New You Magazine Interview with Dr. Sangeeta Pati MD, FACOG

Here's the gist of what I'd like to know:

From Sangeeta Pati

1. There's a lot of resistance to the idea of replacing hormones. Why?
   • Although the resistance to replacing hormones is on the decline, in general that is very true.
   • The main reason is because of the way in which some studies have been represented to the public in media. Generally when media and even journals provide information about hormones, they refer to HRT (hormone replacement therapy [Hormonal Restorative Medicine]) as one treatment, when we know there are several different forms of estrogens (some protective and some harmful). There are several different forms of progestogens (some protective and some harmful). It is like saying that all soy is "bad" for you, without specifying that fermented non-GMO soy is actually beneficial. Specifically referring to hormone for example, a great deal of confusion surrounds the topic of whether progesterone causes cancer. This is because when we speak of progesterone, we lump all the progestogens into one group, but there are critical molecular differences which make one progesterone molecule either protective or harmful. There are over 5 large studies showing that if you use progestin (which is the natural progesterone molecule with an added side chain), the risk of cancer, heart attacks and clots increases. If you use the progesterone molecule which is identical to the one the body has, there is a protective effect on cancer , heart attacks and clots. Its all in using what the body recognizes as identical and protective. Often results which are negative make the media and positive results do not. For example several years ago the media reported based on a study that "testosterone increases breast cancer". The testosterone used in the study was methyl-testosterone, a relatively toxic form of testosterone which is not identical to the human body. A year later, a study published in menopause showed that testosterone that was identical to the human body decreased the proliferation of breast cells 5-fold. POfcourse this did not make the media. It is very important for the media to specify which form of hormone caused the problems and for the public to ask the same question, when trying to understand any information.
2. What role do hormones play in the female body?
   • Every organ in the body has hormone receptors: all the brain cells, all the heart cells, all the vascular and neurological system, all skins cells, bone cells and so on. When hormones are at optimal levels, they play a critical role in maintaining these organs. So as the hormone levels start to decline at age 25, women (and even men) start to have, not only a slow onset of symptoms , but also slow degeneration of the organs that are maintained by the hormones (brain, bone, heart, skin tone, etc) which leads to Alzheimers, cancers, osteoporosis, fractures, loss of muscle, loss of teeth and vision and even sagging.
3. What happens to our hormones as we age?
   • Hormones start to fluctuate from the age of 10. The first hormones to fluctuate are cortisol (which increases during stressful times), thyroid (which is suppressed when cortisol is high). The thyroid recovery after the age of 40 is never 100% so even if people are in the normal lab range they are not in the optimal range and function compared to where they originally were and therefore the start to have symptoms of low thyroid such as low energy, poor focus and mental clarity, weight gain, depression and a host of other symptoms.
   • As women reach their 30s, progesterone declines and begins to cause lighter sleep, anxiety , panick attacks, mood swings and development of breast cysts, ovarian cysts and fibroids, because progesterone is a major anti-proliferative hormone for reproductive organs.
   • Then comes decline of testosterone and estrogen causing drop in sex drive, mental function, muscle mass, bone mass. Men may additionally experience anxiety, depression, loss of confidence and loss of motivation.
4. Which hormones should we be aware of/concerned about?
   • As above but also now we need to pay attention to the function of the adrenal gland. With the current levels of stress in daily life we are seeing more and more dysfunction of the adrenal gland. When people are exposed to long periods of stress, the adrenal gland which is programmed to respond with increased cortisol production , does not have the nutrients to continue to respond. The adrenal gland then enters an insufficiency status, (some call adrenal burnout) characterized by severe fatigue, multiple sensitivities, allergies, difficulty dealing with normal life stressor like a flat tire, salt cravings, wakefulness in the middle of the night and a myriad of other symptoms treatable by high dose nutrition and hormone replacement (Hormonal Restorative Medicine).
   • Other hormones to pay attention to include melatonin (the main anti-cancer hormone), DHEA (an adrenal immune hormone), PTH (calcium metabolism)
5. What are the benefits of hormone replacement (Hormonal Restorative Medicine)?
   • Better mood, better energy, better sleep, better sex, less pain, weight control
   • Better bones, heart, brain, skin, immune system, muscles, hair, nails
6. What are the risks?
   • Here I would mainly comment that there are risks of using anything at a level too high or a level too low in the body. It is important to aim for physiologically balanced levels.
   • WHI study found what it did because
     1. Women had preexisting disease at average age of 63, which was exacerbated by use of estrone (Premarin), which is a more carcinogenic and clot promoting form of estrogen.
     2. They used Progestins as we mentioned before instead of progesterone
     3. They used oral route which increases clotting mechanisms and estrone
     4. They used a ratio of estrogen heavy in estrone and low in estradiol and estriol
7. Is there enough research in this area to replace with confidence?
   • There is plenty of data to support the risks of not replacing hormones to name a few osteoporosis, dementia, diabetes, cancers, muscle loss, fat gain, loss of sexual function, skin tone, vision and balance. There is data showing that a progesterone deficiency increases the risk of breast cancer 5.4 fold and increases the risk of all cancers 10 fold. So before we ask how safe is hormone replacement therapy (Hormonal Restorative Medicine) we need to ask how safe is it to not replace hormones? Obviously if we were only living to the age of 50 we could have a martini and call it a day. But with the knowledge that we will live longer than those before us, comes the quest to live the best quality of life we can for the next 50 years. If the body has what it is suppose to have (hormones and nutrients) it will do what it is suppose to do.
   • French Cohort Study 88,000 women showed .98 RR breast cancer,
   • The cardiac literature has dozens of studies showing the protective effect of bio-identical transdermal estradiol and progesterone on vascular function and therefore clots, heart attacks and strokes.
8. What other hormones do we replace in the body (to draw a comparison)?
   • Insulin
   • GH
   • Cortisol
   • Thyroid
9. Who can I trust my hormone therapy to?
   • Someone who has dedicated themselves to become an expert in the field through intensive study, review of literature and large patient experience
   • Someone who aims to restore optimal function in the body by optimizing several areas. We use the 5-point restorative model (developed at SaJune Institute for Restorative and Regenerative Medicine) to optimize 1) hormones 2) nutrients 3) remove toxins 4) balance mind 5) balance body. As an example, the thyroid needs iodine to work, insulin needs chromium, testosterone needs zinc, and all three need the liver for activation and safe processing.
   • Someone who puts your interests and concerns first and does not dismiss even the most seemingly minor complaint