The Truth About Estrogen
On December 20, 2000, the morning news programs were full of the "latest" health news - this time concerning estrogen and hormone replacement therapy. If you didn't hear it, the announcement was that estrogen is carcinogenic and women should rethink their use of it for prolonged periods.For years, I've been pointing out that estrogen is a carcinogen. In fact, the "Physicians' Desk Reference" used to contain a warning that estrogen products should be used for no longer than 6 months, due to an increased risk of both uterine and breast cancer. However, about 10 or 12 years ago, the pharmaceutical industry decided to target menopausal women, as the next big potential market. I remember the concerted media campaign to make menopause a "disease," rather than a normal sequence of the life cycle. As a result, doctors were encouraged to prescribe estrogen for all menopausal women. The hook was that estrogen therapy would protect women against osteoporosis and cardiovascular disease. Expect doctors to continue prescribing and encouraging estrogen use. The current line is that "More women will die of cardiovascular disease than of cancer. So, the risk is worth it." I have to say, I don't know many women who would agree with that point of view.
In the first place, estrogen lack is not the culprit in bone loss. Bone loss begins before menopause, in the perimenopausal period. Once you stop ovulating, you lose progesterone, and progesterone is responsible for keeping your bones strong. More importantly, natural progesterone is not carcinogenic. However, most prescription products are progestins which are progesterone-like male hormones. The physiologic effects are very different.
Nor is their any evidence that lack of estrogen causes heart disease in women. The case is entirely circumstantial. We know that estrogen is protective to women of child-bearing age. However, that does not mean it is good for menopausal women. Diet and lifestyle are far more important in the development of cardiovascular disease than our hormone status. For more information on good diet and lifestyle choices, call the RFHC and order my lecture tape "Cardiovascular Disease: Is Your Diet Your Downfall?"
At the RFHC, I recommend natural, plant-based phytoestrogen (estriol, which is non-carcinogenic) for the 3 to 4 year period when hot flashes are most severe. Our product is a combination of estriol and natural progesterone. Also, I recommend support for the adrenal glands, when required, since our adrenals produce our entire supply of estrogen post-menopausally. After the hot flashes subside, I then recommend a woman shift to progesterone alone to maintain libido, well-being and bone density. In those women where vaginal dryness becomes severe (in the 6th and 7th decade of life), a small quantity of phytoestrogen can again be used to alleviate the problem. This is a far different protocol from lifelong use of prescriptions that contain estradiol (the most carcinogenic form of estrogen, except for Premarin [tm] which is the absolute worst!). For more information on the different forms of estrogen and what's best for you, you may order my lecture tape, "Hormone Replacement Therapy: Is It For Me? Do I Have a Choice?"
This is another instance where "current scientific knowledge" can lead us to a serious problem. What is a woman supposed to do who has been on estrogen replacement therapy for years? Is it enough to be told, "Oops! Sorry!"? I don't think so. My mother had that experience, and she died of breast cancer. I believe it's much better to err on the side of caution where a woman's health is concerned.
If you or someone you love is experiencing menopausal symptoms and would like a personalized program, [please call us and make an appointment for a consultation.]
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Hormone Replacement Therapy
July 2002 brought "breaking news" in health care that left me feeling extremely validated. After all, I've only been speaking out against hormone replacement therapy for the last 15 years! I believe it was the National Institutes of Health that had been conducting a huge longitudinal study on hormone replacement therapy (HRT). A longitudinal study is based on tracking many women over many years as they use hormones, and watching what happens. The study was abruptly cancelled due to the severity of the side effects.The researchers made the following "amazing" discoveries:
1. HRT markedly increases the risk of cancer. The figures are 8 more women out of 10,000 will develop cancer of the breast.
2. HRT does not protect against heart and cardiovascular disease. In fact, it markedly increases the risk of cardiovascular events: out of 10,000 women, 7 more will suffer a heart attack, 8 more will have a stroke, and 18 more will experience blood clots.
3. HRT does not protect against osteoporosis.
These findings should come as no surprise to anyone who has followed the history of hormone use in the United States. It began with diethylstilbesterol (DES) for pregnant women to prevent miscarriage. The results long term: an increase in reproductive cancers among the children exposed to exogenous estrogen in the womb.
Then, came the birth control pill (BCP). The initial formulas were a debacle - high doses of unopposed estrogen. The result: strokes, hypertension and heart attacks in the very young women who were the first users. (My feeling: anyone who uses a new drug is volunteering to be a guinea pig. Of course, that's not how it's presented to you, the public.) Interestingly, the doses were not much higher than the amount of estrogen in a typical Premarin( prescription.
The cancer connection actually should have been a "duh." For many years, the Physicians' Desk Reference stated unequivocally that no woman should take estrogen for more than 6 months because it increases the risk of cancer 9 times. That warning was suppressed in recent editions as more and more women were prescribed lifetime HRT. All the research supports the data that breast cancer risk increases in direct proportion to lifetime estrogen exposure. The older you are, the higher your risk. If you've never been pregnant (during which time you have very low estrogen and relatively high progesterone), your risk increases. If you've taken BCP or HRT, your risk increases. Also, both smoking and alcohol increase the risk, because both of these drugs impair the liver's ability to detoxify estrogen, increasing the lifetime tissue exposure.
Finally, the data has been available for years that perimenopausal women start losing bone mass before they stop menstruating. When they become anovulatory, they no longer produce progesterone and begin losing bone mass. Natural progesterone arrests bone loss, but the progestins found in HRT do not. Progestins are actually closer to male hormones in their action than they are to progesterone. The problem with progesterone (from a pharmaceutical company point of view) is that, it can't be patented, because it is a natural product. Also, oral delivery of progesterone is not very effective, because it is immediately metabolized by the liver. Transdermal or sublingual delivery is much more effective. The data on osteoporosis indicates that natural progesterone combined with appropriate calcium supplementation (which includes your vitamin D status, your parathyroid status, as well as adequate amounts of bone matrix) maintains and restores bone mass. Of course, you have to do mild weight-bearing exercise and get a little sun, but those lifestyle changes are much safer than exposing yourself daily to a dose of carcinogens.
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The other very important piece of data that has not been well publicized is that the women at highest risk for cancer from HRT are the women taking Premarin(. Premarin( consists of more than 100 horse estrogens which are conjugated to make them longer acting. Premarin( is actually made from pregnant mare's urine. Because these compounds are foreign to the human body, they can only be metabolized down the 4-hydroxestrone (4-OH) pathway. Unfortunately, the 4-OH pathway is the most carcinogenic of the 3 pathways in the body; and, the intermediate products are much more carcinogenic than the estrogens themselves.
There are several interesting aspects to what's currently going on in both the media and with traditional doctors. I have been fascinated as I watch them try to back-track without really seeming to and then propose strategies that are basically more of the same. I have heard at least 3 medical reporters (most of them MDs) advise women to simply switch to herbal estrogen (black cohosh); and, then, of course, go on to encourage women to take Fosamax( and prescription calcitonin for osteoporosis while giving lip service to the notion that calcium supplementation is helpful. This is still an allopathic approach: medicating menopause, rather than balancing the underlying physiologic pathways. Even more importantly, it continues the pattern of medicating women for menopause and devil take the side effects. At the RFHC, I have repeatedly reversed osteopenia (bone loss, the first step towards osteoporosis) with the appropriate, personalized supplementation program.
I clearly remember when the drug companies began pushing hormone replacement therapy as they realized the size of the baby-boom menopause market. And, I watched in dismay as they had television "specials" designed to terrify women with the idea that their bones would crumble and they would all die of a heart attack 10 years after entering menopause!
Speaking of side effects: Are you aware that Fosamax( calcifies the soft tissues, particularly the esophagus? The result is a painful and serious condition called achlasia wherein you lose the ability to swallow or, at best, it becomes very painful. Fosamax( also makes the bones brittle, causing concern that it may actually increase the risk of hip fracture rather than reducing it.
So, what is a woman to do? Let me say, first of all, that there is no one solution for every woman. It is a matter of balancing your metabolism to achieve optimum results. One of the tools we have available is a hormone assessment panel which shows how you personally are metabolizing estrogen, your adrenal status and your DHEA sulfate stores. Those last two items are crucial, since all of your estrogen post-menopausally comes from your adrenals. DHEA provides your body with the precursor to both adrenal hormones and androgens, which maintain your body strength and your libido. Interestingly, low dose DHEA supplementation in women is not masculinizing. The body converts just as much as it needs. Another critical factor is your insulin status and whether or not you are insulin resistant, since excessive production of insulin over stimulates the production of sex hormones. Once we have determined your personal metabolic profile, I can then recommend the appropriate supplements to optimize your health. In severe cases, small amounts of phytoestrogens can be used until your hot flashes subside. However, I don't recommend staying on even these mild agents long-term.
Basically, as with everything else we do here at the RFHC, I can personalize a program for you to get you through menopause comfortably and naturally. If you or someone you love needs to get off of HRT or needs help with menopause, call and make an appointment for a consultation. At that time, we can address your personal situation in greater detail.
Forgive me if this article seems angrier than usual. My mother died of breast cancer induced by Premarin( over 25 years ago. Her doctor admitted that to my father after performing a super radical mastectomy, and subjecting my mom to intense radiation therapy. After all of that, he told my father that she had less than a year to live, and that he was sorry he had prescribed Premarin( for her after her hysterectomy 5 years before. He was devastated and retired just a month after my mom's surgery. I get angry when I realize there are thousands of other women and doctors who have been similarly victimized by the drug companies.
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Hormone Replacement Therapy: Is it for me?
Note: this is a lecture tape transcription. To obtain a copy of this tape, contact the RFHC.What do you personally believe based on everything you have heard. The reason I want you to do that is because it will set us up in terms of the conversation. I would like you to know what you're thinking about this so that when I introduce ideas you can know whether that corresponds to what you have been taught by the media. Because we've been hearing more and more and more and more haven't we about women, menopause, and all of the different drug treatments available for menopause. It seems like it's the thing that's in the news more than anything else recently. I'll just give you folks just a couple of minutes here. So did most of you feel like you had a definite opinion on most of these questions? They're all false. Every single last one of them is false. And some of you may find that to be, "Oh, yeah, of courseÉ" and some of you may find that to be surprising. It would be surprising to those of you who get most of your information from the popular media because there's all this kind of misinformation floating out there. So we're going to go through now this evening and go through each of those different points.
"I have a bias." I have a huge bias, and since I have a bias, it's only fair that I share it with you. I'm totally anti-pharmaceutical treatment for menopause. Totally, okay? That's a result not only of my personal education, it is also a result of my personal life experience in terms of family members with breast cancer. I mean there's a whole bunch of things that feed into that for me. And what I hope to share with you tonight is the data about it. What has happened is that approximately 10 to 15 years ago menopause became a treatable disease. I remember when this happened. The drug companies started a public relations push to put over to the public the idea that every woman who is post-menopausal has a disease that requires treatment. Because they have this enormous ready made market after all. Women, sorry guys, live longer than men, right? And if you can treat them for the entire second half of their lives you have an instant cash machine, and that really is what's behind it all. And I'm going to share some information about that with you that I'm not the only person who holds this opinion. There's been a lot published about it lately. And the problem with it is that hormone replacement therapy is an untreated, unproven experiment that's being practiced on the women in America and we have not yet begun to reap the harvest of it. We don't have a clue what is going to be the outcome 20 to 30 years down the road. So the question for each of us becomes how much risk are you personally willing to accept? And we're going to talk a little bit tonight about the different choices, what the risks are, so that what my hope for you is, is that when you walk away from here tonight you will have enough information to make an intelligent decision. And that's basically where this whole lecture is heading. For those of you who've received my letter announcing this lecture I mentioned the fact that Dr. Dean Edell and I agreed on something. This is like a miracle. When I want to get my blood pressure up so I'm not so fatigued, I listen to your Dr. Dean. Because in general he and I are at polar opposites on everything. But he has a very conservative view around menopause. And I really approve of it because he asks some really timely questions. There was a recent study that was released about Alzheimer's disease and the effects of estrogen on Alzheimer's. Okay. Well as he pointed out this study is so flawed that you could drive semi-trucks through the holes in it, okay? In the first place it's not a controlled study. What it is is what they call a perspective study. They've gone back and analyzed statistics, alright? And in the first place women who are on hormone replacement therapy medical hormone therapy in general have a better health overall to begin with. They're more health conscious, they go to their doctors more, they're more proactive about their health. So you're working with a healthier population to begin with, okay? Then the second part of it is that they couldn't find any women who were willing to be the controls because everybody's terrified of Alzheimer's. So there was no way to perform this study in any kind of a meaningful way and it's an extremely small sample which is the other problem. When you have a statistical analysis, the smaller the sample, the bigger the deviations. Those of you who know math and statistics, I see you nodding your head. You don't get anything like a nice bell-shaped curve until you have huge sampling numbers and this was a tiny tiny sample. But of course the drug companies are so anxious to impress upon women the need to take their prescriptions that all of these things hit the news. They're being released by drug company researchers, that's the reason behind it. So the other thing that was said in this particular program when I went "cheer" is that they're pushing it now as a way to prevent cardiovascular disease, right? Well, we know so much about cardiovascular disease and how to prevent it. It isn't that, it's just that people aren't doing it. It's not hard to turn heart disease around. I've been doing it in my practice, I had a man walk in in late stage heart failure who's now doing fine just with the proper nutrition. I had another man setup for a valve replacement therapy, they said he'd die without it, he was back in just before I went on vacation, he doesn't need the surgery anymore because his nutrition turned it around, okay? It was so exciting. So we know how to do cardiovascular disease. Cancer is another story. And when you're talking hormone replacement therapy the risk you have to weigh is cancer. Because that's the tradeoff. So we're going to talk a little bit more about that. And let's go on to our next slide.
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Where I'm going in my lecture, this little hormone replacement therapy outline in your handouts is kind of an outline of how we're going to discuss this. We're going to start out by talking about a little tiny bit about the phases of a woman's life. Menstruation starts at menarche. Menarche currently in the United States is somewhere between 9 and 11 years of age. At the turn of the century it was 19. Okay? So what that means is that young girls are beginning to menstruate sooner and you're, we're having a longer effective time when the body is subjected to estrogen. Now the issue about onset of menarche is probably a nutritional one. Girls start menstruating at about 103 pounds, it's kind of like a trigger. That's enough body weight, enough body fat, to initiate the activity of the estrogen and so we now have younger girls that are much much heavier. We have an obesity problem in the United States because of all the fast foods that we eat. So little girls are much heavier than they used to be. And that's one of the reasons why the age has dropped the way it has. The other thing is we have a lot of synthetic hormones in our food supply, particularly in dairy products. And that period of menstruation continues until what we know as menopause, the menses stop. And as you go through each stage of a woman's life you have an ebb and flow of hormones. This is probably the piece about hormone replacement therapy that I find the most appalling. If you look at a graph of a woman's menstrual cycle it's like a symphony. It's a complex precisely timed thing where one hormone's going up and the other one's coming down and they interact with each other and they just kind of criss cross, it's beautiful. When we were studying it in school, my friend and I, this is a symphony, I mean, it's just gorgeous. We had great respect for it. We're trying to approximate that by giving people a single pill. It's like instead of a Tsaichovsky symphony you have a single note droning. That's the only comparison I can make and it just really doesn't make a whole lot of sense. During menstruation the menstruation phase of a woman's life you will have an ebb of flow with estrogen and progesterone peaking at different times. Those hormones are primarily produced by the ovaries but the entire cycle is initiated by the pituitary gland which also secretes hormones that begin the whole process of ovulation and as the egg is released then you get the high progesterone, right, mid-cycle, and at the first part of the cycle you're getting high estrogen to build up the internal lining of the uterus so that the baby can implant. And that's what's going on through the entire time that you're menstruating. What happens at menopause is that the ovarian production of these hormones starts to get less and less and less because if you're not ovulating you're not getting the progesterone surges and the estrogen production also drops. What's supposed to happen is that your adrenal glands are producing steroid hormones and those steroid hormones, you want the names? We go from pregnonolone into progesterone into androgen into estrogen. That's the cycle of steroid hormones all of which are made from the cholesterol molecule. And in a woman as you enter menopause you continue to product your androgen which is responsible for your sex drive, your libido, your adrenals make that, and they also then will produce the precursors to estrogen and in the fatty tissues of your body those will be activated into an estrogen that you can use, okay? That's why one of the things that happens as we age, we get fatty replacement in our breasts? The glandular tissue is gone and it's mostly fat tissue. Well that's where our bodies then can utilize part of what our body can utilize to make the estrogen that we need. So this is how we're designed. We're designed to start having less and less estrogen production, have our adrenals kick in, and then do the rest of our lives. That's the way it's always been. I think at this point in time I want to share an article with you that I have here, here it is. Sorry about that. This is a book that was actually written by Dr. Susan Love. Some of you may have heard of her? And the book is called The Hormone Therapy Book: Making an Informed Choice. And it was reviewed in the March 1997 issue of "Healthfacts" to which I subscribe. And she makes this point about it. That the gynecology textbooks in the United States talk about menopause as ovarian failure, okay? And it's a very male-oriented point of view that women's job is to reproduce. That's the medical viewpoint. And that no woman is supposed to ever outlive her menstrual years, her reproductive years. The medical profession has this point of view that before that women would die when their menses were done. Right? They have this mythology that because the average lifespan was shorter that meant that no woman lived passed her menopause and that's simply not true. Those statistics are artifically skewed by the fact that there was such a high infant mortality rate, so many women died in childbirth. The women who survived all of that? They lived to be 80, 85, 90, just like people do today. And they lived that way in a post-menopausal state. She makes the point here that the actual symptoms of menopause, the hot flashes and the acne and the bloating and the insomnia and all the things that we go through as we begin menopause are actually a result of the unevenness of the estrogen production. Our bodies have been accustomed to this certain amount and then you'll get very little and then you'll get a little bit more and it's this back and forth business that's actually causing the symptomatology. Which I think is a very good point. For people who have really severe hot flashes she recommends very short term therapy perhaps six months or so which used to be the medical recommendation in the Physician's Desk Reference. They've only recently changed it in the last edition. And then to taper it off and slow it down and take less and less and less so that then you can come to the point where you don't have the hot flashes and you are living without the drug, okay? I think that's a very interesting point of view and it is one of the ways I think that we should look at managing menopause more effectively. Because all those symptoms, the fuzzy thinking, you know, you can't sleep, all that stuff will eventually disappear as you adjust to having less estrogen in your system. I thought that was a very interersting and if anyone want s a copy of it if you could let us know we can make a copy and provide it to you, send it to you from the office. Let's go on to the next slide, please.
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There are three basic types of estrogen and I'm really going to go through this kind of rapidly, it's kind of technical. E1 is called estrone and it was discovered first but it's actually the second strongest estrogen, okay? It will stimulate the uterine lining to thicken so estrone is one of those that is considered to be very carcinogenic because of that. It also is the one that carries the highest risk of breast cancer because estrone is converted in the tissues to estradiol, I'm sorry, I read that backwards, the fatty tissues take your estradiol which is E2 in your testosterone and make into estrone. So the breasts have a very high concentration of estrone. What you have made as well as all the conversions. Because the body breaks estrogen down by going estradiol, estrone, estriol. Estriol is the least toxic and is the final breakdown product in the body. This one's about 7 times stronger than estriol. Let's go to our next slide which is E2, estradiole.
This is the strongest and longest acting of all the estrogens. It's 12 times stronger than estrone and 80 times stronger than estriol. It is the most carcinogenic because it's the longest acting and it is also the most toxic to the liver. You now cannot get prescriptions, medical prescriptions, for anything except estradiol and Premarin. Those are the two prescriptions that are available. You used to be able to get estrone, you can't even get it anymore. I recently reviewed my Physician's Desk Reference for one of my patients and it's just not available. So the pharmacologic point of view is the stronger the better, right? That's very typical of medical thinking so this is their favored estrogen. And then there is estriol. Estriol is a very interesting compound because it is very weak. It is in fact not a strong long lasting estrogen because it's very easy for the body to get rid of it. Um, the medical people don't like it very well because it is not long-acting, okay? I use a lot of this, it is available from plant source. Several plants produce it, licorice root, soy products, clover and alfafa and the product that I use is actually a soy based product. The fact is that you can't take one pill and have it work all day. It just doesn't work like that. Because the body can break it down relatively fast you have to taken it often through the course of the day, three or maybe even four times in small amounts to control the symptoms. See, what I'm talking about using anything for menopause I'm talking about the most natural thing at the smallest possible dose. And to stop it as soon as you can. To get it under control, get the body working better and then let go of it. But this is for those people who have really severe hot flashes or women who have really bad vaginal dryness which is a late stage effective menopause. You don't see that until women are in their 70's and 80's and for some at that point in time they need some help and then we provide them with the estriol. It doesn't stimulate the endometrial lining so it doesn't have any carcinogenic effects. The other thing about it is that it actually acts as an estrogen blocker and so therefore it is anti-carcinogenic in the way that tamoxifen is. You folks know what tamoxifen is, it's that drug they give to people who have breast cancer to block their own estrogen production so that it doesn't stimulate the cancer growth? Estriol has a very similar effect to that and there's a doctor in Europe his name is Aldercruts?, he's written 250 articles on estriol, researching it in terms of use with breast cancer to see if it can be used as a natural plant source to help women with this increased risk of breast cancer we have been experiencing. You are aware that the tamoxifen study that they were doing in the U.S. as a prophylactic for breast cancer was discontinued? Tamoxifen was being touted as a way for women who have a very high family incidence of breast cancer to avoid getting the disease. So they did a double blind controlled study and they gave women with no cancer the drug and they had a controlled study and they had to stop it because the women were developing cancer, particularly endometrial and uterine cancer. And so therefore they just had to get rid of it and tamoxifen is only approved for 5 years of use so if you have a friend who has had breast cancer and who is on tamoxifen they're only supposed to be taking it for 5 years. That's a very important point because many times they aren't ever taken off of it. It's the same way with Premarin, women are put on Premarin with no understanding that those estrogens are only approved for 6 months of use. And part of the problem with this is that the medical people aren't informed about these limitations by their drug reps in a lot of instances and they just don't know. Estriol is the active ingredient in soy products as I've already mentioned: tofu, miso, soy milk, and all that stuff? Interestingly, you may be aware that women in the Orient have the lowest incidence of breast cancer in the world. Their urinary output of E3, estriol, is 1,000 times that of American women. American woman have almost none in their urine because we don't eat those products. And where these products are eaten freely the urinary output is very very high. So is there a connection? You know, do they know something that we don't? I suspect that they do, given that when Japanese women come to the United States and adopt a Westernized diet their incidence of breast cancer matches ours. So there's definitely some kind of a connection. How many of you have heard that breast cancer risk is increased by certain lifestyle things like, never having had children or not having breastfed, or having had an abortion before your first pregnancy went to completion? There's all those factors that increase the risk of breast cancer. What they found is each and every one of those decreases your natural production of estriol, E3, and that there's a connection to those, uh, that this is the common factor between all of those seemingly unrelated statistics. Okay/ Let's look now at progesterone.
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Yeah, I want to look at progesterone next. As you may be aware, if anyone is on hormone replacement therapy and has an intact uterus, if you're taking high doses or if you're taking estrogens, they want to put you on progestins so that you'll bleed every month so that they'll reduce that risk of endometrial cancer. That's the reason behind it. But what you're taking is not progesterone, which is the female hormone, it's a progestin, which is actually a male hormone. And they're very different, they're very different in their metabolic effects, especially on a woman's body. We now know that estrogen is not what is responsible for increasing bone mass. It is the progesterone. On the other hand, progestin has been shown to have no such effect. It is a male hormone, that's what the word androgenic means. Progesterone will lower blood pressure whereas progestins increase it. Progesterone decreases water retention and progestin increases water retention. Progesterone for most women is very very calming and progestins can make a woman very aggressive. And if you've heard of Provera or Depoprovera that is what the active ingredient is, it's this progestin. Now there's a reason again why this is used medically. It's the same reason that we talked about with the estriol, the E3, natural progesterone is relatively short-acting, you can't take it orally because your liver drinks it, it just instantly takes it and converts it to all these other things that you need. And so unless you're going to do like a transdermal route where you rub it on your skin or an injectable, natural progesterone is really hard to get the benefit from. Um, the other thing is there's no financial incentive for progesterone, you can't patent it, it's a natural product, and so the profit margin on it is very very low if you want to talk in terms of commerce, which, when we're talking pharmaceuticals, we need to do that. And the reason I bring this up is because natural progesterone is now widely available and it is available in these transdermal creams, and it's very effective taken that way. Let's go to our next picture.
The most common prescription for hormone replacement therapy in the United States is Premarin. I'm sure everybody's heard of it, it's almost like a watchword. Well, Premarin contains about 100 conjugated equine estrogens. It's made from pregnant mare's urine and they distill it out to get these estrogens. None of them are human, they're all horse, and they're conjugated. What that means is that the liver can't break them down. So they are very very very long-acting. And because of them being so long-acting, it's increasingly carcinogenic. Premarin, all the studies that have been done on Premarin show it to be the most carcinogenic of all of the pharmaceutical estrogen preparations. And Depoprovera which is becoming increasingly popular, is a combination of Premarin together with that progestin that we just discussed, whose chemical name is methoxyprogesterone acetate. Had to say it, I've got it written down. Okay? So let's go to our next slide.
One of the important facts that I've already mentioned and I want to reiterate is that all of the original studies on estrogen, it was only approved for short-term use. The FDA approved it for use for no longer than six months. And there was a reason. Because at six months the carcinogenicity begins to go up, alright? And estrogen replacement therapy doesn't cure menopause symptoms. What it does is it allows those symptoms to be suppressed and if you cold turkey the estrogen it will all come right back. This is why I found Dr. Love's suggestion so fascinating: I'm beginning to manage menopause in a way that I never did before because as with all of us you have what your teachers tell you and then you have personal experience. And I started menopause six weeks ago, like that! All of a sudden, I had hot flashes. I hate them by the way, don't you hate them? Anyway, and I've gotten now a really good first hand idea about how to manage dosages and all of that sort of thing. The interesting thing is that when I was in Wales I had almost none. And there was less stress, right, and my adrenals were not overworked, and so I immediately noticed a change in all of that. So this reinforces my, what I've been teaching and treating, which is that you have get good adrenal function in place so that you don't have the symptoms of menopause, right? And the stronger and healthier your body is then you can start cutting back on your estrogen replacement and get to the point you don't have to take it anymore. Because I'm really a firm believer that you shouldn't have to take it indefinitely for the rest of your life, okay? Now because of the carcinogenicity of estrogens, they went to a combined therapy which is this estrogen with progestins so that you have the monthly bleeding and you don't have endometrial cancer, right? But the problem that nobody was addressing was this issue about breast cancer. The incidence of breast cancer was directly related to the length of estrogen exposure during a woman's lifetime. So, for example, we know that never having been pregnant will increase your risk of breast cancer. That means you had estrogen production through your entire reproductive cycles, you've never had that period when you had the high progesterone and you didn't have the excess estrogen. Everytime you were pregnant, your body was not being subjected to estrogen, folks, it was just progesterone at that point. And the newest studies that we have show that putting progestins with estrogen now are believed to increase the risk of endometrial cancer, not lower it. There was a journal article, New England Journal of Medicine, in fact there were two of them in 1989, the risk of cancer in long-term perimenopausal treatment with estrogen is not prevented by the addition of progestins, especially after a few years. And then the second article was that it actually may be increased. So we now have problem. If you're a pharmaceutical person, and you're trying to prescribe estrogen for women for the rest of their lives because this is 50 percent of the population and you have just been demonstrated that it's not doing what it's supposed to, now what? Cardiovascular disease and osteoporosis, there's our answer, that's what we'll go for. So if you've noticed, the tenor has really changed. That's now where the emphasis is, it's in osteoporosis and cardiovascular disease. Let's go to our next slide.
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I'm going to skip that one, let's just not do it, it's too technical, I think we've covered that far enough. We're going to talk just a moment here about the side effects of estrogen therapy, because there are really a lot of them, and it isn't something that's generally shared with people. If you use estrogen for longer than a year, your risk of endometrial cancer is quadrupled and that increase in risk continues for up to 10 years after you stop it. If you take estrogens for longer than two years, the incidence of gallbladder surgeries where they have to take your gallbladder out because it stopped working increases double or even triple from the unmedicated woman. Blood clots, also the incidence of blood clots increases. Do you guys remember when the birth control pill first came out and there was all of that uproar? ÉSo when birth control pills were first developed they were very high dosage estrogen, unopposed estrogen, and that's what was causing the pulmonary embolisms and the strokes and the blood clots in the brain and all the stuff that went on in the very beginning. It's kind of been hushed up but it's still the effect of estrogen therapy, that's what it will do. And in fact estrogen therapy increases the risk of heart attack. Now does that astonish you when we're being told to take it to be protected from cardiovascular disease? Here's the study, okay? Researches at the Lyden? University Hospital in the Netherlands analyzed 18 large hormone replacement studies. In other words, they took the statistics from 18 huge studies that had been done elsewhere and put it all together. And their report was actually published in the Harvard Health Letter. They couldn't get into a peer-reviewed journal but they got it in as a Letter to the Editor. Um, hormone replacement therapy doesn't protect against breast cancer or heart disease. Their conclusions were 1) it increases the risk of breast cancer and 2) that women who take the hormones are actually healthier than non-users and have had a lower risk of heart disease before they ever started the therapy so it's an artifact. It's an artifact of the populations that they're studying. And that makes the claims that are being made meaningless. And Danforth, which is the leading obstetrical journal, obstetrical textbook in the United States, actually has a statement in it that estrogens increase good cholesterols (HDLs) and they decrease (LDLs) which lowers your cardiovascular risk, so that should be a good thing. But the statistics show that women on estrogen therapy actually have a higher mortality from cardiovascular disease and heart attack in the epidemiologic studies. So cardiovascular disease is not well-served by estrogens. This is a, there've actually been no studies which demonstrate anything other than that estrogen replacment therapy is carcinogenic. We've had a lot of stuff in the press about you can use hormones to reduce the risk of both cardiovascular disease and osteoporosis but we have studies in 1989 that I've already read to you and then in 1994 in a monograph of the National Cancer Institute there was overwhelming evidence that shows that breast cancer risk is closely related to exposure to synthetic estrogens and progestins. And in 1993 Cancer Journal, that's the name of the cancer, estrogens are implicated in breast and endometrial cancer, synthetic progestins can cause some estrogen-like effects, and some formulations place women at actually greater risk of having breast cancer. I think it's really important that you know these things and you know that they come from scientific journals that are well-respected in the medical community, we're not talking here to try and sound like we're some kinds of alarmists. This is the data that is out there in the literature. And as women you're entitled to know that when your doctor hands you a prescription. You're entitled to know the effects of it. And in many cases you don't' get informed about that. I remember when I was much longer I took birth control pills for a number of years because I had such horrible horrible dysmenorrhea, I couldn't stand up, and in order to keep a job I had to do something to manage that. And nothing had worked, so they put me on them. And I asked specifically about the cancer risk, I was pretty young and ignorant at the time, I didn't know any of this stuff. My doctor pulled down a notebook that she had with all of these reassuring things, they were all promo pieces prepared by the drug companies, but no hard data, okay? So I feel my job is to inform you so you know where you stand. So let's look at the myths of menopause for a moment and explode some of these myths. Menopause is not a disease, first of all. You're not sick if you're in menopause. It's a natural part of the lifecycle. Taking hormones for the rest of your life will increase your risk of cancer. That's a fact. And osteoporosis and cardiovascular disease are lifestyle issues best treated by diet and nutrition. I'm going to spend just a little bit, a moment here with each of these issues, because actually I have two whole lectures, a lecture on osteoporosis, a lecture on cardiovascular disease, but we'll just hit the high spots, okay? Um, have you guys heard about Fosamax? The newest and latest drug for osteoporosis? You've heard of it. I've gotten a lot of people coming in and asking me about it. Because now they're saying that, now I can take this drug and I won't get osteoporosis. And I just read an article about it , I just got a book about the side effects of drugs. It's fascinating. What it does is it locks your skeleton into a static state. In other words, our skeletons are constantly changing, constantly being broken down and built up depending on the stress we put on it, right? Like, if you're a runner, you're going to have really strong leg bones because you're constantly are pounding because your body is responding to that stress. Fosamax doesn't do that. It totally shuts down the body's ability to break down bone and remodel and create it where it's needed. So the bones get very very brittle and the concern is is also that where it's needed is not where you're getting the bone. It isn't going to be the hip that's going to be strong and that's like 85 percent of all women who have fractures, it's hip fractures that are the big problem. Um, the other piece about this is that most women will not suffer a hip fracture in old age and most women who would do that anyway will do that in spite of taking long-term estrogen therapy and that means that you've taken the estrogen for no return. And with the Fosamax there's no information about its safety for longer than three years, that's all, three years of study on it. And it puts more bone in the spine than it does in the hip. So all of those are factors to consider when somebody tells you oh, here, let's take this, now. One of the other very very interesting things about osteoporosis and estrogen hormone replacement therapyÉin 1993 in this medical journal called Maturitas which is a study of the geriatic population, they both start with a G, that's why I came up with gynecologic, um, they found in their study that hormone replacement therapy actually decreases the amount of minerals in your bone. It decreases bone density. And there was an article, it was a study in 1992, in the Journal of Obstetrics and Gynecology, which showed that stopping estrogen therapy stops the bone loss. That's an interesting thing that hasn't hit the public yet, isn't it? And it becomes, in the New England Journal of Medicine in 1993 there was an article which I found was really, probably the crux of this whole thing. That estrogen therapy becomes increasingly irrelevant at the age at women are most at-risk for fracture, which is 75 years of age and above. If you are a woman who has had menopause at the average age which is 51, at 75 if you had been taking estrogen that entire time you've been on estrogen for over 20 years, going on 25 years. Enormous risk for very little return. Because in fact, the statistics show that it doesn't do anything for you. So why on earth would you want to be taking estrogen into your 70's and 80's? My very first chiropractic assistant when I worked with Dr. Patt?, she was 72 and she was still having menstrual cycles because they had her on those, what do they call them, cycle pills? And she was still bleeding. And she hated it, by the way, but didn't know that there was an option. Osteoporosis, we just kind of accept it as a known fact that it's menopause and estrogen loss that causes osteoporosis. The truth is is your bone loss begins before menopause, well before, that's been documented. And that estrogen therapy as we've said increases that bone loss. It's a different story when a very young woman like in her 30's or 40's has an ovarian removal like it's a surgical castration. Those women lose a lot of bone mass as a result of that but that's not true for the average woman who goes through menopause naturally. And the mainstays of prevention where osteoporosis is concerned is nutrition, nutrition, nutrition, weightbearing exercise and lifestyle modification, okay? Your nutrition consists of calcium and the co-factors needed to metabolize it, and that's different for everyone. Some people need vitamin D in greater amounts, some people need parathyroid complex in greater amounts, that can all be determined from the blood test, it's really not very hard to figure that out. But you have to customize that to the individual. You also have to customize it to urinary pH so that the person doesn't develop kidney stones. And it has to be the right kind of calcium, one that's absorbable. Weightbearing exercise, particularly like using ankle weights from walking or little wrist weights, not heavy ones, maybe a pound or so, that has really been shown to increase bone mass. Twenty minutes of sunshine a day, doesn't have to be at the height of the summer sun if you're worried about skin cancer, it can be late in the day, it can be 3, 4 o'clock. Reduce coffee, no cigarettes, no sodas, and a diet that is heavy in dark green leafy vegetables like broccoli and kale and all that stuff, great magnesium and great calcium, okay? You can evaluate your own bone density, there's bone density studies that can be done and you're, as I already mentioned the blood chemistry panel profile will show what your calcium needs are. And that's the real story on osteoporosis. It's perfectly safe and non-invasive. Where cardiovascular disease is concerned, hm, I've lost my page, but that doesn't really matter, I'll just tell you about it. That's not the one, that was the one I just was talking on but it doesn't matter. Cardiovascular disease is strictly a matter of nutrition and lifestyle. I'm going to share with you a graph that I put together for one of my other lectures, my cardiovascular lecture, this is a really interesting set of statistics. They come from the National Center For Health Statistics, that's the deaths per 100,000 from heart disease, okay? And on the right hand side, we have vitamin sales, in billions of dollars, and that graph comes from the U.S. Department of Commerce, right? What's really interesting is when you put them side by side. Do you notice that as this whole movement with natural foods and the information about vitamins and the vitamin sales started to skyrocket in 1970, the deaths started to plummet? There is a direct correlation between proper nutrition, specifically vitamins and minerals and all the co-factors that are needed and the deaths from heart disease. I've said this many times before and I'll just repeat it in a nutshell right here, heart disease in this country is a matter of too much refined carbohydrate, not enough B vitamins, not enough trace minerals, not enough of the proper nutrition that our bodies really need. It makes sense, doesn't it? The heart is the hardest working muscle in your body. It works constantly and it's going to show before anything else these nutritional deficiencies and I'm really excited about how effective it is to treat heart disease with the proper nutrition because all of our cardiovascular drugs are terrible. And so this is a real boon to people and it's not even hard to do. So in summary I'm going to share with you an article from, it's a professional publication put out by one of the many companies that I work with, and they're talking about the risks of hormone replacement therapy and I just want to share one thing with you. "The promotion of hormone replacement therapy as a positive health option for all post-menopausal women has been one of the most successful publicity campaigns of this decade. However, the fact that the long-term safety is not proven seems to have been overlooked. Clearly, long-term hormone replacement therapy should not be given to a woman known to be at risk for either lupus or breast cancer." Because they were quoting a study which shows the increase in lupus, skyrockets with hormone replacement therapy. So what are our alternatives? Let's talk about natural alternatives.
If you're not going to take drugs, what are you going to do? Right? What can you do for yourself? One of the most important things is to stay healthy and sexually active. All the evidence indicates that vaginal dryness is kept at bay by sexual activity. If in the late stages as we were mentioning a woman in her 70's or 80's where she's been menopausal a long time, if there is some vaginal dryness at that point, you can then use the natural estrogen cream directly onto the vagina. That can be used immediately before intercourse and have a very positive effect. The other thing is you want to improve your endocrine system, which is thyroid, adrenal and liver. Those three together balance a woman's hormones throughout her entire life. And if you optimize that function then you won't suffer so much from the menopausal symptoms. I personally believe that our modern society is very counterproductive for a woman's lifecycle, right, because we have all these pressures and all these schedules and like myself, I run a business and I do all of these things and I have all of these demands on me, which puts my adrenals at stress, I admit it, and for that reason I'm not able to be as body conscious as I would like to be. I got really in tune with that when I was on vacation. I very often push myself because I have things I must do. And I think all of us live in kind of a pattern these days. Those of us who don't are very fortunate. There are also Chinese herbal formulas which are used to balance a woman's system and again the Chinese approach is very much like what we're discussing here, it isn't about taking estrogen or a single pill, it's about balancing your entire system. I have here a description of the menopausal formula, Chinese herbal formula, that we use in our office. Some women do well with the estrogen cream, some women do wonderfully with this. So it's just a question of who does best with which one. This one in the traditional formulation, it says, "It strengthens the body. It clears heat from the body and it disperses stagnant chi." And unless you know something about Chinese medicine that might not mean a lot to you. Modern terminology is that is strengthens the complete body, the overall body, and reduces hot flashes in menopausal disturbances. And it does that by supporting the liver and thyroid and the adrenals and actually your whole system. And lastly, lifestyle and dietary change, and by that I mean reducing your overall stress. Allowing your body to function as it is intended to and getting away from those things which we mentioned, coffees and sodas and processed foods and too much carbohydrates, and eating a relatively healthy raw foods diet. One of the things that's really missing in our diet is a lot of raw fruits and vegetables. Most of us eat either frozen or canned or cooked to death kinds of things because that's what's most available. If you want to do anything for yourself that's really simple and easy, just avoid processed foods. If it comes in a box or a microwave container don't eat it, it's not food anymore, it's processed, it's a product, not a food. So I hope that this evening's presentation has given you some food for thought. There's a lot of what sounds like negative data in it but my feeling about this topic is that there's so much misinformation out there that it's really important that you hear the rest of it, the other side, and that you know that there's an option, something you can do for yourself. At our Center we do this all the time, we provide people with programs based on their own personal body chemistry and symptomatology that just kind of makes them healthier, get them better. So we can open this, uh, up to questions at this point, if there's any lack of clarity, I'll be happy to clarify it.
Does this apply to you? If so, see our information on Consultations.
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Osteoporosis Affects Everyone
Note: this is a lecture tape transcription. To obtain a copy of this tape, contact the RFHC.The beginning of our presentation this evening is going to be what we call our new patient orientation lecture on principle centered leadership in healthcare. I repeat this often because one of the biggest problems that I find when I meet with new people in a consultation situation is this is a completely different paradigm. It's a different way of looking at the body, it's a different way of looking at health, it's a different way of looking at doctors. And so therefore it can't be reiterated often enough, because it is really a reality shift, it's a paradigm shift. I actually like to call people clients because we're in a working relationship. I have a few patients who are quite ill and need really a lot of supportive care, but for the most part I like to look at this as a partnership where we work together and as we go through you'll see why. Raymond, would you keep an eye on me and I will point at you when I want you to turn. Oh, it's you? Okay. I'll get it straight. So, principle-centered healthcare is just what is suggests, and for those of you who are familiar with Covey, principle-centered leadership, Stephen Covey, the 7 Habits of Highly Effective People. He also, I happen to adore his tape series, principle centered leadership, it's wonderful. But this principle-centered healthcare goes on these principles. There are natural principles or laws which govern our function and health. Which makes sense, doesn't it? You know, we've got the law of gravity. We've got the law of homeostasis in the body. And all these things work according to principles that have been established for a very long time. And when you understand them and when you adhere to the principles they allow you to access more of your health potential. One of the things which is poorly understood in American healthcare or in terms of the way American healthcare functions although we're beginning to understand it more and more, they aren't working with the natural physiologic principles of your body. Everything they do is to suppress something, change a symptom, usually by suppression. And that is not necessary the way that you heal.
So, here's our first principle. The creative intelligence, God, Higher Power, whatever you're comfortable with, which made the body is what heals the body. And it's your thoughts, emotions and lifestyle which either allow for this process to unfold or which interferes with it. You know, Stephen Covey talks about that moment between the stimulus and your automatic response where your choice lives. This is very much the same thing. You may get an irritant and want to fly off the handle, right? But you always have a choice. You may be driving down the street and see McDonalds and be hungry, but you always have a choice. And it's in that moment of choice where you can start making changes that coordinate with the way our bodies are designed to function. It's very empowering, I think. That's my personal opinion. Now, signs and symptoms are interesting. Have you ever gone into a doctor and start telling him your signs and symptoms and you get the feeling that he just wants you to shut up? This ever happened to you? It's happened to me. Because the way the medical profession looks at this, well these are just things that are beyond your control, and I don't want to hear about it, let me just give you a drug, right? Naturopathy, homeopathy, all kinds of alternative healthcare takes a very different point of view. 85 percent of your diagnosis will be made in the person's story. You have to listen. And you have to listen with an ear to hear the distinctions and ask the right questions. But if you think that's it's nothing but your genes, a germ or some kind of disease that you're inevitably going to get like osteoarthritis, where can you go with that? Medically you can't go anywhere. So as I said, the way we look at it is the majority of these things are about factors that are within your control. So my job as the official chief detective is to determine which those factors are and share that with you and then you can start making choices around them. What usually happens to cause a symptoms is some kind of stressor or even a combination of stressors that exceed your body's ability to readily adapt. I had this situation this morning. On Sunday when I came back from Seattle the car park place left my air conditioner running and burnt out my compressor. I have no air conditioning in my car. This morning I had to drive to Canoga Park to see my dentist and rush hour traffic with no air conditioning and no way to close the car up, because I run an air purifier in my car because I'm so allergic to exhaust fumes. I had a symptom this morning. I was falling asleep on the freeway from the fumes. So I thought, hm, I know what this is, right? So, there's a combination of stressors, a burnt up compressor and car exhaust. Let's go to the next one.
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Then you get these purposeful changes, I'm falling asleep, my body is trying to tell me, "this is toxic, I hate it," right? And it represents your body's best attempts to adapt to the stressor, okay? So where some people, you know we have a whole group of people in this generation currently who think that a fever is a disease, that a fever is an illness by itself. All it is is your immune's system attempt to get you better, it's not an illness. And then your body has to communicate with you somehow and the only thing it has is the language of signs and symptoms. Going to sleep, running a fever, getting a headache, having an ache or a pain, it's your body trying to tell you something. Irritable bowel syndrome, good example of this, diarrhea and constipation, your body's saying "get this stuff away from me, I can't stand it, get it out of here!" Then we have to find out what "it" is, right?
Next. So, here is a new interpretation, let me see, make sure I get the right one. Oh, good. See when I do that, see what happens? So I've got to push the right button. So this is a new model. Here is your health potential, your absolute maximum genetic potential if you were in optimum nutrition, optimum rest, everything. And down here is disintegration which is somewhere after death, right? We, all of us, exist somewhere in this spectrum. We like to stay up here, right? Most of the people I see, and most doctors see, are here. And then the doctor says, come back, we'll watch you. What he's waiting for is for it to get to here because he can't put a name on it until it does. And he doesn't know what to do Ôtil he's got a name. Seriously. They've got a Kahn's Current Therapy, I don't know what they're using at this point, but that used to be the book, if you have a name for a disease it tells you what to do for it. And until you have a name you don't know what to do. So we have this stress and trauma and toxicity living in this area, this is a biggie, which comes up against our own internal resistance and our internal stores, most of us being insufficient and that's why you get dysfunction and/or disease. And after your signs and symptoms develop then you get into pain and inflammation and degeneration and it goes downhill from there. So, here's a very important principle: your interpretation determines your response. Yours, not mine, not Melissa's, not your husband's or your wive's, yours. So you have several choices, the first one being, this is being the most common, especially unfortunately amongst the male gender although more and more women are doing the same thing, you ignore it! You make no changes, dysfunction, disease and degeneration are the logical and natural outcome. In over 50 percent of men who die of myocardial infarct, heart attack, their first symptom is sudden death. And that statistic has not changed in the last 20 years. It's still the same, isn't it? I mean, despite all of the publicity, all the talking, all the public awareness, all the ads, everything, the first symptoms is sudden death. Now, you and I both know that's not the first symptom he had, it's the first one he chose to pay attention to. That's the most extreme example of this, it happens in a lot of other areas as well. Your second choice, you want to seek a therapy that only relieves the signs and symptoms, doesn't identify the underlying cause, isn't too hard, this is part of it, right? I've given many people programs who've walked away. It's too hard. It's what I hear. Then they come back, four or five years later, they're worse. The situation hasn't changed, they still have to do the program, only now they have to do it from worse instead of where they were before. And these therapies which don't address the underlying causes contribute to further degeneration and disease, so it's just kind of like this. Now, your third choice is you actually go through an effective evaluation to understand the fundamental causes of your signs and symptoms and engage in some practical coaching on how to best address these causes. Now, here's the kicker, finding someone who can evaluate and understand the processes that are going forward. I've spent the last 13, 14 years studying this and so I feel pretty confident that at this point in time someone can come in, tell me their story, we can trace it down. If I don't know what it is we can trace it down. But unfortunately in the medical profession, still, and I don't want to sound like I'm wailing on medical doctors, because the same thing is true of people in my profession who don't do this kind of approach, they focus on the minimum. What they can see right in front of them. For one thing it feels safer, it's not as overwhelming, there's not as much to do, and they know that thing and they take care of it and they don't go any further. So finding the right person in this instance is really the key issue. And finding someone who can coach you. It's very good to have someone who has lots of experience, or who's had lots of health challenges, like myself, I've had to learn some of these things in order to keep functioning. I have other friends who have lots of education so they can coach well as well. But it certainly isn't every doctor, unfortunately. So as you make your choices you can stay where you are or you can get worse, they didn't put that on this picture, or you can make responses in a kind of a stepwise fashion so little by little get better. I like this graph for one particular reason. My favorite word is achievable, okay? So we don't try to take you from here to here in one step. It has to be achievable. You start with something you can do, maybe like you had an accident so we get rid of the trauma for you. But you still have some toxicity and you may be taking a little nutritional support just for the trauma but there's still some issues with your internal resistance so we get that taken care of, we go to the next stage. We improve your toxic status, you get more rest, more exercise, and you get a holistic comprehensive nutritional program, and pretty soon before you know it, you've made all these changes and you're way up here. It took me three and a half years to change everything about my lifestyle. I've now lived it for so long that I don't realize how different it is until I travel like I did last weekend. And you have to forgive me if I seem just a little fuzzy because Sunday, you know there's nothing to eat in Seattle? What I discovered in Seattle is I starve or I eat things I'm allergic to so I opted for things I was allergic to. In Portland I had a great time there were lots of health food restaurants and things I could eatÉI couldn't find that where I was in Redmond. So I had an interesting weekend, and I'm better today, but Monday was a disaster, wasn't it, I came home, "hiÉ" I was just barely able to function. So there's nothing to eat in Seattle. And every time I do that it reminds me of how much my lifestyle is different from the average. So now we face a challenge in our culture and the greatest challenge especially living in Southern California is managing toxins. And there are microbial toxins everywhere although I'm not as uptight about this as most medical people are because if you have a strong immune system that's not the issue. The real issue is the chemicals. We live in a chemical soup, from the air to the water to the ground to the foods that we eat, everything is chemically adulterated. And learning about that is one of the most valuable things you can do to preserve your health. So here is a picture of toxic waste management, starting with optimum health again and down to disintegration, as we take in toxins because you can't not, it's going to happen, you have to be able to get rid of them, real efficiently. If you can't, then they start to get deposited in your tissues and finally they lead to disintegration and degeneration. So the issue is to keep moving up this ladder instead of down. Next, thank you.
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This is a picture of weight management and preventive care. It's another version of what we've been talking about, the foods we eat and how they impact our vitality and wellbeing. Your body fact to lean mass ratio, your ability to heal. All of these things, food, macronutrients which are proteins carbohydrates and fats and your micronutrients which include vitamins, minerals, hormones, fats and oils all have to be of good quality in order for your body to stay over here in anti-fat, anti-fatigue, anti-aging and disease and anti-inflammatory pathways. Too many of us are over here, constantly in toxic overload, constantly eating antigens, like I had to this weekend, and this is where we end up, inflamed, always tired, and constantly gaining weight. This is a picture that tries to explain how important gut permeability and bowel toxicity is to this system. Last December I did an intense and in-depth lecture about this topic because the gut wall is the beginning of your immune system and it's the single most important part of getting you well and keeping you well. When the small intestines and colon become compromised, undigested food particles which are these big guys, get into the bloodstream and the first thing you know your body's making antibodies and treating it like a foreign invader. This is the genesis of autoimmune disease and it happens to many of us because we have a multitude of things in our culture, everything from chlorinated water to antibiotics added to our food supply that constantly are destroying our gut lining, so it requires maintenance which most of us don't know about. The Discover magazine last summer in its "Breakthrough" columns was stating that "what do you know? M.D.'s may start giving probiotic bacteria to people, they've figured out it might be important. We've only been doing it for like 30 years. And here we are, our friendly bacteria, this is what probiotics are, the friendly gram positive bacteria that maintain the health of the digestive tract. That's a picture of a healthy gut cell with good bacteria all over it, it's plump, it's healthy, you can just see that good blood flow, everything about is appropriate, we call that eubiosis. And when you have good bacteria, eubiosis, in your gut, you have a healthy intestinal wall, you make your own antibiotics so pathogens come and go, they visit, they don't stick around, you don't get sick from them. You get normal bowel pH, good synthesis of your B vitamins, as well as vitamin K, it keeps pathogens from populating the gut and you get good digestion as a result. Dysbiosis on the other hand is when you have unfriendly toxic bacteria, maybe parasite, maybe yeasts, that's what these white things are, invasive yeasts digging into the gut wall, and they contribute to leaky gut syndrome. You notice how these cells are small and shriveled up and pulling apart. That's a picture of an unhealthy gut. So the goal is to re-establish a healthy intestinal microflora, to help prevent pathogens which are omnipresent to have more than the opportunity to just visit.
This is a whole different topic on pain and inflammation. Did you know that pain killers are the largest selling class of over-the-counter medications in America? Everybody's in pain. Isn't that sad? And yet when I do topics or talk about pain, nobody bothers to come. It's like, "Éwell, I just take an aspirin." However the problem with aspirin is it suppresses your healing process as well. Inflammation is a complex process that you can actually influence by means of diet. This is a cell wall. This is, I can't read this from this angle, excuse me, um, omega-6 fatty acids, thank you very much. These are anti-inflammatory. These are omega-3 fatty acids, anti-inflammatories. Fish oils, have you heard of those? Omega-3's. Warm weather vegetable oils are omega-6's, things like soy and safflower and those good guys, sunflower, all of that. And coming down from the cell wall when inflammation is present, there's a switch right here that goes into pro-inflammatory building blocks resulting in inflammation in the body and this switch is turned by vitamins and minerals and the proper fatty acids. You can eat this pathway which a lot of us do, a lot of us eat a lot of warm weather oils, and actually switch over to inflammation because you don't have enough of the right co-factors. So here's what the drugs do, remember I mentioned that aspirin? They inhibit everything. Aspirin is a non-steroidal anti-inflammatory. So it wipes out both of your good pathways and one of your inflammatory pathways and interestingly leaves the other one. And steroids wipe out everything because they act much closer in. But of course steroids have terrible effects on your immune system as we know. So with nutritional modulation there are a variety of nutrients including ginger, zinc, vitamin E, EPA which is your fish oil, selenium, bioflavonoids, more natural approaches resulting in wiping out both of the inflammatory pathways and switching you over into an anti-inflammatory lifestyle. And there are a variety of products which can be customized to each individual person depending on what they're able to take. I for myself, I use this, ___? Because it does very well for me. I'm very allergic to pineapple which is one of the major anti-inflammatories. I can't take it, bromelain, bromase. So you have to customize this to the individual metabolic profile. So in conclusion, do you think that your choices play a role in your health? Did I do my job tonight? Do you think it's important what choices you make? Good. So once you have made this decision to stay healthy we can guide you in the steps required based on your personal metabolic profile, in fact, we would consider that to be a privilege.
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I would like to go directly into osteoporosis unless someone has big questions about what we just went through. Okay? Alright, let's undertake our topic for the evening. They titled this slide presentation which was prepared for us by the Metagenics people, "Do All You Can To Build Strong Bones." I prefer my title which was, "It Affects Everybody." Because truly in our culture here in the United States we have an epidemic of osteoporosis. I don't like the word epidemic, and I avoid it at all costs, but we have the single highest incidence of osteoporosis of anywhere in the world, and it's all about lifestyle choices. So tonight we hope you've learned something to avoid this. We also have a mindset in this country that as we get older things are going to happen and there's nothing we can do about it. I was struck by this when I was in Louisiana visiting my father. There's a whole group of these men that are in this cardiac rehab together where they do exercises. My father's the only one there who even looks healthy. He's not taking any of their drugs. The rest of these men look like ghosts, they're white as sheet and they're all like, almost like invalids. It's the most interesting thing I have ever seen. And my father is taking a variety of nutrients and everytime the doctor hands him another pill he says, no thank you. And the doctors are like, what do we do now? But he's doing better than almost any of them. And of course all the drugs they want to give him are wrong for him because he's atypical, he doesn't have standard heart problems. So the problem is what we so glibly call the golden years may not in fact be golden for some people. This x-ray where the doctor's pointing right there is a compression fracture, this side of that vertebra has collapsed and as a result of that you can see the spinal curvature and that will never heal. That's going to be a source of continuing pain for this particular person for the rest of her life. And when you get to the stage of compression fracture, osteoporosis is extremely, extremely painful. Why don't you shift that while I finish talking about this slide just a little bit. Osteoporosis is one of the things that dramatically decreases the quality of life. It is a disease which is characterized by decreased bone mass, increase bone fragility, and increased susceptibility to fractures. And there are more than 20 million people in the United States that have osteoporosis. I have interweaved this with some statistics that I did for my lecture some years ago that I wanted to share with you. This disease was unknown before 1940. And in many developing nations in the world it's unheard of, nobody has it, okay? So there are several important points here that I want you to see and to notice. Remember in my little flyer I mentioned that the optimum age for preventing osteoporosis is 18 to 35? Because if your bone density is high before menopause and you can slow the rate of bone loss after menopause the onset of bone demineralization may not clinically appear until the person is older than 150 years. So far isn't the record 136? I think. Nobody's currently alive that is that old, the oldest person currently alive is 118. But you could put it off, Ôtil you were 150! Wouldn't that be cool? I could go there. So, here's what happens in America. These statistics are from 1986, and I have some later from 1994, 200,000 osteoporotic women over the age of 45 fracture one or more bone. And of these 200,000, forty thousand die of the complications of fracture. Hip fractures kill, whether it's because of the pneumonia that develops or the embolism, hip fracture is a very very dangerous event in the life of an elderly person. That's 20 percent of them die. Then fewer than half of all the women who suffer a fracture will ever regain normal function and 15 percent will die just very shortly after the injury. And of those who recover, half of them will have disability. This is a 1980 study of 108 patients, 81 of whom were women as you can see there's a huge preponderance of women in this category, although men are fast catching up as men are leading more sedentary lives. This was published in the Clinical Orthopedica in 1980, 41 percent of these people went directly to a nursing home after a hospital stay, and the remaining 59 percent went home, went to another hospital or died. So not everybody went home. At the end of one year out of this study, only 23 percent of them had been able to go home. Sixty percent of them remained in the nursing home and 11 percent of them had died.
So here's our next transparency. Since 1986 we've had a lot of media attention about osteoporosis, you know, Fosamax, and protect your bones and it goes on and on and on. And a lot of women are receiving estrogen prescriptions to "prevent the development of osteoporosis." This is a sideline, I'd just like to say to you, there is no proof that estrogen prevents osteoporosis. All of the proof is that natural progesterone is what prevents bone loss, not estrogen. But remember that the next time somebody says to you you have to take estrogen to make sure your bones are okay. So we would think that the situation would be getting better, right, I mean look at all the things that we're doing. Well in 1994 Dr. Gabby? Who's a really well known M.D. who does alternative health care, wrote this book Preventing and Reversing Osteoporosis. 1.2 million women suffer fractures each year as a direct result of osteoporosis and the situation is getting worse. More than twice as many major fractures occur now compared with 30 years ago and this difference cannot be explained by the aging of the population, you will often hear that. Oh, a lot of us are a lot older. This situation with osteoporosis is skyrocketing and I'm going to share with you some of the factors that feed right directly into it.
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Now we're ready with the slide. So, we're going to talk a little bit about the aging of our population. The costs of the health care system is estimated to be billions of dollars every year and it doesn't even take into account personal suffering, loss of function, any of that, and of course us guys, the baby boomers, are going to increase this whole demographic significantly. Some of the direct costs include hospitilization, surgery, convalescence, expensive diagnostic and treatment procedures, but there's no way to put a price tag on self-reliance and mobility. So it's very difficult to try to estimate the true cost of all this. There's a lot of good news. The irony is that it can be prevented. It's almost totally preventable. They're being safe when they say "largely preventable." I believe osteoporosis to be totally preventable if you do the right things for yourself. And you can reduce your risk of fracture by your lifestyle choices. Now we know there's a genetic component, a little bit later in the presentation I'm going to show you the risk factors for different demographic groups, but actually the fact is it's what we do with what we're given that's more important than the genetics themselves. Osteoporosis and fracture is almost unknown in Italy, but in my family I've had two or three of my aunts who've had hip fractures who are Italian, so you see, there's something else going on here, right? And, it's the decisions that we make now that will determine how strong and healthy an old age we have. The best time to take steps is as early as possible, preferably in childhood, but since nobody here seems to be under 18, we'll start now, okay? We can certainly improve our chances by making good choices from now on. Go ahead to the next one.
I love this slide. The FDA has been in existence for 60 years. And the FDA is the crme de la crme about everything, right? Do you know there's only a few health plans that they've even approved, there's like four or five, total, and one of them is for calcium and osteoporosis, that calcium helps prevent the development of osteoporosis. Now, we haven't heard a lot about it, we've heard a lot about Fosamax because Fosamax is a new drug that they've developed that's patentable, so it brings them a lot of money. But calcium is unpatentable, so nobody talks very much about it. But one of these statements approved by the FDA revolves around the role of calcium in reducing the risk of osteoporosis and because they recognize how important calcium is to bone health they took this major step and issued an approval on it. So what we're going to do right now is look at the problem produced by osteoporosis and how it develops through life and what a role calcium will play in it. Okay, this is the part that I was talking about about the 18 years olds, peak bone mass, right? Your cells of your body go through their own lifecycle, they form, they age, they're replaced. The older we get the less well this process works. When you're an infant, under two years old, you can watch a baby's capillaries grow, did you know that? If you get like a little baby's ear or a finger or something that's fairly transparent under one of those microscopes, the double ones that you look at larger things with, you can watch the capillaries grow, they grow that fast. Now that isn't happening for you and me. Now that isn't happening for you and me, we're way past that stage. But in childhood and adolescence you can really strengthen and build this
Éthe estimates are your body replaces itself on an average of every 18 months. So your gut cells replace themselves every 4 days. Every 4 days you have a completely new gut lining. But the bone cells it's slower, it takes about 18 months. That's why damage from a mammography study takes 18 months to heal. If you have radiation damage from having your breast mammography done, you need to wait 18 months, but what is the current recommendation? Every 12. So they're working against your body's healing process with that recommendation. That's why I like thermographies so much. There's no radiation. But anyway, we're talking about bones here, and they take 18 months to replace themselves. And you want to be while they're in that replacement process making sure they've got everything they need, all the right nutrients, so they can form healthfully and strong, okay? So a diet that's really healthy in calcium and other nutrients as well as regular exercise is essential to this process.
So here is our peak bone mass age, sometime between 28 and 35, depending on the individual, you reach peak bone density. And at this point the bones are as strong and as dense as they will ever be and from then on bone loss exceeds bone formation, that's just a natural physiologic process. And if you don't provide your body with the right things it accelerates that bone loss. One of the most important features to this is lifestyle. This is one of the reasons why the sedentary nature of the American population is such a worry. Because bones form in response to stress. It's called Wolf's law. They calcify and put down extra calcium when they're weightbearing and loaded. It's also the reason why swimming is not a good exercise for someone who has osteoporosis. There's no weightbearing. You want weightbearing to build bone mass. Okay, let's go to the next.
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Alright, for just a moment now, I'd like to refer you back to your handout. Does everybody have this? Okay. We're going to discuss features of this little by little on each of the slides and I thought it would be nice if you had something up close that you could refer to. Okay. So these are the strong and healthy bones. On your handout it's the bone on the left side. That's a very strong section, it's a section of strong and healthy bone. They have a structure that's similar to reinforced concrete, interestingly enough, there's this very strong protein fiber right along in here, you see that? And it exists in a dense crystal matrix that surrounds the bone, that's what of this is, okay? See that there? Now, we're talking about calcium, but gosh, doesn't that look like it has more in it? And you're right, it does, because there's bunch of minerals that go into the formation of bone. But they all collect around this collagen strand which gives the structural integrity and the template for the bone to form. And that's why it has such tencel strength as well as structural integrity. This is the thing about Fosamax that worries me. And we haven't had it out there long enough to know for sure yet but I predict (I like making predictionsÉusually I'm right, we'll see, check me in 5 years, okay? ) what we're going to find is an increase in fracture with Fosamax. Fosamax prevents the bone from being resilient, it makes it rigid, and that's the worst thing you can do to a bone. A bone should be spongy, it should bounce back when it has trauma on it. Fosamax doesn't allow that to happen, it literally solidifies your skeleton. And so, they're so excited about it that I predict that we're going to have some trouble with it. Next slide.
Now, as we age, we get to start looking like this bone over here. Isn't that groaty? That's really nasty. Look at how eroded it is. See that? It's all weak, there are holes in the matrix, the protein filaments aren't even continuous anymore, they're starting to break down. So the bone is getting more porous and it's getting weaker. The things that cause this to happen are multiple. Environmental stresses, poor diet, aging, a whole bunch of things like that including lack of proper exercise.
Okay, so at some point the bones become so porous and fragile that they can't support the weight and that was what had happened to our lady in the first slide. She had a compression fracture in her spine. That's the most common place that you see it. And it occurs at the places where the curves change. So usually they start out down here, the first ones, and then they move their way up because everytime there's a fracture it changes the curvature of the spine and puts more weight on the one above it. So it's a continuous process. Sometimes nothing more than stepping down off a curb will cause a bone to break. It's a really sad process. I had a wonderful friend, she was an M.D. from Russia and she had worked with Dr. Kenny in the big polio epidemics doing physical therapy, she was this fabulous person, and she got to the point where she couldn't be upright. Everytime she'd sit up another bone would break. So, she spent the last five years of her life in bed in a convalescent home in pain. Very sad. She was a brilliant woman.
And women of course are the ones who are most at risk. They're about 3 more times more likely than men to develop osteoporosis and if you think about what we've said so far this kind of makes sense. It isn't just the hormones. It's also the lifestyle. Far more men than women do heavy labor, are on their feet, are weightbearing, are lifting heavy loads, their muscle mass, their testosterone, promotes that. And women tend to be a little more sedentary, not doing as much to build their bones. There's this one lady that has this book out about weightlifting to keep you young. Well, maybe slightly, light weights might not be bad. And some of this is related to the changes in the hormones that occur at menopause. But as I said, it isn't about estrogen, it is about progesterone. Bone loss begins before menopause. They've now tracked it and they show, you know how when a young girl starts her cycle she's anovulatory. She's just putting out estrogen, no progesterone, she's not making eggs. Well the same thing happens to a women at the end of her cycle, she's not producing eggs, she still has estrogen. So she has her monthly menses, but when she starts becoming anovulatory is when the bone loss starts with the loss of the progesterone, okay? Let's go to the next slide, please.
Let's talk now a little about those things that are within your control. Remember I promised. These are they. Diet, so, what about diet? Well, a lot of us have a long habit of consuming a diet which is very low in calcium and other important minerals. This is one of the most common risk factors. I have some really startling statistics. Let me just go back, you stay where you are I'm going to go back, I wrote it one one of the other slides. The average woman over 45 in the United States has a daily intake of calcium of 550 mg. Does that sound like a lot? If a woman weighs 120 lbs. or less she needs 1100 mg a day. That's less than half of what she needs. If she weighs between 120 to 200 pounds she needs 2,000 mg a day. And if she's on the heavy side and is over 200 pounds she needs 4,000 mg a day. So that 550 starts looking pretty puny, doesn't it? And that's on the average. And the other piece you need to know about that is we only absorb about two thirds of the calcium we need to take in. There's a gut barrier, that's all that we can take in. So if you eat a lot of refined foods (and I hope no one in this audience does if you've been listening to me to any length of time), you're in this category. The things that are high, we'll go into a little bit the things that are highest in calcium and you can do a self-check. High carbonated beverage consumption. I know that soda pop used to be called phosphate of soda because in the Music Man they talk about phosphates, remember? 76 Trombones? That's where I learned it. But that's the main ingredient in soda pop is phosphorus. Phosphorus leaches calcium out of your bones. Takes it right out. And so does red meat. Red meat is very high in phosphorus. And that's what both of these things do, they're very similar. Now we need about 80 mg of protein a day. Excuse me, 80 grams of protein a day. 75 grams of protein is approximately 10 ounces of meat. But I would hope that not all of your protein would be red meat, right? Things like yogurt or eggs or turkey or chicken or whatever or fish are also good choices, keeping your red meat to maybe once or twice a week, right? And people who are strict vegetarians in this culture (let me emphasize this), in America, people who are strict vegetarians tend to be very very calcium deficient. And that's because they're stupid vegetarians (pardon me for saying so) but people in America don't know how to be vegetarian. They don't eat the kinds and the variety of foods that are eaten in cultures that are vegetarian like India and so because of the food choices they make they never get enough calcium. Good sources of calcium in the vegetarian world include dark green leafy veggies and I don't mean lettuce. We're talking about collard greens, kale, and turnip greens. Now how many people do you know in our culture who eat those greens? Some of the É and you do, I know, and so do IÉand in the South and in the black culture although the black culture is now changing, in the Southern black culture they still eat those things, I'm not so sure about out here in California. And then there's broccoli which maybe some vegetarians may be eating, and blackstrap molasses, but for the most part vegetarians do not eat an adequate diet for many nutrients, amongst them being calcium. The other problem with vegetarians in America is their diet is probably 90 percent grains and carbohydrates. Have you noticed how people who like a vegetarian diet, they eat all kinds of breads and pastas and all that kind of stuff? Well grains contain a chemical called phytate and what phytate does is it binds with the calcium in whatever foods you're eating and you can't absorb it. So there's another double whammy in that, okay? This right here I think is probably the biggest risk factor in our culture for young girls because adolescent girls are drinking diet pop, right, when they should be building their bones? And then they get pregnant. And of course pregnancy puts a huge demand on their calcium reserves and they don't have anything to spare because they didn't get it in the first place. So we're going to go to the transparencies now. So if anything else in your family, never serve soda pop. Just that would be a big help. Try to get people off of soda pop. This is an interesting, actually, I love this graph. This is a picture of the insufficient accumulation of bone mass in young adulthood. It came out of The Journal of the American Dietetic Association in 1986. It's an intake of calcium as a percentage of the 1980 RDA. Now, the recommended daily allowance of 1200 mg isn't adequate as you already see from what we talked about so far but that's what this is based on. So these are boys who don't drink soda pop, boys who drink a little soda pop, and boys who drink a lot of soda pop. And the same thing for the girls. So in this classification the only people getting enough calcium are the boys who don't drink any soda pop. Do you see that? The girls are pathetic. Even amongst the non users they're only getting 75 percent of 1200 mg. They've got growing bones, they need closer to 2,000 mg. And the girls who drink the most soda pop are getting only 59 percent of 1200. So what we have here is the group who has the most need for calcium considering the risks of pregnancy to your calcium status are having the least intake of calcium and most of them are drinking lots and lots of soda that's taking away whatever calcium they are taking in anyway. We're going back to the slides, Raymond.
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Now let's talk about the next slide. The other risk factor (for osteoporosis is) lack of exercise. This is a huge problem. One of the things I noticed when I was in Europe is how everybody walks everywhere, you know? You just go out and you think nothing of it. You walk up to the greengrush? And you walk up the hill and you walk here and you walk thereÉwe tend to take the car if it's longer than a block, right? So regular moderate exercise increases your muscle strength and adds to your bone density. So it's very important. If nothing else go out and walk in the evening. It's wonderful for you. Now smoking is a huge risk factor for osteoporosis. Women more than men. Men who smoke have 10 to 20 percent less bone mass than non-smokers and in women it's 15 to 30 percent. So it really hits us hard. Caffeine also affects bone mass. It's a diuretic and it tends to take calcium out in the urine. So if you drink a lot of caffeine you're having a lot of diuresis and you're losing calcium that way. And excessive alcohol consumption and by that I mean more than 2 drinks a dayÉwith men it causes malabsorption of all the nutrients but in women it decreases your estrogen level, so it actually impairs calcium absorption. The other thing about tobacco smoke, I'm sorry, I had this noted and I forgot to talk about it, tobacco smoke contains all kinds of things that interfere with calcium amongst them being cadmium. Cadmium is a heavy metal and it keeps your body, the enzyme which helps you absorb calcium is inactivated by cadmium. So smoking is really a double whammy.
We have age, of course. As we've already spoken, your body stops building bone as efficiently after about 35, and in the genetic picture, small-boned, small-statured women, these are Caucasian and Asian women, are more likely to become osteoporotic as they age, and women whose mothers have developed osteoporosis are at higher risk than those whose mothers didn't. That's a very misleading statement. You have to think in terms of did they nurse, was there an inadequate supply of calcium in the breastmilk becomes the women had inadequate calcium to start with, what were the lifestyles in the family, what was the nutrition in the family, there's a huge number of factors that go into this statement apart from genetic by itself so I just wanted to make you aware of that, okay? Now we're going to our overheads for one minute. We have two more and then we're done with the overheads. This is a risk factor chart. It's easier to see than it is to say. It's the incidence of osteoporosis. Those women at highest risk are white women who have the least skeletal density and the most fractures. Those who are at least risk are black men. And they only, by the way, in this study compared Caucasian and blacks, no other races were included. And the most skeletal density and the least fracture and black women are a little bit more at risk than white men but not a whole lot. So the greatest risk is women of north European, British and Oriental descent. And I think they just through the Oriental in there because it wasn't in this study. I'd like you to take a look at this next chart. There will not be a quiz. I just want you to see it. There's a reason. Probably the most common question I'm asked is, "Doctor, should I take calcium? And what kind should I take?" I would like you to look at this graph of calcium metabolism and then you'll know why it gives me a headache to hear that question, okay? First of all you have to be able to absorb it through the gut and you need all the right nutrients for that. You need adequate amounts of vitamin D plus sunshine because if you don't get sunshine it doesn't convert. Then your liver needs all the right nutrients so that it can convert vitamin D into its active form so that in the kidney you can save your calcium and excrete your phosphorus. And this is all interrelated, okay, and notice all these arrows? Finally, the calcium gets to your bones. My standard answer to this question is I don't know until you take the right blood test for me and people don't understand why. It's right here. Calcium metabolism involves everything in your body and the piece that's not here is your brain and central nervous system. We all think that we have calcium in our body for our bones, don't we? The truth is the calcium in your bones is a reservoir for your brain, because calcium buffers your body to keep your blood at the correct pH so that you don't have seizures or go into a coma. So I have people in my practice who have really high serum calcium but the ratios and the factors are all off so I know they're taking calcium out of their bone to protect their brain. Okay, so that's the last of our transparencies, thank you very much. We're going to go back to the slides now to finish our presentation.
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So, calcium and phosphorus are the major ingredients of bone but there are other trace minerals that play a role as well, there are things like manganese and boron and other elements. And a great deal of attention has actually been focused on calcium in maintaining the health of the bone, there's been a lot of research. Calcium is actually the most abundant mineral in our body, and it exists in the bone as part of a mineral complex called microcrystalline hydroxy apatite which for purposes of this presentation and for everybody in general we abbreviate MCHC. You'll see that on some of the supplement bottles, MCHC, because microcrystalline hydroxy apatite is a mouthful and half the time you can't remember what it is anyway. So in this form there are other minerals and all the trace minerals present. And in order to build bone the body needs all of these trace minerals. So there's now a consensus at long last among scientists that adequate calcium intake when you combine it with regular exercise, 20 minutes of sunshine a day and other risk reduction strategies can have a positive impact on reducing the risk of developing osteoporosis as we age, okay? Remember that. Twenty minutes of sunshine a day. Doesn't have to be in the middle of the day, could be at the end. But you need that to convert your vitamin D to its active form. Yes ma'am, you have to be outside. I go out and do my garden first thing in the morning, when it's cool and the sun isn't too burning? That's how I get mine. And because most of us don't get enough calcium through our regular diet, calcium supplementation is actually a must for most people. This will help us get adequate amounts. And one of the most often quoted studies about the deficiencies in our diet is the Health and Nutrition Examination Survey and it led to a massive government effort to educate people about the importance of eating a healthy diet, so they revisited this study 10 years later and found out that the problem had gotten worse not better. So much for education, people weren't paying attention. So now more and more people are taking calcium supplementation but the question is always which calcium? We now have microcrystalline hydroxy apatite (MCHC) as a supplement. For many years it was not available. The problem with it is it has to be high quality. If it's improperly prepared, it degrades and it isn't useful to the body. It also has to be from a very pure source, the MCHC we use in our practice comes from New Zealand where the herds are organic. In New Zealand they have very strict requirements, they don't use any pesticides, they don't use hormones, they don't use drugs, nothing. New Zealand has built its whole country on this industry where they provide products for vitamins and minerals and health food companies and so they're very stringent about it. And there's a lot of MCHC out on the market, Metagenics developed it, brought it to market, and other people tried to copy it but not with the same quality control. If you'll turn your handout over, I'd like you for a moment to look at the back of it, and you'll see a little (you can read this at your leisure) but you'll notice there's a little chart on the right hand side about the types of calcium. And what I have found in my practice, I used to use exclusively calcium citrate, and then this bone resorption study we talked to you this evening about, this test came out, it's only been available for about a year and a half. And so I ran it on some of the people that I've had on good quality calcium supplementation for years and I found out that although for their age they were doing well they were still losing bone. So I added this MCHC product together with additional calcium citrate to get enough of the elemental calcium and what do you know? The bone loss stopped. So I am now of the opinion that you need both. One by itself won't do enough. And then it lists out all the most common types of calcium, and most people take calcium carbonate because it's inexpensive, oyster shell calcium, dolomite, that's all calcium carbonate. It is the least absorbable and the most adulterated form of calcium there is. There's a lot of heavy metals in it and worst of all, it's cement. Your body has a terrible time breaking it down. I had a patient bring us a bottle of something, Cholestaway or something? It's a product that is supposed to reduce cholesterol by binding it to calcium and when you put this stuff in water, it climbs up the side of the jar to get away from the water. It's averse to liquid. So how can it even dissolve so that you can get the benefit from it. It was fascinating to do that and watch it climb the glass. So bone meal, if anybody's taking bone meal, please stop immediately. Bone meal is incredibly toxic in this country. It's loaded with strontium 90, it has all kinds of heavy metals in it, and I don't, I'm not aware of any clean or good bone meals products. It used to be but it isn't anymore. So you really have to watch it. Alright, could we go to our next slide please.
This is one of the problems with bone meal, lead. Lead accumulates in the bone, so because we have such a high exposure to lead in our culture, all the bone meal products are contaminated with lead. And the other one that is real prone to lead is oyster shell calcium because it concentrates lead out of sea water, the oysters do, when they're building their shells, okay?
So the recommendations in our practice is that you increase your dietary sources of calcium, get regular, moderate exercise along with 20 minutes of sunshine a day, (that's the missing piece on this slide) eliminate your smoking, reduce your consumption of carbonated beverages and alcohol, keep your alcohol to a moderate level, and take a good quality calcium supplementation which has all the other nutrients important to bone like MCHC. The products we have in our office there's three of them and two that I use the most. One's called Cal Apatite and the one that I take is called Cal Matrix and what I call them is bone food because they have all the parts in them and you don't have to worry about a lot of different things, it's all there, and then you add a little bit of extra calcium to get enough calcium. Cal Matrix is most used for fractures, people who have actually broken their bones and reason I take it is it's very alkaline and it works very well with my allergies. I do better with it than I do with Cal Apatite. But that's another choice that you make based on the individual. That's the conclusion of our presentation this evening, and as Melissa mentioned to you we would be more than happy to screen anyone if they're concerned about osteoporosis and all you have to do is call the office or speak to my staff this evening and they'll make arrangements for that test.
Does this apply to you? If so, see our information on Consultations.
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Osteoporosis Statistics
This disease was unknown before 1940; if bone density is high before menopause and the rate of bone loss after menopause is slowed, the onset of a bone demineralization disease may not clinically appear until the individual is over 150 years old.1986 statistics (in America)
> Every year, 200,000 osteoporotic women over the age of 45 fracture one or more bones
Of these, 40,000 die of complications;
> Fewer than 1/2 of all women who suffer a hip fracture regain normal function; 15% die shortly after their injury;
> 1980 study of 108 hip fracture patients, 81 of whom were women (J.C. Gallagher, clinical orthopedics and related research, vol. 140, p. 207, 1980);
> 41% were sent directly to a nursing home after the initial hospital stay.
The remaining 59% went home, went to another hospital or died.
> At the end of one year,
23% had been able to return home 11% had died.
60% remained in a nursing home.
Since 1986, there has been a great deal of media attention to osteoporosis. In addition, many women are receiving estrogen prescriptions to "prevent the development of osteoporosis." We would expect that the situation must be getting better, right?
Currently, at least 1.2 million women suffer fractures each year as a direct result of osteoporosis. (Preventing and Reversing Osteoporosis, Dr. Alan R. Gaby 1994)
And, the situation is getting worse. "more than twice as many major fractures occur now, compared with thirty years ago, and this difference cannot be explained by the aging of the population." Ibid., p. x
OBVIOUSLY, THERE IS MORE TO THE STORY THAN WESTERN MEDICAL SCIENCE KNOWS.
Insufficient accumulation of bone mass in young adulthood: (Table Is adapted from Journal of American Dietetic Association, April 1986, Vol. 86, No. 4)
Soft Drinks and Calcium
Intake of calcium (as percentage of 1980 RDA) by non-users, low-users and high -users of soft dirnks in boys and girls ages 13 to 18
| Group | Calcium % | RDA |
| Boys Non-users | 108% | 1200mg |
| Boys Low-users | 94% | 1200mg |
| Boys High-users | 89% | 1200mg |
| Girls Non-users | 75% | 1200mg |
| Girls Low-users | 66% | 1200mg |
| Girls High-users | 59% | 1200mg |
75% of Low users: consume the median amount of soft drink for their age group, or less
High users: consume more than the median amount of soft drinks for their age group
Girls get less than the RDA no matter what their soft drink status. Women have the highest need for calcium (pregnancy). Soft drinks are high in phosphorus which leaches calcium out of the bones.
SKELETAL MASS
Genetically predetermined:
INCIDENCE OF OSTEOPOROSIS
| Gender and Race | Skeletal Density | Fractures |
| White Women | Least | Most |
| Black Women | Intermediate | Intermediate |
| White Men | Intermediate | Intermediate |
| Black Men | Most | Least |
Those at greatest. risk: Women of Northern European, British and Oriental descent
[see Diagnostics/Bloodwork]
Does this apply to you? If so, see our information on Consultations.
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Calcium
One of the most common questions I am asked - and one of the most difficult to answer is "Doctor, what calcium should I take?" There is no easy and straightforward answer to that. I am, however, very glad that everyone is becoming more aware of the importance of calcium - particularly since it is so deficient in most American diets.The daily requirement