Once those are ruled out, then I'd consider. when I was 14years old I recieved low-dose, oil soluble Testerone injections (into my quadricep) and higher dosages of Human Growth hormone. The reason I got these was because I had an eating disorder during a key growth phase in life, and my doctor belieived that this would help me catch up with the other kids. I stopped after a year because I ended up with elevated liver enzymes (which may or may not have been because of the testosterone). Once I stopped abusing my body, I ended up going through puberty and having a large growth spurt, but it took entire year of maintaining a normal bodyweight to do so. I continue to get get biannual hormone panels and maintain very healthy hormone levels. So, I managed to get on track in the absence of HRT, and probably largely through simply maintaing a healthy diet and lifestyle. Something to consider before embarking upon such therapy.

In restrospect, the more I learn, the more glad I am that I only stayed on these two for a short period of time.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on August 02, 2012
at 09:47 PM

Yeah.. probably was a good thing! sound like you had a good doctor!

0
95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 06:10 PM

I have to admit I have never really understood the distinction between BHRT and conventional HRT outside of the more consistent practitioner monitoring, which is something that should be happening with a trusted endo anyway. Most of the compounds are derived from the same sources (soy, horse pee, etc) for both treatment protocols, so it seems disingenuous when BHRT is presented as safe and natural in opposition to HRT. (If my severe lack of knowledge is leading me to faulty conclusions, feel free to steer me towards some info on the subject.)

Personally any form of HRT scares the crap out of me and I would have to be provided rock solid proof of the benefits outweighing the side effects before even considering taking anything. The history of treating normal aging in women as pathological is really gross to me and is the rationale for a lot of totally unnecessary hormone replacement. The history of America's (thankfully waning) obsession with "treating" menopause is really fascinating/infuriating (I strongly recommend Chapter Five in John Abramson's Overdosed America, available for free here) and just compounds my already heavy resistance (which is colored by my negative experiences with hormonal birth control and, more importantly, with the fact that several women in my family have developed breast cancer after HRT) to considering it as a treatment option. That being said, I am certainly not opposed to all forms of hormone replacement when medically necessary (no way to treat the underlying imbalance, extreme circumstances preventing someone from doing so, quality of life being negatively affected) and closely monitored. For instance, I've seen amazing transformations in people with thyroid problems and, on the home front, in my boyfriend who takes corticosteroids for irreversible adrenal insufficiency resulting from radiation therapy on a pituitary tumor.

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 11:10 PM

Also, there is totally a strong correlation between ED and obesity/metabolic syndrome that scientists are looking into that I assume Dr. K is referencing. http://www.ncbi.nlm.nih.gov/pubmed/19754871, http://www.ncbi.nlm.nih.gov/pubmed/18641413, http://www.ncbi.nlm.nih.gov/pubmed/19172551, etc etc etc

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 06:58 PM

just because it's normal aging doesn't men we have to like it. Men have been treating "normal aging" too with viagra and whatnot.

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 10:14 PM

PS--Again, I know next to nothing about this stuff and have had to watch many loved ones suffer over the years from breast cancer and strokes that are quite possibly attributed to HRT so I get a bit cranky about the issue, perhaps unnecessarily.

9d43f6873107e17ca4d1a5055aa7a2ad

on March 14, 2011
at 09:50 PM

What? Dr. K can you translate to English? Or cite actual science?

95601768ec9cb75cc3a9cbcd2271ed14

(2206)

on March 14, 2011
at 10:12 PM

Melissa--I guess I just don't get what benefits HRT brings to women who don't fit really specific categories like early menopause or something that outweighs increased risk of stroke, breast cancer, blood clots, and heart attack. Possible reductions in dementia and osteoporosis, sure, but I would think healthy lifestyle would do the same. I can see using it short-term for a particularly difficult menopause, but the Women's Health Initiative data leads me to believe that longterm usage is inadvisable in most cases.

Ed71ab1c75c6a9bd217a599db0a3e117

(25472)

on March 14, 2011
at 09:35 PM

Viagra is a symptom of bigger issues.....CVD atherosclerosis and andropause. And after sometime all humans get it no matter how good their diet is. It would behoove you younger paleo's to start reading a bit about it. The science meshes well with paleo living. I am proof of that and I have thousands of patients who also think so.

3e88219ad76dbcdb3d96d2a0788b83a0

(155)

on January 20, 2012
at 09:58 PM

Unfortunately, the women commenting on this thread are NOT post-menopausal. I wasn't a fan of HRT either until I started having rage attacks that I believe were a hormonal issue. Since I have been on bio-identical hormone replacement (no horse-pee, by the way), I am feeling like my "old self". I waited too long to start, so my body could not be coaxed into making my own estrogen again. Life is much better in that regard. Now, if I could only lose my belly fat!

C8b2136ef95ba6aac211825ff38cc0e9

(971)

on August 02, 2012
at 04:30 PM

I am all for increasing endogenous production whenever possible and staving off menopause through good health, but "menopause" is not just a term for getting older- there are effects that are very obvious if you are in it and feeling politically supportive of them doesn't make them more enjoyable. A decreased sex-drive, painful intercourse and vaginal dryness will never be on the table for me as a viable option. I love sex. I don't think lubricant is paleo either.

662a4ea915eb7c758bdd797d77ead7b6

(656)

on August 11, 2012
at 04:23 PM

Wow Heather, you sound like me. I am wondering about bhrt myself, but with all the breast cancer, mom, moms dad, and my own dad, I winder if I am doomed to have no sex drive, painful intercourse, and no energy......how do you stave it off naturally?

0
03db20f160e58814827ae5a05a5c8792

on March 14, 2011
at 05:22 PM

I would not use supplemets (hormones) but find the cause for the problem. Bioidentical Hormone Replacement Therapy is better than the conventional crap. But it can be dangerous.

Dr. Janet Lang DC explains why.

Janet Lang on Nora Gedgaudas' Show: Female Hormones . Restoring lost function instead of managing symptoms!

http://www.primalbody-primalmind.com/radioepisodemp3s /gedgaudas042110.mp3

Thyroid & Adrenals http://www.primalbody-primalmind.com/ra ... 072209.mp3

Dr. Lang doesn't want crutches when healing is possible. I would look for a doctor who is trained in Dr. Lang's approach. http://www.restorativeendocrinology.com ... ative.html

I found a public lecture from Dr. Lang (pdfs).Very helpful to get a basic understanding of your endocrine system and the shortcomings of conventional medicine. Everybody with hormonal, thyroid, PMS or menopausal problems should read the stuff.

Part 1: female hormone problems from PMs to menopause. Why "normal" lab test ranges are wrong. http://www.triadofhealth.net/images/for ... 202008.pdf

Part 2: thyroid, bone health, benefits and dangers of bioidentical hormone replacement therapy http://www.triadofhealth.net/images/for ... 202008.pdf

Part 3: stress hormones disturb sex hormone balance http://www.triadofhealth.net/images/for ... 0Notes.pdf

03db20f160e58814827ae5a05a5c8792

(520)

on March 15, 2011
at 12:32 PM

Aging is not a CAUSE for hormone imbalance or diabetes or obesity or whatever. These are the diseases of western civilisation. Aging is not a desease like being female is not a disease. Period. If it were the whole paleo lifestyle gig would be a terrible waste of time. As Dr. Janet Lang says: Having symptoms of hormonal imbalances is NOT normal -at any age. It can be corrected. I totally agree.

100fd85230060e754fc13394eee6d6f1

(18706)

on March 14, 2011
at 05:39 PM

But what if the cause is ageing? Then not taking hormones would be a bit like not taking insulin if your pancreas stopped working.

03db20f160e58814827ae5a05a5c8792

(520)

on March 15, 2011
at 12:53 PM

PS: Everybody will age but not everybody has to become sick and crippled. Watch this: http://growingbolder.com/articles/sports/track-field/growing-bolder-grandma-us-decathlon-646381.html http://www.youtube.com/watch?v=Qvgj02fanO4&feature=related http://www.youtube.com/watch?v=0OR-6y-8-nM

D67e7b481854b02110d5a5b21d6789b1

(4111)

on March 14, 2011
at 06:10 PM

Andrea, Thanks for posting all of these links, can't wait to start reading.

0
3e88219ad76dbcdb3d96d2a0788b83a0

(155)

on March 14, 2011
at 05:08 PM

Thanks for bringing this up! I have had the same questions. Anyone???

322a2783dfe4086591f323c6d2c086d6

on June 08, 2015
at 08:13 PM

"age is not a cause of".... ??

Huh?

You mean like age is not a cause menopause like age is not a cause of adolescence??

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