Can Hormones Be Used Safely
Hormone Replacement Therapy (HRT) can improve health and treat many unpleasant symptoms but it needs to be done safely. HRT is often used to treat hot flashes, osteoporosis, depression, fatigue and other conditions. Oral Contraceptives (OC), or birth control pills, is another form of HRT. How safe are these approaches?
Although outcome data in studies is still controversial, they generally suggest that both HRT and OC pose a risk of increased breast cancer and/or other hormone-related cancers (uterine and ovarian). Given that a significant risk is likely, can the benefits of HRT and OC be realized without the risks of cancer? Is there any advantage to bio-identical HRT, which is the use of hormones that are identical to those produced in the body, as opposed to artificial hormones, which are chemicals that are not naturally produced in the body?
In conventional medicine, HRT is often prescribed as Estrogen-Progestin Therapy (EPT) because the addition of progestins may offset the risk of estrogen therapy alone in causing uterine cancer. According to studies published in the Journal of the American Medical Association, however, EPT is likely to be a significant risk factor for breast cancer, and EPT probably increases the risk of breast cancer more than HRT using estrogen alone.
Naturopathic, holistic and integrative health care practitioners generally recommend bio-identical HRT such as the use of natural progesterone, which has the advantage of being a “mother hormone” that is made into testosterone and estrogens. Since oral contraceptives also contain artificial progestins which may increase the rates of breast cancer, other forms of contraception are generally recommended by naturopathic, holistic and integrative health care practitioners.
Even though estradiol is a bio-identical estrogen, studies also suggest it can significantly increase the risk of breast cancer. However that risk may have more to do with certain metabolites of estradiol than with the estradiol itself. Biochemically speaking, a metabolite is a “downstream” molecule that “upstream” molecules or precursors like estradiol are turned into.
Estradiol is metabolized into estrone, which in turn can be metabolized into several kinds of “hydroxylated estrones”, and the type of hydroxylated estrones generated in a woman’s body can significantly predispose them to breast cancer and possibly uterine, ovarian and cervical cancers as well. Men are not off the hook. Hydroxylated estrones can predispose them to prostate cancer, so testosterone treatments should also be accompanied with an evaluation of the hydroxylated estrones.
Two main metabolites of estradiol are the 2-hydroxy and the 16-hydroxy estrone. The 16-hydroxy metabolite binds to estrogen receptors very strongly and, like any anabolic hormone, causes most cells with estrogen receptors to divide and reproduce more quickly. Cancer is out-of-control cell growth, so the 16-hydroxy metabolite of estradiol may be a very significant reason that even bio-identical estrogen therapy poses a significant risk of breast cancer.
A simple, inexpensive, blood test called Hormonal Health is available from commercial labs or from specialized labs such as Genova Diagnostics, to test the 2-hydroxy and the 16-hydroxy estrone metabolites. Anyone taking HRT (including men) or OC would benefit from getting this test. If these metabolites are out of balance one, is advised to implement dietary and lifestyle adjustments which can correct the imbalance, which then should translate to a significant reduction in risk for breast cancer and other hormonal-related cancers.
Changes in diet, lifestyle and medication which are intended to modify metabolism and gene expression to decrease risks or prognoses of diseases like breast cancer is called optimizing epigenetic expression. Below is a very effective protocol to optimize epigenetic expression and shift the metabolism of estradiol away from the cancer-related metabolite 16-hydroxy estrone toward the potentially much safer 2-hydroxy estrone.
- Consume organic foods whenever possible. Pesticides decidedly shift the balance of metabolites in the wrong direction, which in part explains how pesticides are factors in causing breast and other cancers.
- Limit alcohol use. The average drinks per day that a woman consumes is directly proportional to breast cancer risk, in part because alcohol shifts the balance of estrogen metabolites in the wrong direction.
- Although it’s hard to recommend most soy products these days because of GMOs, some studies suggest that women in high soy-based-consumption cultures do have lower rates of estrogen-related cancer risk. As an alternative to tofu therefore, one can get the best of both worlds and take the supplement soy isoflavones which gets you the good stuff in soy without the bad.
- Besides the omega-3 oils in flax which are generally always good for you, flax oil and ground seeds have lignans which also shift the estrogen metabolites in the right direction. A few tablespoonful of flax oil a day may keep the doctor away.
- Exercise and fish oil helps to make a positive epigenetic shift in estrogen metabolism in the right direction, as they do for so many other health conditions.
- Consume more of the mustard family of plants, also known as brassica, which includes broccoli, collard greens, cauliflower, cabbage and kale. This, in part, explains how these foods prevent breast cancer. If you wish to avoid these foods to prevent thyroid suppression or for some other reason, there are two supplements that supply the good stuff in the veggies and shifts estrogen metabolism in the right direction. They are I3C (Indole-3-carbinol) and/or DIM (Diindolylmethane). Take as directed on the supplement bottle.
- Certain drugs like some of the anti-acid variety (Cimetidine) send the estrogen metabolites in the wrong direction, so alternatives for heartburn should be sought if you take these drugs and want to prevent or adjunctively help treat breast cancer. However, Cimetidine can improve treatment outcomes for other non-estrogen-related cancers, so seek medical advice.
- Occasionally patients will do all of the above and astonishingly, on retesting of the Hormonal Health, no benefits are realized. These patients invariably are found with additional lab testing to be toxic with DDT, DDE or other pesticides and/or plastics and/or other carcinogens, so they are prescribed intensive detoxification protocols.
Dr. Chas Gant, M.D., Ph.D., is an author, physician and educator, specializing in functional medicine, molecular health and healing. For more information, call 202-237-7000, ext. 120 or visit DoctorChas.com.
To hear Dr. Chas speak on this topic, attend a free seminar/webinar at 2 p.m. on May 30 at Barre Tone, 370 Maple Ave, W, Vienna