Weight Loss and Naturopathic Medicine

Lose Weight, Feel Great

Five Part Series on Weight Loss

1) Introduction and Physical causes to weight gain – Low thyroid function 

2) Physical causes of weight gain– blood sugar regulation

3) Emotional Eating

4) Nutritional Strategies for Weight Loss Success – How to Eat

5) Nutritional Strategies for Weight Loss Success – What to Eat

Introduction to weight loss series – Part 1: Low thyroid function

Lose Weight, Feel Great!

If you have decided that it is time to get healthy, fit and lose weight you will need a plan of action to turn your resolutions into reality. Too often, weight loss goals turn into a familiar roller-coaster of short term success and eventual rebound. Now is the time to get clear on your strategy for long-term success. In my experience of helping hundreds of people to lose weight, I have found that there are three main areas that must be addressed in order to achieve lasting weight loss. First, there are physical reasons why some people are prone to weight gain. Until these issues are addressed, weight loss can seem frustrating, even impossible. Second, most people sabotage their dieting efforts with emotional eating. Coming to peace with our relationship with food is often the key to creating change. Third, education about nutrition and effective eating strategies help us make good choices and ultimately take pounds off. This article is the first of a five part series designed to explore these issues.

Why is it that some people seem to be able to eat everything they want and not gain weight, and others seem to pack on the pounds if they look at food? Genetics certainly play a role, but there are other physical issues that you have more control over that should also be looked at. Low thyroid function is sometimes the culprit. The thyroid gland is situated in the front of the neck and produces thyroid hormones that regulate our metabolism. If the thyroid is sluggish, so too is the rest of the body. When the metabolism is low, we don’t burn as many calories, so more are stored as fat (unless the diet is adjusted). Low thyroid function can affect anyone, but is common in menopausal or peri-menopausal women. Symptoms to look for are as follows:

Symptoms of Low Thyroid Function

  • Low basal body temperature
  • Cold hands and feet
  • Lack of energy
  • Easy weight gain
  • or difficult weight loss
  • Depression or anxiety
  • Constipation
  • Dry skin – esp. shins
  • Dry hair or hair loss
  • PMS and/or menstrual problems
  • Fluid retention or leg cramps
  • Poor concentration / memory
  • Headaches
  • Low sex drive
  • Carpal Tunnel Syndrome
  • Digestive problems –
  • Esp. burping
  • Allergies

The challenge in dealing with low thyroid function is that our current standard laboratory test, called the TSH test, can sometimes miss cases of mild low thyroid function and many people who don’t show a problem on standard lab tests may still need help to improve thyroid function. The Journal of the American Medical Association published an article on this phenomenon. Naturopathic physicians however assess thyroid function through both laboratory and clinical evaluation.

An often overlooked but related condition is Wilson’s Syndrome. It is a condition where the liver is unable to convert the inactive thyroid hormone, T4, to the more active hormone, T3. T3 is the form of thyroid hormone that actually acts on the cells, so it’s function is crucial to how the body operates. Wilson’s syndrome itself does not alter the thyroid hormone test (TSH and T4) so often goes undiagnosed. It may exist in association with true hypothyroidism but drugs prescribed to treat that condition may not entirely solve the problem. Why does Wilson’s syndrome occur? One reason is that prolonged stress can cause excess adrenal hormones (cortisol) to inhibit the conversion of T4 to T3. As a result, the chemical reactions of life slow down, our bodies are colder and we gain weight more easily. The first step in an effective weight loss program is to do a thorough evaluation of the thyroid hormones to determine if they are the root of the problem. Naturopathic physicians then routinely recommend nutritional supplements to restore normal thyroid function. As a last resort, pharmaceutical drugs are sometimes necessary and are often used in conjunction with natural medicines to prevent atrophy of the thyroid gland. When the thyroid is working well, not only do people begin to lose weight, they also feel great.

Physical causes – blood sugar regulation

Blood Sugar and the Battle of the Bulge

The battle of the bulge is a war many people fight daily. With so many dieting philosophies out there, how does one decide which strategy is right? As a naturopathic doctor, I have had many patients come to see me, frustrated by their failed diet plans. In fact, some diets can set people up for cravings and bingeing. In order to lose weight and not feel too deprived at the same time, it is crucial to learn how to regulate your blood sugar.

Blood sugar problems can easily set people up for weight gain, especially fat around the abdomen. We often refer to hypoglycemia or low blood sugar, but the lows are usually the result of blood sugar fluctuations caused by the typical Western diet. The body tries to keep blood sugar within a tight range. If we eat high carbohydrate foods like sweets, breads, juices and pasta, the pancreas puts out a lot of insulin to quickly transport the glucose out of the blood into the cells. Because the human body is not intended to have such highly refined carbohydrate meals, it is confused by the onslaught of carbohydrates caused by these highly refined foods. Too much insulin is put out and the blood sugar plummets. That is when we feel the symptoms of low blood sugar such as confusion, lightheadedness and spaciness.

The brain then sends red alert signals to the adrenal glands telling them to produce adrenaline. This adrenaline rush accounts for the other hypoglycemic symptoms of shakiness, sweating, irritability, anger, heart palpitations, anxiety, insomnia and more.
Unless a person is just not eating and is running out of fuel, the most common cause of hypoglycemic symptoms is “reactive hypoglycemia”, or the crash after eating a high carbohydrate meal. Years of this pattern cause the body to have to put out excess insulin; often several times a day. The cells eventually tire of dealing with so much insulin, and insulin resistant diabetes, otherwise known as adult onset diabetes can result. The other health consequence of blood sugar imbalances is weight gain. Insulin is the hormone that tells the body to store fuel in several ways, including storing fuel as fat. The more insulin in a person’s body, the more likely one is to pack on the pounds. So keeping blood sugar down and in a healthy range will help to avoid that weight problem. Dietary control is the key to blood sugar management, and there are vitamins, minerals, herbs and healthy oils that can help too.

Key Steps for Balancing Blood Sugar:

  • Avoid refined carbohydrates. That means eliminating sugars, sweets, candy, desserts and minimizing fruit juices, breads, crackers and pasta. Increase grains like brown rice, millet and barley.
  • Eat regularly. Enjoy 3 regular meals a day and 2 snacks
  • Eat modest amounts of quality, low fat protein regularly (2-4 times a day). Protein provides nutrients and fuel without raising blood sugar. Examples of protein are nuts, seeds, beans, tofu, eggs, fish, chicken, red meat, and wild game.
  • Include healthy oils like olive oil, flax oil and fish oil daily

Chromium is a trace mineral that has been proven to assist the body to regulate blood sugar and is often deficient in the typical Western diet, but can be taken as a supplement.

Your naturopathic doctor may also recommend supplements to support your adrenal glands.

Recurring blood sugar ups and downs put stress on the adrenal glands and can lead to fatigue and burn out if measures are not taken to control the damage.

Using a strategy of eating whole, healthy foods in a balance of proteins and un-refined carbohydrates, many people lose weight effortlessly and feel more energized. Cravings for sweets and starches quickly fade away, leaving you better able to make healthy choices.

Emotional Eating and Weight Loss

If you know you need to lose weight but have difficulty staying on track to achieve your goals, it may be time to take a deeper look at your relationship with food and with your body. I have had hundreds of patients come to my clinic wanting help to lose weight. Many of them have tried and failed in the past, or lost weight on short term diets that left them feeling deprived, so their weight inevitably rebounded. With each failed “diet” their self-esteem faltered and they had more difficulty trusting themselves and their resolve. When patients tell me they find themselves unable to control their food intake, I know it is time to look at what is really driving the problem. In my personal experience, and with the knowledge gained from helping others to lose weight, I know that a person’s emotional relationship with food and their bodies is the number one factor that can make or break weight loss goals.
Eating well can be an enjoyable part of life, but nutrition needs to be the primary factor in ones food choices in order to achieve good health. When food is primarily a tool to make you feel better emotionally, you will never be able to get enough, and you will be riding the weight roller coaster.



Do any of the following behaviors sound familiar?

  • You say you want to lose weight, but find yourself raiding the fridge before bed.
  • You feel guilty after eating, then eat to make yourself feel better.
  • You sometimes go semi-unconscious and find yourself half way through a chocolate cake.
  • A stressful day at the office or conflict around the house sends you running to the cupboard for something to make you feel better.
  • You find yourself obsessing about what you are going to eat and when.
  • You eat not just for hunger, but for a quick energy boost.
  • You eat when you are tired, bored, angry, sad, hurt, embarrassed etc.
  • If you lose weight, you feel uncomfortable with receiving attention, and find yourself eating more.
  • You’ve read all the books on nutrition, but are unable to give up the “treats” that make you feel good.

If any or several of the above are “you” then you may be experiencing the turmoil of emotional eating and may need a new approach.
When emotional eating becomes a habit, you have entered the realm of addictive eating. I define addiction as the dependent use of a substance or activity to change the way you feel. Discomfort with feelings is the root of all addiction. Learning strategies for dealing constructively with feelings frees you to eat for the right reasons; not for comfort, punishment, social inclusion, safety etc. Here are some key areas to consider in looking more deeply at this issue.

1) Excess weight as a survival strategy:

We are wiser than we think. Sometimes being overweight is a conscious or unconscious strategy to stay safe or avoid pain in some way. Theresa (name changed) was a patient who said she wanted to lose weight, but feared that she would be ridiculed by her sisters and mother, all of whom were overweight. “We are cookin’ and eatin’ women!” was the message from her family. She didn’t want to stand out and make anyone uncomfortable if she lost weight. She had to confront her family patterns and challenge her beliefs about the need to hold herself back to avoid making others feel envious. Until these issues were resolved, any weight loss plan Theresa undertook would surely be sabotaged.

2) Excess weight can also become a survival strategy for women who are uncomfortable with sexual attention. For some women who have been sexually abused, deep down they feel that their extra weight keeps them unattractive to men and therefore safe from unwanted advances. Learning assertiveness skills and even self-defense can be very empowering. Once a woman learns that she has control over her body, she can feel comfortable at a healthy weight. These are not changes that happen overnight. Honor the process as you uncover how weight is serving you.

3) Family of origin patterns:

What were meal times like in your family? Did someone teach you to eat for comfort? Was food a treat for being a good girl/boy? What foods? Was food controlled or overindulged?

Answers to the above questions will shed light on the unconscious patterns and beliefs that may drive your behavior now. Once you are aware of these patterns, you can choose not to let them determine the rest of your life. Achieving and maintaining weight loss requires becoming ever more aware of yourself and your relationship with food. Awareness means that you can be the witness who watches what you are feeling and doing, instead of just blindly consuming and wondering what happened or why lasting change eludes you. Once you are aware and conscious, you can begin to make new choices and employ new strategies that serve your current needs and goals. This is called conscious eating.

Conscious Eating:

The key to conscious eating is to slow down. Before you eat, take three deep breaths. Take that time to check into your body and assess your feelings. Are you drawn to eat for hunger or for emotional reasons? If you are having an emotionally based craving, be resourceful and find another way to deal with your feelings. I spend a lot of time in my practice counselling people on healthy ways to reduce stress and transform their emotional state. If on the other hand you are hungry, take 3 more deep breaths and consciously choose foods that serve your body as a whole, not just your tastebuds. Eat only when you are sitting down and relaxed, not distracted by TV or reading. Enjoy your food and be grateful for the nourishing goodness of whole, natural foods. Conscious eating takes practice and mindfulness, and it can lead you not only to weight loss but also to greater health, vitality and self-awareness.

Top 10 Strategies for Healthy Weight Loss –Part 1 – How to eat

Remember New Year’s Eve? Was this year supposed to be the year of the slimmer and healthier you? If you are still struggling to lose those extra pounds, I want to share with you the safe, common sense principles that have helped many of my patients lose weight. In this article series on weight loss, the first and second installments looked at the physical causes of weight problems such as thyroid and blood sugar disorders. The third article was dedicated to emotional eating. How many people know what to eat, but are unable to stick to the plan? Since emotional eating sabotages most people’s long term weight loss success, the first of my top 10 strategies for healthy weight loss will focus on ways to ensure you will stay on track and achieve your goals. Once we have tackled how to eat, next week we will look at what to eat.



Key Strategies for Weight Loss

  • #1 Eyes on the Prize: Write down why you want to be at a healthy weight. Do you want to have less joint pain so you can play with your grandchildren? Is it so you will feel better about yourself and have less negative self-talk? Is it to have more energy? You will need compelling reasons why you want to lose weight in order to get through the summer barbecues, Halloween candy, Christmas parties and sometimes just the supermarket checkout!
  • #2 Conscious Eating: Before you eat anything, take 3 deep breaths. Check in with your self and your body. Listen for what is motivating your desire to eat. Is it hunger or an emotion? If it is an emotion, a craving, or a body sensation other than hunger, keep breathing and find another outlet for your feelings. If it is hunger, then consciously choose nourishing food.
  • #3 Know your triggers for overeating: Chances are by now you know where the rough spots are. Does boredom send you to the fridge, or do pot-luck dinners result in some serious grazing? Make a plan for dealing with your known trigger situations. Since most diets fall apart when we are under stress, have a list on your fridge of 10 ways to reduce emotional stress without eating. Some good examples are: going for a walk, writing in a journal, reading a spiritual book, talking to a supportive friend, deep breathing, yoga… make your own list.
  • #4 Menu Plan: Many diet books recommend writing down what you have eaten. This strategy can be a helpful part of conscious eating. However, writing down what you are going to eat is also very important. Knowing there is a plan in place means less impulsive eating. Planning means shopping and cooking are more efficient and you will be more likely to stay on track.
  • #5 – Eat to 80% full: Many people who have dieted extensively have a “scarcity consciousness” when it comes to food and they feel they have to eat everything now because there may not be food later. Trust that it is okay to eat just enough to feel comfortably satisfied without feeling stuffed. If you do get hungry, don’t panic. If you find yourself saying, “I’m starving”, reframe that survival mode thinking with “I’m hungry, and when the time is right, there will be plenty of healthy food to eat”.
  • #6 Eat 3 meals a day plus planned snacks: Skipping meals makes conscious eating very difficult. It is hard enough to make good food choices without dealing with the brain fog of low blood sugar. Eat three balanced meals a day, and plan on healthy snacks for mid morning and afternoon. Doing so will keep your blood sugar and energy stable to avoid the temptation to eat sugar for “quick energy”. Nuts like raw almonds make a very good mid afternoon snack.
  • #7 Eliminate late night eating: In many cultures, the evening meal is quite small, thus not loading up the body with calories it can’t burn in the quiet of the evening. I advocate eating a modest meal in the early evening, brushing your teeth, and forgoing eating for the rest of the evening. This strategy eliminates some of the most disastrous eating patterns – eating in front of the TV and grazing all evening on quick, junk food.

Remember, our food becomes who you are. Let your food serve your health first and your taste buds second. Taking charge of your eating habits is an essential step to taking charge of your health.

Top 10 Strategies for Healthy Weight Loss –Part 1 – How to eat

Over the years we have all seen many diet fads come and go. Whether it’s the grapefruit diet, high carbohydrate diet, the Atkins (low carbohydrate) diet, the blood type diet, the Susan Summers diet, they all promise weight loss results. In my experience, any diet that you go on, you can also go off eventually. Most diets result in short term weight loss at best. How do you get off the roller-coaster of quick fix diets? My first goal is to educate people to understand how understand what the obstacles to long term weight loss are for them. (The previous installments in this article series addressed physical and emotional blocks to weight loss). Only then can they implement the long term eating strategies necessary to maintain a healthy weight. Good food also takes time to prepare. That time is an investment in your health and that of your family. No one is exempt from the laws of nature that say that humans need real food on a regular basis in order to think and feel well. Healthy food can be pleasurable not only in terms of taste, but also in knowing that you are fueling your body well. When you eat healthy food, you are creating a body that will allow you to get the most out of life. Eating well does not have to be complicated. In fact, it is very simple. The following are not only common sense practices, they are all scientifically validated strategies for optimal health.
  • #1 Eat a nutritious breakfast: – Eating a healthy breakfast jump-starts metabolism to help you burn calories all day. It also helps you avoid the midmorning crash that can send you running to the coffee and donut cart. To provide stable energy for the morning I recommend having some protein for breakfast (eggs, chicken, fish, beans, tofu, nuts, nut butters, protein powder drinks).
  • #2 Avoid caffeine: Caffeine in the morning not only increases emotional stress, it causes excess acid secretions from the stomach that simulate hunger and can cause overeating. A few hours after the energy spike of caffeine, your energy will plummet and potentially set you up for eating sugar for “quick energy”.
  • #3 Eat whole, simple, unrefined foods: Whole foods consist of fruits, vegetables, whole grains (rice), beans and meats, nuts and seeds, and healthy oil like olive and flax oil. Whole foods are full of nutrients and are the foods that nature intended us to eat. Whatever great intelligence created the human body, provided us with exactly the foods and medicines we need right here on the earth. When we refine and package our foods, we destroy needed nutrients and add chemicals, often making the foods more addictive. Refined foods like flour products, store-bought juices, pre-packaged meals, and of course junk food, have less food value per calorie. Learn to enjoy the simple, delicious flavors of natural, unadulterated foods.
  • #4 Find physical causes of cravings:
    • a) Food allergies: Many of my patients have lost weight effortlessly by eliminating foods that they as individuals are allergic to. We tend to crave the foods we are allergic to thus setting up over eating. With proper coaching, my patients learn to make healthy substitutes for the foods they are allergic to and they feel much better without them.
    • B) Candida: A common cause of carbohydrate craving is a Candida yeast overgrowth in the intestine. This imbalance in the intestinal lining is caused by antibiotic use, oral contraceptive and hormone replacement therapy, or excess sugar consumption. Once yeast has taken over the intestine, it has a way of creating carbohydrate cravings to ensure its fuel supply. Yeast overgrowth also can cause digestive dysfunction, fatigue, skin, hormonal and other problems. In my practice I routinely evaluate my patients for intestinal yeast overgrowth and advise them on how to correct this problem. Once balance is restored, cravings quickly dissipate and weight loss is much easier to achieve and maintain. Avoiding sugars and reducing carbohydrates will help prevent and reduce yeast problems, so that is a great place to start. You will quickly be rewarded with fewer cravings and more energy.
  • #5 – Drink Water We all know that drinking water is good for us, but did you know it could help you lose weight? Firstly, the body’s signal for thirst can be mistaken for hunger and you may think you need to eat when all you need it water. Secondly, drinking water increases your energy and mental clarity. If you drink lots of water, you’ll be less likely to grab a snack for quick energy. Thirdly, water can be used to fill your stomach until you have time to make a healthy meal, thus avoiding grazing while you cook.
You are now armed with powerful tools to help you lose weight. I look forward to hearing from any readers who wish to share their experiences following reading these articles. In addition, if you wish individual coaching or medical advice, please contact my office.

Breast Cancer Prevention

Breast Health Tips for Women:
Early Intervention Strategies in Preventing Breast Cancer

In Canada one in nine women will be diagnosed with breast cancer at some point in her life and the incidence of the disease is rising each decade. In the 1940’s the risk was one in twenty. If we increase our awareness of the causes of this disease and start early with prevention strategies we can help to protect ourselves, our daughters and future generations from breast cancer. Examine the tips below and change what you can each month. 

Lifestyle

  • Spend an hour a week in the sauna to eliminate chemicals stored in your fat cells. Do an 80 hour sauna detox program before you plan to have children so you don’t pass on your body burden of chemicals on to the next generation.
  • Exercise at least 40 minutes each day.
  • Sleep in a dark room, and keep electrical devices at least 3 feet from your bed. Use a night light in the washroom, and avoid turning on a bright light at night.
  • Meditate, or do slow long deep breathing exercises for at least 11 minutes before bed to increase melatonin levels.
  • Take regular relaxation breaks every 2-3 hours throughout the day for about 20 minutes to alleviate stress.
  • Switch to non-toxic cleaning products, like baking soda and vinegar.
  • Avoid cosmetics unless they are free of chemicals and preservatives.
  • Drink filtered water, with the chlorine and pesticides removed from it.
  • Drink water stored in glass rather than plastic. The plastic often leaches chemicals that act like the hormone estrogen.
  • Maintain an appropriate weight. Seek help to lose weight if required.
  • Seek a dentist who will use porcelain fillings in your teeth. Avoid mercury amalgam fillings.
  • Do not use the birth control pill, but consider barrier methods.
  • Use a looser cotton bra rather than an underwire bra. Avoid tight bras.

Dietary

  • Use 30 grams of fibre each day to ensure at least 2 bowel movements a day – add 2 Tbsp. bran to your breakfast cereal, eat legumes daily, use more whole grains, less bread.
  • Add 2 Tbsp. of freshly ground flaxseeds daily to your cereal, juice or fruit smoothie. (Use an electric coffee grinder to grind them).
  • Use 8-10 servings of fruits and vegetables daily.
  • Eat some raw broccoli, cauliflower, kale or cabbage daily.
  • Eat organic food whenever possible.
  • Decrease meat consumption, replacing it with legumes and soy.
  • Decrease dairy consumption, replacing it with organic soy products.
  • Minimize fish consumption unless you know it is free of chemicals and heavy metals. Salmon is an excellent choice.
  • Use extra virgin oil for cooking. If you are frying, use a little water first, before adding the olive oil. Minimize other oils and fats except coconut oil.
  • Minimize sugar, sweets, pastries and desserts, using fresh fruit instead.
  • Spice your food with turmeric regularly.
  • Use onions and garlic with gusto.
  • Use 2 Tbsp. of seaweed daily (nori-sheet, dulse powder) or use a kelp tablet daily.
  • Store your food in glass or stainless steel, rather than plastic.
  • Avoid canned food when the cans are lined with clear or white plastic – this is bisphenol-A, which acts like estrogen and stimulates breast cells to divide.

Supplements

  • Use a multivitamin daily that contains 100-200 mcg of selenium and at least 30 mg of zinc.
  • Supplement with calcium citrate, magnesium citrate and vitamin D daily, with about 800 mg of calcium.
  • Take a total of about 2000IU of Vit D a day.
  • Use 2000 mg of Vitamin C daily. This will help prevent the accumulation of toxic metals, and improve immunity.
  • If you are unable to eat 8 servings of fruits and vegetables, use 1 Tbsp. daily of a green powdered supplement, rich in carotenes and protective plant nutrients.

Environmental

  • Encourage your partner and/or neighbors to discontinue pesticide use on lawns and gardens.
  • Use fewer electrical devices so we rely less on nuclear power. Conserve energy.
  • Spend less time on the computer or watching television, to decrease exposure to electromagnetic fields.
  • Avoid products containing PVC (polyvinyl chloride), such as raincoats, shower curtains, vinyl furniture.
  • Use alternatives to plastic.
  • Take cloth bags or bins shopping to avoid using plastic bags.
  • Find out who the polluters are in your area by logging on to www.pollutioncontrol.org and write letters of lobby to decrease local pollutants.
  • Host an environmental film festival each year to educate yourselves and others.
  • Celebrate Rachel Carson Day, May 27 each year by doing what you can to protect the environment on that day. Clean up your little corner of the earth.

Psychological

  • Find ways to express your anger constructively and let it go. If you have a backlog of anger, seek counseling.
  • Invest your energy in activities, hobbies, volunteer work or causes you feel excited about that develop your skills and abilities.
  • Learn to define your needs and develop assertiveness.
  • Connect with groups of like-minded individuals throughout your life who support and validate you.
  • Find a spiritual practice that connects you to others and to the universal energy or God and use that practice or worship to strengthen faith, hope and love.
  • Resolve conflict as it occurs, rather than holding it inside you, or let it go.

These suggestions are outlined in more detail in the book The Complete Natural Medicine Guide to Breast Cancer, by Sat Dharam Kaur, ND, published by Robert Rose Inc. in 2003.

Bioidentical Hormone Replacement

The pros and cons of hormone replacement therapy (HRT) for menopausal women have been hotly debated for many years. As a naturopathic physician, I’ve helped women navigate the choppy waters of menopause for over two decades. I believe that hormone management should be very individualized, and generally practice a philosophy of lifestyle first, natural medicines second and pharmaceuticals third, if possible. I recently completed a course that analyzed the research on HRT over the last 20 years. When you look carefully at the research, there is a role for hormone replacement therapy not only to help to safely and effectively manage symptoms of menopause but also as a preventative medicine. 

First a bit of history. HRT was used for 70 years before the Women’s Health Initiative (WHI) did the first large placebo controlled study on it in 2002. This groundbreaking study sounded some alarms regarding increased breast cancer risk in the women who took Premarin (estrogen) and Provera (synthetic progesterone).  In addition they found a higher rate of blood clots, which can cause strokes and more. As a result, many women were taken off HRT at that time. 

Then subsequent analysis determined that the study had some major flaws. The average age of the women starting estrogen therapy was 65. We now understand that there is a critical window for starting hormone therapy to maximize the benefits and reduce the risks, which is within 10 years of one’s menopause, or under 60 years of age. 

Secondly, the type of estrogen they used was extracted from pregnant mares’ urine and contained non-human estrogens. Now almost all prescriptions written use a bioidentical estrogen called estradiol or E2. It is processed much differently in the body and has less risks. The progesterone used was a synthetic cousin of our progesterone called progestin, which has many more side effects. Thirdly, the route of administration of estrogen matters. Yes, taking oral pills of estrogen does increase blood clotting especially in women over 60. But using a patch or cream on the skin does not do so in any significant way. We’ve come a long way from 2002 to understand how to use estrogen safely. 

According to the North American Menopause Society, estrogen has strong evidence showing that it helps with hot flashes, and night sweats. They say it can be used for women of any age in very low doses locally for genital and urinary symptoms and to improve sexual function. Systemic estrogen also helps to prevent bone loss and fracture associated with osteoporosis. The research shows that this benefit is most relevant if estrogen is started within five years of menopause and the benefit is lost after ceasing the estrogen. Estrogen therapy can slightly reduce cardiovascular disease risk but only if started early.  

To me, the most interesting evidence regarding estrogen replacement therapy is around reducing cognitive decline. One in three people develop significant cognitive decline in their lifetime, and ⅔ of the people with Alzheimer’s are women. Estrogen has many protective effects on the brain, including increasing neuronal growth and repair, increasing neuroplasticity, decreasing build up of tau proteins and amyloid plaques (associated with Alzheimer’s) and much more. Estrogen seems to help slow cognitive decline, not reverse it. One study showed that women who started estrogen at 75 years old had a worse rate of decline. So yes, there is a critical window for starting estrogen. Women who have their ovaries removed may especially benefit from starting estrogen therapy right away. 

There is some evidence showing that estrogen may help with joint pain, muscle weakness, sleep issues, depression, skin laxity, dry eyes, hearing loss and diabetes. But what about breast cancer? Well, after years of analysis of the WHI study, it has been shown that when they gave horse estrogen and synthetic progestin to women far beyond the critical age window in oral vs transdermal doses, after three years, there was an increase of less than one case of breast cancer over the placebo rate per 1,000 women per year that could be attributed to the hormones. That risk is less than the increased risk of breat cancer associated with drinking two glasses of wine a day, and the same as the risk of being obese or inactive. In women who took only estrogen (women who’d had a hysterectomy), there was a slight decrease in breast cancer rate vs. placebo. Three French studies showed that when estrogen is used with women in a better age window, and coupled with bioidentical progesterone there was no increase in breast cancer rates.  

So the bottom line is that bioidentical estrogen with bioidentical progesterone can have a role to play in the management of symptoms of menopause and possibly to enhance the aging process along with a healthy lifestyle. It’s not for everyone, so discuss it with a doctor who is up to date on the latest research analysis to see if you would be a candidate. For people without extended health insurance, compounding pharmacies can make up HRT prescriptions for about ⅓ to ½ the cost of 1pharmaceutical suppliers, so be sure to let your naturopathic doctor or medical doctor know your preference. Another advantage of compounded bioidentical hormones is that there are a variety of delivery methods that can be used depending on the desired effects and preference of the patient. Transdermal absoption of hormones has been well established in scientific research.