Prepare to have your health questions answered here on Safe, Effective, Natural Solutions
with Dr. Todd Binkley, owner of Binkley Healing Center in downtown Ventura.
Now, here's Dr. Todd.
Good afternoon.
I'm Dr. Todd Binkley, board certified doctor of non-force chiropractic and practitioner
of functional medicine.
Functional medicine means using the same tests all doctors use, but instead of using tests
to diagnose and treat disease that you already have, practitioners of functional medicine
use the same tests, usually more of them, and a different yardstick, a better way of
measuring for normal health, for places where normal function has started to fail, where
things are no longer working as they should.
Guess what?
When things aren't working as they should, you don't feel the way you should feel, and
the reasons for that are identifiable with standard testing, but with measuring for different
levels of certain things on those tests where normal function is lost.
Not bad enough to require a prescription or a referral to a specialist or a scan, but
just things that aren't the way they used to be when you were in your 20s, when you
were teens, when everything is working perfectly, that can be remedied with better food, exercise,
and supplements.
One of the most important realms of human health and healing and disease where this
is just hugely applicable and can make such a big difference is with hormones.
So today we're going to talk about hormones.
I'm going to present a really exciting case about a 58-year-old female with overwhelming
stress and fatigue and brain fog and irritability.
These were her main symptoms.
There were several others, and she got amazing results.
Once we did comprehensive testing to identify the things that needed support in her body.
We're also going to talk about the most appropriate forms of testing for hormones in particular.
Gold standard for most tests is blood.
Blood tests are the gold standard for most conditions, but there are important exceptions.
Intestinal pathogens don't show up on a blood test.
Metallic toxicities, mold exposure, heavy metal toxicities, and importantly, hormones,
especially estrogen, progesterone, and testosterone.
These hormones for menopausal symptoms for men with low testosterone and women with perimenopause,
menopause, and postmenopause.
The best way to often, the best way to test for these is not with a blood test.
Your hormones in your blood, your serum levels, you're actually measuring serum levels.
And these, if you look at a graph of serum levels of estrogen and progesterone, they're
up and down, up and down, up and down, all day long, every 10 minutes for six hours.
I'm looking at this graph and it's just up and down.
It's all over the place.
So when you do a serum test of that, you're getting a snapshot in time of something that's
constantly changing.
So it's better for women with menopausal symptoms to test for their hormones with a saliva test.
And there's a lot of great things about that.
Number one, you don't have to get a blood draw.
Saliva test is measuring an average of your levels of these hormones throughout the entire
day.
And if you're going to address any deficiencies in these hormone levels with transdermal creams
or oils, other transdermal remedies, which is the most common way to do it, then it's
much better to measure the levels that you have currently with the salivary test because
that will also show how you're responding to the treatment.
When you treat hormones with transdermal therapies, the levels that show up in serum do not accurately
reflect what's happening in your body, whereas a salivary test does.
So we'll talk about that a little bit later.
But first I want to dive into a headline in the medical literature that came out this
week.
Two, the headline is ovarian cancer risk doubled by estrogen only HRT.
Hormone replacement therapy.
So estrogen only without progesterone, hormone replacement therapy doubles the risk of ovarian
cancer risk.
This is from two decades after the landmark women's health initiative, which changed the
way clinicians thought about hormone replacement therapy and cancer from two of the WHO's
randomized trials, which found that estrogen alone in women with prior hysterectomy significantly
increased ovarian cancer incidence and mortality in post menopausal women.
So estrogen and progesterone together did not increase ovarian cancer risk and significantly
reduced the risk of endometrial cancer.
So this is by Dr. Rowan Chablowski and presented these results at the annual meeting of the
American Society of Clinical Oncology.
Rowan Chablowski, MD, PhD, presented these findings at the American Society of Clinical
Oncology and he and his colleagues conducted an analysis from two randomized placebo controlled
trials which between 1993 and 1998 enrolled nearly 28,000 post menopausal women aged 50
to 79 years without prior cancer from 40 centers across the United States.
From one of these trials, 17,000 women with a uterus were given equine estrogen plus synthetic
progesterone standard hormone replacement therapy, Premprote.
So horse urine plus synthetic progestin.
This was the standard hormone replacement therapy for decades.
And another trial, 11,000 women with a hysterectomy were given estrogen alone or a placebo.
Both trials were stopped early because the estrogen only trial caused an increased stroke
risk and the combined therapy of horse urine, estrogen, and synthetic progestin caused an
increased risk of breast cancer and cardiovascular disease.
So 20 years later, 20 years follow up, this is what they just did, the mortality information
available suggested that ovarian cancer doubled among the women who had taken estrogen alone.
Conjugated equine estrogen, horse urine, estrogen, Dr. Chablowski reminded everyone at his presentation
in Chicago, was introduced in the US clinical practice in 1943 and used for over half a
century.
So the question of its influence on endometrial and ovarian cancer, he says, remains unsettled.
Endometrial cancer and ovarian cancer are the fourth and fifth leading causes of cancer
deaths in women and horse urine, estrogen reduces the risk of one and increases the
other.
Well, to add to confusion oncologist Eleanor Tepelinsky, MD of Valley Mount Sinai Comprehensive
Cancer Care in New Jersey said that 20 years ago, the women's health initiative showed
that hormone replacement therapy increases breast cancer risk.
So everyone stopped taking hormone replacement therapy.
And now people are pushing back and saying, wait a second, it was estrogen plus progesterone
that increased breast cancer, not estrogen alone.
So what's the problem with this?
Well, the problem is many doctors are more likely now to prescribe estrogen only and
unopposed estrogen, estrogen without adequate progesterone to balance it out, creates a
lot of problems.
It is one of the main things a functional practitioner is looking for when we test your
hormone levels.
Progesterone reduces the risk of ovarian cancer and the increased risk of breast cancer, even
when taking synthetic progestin, progestin, synthetic progestin instead of natural progesterone
was always minimal.
The risk, the increased risk in breast cancer of taking even the horse urine, pro, pro,
prem pro.
Premorin is horse urine.
That was the brand name for horse urine estrogen and prem pro was the brand name of the combination
of horse urine estrogen and synthetic progestin.
Even when taking that, the increased risk of breast cancer was minimal, equivalent to
the increased risk of drinking one or two glasses of wine per night, equivalent to the
risk of inactivity or just being overweight.
So if there's this much confusion among mainstream doctors, whatever primary care provider may
be your regular doctor, your internist or your gynecologist or gastroenterologist, let
alone endocrinologist, how are you, if the doctors are this confused about it, how are
you supposed to figure out what's best for you?
Well, before we get to that, here's another excellent article that just came out, headline,
don't fear hormone replacement therapy, but prescribe it correctly.
So this is Dr. Dr. Rachel Rubin MD, urologist and sexual medicine specialist.
She says menopausal complaints are not just hot flashes and night sweats.
We see so many sexual health problems, genitourinary syndrome of menopause, low libido, pain with
sex, arousal disorders, orgasm disorders.
And so she interviewed Stephanie Goubian, director of the Mayo Clinic, women's health
and medical director for the Menopause Society.
And so Dr. Fabiana, the Mayo Clinic says the women's health initiative came out, study
this women's health initiative study, the one I was talking about a little bit earlier
came out in 2002.
And after that, we quote, really left women with few choices about what to do, how to
manage their symptoms, which created a huge vacuum.
Basically after that clinicians decided they no longer needed to worry about being educated
about menopause because there was really nothing to do for menopause.
And we weren't going to use hormone replacement therapy.
And where we've come is now women are having symptoms.
They're having a problem.
I'm still quoting Dr. Stephanie Fabiana of the Mayo Clinic.
It's affecting all aspects of their lives, their relationships, their quality of life,
their ability to work.
And they're saying, Hey, this isn't right.
We need to do something about this.
There's still very little research in this area.
We have a lot more to do and they're demanding answers as they should.
So says Stephanie Fobion, director of the Mayo Clinic for Women's Health and medical
director of the Menopause Society.
And she's being interviewed in this article by Dr. Rachel Rubin.
So Dr. Rubin says we have a lot of tools in our toolbox that are evidence-based that really
work and help people.
We can help these people.
I always say to my patients, you have a generation of clinicians who were not taught how to do
this well.
Hormones are not all good or all bad, all right or all wrong, but they require some
understanding of when to use them and how to safely use them.
Because women are being underserved.
Menopause is not just about hot flashes.
There's sleep disturbance, mood symptoms, irritability, just not feeling right.
She talks a lot about one of the main complaints of women, postmenopausal and postmenopausal
women walking into her office.
One of the main things they always say is, I just don't feel right or I feel anxious.
And joint aches also enter the picture quite frequently.
So it's important, she's saying it's important to remember that estrogen affects every tissue
and organ system in the body.
And when you lose it, you have effects in pretty much every system and organ tissue
in the body, which is really important because we're speaking to the primary care world.
This is Dr. Rubin, I'm still quoting Dr. Rubin.
The way medicine is set up, you're allowed to have one problem.
But menopause is never one problem.
These women are getting diagnosed with a mental health condition, with fibromyalgia, with
dry eyes, with sexual dysfunction, with depression or anxiety.
They're getting 10 diagnoses for what is actually one underlying hypogonadal problem, a lack
of hormones.
So Dr. Fabian from the Mayo Clinic says, at the Mayo Clinic, a physician came to see me
as a patient.
An internist traveled across the country because she's gaining weight, she's losing her hair,
she's sweating.
She thinks there's something horribly wrong with her, like she must have cancer or something.
But when you put it all together, the palpitations and the rest, it was all menopause.
Think of the expense to come to the Mayo Clinic and be evaluated for that.
But no one, including this practicing physician, had put together that all of these symptoms
were related to menopause.
Dr. Rubin goes on to say that primary care physicians were raised on the idea that hormones
cause cancer.
Well, what are the data in 2024?
Am I going to die if I take hormone replacement therapy?
Am I going to risk blood clots and horrible cancers?
Dr. Fabian of the Mayo Clinic replies, when it comes down to cancer risk, the Women's
Health Initiative found that if you have a uterus and you're taking both estrogen and
progesterone, specifically horse urine and synthetic progesterone, the risk for breast
cancer was slightly increased.
And when I say slightly, I'm talking about the increased risk of, I mentioned this before,
this doctor from the Mayo Clinic suggests that that slight increased risk was really
equivalent to drinking a couple glasses of wine a night or being overweight.
One case per thousand women per year after about five years of hormone therapy.
So it was a very small increased risk.
In contrast, the data showed that the risk for breast cancer did not appear to be increased
in women who did not have a uterus.
And the blood clot risk associated with estrogen hormone therapy can be minimized with transdermal
preparations of estrogen, particularly with low doses.
So I'm going to come back on that.
That's a really important point.
All of these risk factors are from the Women's Health Initiative are studying the effects
of horse urine estrogen and synthetic progestin, which is not, it's not even the same chemical
as progesterone.
So when you do transdermal therapies of plant-based estrogens and progesterone, most of these
risks go away, especially when you're using really low doses, which often work better
than the high doses of standard hormone replacement therapy, as most people know it.
So Dr. Rubin goes on, we can learn new things, right?
By adding back hormones, maybe we can keep muscles around, keep mental health better,
keep bones stronger because osteoporosis and fractures kill more people than breast cancer
does.
So as a primary care clinician, how can we learn to write prescriptions for hormone therapy?
How can we learn to counsel patients properly?
Do we have to go back and take a fellowship?
Do I have to, how do I learn to integrate the evidence into my practice?
So how astounding is that?
This is a public, public paper published by Dr. Rubin talking to a fellow clinician admitting
basically that most doctors are not well-educated to address and deal with the problems that
menopausal women walk into their offices with every day.
So Dr. Fabian replies, it's an easy thing to gain confidence, an easy thing to do is
to take a course.
The Menopause Society has this annual meeting in Chicago.
We do a Menopause 101 course for clinicians there.
She says, I put out my plea to primary colleagues in internal medicine and family medicine,
you need to do this.
Think about it.
You're already an expert on brain health and bone health and heart health.
You should be most comfortable in dealing with hormone therapy that has effects throughout
the entire body.
It's important for us as primary care providers to really have a handle on this and to be
effectively managing menopause for women in midlife.
Dr. Rubin replies, I couldn't agree more.
My clinic is full of 50 something women who came back and said, sex is good.
My relationship is good.
I'm kicking butt at work.
I have a patient who just started law school because she feels good, so good.
And she says, I'm keeping up with the 20 year olds.
It's incredible to see women who feel terrible and then watch them blossom and get better.
Dr. Fabian replies, we know a lot of women who are missing work, not taking a promotion
or avoiding a leadership role because of their menopausal symptoms.
Women should never be in the position of compromising their work lives because of menopause symptoms.
So Dr. Rubin finally says, our big takeaway is believe your patients when they've driven
and parked and arranged childcare and showed up to your office and waited to see you when
they're telling you they have all these symptoms and they're not feeling like themselves.
Maybe before you jump straight to prescribing them a serotonin reuptake inhibitor Prozac
for their depression and anxiety or just saying do some yoga and deep breathing.
Instead of that, maybe really dive into the menopause literature and understand the pros
and cons and the risks and benefits of hormone therapy.
Wow.
So these are prominent physicians interviewing, discussing this subject with one another in
a medical paper that was just published.
And sure, it's encouraging to see prominent physicians having discussions like this because
hopefully many other mainstream traditional doctors will listen to them and give more
women the care they need.
But think about it.
These prominent physicians are admitting in public that there's a huge gap in effective
care that's happening for women all across the country on their watch.
These doctors, these mainstream physicians come to these experts for their continuing
education.
They consult with them for difficult cases.
And these experts are saying that most doctors aren't doing a good job with women who show
up with multiple symptoms, all of which are often related to menopause.
This is huge, mainly because among other reasons, apart from that horrible lack of getting the
care that these women need is that this type of care has been available for years if you
know where to find it.
This is standard practice among functional medicine practitioners.
This is a classic example of an instance where functional medicine can change someone's life
doing comprehensive testing to identify all areas of your body where normal function has
gone by the wayside, where support is needed and using better food, exercise, and supplements
to restore normal function to all of your organs and tissues and systems, including
your endocrine system that makes your hormones with safe plant-based and often very low dose
transdermal hormone therapy can change your life or the life of someone you love.
I'm Dr. Todd Bankley.
You're listening to Safe, Effective Natural Solutions to Almost Any Health Challenge.
I promised I was going to talk about a specific case of mine.
This is a 58-year-old female who came in with overwhelming stress, fatigue, brain fog, and
irritability, and I did a comprehensive salivary hormone test, salivary hormones.
Instead of a blood test measuring hormones that are going up and down, up and down, all
day long, we did an average.
We did four, she spit, basically the test is you spit into four little tubes and it
measures four readings of your cortisol levels, your adrenal function throughout the day,
a half hour before you wake up, lunchtime, dinnertime, and bedtime because there's a
natural curve in your adrenal gland activity.
And then the lab, Doctors' Data, the preeminent lab for this type of testing in the country,
makes a fifth tube with an average with a little bit from each of those four tubes to
get an average throughout the day to measure your three estrogens, your progesterone, testosterone,
and DHEA, a precursor for estrogen and testosterone.
So anyway, this 58-year-old female's adrenal hormones were basically flatlined, just low,
all of them were super, super low, and her estrogens were all super, super low as well.
Her progesterone was okay, her testosterone was okay.
So I put her on some supplements to build up her adrenal function back up and a little
bit of estrogen support.
Six months later, her overwhelming stress, she's still working, she's still doing her
life, her stress is probably never going to be gone, but her stress is now tolerable,
from overwhelming to tolerable.
That was huge for her.
She has dramatically less fatigue at work.
The brain fog is gone.
And when I asked her, what about her irritability?
She says, well, I'm no longer irritating.
Other people are still irritating, but my irritability is gone.
That's the way she phrased it.
So hormones are a huge topic.
We're not going to get to all of it today.
I'm going to come back and probably talk about this again next week.
But just to close out, common symptoms of low estrogen are hot flashes, mood swings,
anxiety, insomnia, irritability, vaginal dryness, depression, night sweats.
Most people are familiar with those, but they may not be familiar with some of these.
Varicose veins, urinary tract infections are symptoms of low estrogen, panic attacks, palpitations,
flutter in the heart, loss of sexual interest, hair loss, osteoporosis, strange dreams, memory
lapses, weight gain, hair growth on the face.
Weight gain is always important to people.
A lot of people don't realize that low estrogen also increases your risk of osteoporosis.
So we're going to talk more about this next week.
Benefits of estrogen.
Increased metabolism helps regulate your body temperature better, prevents muscle damage,
increases blood flow, improves sleep.
These are benefits of estrogen.
Decreased arterial plaque, maintain collagen in the skin, decrease blood pressure, improved
mood, decreases bad cholesterol.
Hormones are really important.
Are you getting this?
Benefits of estrogen reduce risk of heart disease, decrease wrinkles, enhanced energy, better
bone density, increased sexual interest, better cholesterol, decreased risk of colon cancer,
helps maintain memory.
If you're not getting this already, hormones affect literally every part of your body.
So who should get a saliva hormone test?
Well, any woman who's unsatisfied, who's already on conventional hormone replacement therapy
and is unsatisfied with the results or worried about side effects.
Women you know who have fatigue and depression and chronic inflammation.
Anyone that you know with heart health issues or memory loss, osteoporosis.
And I keep talking about women because most of the people that come to me for this are
women.
It's mostly menopausal women that benefit the most from this.
But men have manopause, right?
So low testosterone affects the heart health and memory loss in men.
And several of those other symptoms that I mentioned that you think of in women also
affect men with low testosterone.
And there are even normal levels of estrogen and progesterone that men need as well.
And the only way that you know if you have enough is to get comprehensive testing.
So we'll talk more about this next week.
Email me your questions.
I'd love to help someone you love get the care they need so that they can feel the way
they should.
Have a fantastic weekend.
You've been listening to Safe, Effective Natural Solutions with Dr. Todd Binkley.
If you have a health question you want discussed on the show, email your health questions to
drbinkley at binkleyhealingcenter.com.
Take advantage of this opportunity to ask questions for yourself and for your loved
ones because our health matters.
Join him next Friday at 4 p.m. for Safe, Effective Natural Solutions right here on 98.3 The Word,
KDAR.