The rules of replacement

Dear Reader, You may not realize it, but funding for clinical research is becoming quite scarce. Which is why it blows my mind when I see researchers continuing to beat the same dead horses over and over again. Now don't get me wrong--I'm a strong advocate for revisiting controversial issues to make sure we get it right. Especially because so much funding comes from dubious sources. But isn't it time we accepted certain facts and moved on? So we can get on with thereal practice of medicine and our most important duty as doctors... the duty of advising our patients well? With decades' worth of research under our belt at this point, there are some issues where the jury really isn't out anymore. And the value of hormone replacement therapy is one of them. So I'm hoping that maybe, just maybe, the latest consensus statement on menopausal hormone therapy will help to put this debate to rest once and for all. Here are the key takeaways: The benefits of hormone replacement outweigh the risks in efforts to ease menopause symptoms--provided that the patient is younger than 60, and the treatment takes place within the decade following menopause. If used within the appropriate time frame, hormone therapy helps to prevent osteoporosis-related fractures. Extensive research also shows that estrogen therapy can lower heart disease and all-cause mortality risk in women under these circumstances as well. While oral hormone replacement therapy raises risk of venous thromboembolism and stroke in women, the absolute risk is still minimal before the age of 60. Combination estrogen and progesterone treatment may be associated with increased breast cancer risk. But again, the risk is small--and it lowers once treatment ends. Menopausal hormone therapy isn't recommended for women with a history of breast cancer. These conclusions are fair enough--and they're certainly based on the best research we've got. They also illustrate why I'm such a big fan of hormone replacement therapy for both men and women. (When used correctly, of course.) But I have one major bone to pick here. It seems the authors don't recommend the use of custom-compounded bio-identical hormone therapy. And that's when I practically choked. Like I mentioned earlier, you always have to follow the money trail. And the fact is, bio-identicals cut into Big Pharma's large piece of the hormone replacement pie. So it's really no wonder that misinformation on this particular topic persists. So let me set the record straight: Hormone replacement therapy can work miracles for women going through menopause. And bio-identical hormones are the ideal choice. In fact, they should be the only choice. There is vast evidence supporting the use of bio-identical hormone therapy over conventional hormone therapy (made from horse urine). Hormone therapy made from horse urine has been shown to do more harm than good, and should be avoided at all costs. For more of my detailed recommendations on natural hormone replacement therapy, see the January 2013 issue of Logical Health Alternatives. If you're not yet a subscriber, you can get started here to access all the back issues at www.logicalhealthalternatives.com. And while we're on the topic of safe HRT... Surgical escape If you do it right, hormone replacement can change your life. And if you do it wrong? Well, it looks like you could be signing up for a life-changing stint in the operating room. A new, large-scale study followed almost 71,000 menopausal French women between 1992 and 2008. And results showed that hormone replacement significantly raised the risk of cholecystectomy--the fancy term for gallbladder removal surgery. The risk appeared to be restricted to women using oral estrogen therapy without added progesterone. I always include both in my HRT regimens for the sake of proper balance. I also typically work with bio-identical creams--definitely a more natural delivery system as opposed to oral therapy. (In this study, gels and patches didn't appear to confer added risk, either.) But both of these factors aside, there are a few things that both men and women should know when it comes to gallbladder surgery. Like the fact that, for as common as it is, it's rarely ever necessary. Gallstones are the most common culprit behind gallbladder attacks. And simple dietary changes can go a long way in warding them off--no organ removal necessary. But despite what you may have heard, giving up fat isn't the answer. So what is? Filling up on healthy, anti-inflammatory monounsaturated fats--from foods like avocado and salmon. So will evening out your body's pH with a steady intake of alkaline foods, like broccoli, cucumbers, and almonds. In other words, stick with my New Hamptons Health Miracle, and you won't end up under the scalpel. It's really that simple. For more on how to avoid gallbladder surgery, see the September 2012 issue of Logical Health Alternatives. If you aren't yet a subscriber, you can subscribe and get full access to all back issues on the website. Until next time, Dr. Fred