The Truth about Osteoporosis

A crippling disease that is preventable and reversible

By John R. Lee, M.D. and Virginia Hopkins

Although cardiovascular disease is the leading cause of death among American women, osteoporosis is the disease they are most likely to develop as they age. Four out of ten white women in the U.S. will fracture a hip, spine, or forearm due to osteoporosis. As many as five out of ten will develop small fractures in their spine, causing great pain and a shrinking in height. This amounts to 15 to 20 million people affected by a crippling and painful disease that is almost entirely preventable and reversible.

Osteoporosis is a gradual decrease in bone mass and density that can begin as early as the teen years. Bone mass should be at its peak in our late 20s or early 30s, but thanks to a poor diet and lack of exercise, many women are already losing bone in their 20s. Bone loss occurs more rapidly in women than in men, especially right around the time of menopause, when an abrupt drop in estrogen and progesterone accelerates bone loss.

When you think of your bones you may imagine a dead skeleton, but your bones are living tissue, just like the rest of your body, and they need a good supply of nutrients and regular exercise. New bone is constantly being made, while old bone is being reabsorbed and excreted by the body. Our larger long bones, such as our arm bones and leg bones, are very dense, and they are completely replaced about every 10-12 years. Our less dense bones, such as our spine and the ends of our long bones, are less dense and turn over every 2-3 years. Thus, as you can see, we always have the opportunity to be creating better bone for ourselves.

We all hear about how having enough calcium in the diet and taking estrogen can help prevent osteoporosis, but there is a much bigger nutritional and lifestyle picture to look at when we are talking about preventing this bone-robbing disease. You’ll be happy to know that for the vast majority of women, there is no need to take estrogen to prevent osteoporosis.

The most important element of bones is minerals. Without minerals we don’t have bones. The most important bone minerals are calcium, magnesium, potassium, phosphorous and fluoride. Equally important is the balance between the minerals. Too much phosphorous or fluoride will create poor bone structure. (Nearly all of us already ingest too much fluoride.) Without enough magnesium, the calcium can’t be absorbed onto the bone. Vitamins are also involved. For example, vitamin B6 works with magnesium to get calcium onto your bones.

The hormones testosterone, estrogen and progesterone are also actively involved in the making and unmaking of bone. Testosterone and progesterone build bone, while estrogen appears to indirectly slow bone loss.

To read more on this article, please visit this website: Dr. John Lee MD and Virginia Hopkins Osteoporosis Home Page

Josh and Jeanne Rubin

www.eastwesthealing.com

Attend a free bioidentical hormone therapy seminar in your area!

Learn how bioidentical hormones can help you control your hot flashes, get your libido back, get your energy back and manage your weight gain associated with andropause, menopause and other symptoms of hormonal imbalance. Our expert physicians host local seminars to answer all of your questions.

Register today!

BodyLogicMD of Little Rock with Dr. Constance Crisp
Thursday October 15th, 2009
6:00-7:00pm 

BodyLogicMD of Encino with Dr. Travis Deuson
Wednesday October 28th, 2009
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BodyLogicMD of Irvine with Dr. Michael Grossman
Tuesday October 13th, 2009
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BodyLogicMD of San Diego with Dr. Stephen Center
Thursday October 22nd, 2009
4:00pm-5:00pm

BodyLogicMD of Ft Lauderdale with Dr. Jeff Thackrey
Monday October 19th, 2009
5:00pm-6:00pm

BodyLogicMD of Miami with Dr. Michael Lee
Tuesday October 20th, 2009
7:00pm-8:00pm

BodyLogicMD of Naples with Dr. Robert Rubin
Tuesday October 20th, 2009
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BodyLogicMD of Orlando with Dr. Jennifer Landa
Thursday October 22nd, 2009
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 BodyLogicMD of Palm Beach Gardens with Dr. Mikhail Berman
Wednesday October 28th, 2009
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BodyLogicMD of Louisville with Dr. John Abell
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Tuesday October 20th, 2009
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BodyLogicMD of The Woodlands with Dr. Wade & Rebecca Huey
Tuesday November 10th, 2009
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Q:

Hi, I have been suffering with anxiety, panic attacks, and depression for years. I have been on Wellbutrin Cymbalata and still have battled the same symptoms for years and need help. Am I on the right meds which I am against them totally? I suffer and so does my family seeing me this way- not going to work, loss of interest in many things, crying all the time, and tired of no answers from any of my doctors. It seems nobody wants to help. I feel my kids need me and I am a bad Mom when I know I am not.  Please help.

A:

You may be suffering from a hormone imbalance. You have some classic symptoms that may be related to estrogen dominance or an imbalance of adrenal hormones. The best way to find out is to find a qualified doctor to do an evaluation of your hormone levels with blood and saliva testing. With proper hormone balance you may be able to get off the medications which you are uncomfortable taking.

Good luck!

Dr. Jennifer Landa of BodyLogicMD

Estrogen dominance is one of the more common hormone imbalances in women from 30-50.  As we age through our 30’s into 40’s and later, it is very important that estrogen and progesterone be in balance.  Most people think of estrogen as the hormone that needs replacing  before the menses stop, but progesterone is actually the hormone that is usually deficient.  Most doctors look at a progesterone to estrogen ratio to determine what the balance is between estrogen and progesterone.  Possibly more important are the medical ramifications of estrogen dominance.  Women with estrogen dominance are more likely to have fibrocystic breasts and possibly even breast cancer, fibroid tumors, endometriosis and problems with heavy bleeding with their cycles.  Many women would be able to avoid hysterectomies just balancing estrogen and progesterone.  Additionally progesterone is our calming hormone and when progesterone is deficient women feel more stressed out.  Many women I speak to feel like they are hamsters on a wheel and are totally overwhelmed.  Progesterone gives women a calmer, less stressed outlook.  Also, because it is calming, it also helps with a full night’s sleep. A proper balance between estrogen and progesterone is essential to a healthy mind and body throughout the 30’s and 40’s and sometimes into the 50’s and even 60’s as well.  

Symptoms of Estrogen Dominance:

(List adapted from energeticnutrition.com)

Mild

• Premenstrual breast tenderness

• Premenstrual fluid retention, weight gain

• Premenstrual headaches

• Premenstrual mood swings

• Menstrual cramps from PMS

 Moderate

• Adrenal fatigue

• Decreased libido

• Depression

• Dry eyes

• Fatigue

• Hair loss

• Headaches and/or migraines

• Heavy periods with clotting

• Restless sleep and insomnia

• Irregular menstruation

• Joint and muscle pain

• Severe menstrual cramps

• Thyroid disorder

• Weight gain

 Severe

• Accelerated aging

• Anxiety and panic attacks

• Auto-immune disorders

• Breast tumors

• Endometriosis

• Fibrocystic breasts

• Fibromyalgia

• Infertility

• Miscarriage

• Polycystic ovary syndrome

• Thickened uterine lining

• Uterine fibroid tumors

The goal is to strike a balance between the two hormones to maintain a healthy mind and body throughout perimenopause, menopause and possibly beyond.  Start by getting your hormone levels tested - testing is quick and easy and armed with that information you can begin the journey to hormonal balance and get a handle on your symptoms.

In health,

BodyLogicMD

www.bodylogicmd.com

I know that there is a middle ground in the bioidentical hormone debate. Suzanne Somers is on one side of the debate.  Pat Wingert and Barbara Kantrowitz appear to be on the other side. The focus of their criticism of “The Oprah Winfrey Show” was mainly on Suzanne Somers and her hormone regimen. Dr Streicher did a great job representing “mainstream medicine.” Her point that there are a few pharmaceutical bioidentical hormones available that mainstream physicians can prescribe is well taken. I was also originally trained in Ob/Gyn and practiced for 10 years before converting my practice solely to nutrition and bioidentical hormone therapy. I currently utilize both compounded and pharmaceutically available bioidentical hormones for my patients – each patient gets what works best for them.

In addition to my medical school training and my residency in Ob/Gyn, I have completed hundreds of subsequent hours of training in Functional Medicine, nutrition and bioidentical hormone therapy. There are many other physicians trained like I am – and, the number of physicians interested in this type of medicine is increasing every day. That being said, the criticism of Ms. Wingert and Ms. Kantrowitz is that these hormones are being prescribed by people who have no training and are not experts. I beg to differ. For the past 7 years, I have been studying bioidentical hormones with the American Academy of Anti-Aging and the Institute of Functional Medicine. During that time, I have developed a stronger understanding and appreciation of physiology and biochemistry than I ever had when I left medical school. I also believe that the current diet, stress levels and toxin exposure of our current population has changed the hormonal milieu to such an extent that most of what we learned in medical school no longer pertains to the patients we have sitting in front of us today. All doctors need extra training to really understand what we’re now seeing. Oprah had Dr. Christianne Northrup on as a guest for both of her shows on bioidentical hormones. Dr. Northrup is a well recognized expert in the field and her book, The Wisdom of Menopause, is brilliant. I’m sure that Dr. Streicher would not have been underlining many sentences in that book. As a matter of fact, Dr. Northrup and Dr. Streicher agreed on a number of points. However, they did disagree on the term “bioidentical.” Dr. Streicher described it as a “marketing term” of no biological significance while Dr. Northrup felt it simply meant “the exact same structure as what is produced in the body.” I agree with Dr. Northrup.

The studies that are being quoted regarding the dangers of hormone therapy are studies that utilize non-bioidentical hormones such as Premarin and Provera.  It is impossible to directly compare Premarin (conjugated equine estrogen) with estradiol (our actual hormone) or Provera (medroxyprogesterone acetate) with progesterone (our actual hormone). The conclusions of these studies cannot be extrapolated to include all hormones. There are many studies that do demonstrate improved safety when hormones which are bioidentical to humans are used. Dr. Kent Holtorf just published an extensive study comparing bioidentical to non-bioidentical hormones and showed a reduced breast cancer risk with progesterone as opposed to Provera. That being said, hormone therapy is not for everyone. It remains a decision to be made by an informed patient with his or her highly trained and specialized physician. It is interesting to consider that breast cancer rates have fallen in the years since 2002 when hormone therapy had been less popular. Is that because the use of hormones in general is down, or is it because the use of Premarin and Provera is down? I believe it is the latter. There are studies that show Provera to be carcinogenic – especially when compared to progesterone. Also, it has been shown that Premarin preferentially metabolizes into the most dangerous metabolites, 4-hydroxyquinones. These two factors would lead you to think that reducing the use of Premarin and Provera would reduce the incidence of breast cancer. There is a great deal of controversy regarding Suzanne Somers and her use of hormones with a history of breast cancer. Again, those discussions need to occur with a patient and her physician. However, there is some evidence that testosterone may be protective and it is important to realize that these patients may also have problems with their adrenals, thyroid and insulin levels. Thus, there may be ways that patients could alleviate some symptoms without using estrogen.

It is intriguing to me that “the decision to take supplemental progesterone despite her hysterectomy baffles mainstream doctors.” Dr. Nanette Santoro states, “There is no medical reason to use progesterone after a hysterectomy.” That is what I used to think. However, when you review biochemistry and hormone pathways, you realize that progesterone is an important building block for other hormones. Progesterone is also the hormone that balances estrogen. The main reason it became “medically necessary” only when there was still a uterus in place was that bleeding and endometrial cancer were the result of unopposed estrogen when the patient had a uterus. So, she was given Provera to keep her from developing irregular bleeding or endometrial cancer. Provera did work in that capacity. However, Provera is a progestin, not progesterone. So, the patient often didn’t get any other benefits from Provera – as a matter of fact, many women didn’t feel good on it. So, the main practice was to only give Provera when the patient had a uterus. That practice has distilled to “there is no medical reason to use progesterone after a hysterectomy.” Progesterone has over 400 functions in the body. In addition to balancing estrogen and being a building block for other hormones including cortisol and the sex hormones, it helps to rebuild bone, it is a natural calming agent, a diuretic and a sleep initiator. By giving women with no uterus estrogen only, we create a state of estrogen dominance that may lead to bloating, breast enlargement and tenderness, recurrent hot flushes as the estrogen receptors shut down and anxiety. Many women in my practice with significant perimenopausal and menopausal symptoms have great improvement utilizing ONLY progesterone.

Oprah never said that she was going to clear up the controversy regarding bioidentical hormones – she was going to start the conversation. When you start a conversation, you usually stir up all kinds of controversy. I applaud her ability to get people talking about it. Although it’s not for everyone, it is great to see that so many women (and men) are becoming aware that there are options. In the end, the main goal is to let everyone know that they have a choice. The one point of contention that I had with Oprah’s shows is that both of them focused on hormone protocols that were higher dosages than what many of us use. I would welcome another show with Dr. Streicher, Dr. Northrup and a few doctors who use the lower dose regimens and combinations of pharmaceutical and compounded prescriptions. Many of the physicians trained by the American Academy of Anti-Aging and the Institute of Functional Medicine practice in a more conservative manner than what was described on Oprah’s shows. Overall, I love the conversation and the fact that there are so many points of view. It gives everyone a chance to ask questions and learn more for themselves.

Dr. Alicia Stanton

BodyLogicMD’s CMO

To read the article Dr. Stanton is responding to, click here.

When I started menopause I did a little research and decided to start taking an estrogen cream to fight off some symptoms.  But my symptoms just got worse and worse.  I finally got my hormone levels checked and found out that I had way too much estrogen; estrogen dominance the doctor called it.  I’m confused, I thought menopause meant a decline of estrogen?

Karen L.

Karen,

Estrogen dominance is one of the more common hormone imbalances in women from ages 30-50. 

As we age through our 30’s into 40’s and older, it is very important that estrogen and progesterone be in balance.  Most people think of estrogen as the hormone that needs replacing in menopause.  But before the menses stop, progesterone is actually the hormone that is usually deficient. Doctors look at a progesterone:estrogen ratio to determine what the balance is between estrogen and progesterone in your body.

Estrogen dominance causes many symptoms for women including many PMS symptoms, weight gain, bloating, breast tenderness, decreased libido, hot flushes, mood fluctuations, insomnia, fatigue and more.  Possibly more important are the medical ramifications of estrogen dominance.  Women with estrogen dominance are more likely to have fibrocystic breasts, fibroid tumors, endometriosis, heavy bleeding with their cycles and possibly even breast cancer.  Many women would be able to avoid hysterectomies just by balancing estrogen and progesterone.  

There are many outside sources of estrogen in our environment. For example – meats injected with estrogenic hormones, water bottles and plastics in general have estrogen. For this reason, don’t heat food in Tupperware or drink from bottles that have been heated. Many cosmetics also contain estrogen.  All of this leads to more estrogen dominance as well, so women with estrogen dominance especially need to avoid these products.

Progesterone is our calming hormone and when progesterone is deficient women feel more stressed out.  Many women I speak to feel like they are hamsters on a wheel and are totally overwhelmed.  Progesterone gives women a calmer, less stressed outlook.  Also, because it is calming progesterone also helps with a full night’s sleep.  A proper balance between estrogen and progesterone is essential to a healthy mind and body throughout the 30’s and 40’s and sometimes into the 50’s and even 60’s as well.

Jennifer Landa, MD
BodyLogicMD Orlando

Hi.  I’ve been suffering with anxiety attacks and depression for years and I have been on Wellbutrin and Cymbalta and still have battled the same symptoms for years and need help.  Am I on the right medications?  I am against them totally.  I suffer and so does my family seeing me this way; not going to work, loss of interest in many things, crying all the time.  I am tired of no answers from any of my doctors; it seems nobody wants to help.  I feel my kids need me and I am a bad mom when I KNOW I am not.  Please Help!
~Alexandra

Alexandra,

You may be suffering from hormone imbalance. You have some classic symptoms that may be related to estrogen dominance or imbalance of adrenal hormones. The best way to find out is to find a qualified doctor to do an evaluation of your hormone levels with blood and saliva testing. With proper hormone balance you may be able to get off the meds which you are uncomfortable taking. Good luck!

Dr. Jennifer Landa
BodyLogicMD Orlando, Florida 

Alexandra,

Estrogen, progesterone and testosterone are all big players in depression and anxiety.  If they are unbalanced, which is common in menopause especially, then depression, along with many other symptoms, may follow.  Many of my patients with your symptoms possess a neurotransmitter imbalance and have had great success having have their neurochemicals balanced with nutritional supplementation.

The type of treatment depends on whether you are menstruating still or not.  If you are menstruating bioidentical hormones should be pulsed with your cycle during the month to get your cycle normal if it is currently not.  If you are in menopause you may need the hormones every day.

But this is all just educated speculation based on years of experience.  The first step is to get tested.  A urine analysis may be ideal for your case because it tells us a lot about metabolites.  Nutrition can have a lot to do with symptoms like yours.  An ALCAT Test, which is a food panel test that identifies your hidden food allergies and the food that is having a negative impact on your body, may also be a good idea.  Your personal and family history will also be needed to get a complete picture at your circumstances.  Your symptoms may result from combination of causes, including hormonal and nutritional.

To sum up Alexandra, I suggest you see a qualified physician who specializes in bioidentical hormone therapy.  Get tested and go from there.  If what you are experiencing is caused by hormones and/or nutrition, there is help and there is relief so don’t lose hope!  Good Luck!

Dr. Michael Grossman

BodyLogicMD Irvine, California

Quick Insight into Estrogen Dominance