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Certified Clinical Densitometrist and Bone Health Expert

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The Hormone Dilemma

Wednesday, October 20, 2010
 
The Hormone Dilemma

Extreme premenstrual or peri-menopausal symptoms are not normal. Excessive hot flashes, depression, moods swings, insomnia, hypothyroidism, and bone loss are a few of the more common symptoms associated with hormone imbalance. Balancing your hormones can be done in several ways, and sometimes simply exercising, changing your diet or adding supplements and/or herbs will balance them naturally. However, if these strategies do not work it is important to consider if the ongoing symptoms of hormonal imbalance are more unhealthy than supplementation with bio-identical hormones - quality of life is a very real health concern after all.  When bio-identical hormones are used wisely and with the right patients, its ability to reduce symptoms can literally be life changing in a matter of days to weeks.

Bio-identical hormone therapy is an option that some women should consider. Bio-identical hormones are hormones produced in a lab to match the exact molecule that is made in our body. Non-bio-identical hormones (including Premarin, Provera and the hormones in birth control pills) do not match the hormones we produce naturally. While both bio- and non-bio-identical hormones may share some similar actions, their total effect on the body can be as different as night and day.  Dr. Simpson and Dr. Gottfried will discuss these differences in their upcoming webinar.

Before you settle on any treatment, however, know your range of options! First, your health care provider should be well versed in balancing hormones naturally. Lab tests can be ordered to further assess health picture. Most importantly, your health care practitioner should be evaluating your need based on a complete personal medical history that includes a detailed symptom assessment. Generally, an initial consultation is 45-75 minutes long and you should not feel that your doctor is rushed while they are listening to you.  I think this is especially important because each patient I work with arrives with a different set of symptoms and therefore needs to be treated individually. There is not a one-size-fits-all option in balancing hormones. Your health care provider can and should be your partner in working towards your good health.

Did you know...?

Osteoporosis fact: During the time in and around menopause, a woman can lose up to 20% of their bone mass.

I recently stated this fact to a new patient who lost about 15% bone mass during peri-menopause. She just looked at me and said, “Why didn’t my doctor tell me this was a possibility?” This is one reason why women who have risk factors for low bone density should be tested prior to menopause, not after!  In November, Dr. Lani will be offering an osteoporosis course on-line for those who want to learn more. More details on the course will be sent in next week's newsletter.

What I learned in school: “80-90% of a diagnosis is made though listening to your patient’s story and symptoms.” I believe this to be a true statement.  All too often doctors rely on lab work for a diagnosis rather than piecing together the symptoms and using lab work as an adjunct.

Ask Dr. Lani

Question:

Dr. Lani, can a person have an allergy to gluten, but not test positive for celiac disease? 

Answer:
You can have food sensitivity to just about any food. This is not the same as Celiac disease because Celiac is an autoimmune condition that causes damage to the small intestine. Some people simply have sensitivity to wheat but are not necessarily gluten intolerant. Others suffer from non-celiac gluten intolerance (NCGI). I tend to think that those with NCGI may wind up with celiac down the line, often after some stressful event, such as menopause, enhances the intestinal reaction. With food sensitivities, removing the food completely from the diet for 3 to 6 months is often long enough to stop the symptoms. Reintroduction of the food 1-2 times a week is usually fine. If you have a stronger sensitivity, you may need to look into eliminating wheat-based products from your diet.

Question:

Dr. Lani, what do you think about the Wiley Protocol for bio-identical hormones?

Answer:

I think the protocol is dangerous. The Wiley protocol was created by T.S. Wiley and endorsed by Suzanne Somers in her book, Ageless.  They recommend dosing menopausal women with extremely high levels of bio-identical hormones, equivalent to what a 25-year-old woman would produce. Part of the rationale for the protocol is that 25-year-old women are less likely to get breast cancer. This absurd statement does not consider the multitude of problems that can arise when you add estrogen and progesterone at such high levels later in life. While some women will feel better initially on the Wiley protocol, many will experience other problems down the road, most notably a decrease in thyroid function and/or adrenal problems.

While I do feel hormone therapy is appropriate for some, I recommend only low doses. A small amount can stop bone loss during peri-menopause, when a woman can lose up to 20% of bone mass. Hormone balancing can also relieve hot flashes, brain fog, and depression. However, I believe that nutrition and exercise should always be the foundation of any program. Yes, you can get too much of a good thing. Avoid the Wiley scam!



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