How to Ask Your Doctor For Bioidentical Hormones

Your doctor can prescribe Natural Bioidentical Estrogen as Estradiol. This is available from any pharmacy as a skin patch or cream. It can also be compounded as a (more concentrated) skin lotion. The more concentrated the cream or lotion the easier and less messy it is to apply.

Bioidentical Progesterone, is available in capsules, known as Prometrium. Oral progesterone should be taken at bedtime because it causes drowsiness. The upside is that it improves sleep and anxiety. Prometrium is made from peanut oil, so don’t use it if you are allergic to peanuts.

Compounding pharmacists can make Bioidentical Progesterone in peanut-free capsules and skin creams. Skin creams will not cause drowsiness and can be used any time of day. Some women need skin creams in the daytime and capsules at bedtime.

Always balance Estradiol with Progesterone, at any age, even if you had a hysterectomy.

Latest JAMA Article Supports Estrogen, Finally!

Estrogen has been deemed safe once again by a new study published in the April Journal of the American Medical Association (JAMA).

In the the original 2002 WHI study there was a group of women taking Estrogen alone, without synthetic Progesterone. This Estrogen only group had NO increase in breast cancer in 2002 and now, over 10 years later there is still less breast cancer compared with women not taking any Estrogen. Women in this group who started Estrogen at menopause had less heart attacks and less bone loss in 2002 and this protection has lasted. Women using Estrogen also had lower death rates, 10 years later.

Sadly millions women were advised to stop all forms of hormone support based on a single study in 2002. Studies have since shown that women not using hormones during menopause have an increase in bone loss, heart disease, depression, insomnia, and less sexual satisfaction.

(JAMA, April 6,2011;305:1354-1355)

Mammogram Debate, Solved with Recent Study?

In 2009, the U.S. Preventive Services Task Force, (USPSTF), turned mammography guidelines upside down by advising women not to start mammography screening until age 50 and to continue every other year, stopping at age 74. I have always disagreed with these revised recommendations and was disappointed that there was an about face in medicine, once again placing women a confused state about how best to handle their preventive health.

A new study, supports the previous recommendations of the American Cancer Society (ACS) to annually screen from age 40 until age 84.

New analysis of 6 Cancer intervention studies have shown that screening in the younger years and continuing into the mid eighties reduced mortality by 39%.

If your doctor changed their recommendations, have him/her check out this February study published in the American Journal of Roentenolgoy, (AJR.10:5609.Feb 2011).

Hormones For “Older” Women

Okay, in the last 2 days I have stumbled across 2  letters to “Dear Annie” in the Boston Globe concerning “older” women lacking sex drives.

One of the women was in her early 60’s, the other was only 48 years old. Both were  lumped into the, “sorry that menopause has taken it’s toll,” category. The advice offered to both was pretty much, “suck it up,”  (literally), and  see a counselor. In both instances NO mention of hormone support was offered. Such a sad state. Unfortunately I am certain we are not the only state where this is happening!

So, for you “older” women out there, here is my advice: you can, and SHOULD use hormone support if you are suffering, no matter what your age. Yes, you are hearing me correctly, there is NO age ban for women to use hormones, even though we have been ill-advised to run from all hormones, especially women over the age of 60.

Why all the misinformation? It stems from the infamous WHI study that showed an increase in heart disease and stroke in women 60 years old and over. As you know from my book, the WHI study had many flaws such as: only carcinogenic Provera was used to substitute for progesterone, only oral horse estrogen (Premarin) was used, by mouth, most women studied had not previously used hormones, so they were already at an increased risk for heart disease and stroke, many women had preexisting heart disease, and most of the women had no complaints, so they did not need hormones at all.

Nothing, and I mean NOTHING improves a woman’s sex drive better than estrogen. Sure testosterone helps, but without estrogen there is no bell ringing and probably a little too much soreness to be thrilled. I know from years of clinical experience with hundreds of women, and I know firsthand, as I am “an older” woman myself.

You can safely use estrogen. I recommend vaginal Estriol (my favorite brand, made by Bezwecken, is available  on the internet), and transdermal Estradiol, (balanced with Progesterone), available from your doctor. If he or she is unenlightened please slip them a copy of my book which has hundreds of references supporting my advice.

Studies have clearly shown that transdermal estrogen does NOT increase clotting, but  estrogen given by mouth does. Natural forms of Progesterone are not the same as Provera, chemically or biologically. Provera has been shown to increase the risk of heart disease.

Transdermal estrogen is available using skin patches, gels, sprays, or creams. All are FDA approved, except compounded creams which cannot be FDA approved because compounded things MUST be regulated by their own approval boards, not the FDA.

In addition to sex hormones, DHEA has been shown to increase a woman’s “vitality,” (yes that’s the term used in the study), and also raises testosterone in women. Viagra does not do much for the sex drive of men and women. Viagra, and similar drugs, pushes the “joy stick,” but it does not make the driver more amorous. Testosterone in men (and some women) is necessary for that. Please go forth and enjoy at all ages!

Mammogram Debate

Okay, once again we woke up to new recommendations, from the latest study, telling us to change everything we’ve been indoctrinated to do about our breasts.

Until now we’ve been “ordered” to endure mammograms, no matter who we are, and what we think, every year,only to be told this morning, “Oops, we got that  that wrong- let’s not do mammograms at all, at least until you are 50.” Confused? Who wouldn’t be. That’s why I always tell women to take control of their health, and not be swayed by the latest headlines. Look critically at all the facts, stay calm, and listen to your own body.

I can pretty much guarantee that in 5 years the latest hormone recommendations, which have for now swung away from any hormone support, will swing back and we’ll be waking up in years to come thinking “I knew I should have been doing that!”

So, what do I think about the latest recommendations? Like always it comes back to common sense and being proactive with your health. Regarding mammography, if you have a strong family history, get a baseline at age 40 and if all looks good i.e. no calcifications, or other suspicions, get another by age 45 and continue to monitor as you and your doctor see fit.

You can even do better. Make sure that your estrogen is balanced by progesterone. Studies have shown that women with progesterone deficiency have an increased risk of breast cancer. Iodine deficiency is also linked with breast cancer. At any age I recommend doing genetic screening for problems with hormone metabolism. There are several companies out there, I use Genovations. The important thing is to find a lab that has a doctor that you can follow with to review results and advise supplementation to improve your metabolism.  I discuss this in detail in the  “Hormone Safety” chapter  in my book.


As many of you are aware, I have been recovering from disseminated Lyme. I am doing much better and hope to be regualarly blogging and speaking in the very near future.  I recently found this quote and thought I would share it with you, as it has brought me inspiration.

“The longer I live the more I realize the impact of attitude on life. Attitude is more important than education, than money, than circumstances, than failures than successes, than what other people think or say or do. It is more important than appearance, giftedness or skill. The remarkable thing is we have a choice everyday regarding the attitude we will embrace for the day.

We cannot change our past.
We cannot change the fact that people will act in a certain way. We cannot change the inevitable.

The only thing we can do is play on the one string we have and that is our attitude…

I am convenienced that life is 10% what happens to us and 90% how we react to it.”

By Charles Swindoll

Am I Giving My Child the Swine Flu Vaccine?

Most of you will be surprised, but yes, I am vaccinating my 10 year old and I am asking my other (college age) children to consider getting the vaccine.  She will be getting the single dose vial immunization (shot, not nasal vaccine) this week.

As many of you know I am against many vaccinations. For instance, I did not vaccinate my children against chicken pox because we do not know if this vaccine provides long term immunity  and I do not want my children to be dealing with this illness as an adult. (I did expose them to the illness when they were young- so now I know they have lifelong immunity to chicken pox.)

I do not recommend getting the cervical vaccine, Gardisil, as it does not offer protection for all strains of the virus associated with cervical cancer. In addition, I have seen some serious adverse effects from its use.

I have not given my children the annual flu vaccine because it is not an “intelligent” vaccine. That is, each year the CDC and the makers guess about the most likely type of  flu that will circulate and build the vaccine based on this prediction. Most years it is only 30-50% accurate. I also worry that my children would not develop immunity to seasonal flus and that repetitive vaccination will weaken their immune system in the long run. Most seasonal flu deaths occur in the very young (<5 yo), and the very old (>65 yo).  I council my patients to decide about flu vaccines for themselves.  If they do well with it, and find it effective, then by all means they can get it. If they do not notice protection or do not tolerate it, I recommend skipping it.

I did not vaccinate my children against the German Measles (Rubella), until adolescence as the Rubella vaccine is necessary to prevent birth defects. I saw no reason to expose my young children’s immune system before they were sexually active.

I am  against multiple vaccinations given at any one time. This can weaken the immune system. I believe that vaccinations should be give separately (single antigen dosing), spaced out over a child’s lifetime, and given at a time when  they most need the vaccine, that is when they expect to be exposed.

So what about the swine flu? I can not convince myself not to vaccinate my children. I have been reading and listening to what is out there. Here is what I’ve learned:

  1. Most people with H1N1 infection will not die. (But most will  be ill for 2 to 3 weeks and have significant symptoms including painful cough, high fever, diarrhea and vomiting).
  2. Most of the pediatric deaths occurred in children who had underlying  neurologic problems, but, 16.6%  or 6 out of 36 children who died were over the age of 5 and completely normal.
  3. The swine flu vaccine is “intelligent,” that is, it is accurate. It is not a guess of what the virus might look like. We know what the virus looks like and have built a vaccine to protect against it.
  4. There are 2 types of vaccine: (1)a nasal spray, which contains a live, weakened (attenuated) virus and (2)an injection that does not contain any live virus. Most studies have have shown that immunity is better in adults with the injectable form. (Because of my Lyme/immuno-compromised state, I can not be exposed to live vaccines-hence the injectable.)  FYI, the single dose vials of injections are thiomersal free.

Chia Seeds: New Super Food for Health

I have been espousing the wonders of ground flax seeds for breast, heart and bowel health for years. Now I want to help you to explore a new “super food,” Chia seeds.  Yes, the same seeds that give us furry green pets can help spring cleanse our bowel, pump us with Omega 3 fatty acids (linolenic acid), provide us with protein and calcium (as much as 2%milk), and hydrate us. This ancient (Aztec) food source is rich in  insoluble and soluble fiber, which have been shown to lower risks of breast and colon cancer, lower blood sugar, triglyceride and cholesterol, and boost the immune system.

Chia  seeds are tiny, white or black (both are equally beneficial) and found in most whole food stores. They are amongst the highest plant source for essential omega 3 fatty acids, important for stable moods, and hormone function. They are inexpensive and  because they swell, like tapioca, have been used as a satisfying food source in weight loss and very helpful for IBS, constipation, and as part of any detox program.

Drink them with warmed almond milk in the morning, add them to cereals, soups, or smoothies.  Check out for information and recipes.

Feeling Great Is The Goal!

I was having breakfast with a friend who proudly confided that she had successfully weaned herself off of all hormone support, less than one year after her total hysterectomy. “Why?” I asked, horrified. “I thought that was the goal,” she replied. “That’s what my doctor said and even you said so in your book.”

She was woefully misinformed. Hormones are not an evil to be avoided and weaned from. Let me clarify: stopping hormone support is not the goal. Feeling great is the goal. Staying healthy as we age is the goal. Having strong bones to dance at your 100th birthday is the goal. Enjoying sex, feeling joy at the sight of your great grandchildren, remembering phone numbers and how to drive your car in your nineties. These are the goals. Using natural hormones, safely, for the rest of your life will make this possible.

Why do we need hormones? Because our bodies are designed to last roughly seventy years, eighty max. If you win the gene lottery you may make it into your nineties- but it won’t be  pretty. Tour a nursing home. Ask the ages. See for yourself what lies ahead. Ask how many women there had total hysterectomies without hormone support (they are the ones using walkers).

Studies have shown that women who use estrogen in the first 10 years of menopause have less calcifications (hardening of the arteries) around their heart. Studies have also shown that using hormones reduces memory loss, bone loss, depression, weight gain, and wrinkles. Hormones prevent sexual dysfunction, urinary tract infections, and vaginitis. The references are in my book.

Ask your doctor for estradiol (patch or cream), natural progestereone (pill or cream). Measure your DHEA-S, maintain your DHEA in the midrange- it will support your testosterone and it has been shown to improve sex drive. Keep your eye on the prize. The world needs more healthy women.

How I am Treating My Lyme

Many of you have emailed asking how I have been treating my Lyme disease. Lyme is the fastest growing infectious disease in the U.S. and most doctors do not diagnose or treat it properly. If you are not suffering from, or interested in Lyme please skip this blog  but pass it on to whomever may be suffering. I hope this will help anyone struggling with this illness.

I am not a Lyme expert, but I found doctors who are and I am doing really well. Lyme disease is curable. Here is what has been working for me.

  • Testing for Coinfections. Most people with Lyme also have other infections, called co-infections.  Some people never fully recover from Lyme even after their initial infection is succesfully treated because they have untreated/undiagnosed coinfections. One coinfection (that I was diagnosed with) is Babesia. Babesiosis is protozoal infection similar to Malaria that infects the brain. The only laboratory that found my Babesiosis was Igenex Labs (listed in my book). Some say that “everyone tests positive at Igenex.” This is not so. I have tested many chronic fatigue patients over the years for Lyme with Igenex and many test negative. It is important to understand that negative tests for Lyme or co-infections is not always accurate. There are many reasons for this. In the case of Lyme, the infection could be in a form that is invisible to the immune system (L form or cysts, see below). False negative tests can occur if a particular bacterial strain was not tested or if a weakened immune system is unable to form an antibody response to the infection. Symptoms are the most important way to determine what co-infections are present. Some infections are not obvious initially, but as treatment progresses, symptoms change, and coinfections become more obvious. As I complete my Babesial treatments I now suspect that I have Bartonella. My Bartonella tests thus far are negative but as symptoms emerge and persist (neuralgia, persisting fatigue, nausea/malaise), I suspect this coinfection and plan to treat for it.  I am also doing further testing for it, (Endothelial Cell Growth Factor Test).
  • Treating Coinfections. My Babesisos was treated with Mepron, Azithromycin and herbs (below). You must treat Babesisos for at least 5 months- if your doctor says otherwise get another opinion. It must be treated for the full life of a red blood cell (4 months) otherwise the infection will recur.  Studies have shown that treatments lasting 5 months had less failures. After 3 to 4 months headaches, and noise/light sensitivity, chills and sweats improved. Using a high dose homeopathic (LM or Q dosing of Nux Vomica) with a skilled homeopath finally got rid of my headaches. I would not recommend doing a homeopathic treatment early on as homeopathy can flare a symptom before it improves it, and that can be confusing. Make sure your homeopath is very experienced.
  • Antibiotics. I used Doxyclycline initially for Lyme, which is a great treatment, but I became very depressed on this. Because of mood problems my Doxycycline was switched to Omnicef (300 mg twice daily) and after 1 month, Probencid was added to further increase Omnicef levels. Antibiotics drive the Lyme infection from the blood into the tissues, where it persists in a cyst or L form. These forms are not detected by the immune system, so blood tests may be negative, although the infection remains in the tissues. For this reason throughout my treatment I have used Una de Gato (Cat’s Claw) because it treats the cyst/L forms. Flagyl also treats cysts, so I currently “pulse” this in every 3 weeks for 2 weeks. In addition, I use two herbs, Artemesin (initially I used the less potent Artemesia) and  Enula, (from Nutramedix), to treat Babesia and  support immune function. Herbal remedies cause die-off symptoms similar to antibiotics (below) so, if you add these in, do so gradually and of course under your doctor’s supervision.
  • Die-off. As infections are treated, the body reacts to the dead bacteria/protozoa and the symptoms from this are called “die-off.” Die-off is a bitch. Everyone experiences it differently, but die-off makes the treatment of this disease the most difficult part of this disease. My die-off  symptoms were depression, severe unrelenting headaches, numbness, fatigue, brain-fog (literally feeling as if your head is stuffed with cotton), confusion, poor name recall, memory loss, executive function problems (missed appointments, unable to add columns of numbers, forgetting to pick up kids, difficulty organizing/prioritizing/sometimes getting lost in the neighborhood, vertigo, and ADD with difficulty keeping organized or on task), soaking sweats,freezing cold, and joint pains. Cholestyramine (see below) is a prescription medication that helped reduce my die-off symptoms. Supplements that also helped were Pectasol from Douglas (a natural form of cholestyramine – I use both), and Pinella extract (an herbal “brain clearing extract” from Nutramedix). Doing less, asking for help, asking for reminders from friends and family, keeping lists and pre-planning my days (best done the night before so that I could problem shoot and ask for help with driving, shopping, etc) were key.
  • Mood. Mood symptoms were perhaps the worst symptom for me. Many people experience depression from long term tetracycline antibiotics (Doxycycline, Minocycline, Biaxin). Switching to Omnicef helped my mood. Lithium Orotate (4.8 mg) 2 pills three times/day (this is not the same as lithium carbonate used in bipolar illness) was also helpful. During a workshop with Dr Christiane Northrup I was introduced to a world wide healing practice, Bruno Groening Circle of friends, which involves meditation to music (downloaded from the web). This practice has been dramatically helpful both physically and mentally.
  • Sleep. Adequate rest is critical to treat and recover from Lyme. Unfortunately, die-off symptoms and neurotoxins can interfere with sleep. I found using L-Tryptophan 500mg (4 capsules on empty stomach) one hour before bed and 9 to 15 mg melatonin worked very well. (Yes, this is a high melatonin dose,  but melatonin is a powerful brain antioxidant which helps protect the brain from neurotoxins) Regular rest and naps are essential to recover.
  • Cholestyramine. This prescription medication is a resin that is normally used to bind fat. Fortunately for Lyme sufferers, it also binds neurotoxins and can be very helpful to limit neurologic symptoms. There are a few things to know about it. Most doctors prescribe it in packets or yellow powder that contain dyes and substitute sugars not well tolerated by Lyme patients. As a result, many patients give up on it, which is a shame as I found this remedy very helpful to reduce die-off symptoms. Be sure to ask for  Generic cholestyramine in a tub. It is a white, pleasant tasting powder. Two pharmacists had trouble finding this for me- if you have trouble, call Pierce Apothecary (617-566-4080) and they can order it for you with your doctor’s prescription. To avoid constipation while using it, take 4 to 6 tablespoons of ground flax seeds. Cholestyramine must be taken between meals  and at least 3 hrs away from Mepron, because it will absorb your medications and food.  Good times to take this is during the night if you wake up, and late afternoon 2-3 hours before dinner. It can deplete certain minerals so I now take iodine, potassium , vitamin K2 and vitamin D3 in addition to magnesium glycinate and calcium aspartate.