10 Ten Hormone Facts of Staness Jonekos

June 30, 2010

 

10 Ten Bioidentical Hormone Fallacies of Staness Jonekos

A recent article on hormones for menopause caught my attention. I was puzzled by the fact that the author, Staness Jonekos, has no medical credentials, training or even a rudimentary knowledge of biological science. Rather, she is an actress with a theater arts degree from UCLA. She chronicled her menopause experience with a book and blog entitled Menopause Makover. To make up for her lack of medical knowledge, Staness joined up with Wendy Klein MD , an academic physician who advocates synthetic, chemically altered hormones (progestins), and SSRI antidepressants for menopausal symptoms.  The latest article by the two women, "10 Hormone Therapy Facts ", is a compilation of nonsense, falsehoods, and half truths, with a hidden agenda  promoting the synthetic hormone industry by maligning natural bioidentical hormones.

Above left image: Bioidentical Hormones represented by Natural Redhead  courtesy of wikimedia commons.

10 Ten Hormone Facts should be renamed 10 Ten Hormone Fallacies

Firstly, the Jonekos article maligns bioidentical hormones as unregulated, non-FDA approved and not supported by science. These claims against bioidentical hormones are  false, and are a smokescreen to hide the really scary fact that synthetic hormones are monsters that cause cancer and heart disease, as shown in the Women’s Health Initiative study.

Secondly, the article tries to confuse the difference between bioidentical hormones and synthetic, chemically altered hormones made by the pharmaceutical industry. Do not be confused, they are very different. Synthetic hormones are chemically altered monsters that cause cancer and heart disease. Bioidentical hormones are identical to hormones found naturally in the human body, the safe and effective choice.
 
Left Image: Synthetic Hormones are Monster Creations.  Boris Karlof  in The Bride of Frankenstein 1935, Courtesy of Wikimedia Commons

Thirdly the article contradicts itself in number 7, stating that blood testing is not needed, while the author earlier reported that blood testing revealed a high estrogen level. Obviously, blood testing was needed.

Fourth, the article quotes the Menopause and Endocrine Societies as authorities without revealing their financial ties to the synthetic hormone makers such as Wyeth.

Fifth, the author says that bioidentical hormones did not work for her. Quite to the contrary, millions of women use bioidentical hormones every day for relief of menopausal symptoms and quality of life. Bioidentical hormones work quite well.

Sixth, After ranting that bioidentical hormones don’t work, the author reports they DO work, and she uses estradiol, a bioidentical hormone.  Estrogen alone without progesterone causes increased risk of endometrial cancer. This important information is omitted from the article, possibly harming women readers who accept Staness as a medical authority, incorrectly concluding that estrogen without progesterone is acceptable.  It is not acceptable, and is a disservice to women.

Let’s go through the article in detail. Note: the Jonekos article text is in italics:

Bioidentical hormone treatment made my menopausal symptoms worse.

"I splurged for Somers’ expensive Beverly Hills doctor recommendation, assuming he must have the answers. He confirmed I was menopausal and gave me tubes of compounded triple estrogen gel and compounded 10 percent micronized progesterone gel, with orders to apply them regularly. After a few months of visiting this overpriced Beverly Hills doctor, my menopause symptoms were exaggerated and my moodiness turned into depression. "

My comment: This bioidentical hormone program of estrogen gel and progesterone is the correct one, used by millions of women daily. It is safe and effective. However, close patient monitoring is required, and the patient should be alerted to watch out for signs of  hormonal excess.

Blood Test revealed my estrogen levels were 7 times higher than normal

A blood test revealed that my estrogen levels were seven times higher than normal, my increased weight now placed me into the overweight BMI category, and my severe crankiness made it impossible to work. There is no need for testing of hormone levels, either in saliva or blood. The science has shown that there is no predictable correlation between hormone levels in saliva or in blood and severity of symptoms. “

My comment: Apparently Jonekos visited a bioidentical hormone doctor in Beverly Hills. Uzzi Reiss MD  is well known in Beverly Hills and prominently mentioned in Suzanne Somer’s book.  Jonekos obviously did not read Reiss’s books on bio-identical hormones which explain the symptoms of estrogen excess. These are fluid retention, bloating, breast enlargement and tenderness.  Once these estrogen excess symptoms are identified, the estrogen dosage is held until symptoms are gone. Educating the patient about estrogen excess symptoms, and when to hold hormone dosage is the key to successful treatment program.

An omission Jonekos revealed in a blog posting elsewhere is the story of birth control pills for many years. Birth control pills are synthetic hormones, and when these are abruptly stopped, this causes onset of menopausal symptoms. This complicates the story considerably. Birth control pills are a form of chemical castration, halting ovulation. Birth control pills cause artificial cycles without ovulation. Once the pills are stopped, there is usually a delay of months before normal ovarian function and normal cycling resumes. Until ovarian function returns, there is no hormone production and patients experience typical menopausal symptoms with low hormone levels.

Let’s assume such as a scenario took place.  When such a patient begins a bioidentical hormone program, hormone levels will go up with relief of menopausal symptoms. The patient feels better.  However, a few months later, there is resumption of ovarian function which pumps new hormones into the patient’s body, added to the levels produced by her hormone creams.  This causes hormonal excess with all the usual symptoms of bloating, breast enlargement and mood disorder. This is not a failure of the bioidentical hormone medication. Hormonal excess means the hormones are working too well, raising estrogen levels too much. This is not a failure of the medication, rather it is a failure of patient monitoring and failure to alert the patient to these symptoms. Blood testing is useful here to show elevated estrogen levels.

Unregulated Hormones Not Supported by Science

"What went wrong? I trusted a resource not supported by science. I was taking unregulated hormones. It was eye-opening to learn that natural compounded bioidentical hormones were unregulated by the FDA. There was no standardization for producing the product, and no tests on the formulations. There are NO real natural hormone products available."

My comment: Jonekos clearly has a bad experience with this first doctor, and then incorrectly concludes there is something wrong with the bioidentical hormones, saying that biodientical hormones are not supported by science, unregulated, non-standard, and untested. Of course, this is all nonsense. Bioidentical hormones are heavily regulated, tested and supported by science. The statement , “There are NO real natural hormone products available” is more nonsense. Quite to the contrary, millions of women are using them every day.

Science DOES support the use of bioidentical hormones for menopausal symptoms. Go to Medline and do a search for estrogen or progesterone (link ) and 90,000 articles will come up. Dr Holtorf’s article in PostGraduate Medicine , The Bioidentical Debate , cites 196 articles supporting that bioidentical hormones are safer and more effective than synthetic chemically altered hormones.

Bioidentical hormones are heavily regulated as both FDA approved products at the corner drug store and as compounded preparations. Compounding does not fall under the jurisdiction of the FDA, so FDA regulation is not needed or even desired. Instead, Compounding pharmacies have a separate system of regulation at the state and local level which is rigorous and recognized by the AMA. Look for a compounding pharmacy with PCAB accreditation .

1 ) Natural: The word "natural" is a marketing term. There is no scientific evidence that custom-compounded bioidenticals are safer or more effective or more "natural" than standard pharmaceutical bioidentical prescriptions. The only "natural" hormones are the hormones being made by your body.

My Comment: The word “natural” is not only a marketing term. Natural means anything found in the natural world that cannot be patented.  This next comment is a tautology as bioidentical is still bioidentical whether found in FDA approved prescriptions or in compounded preparations.  We know from the Women’s Health Initiative study JAMA 2002 , that synthetic hormones are monsters that cause cancer and heart disease. Bioidentical hormones are safe and do not increase risk of cancer or heart disease as shown in the French Cohort study .

2) Bioidenticals: Laboratories create formulations that are either identical (bioidentical) or not (non-bioidentical) to those in your body. There are FDA approved prescription estradiol products that are bioidentical that are not "compounded."

My Comment: This is correct.

3) Compounded hormones: Made in a pharmacy by combining, mixing or altering ingredients to create a customized hormone for an individual patient. Compounding pharmacies must be licensed and regulated by the State Pharmacy boards. However, they do not have to demonstrate the safety, effectiveness and quality control, based on large, scientific studies that the FDA requires of pharmaceutical manufacturers. Compounding pharmacies use chemically synthesized hormones made from plants —
the same government-approved ingredients that are used in a manufacturer’s laboratory. "Compounded" formulations are neither safer nor more "natural."

My Comment: Compounded Pharmacies are not under FDA jurisdiction, and that is why they are not regulated by the FDA. Instead, they are regulated by the state and local government. To expect and insist on FDA regulation for compounding pharmacies is like saying your state driver’s license is invalid because it was not issued by the federal government.

What Does FDA Approval Mean?

The author creates confusion about the meaning and significance of FDA Approval
Food and Drug Administration approval does not confirm that the drug is the most effective or the safest drug for you.  FDA approval means the drug is more effective than placebo for its indicated use and benefits outweigh risks.  Drug Manufacturers spend 500 to 800 million doing clinical studies submitted for FDA approval, because of the future prospects for greater profit.  The chemical structure of a bioidentical hormone, like other natural substances, cannot be patented, so there is very little financial incentive for a drug company to spend all that money on clinical studies when profits cannot be assured. 

Non-FDA aproved indications

Drugs are FDA approved for certain medical indications.  About 20% of the time, doctors  prescribe drugs for non-FDA approved indications. For example, Dr Wendy Klein advocates the use of SSRI antidepressants as a non-hormonal treatment for hot flashes. This is a non-FDA approved use of the drug. At the same time, Dr Klein criticizes doctors who prescribe compounded bioidentical hormones as non-FDA approved.  This is hypocrisy.

Chemically Synthesized Hormones

By using the phrase, “Compounding pharmacies use chemically synthesized hormones” , the author is again confusing the reader with the difference between synthetic hormones and bioidentical hormones. They are quite different.  Synthetic hormones are chemically altered monsters.  On the other hand, Bioidentical hormones have the same chemical structure as those found in the human body.  How the hormone was made or manufactured is not important as long as the chemical structure is identical to the human hormone.

The North American Menopause Society (NAMS), a non-profit organization of expert scientists and clinicians, "does not recommend custom-compounded products over well-tested, government-approved products for the majority of women." The Endocrine Society has stated that, "Post-market surveys of such (compounded) hormone preparations have uncovered inconsistencies in dose and quality."

My comment: The author omits that both NAMS and Endocrine Society have publicly acknowledged financial ties to the drug industry.   In addition, both organizations advocate the use of synthetic “monster” hormones, and as such, represent the financial interests of the synthetic hormone industry (such as Wyeth and Abbott ), rather than the health of the public.  Half of the board of trustees of NAMS receive money from Wyeth in the form of consulting fees or research support.  Wyeth makes Prempro and Pristiq.  These Financial Disclosures are listed page 10 of the NAMS 2007 position statement on Hormones for Menopause.

4) All hormones, whether made in compounding pharmacies or in manufacturer’s laboratories, are synthetic in the sense that they are made by a chemical process.

My Comment: This is another attempt to confuse the difference between synthetic chemically altered “monster” hormones and bioidentical hormones. Again, they are quite different. Make no mistake, Bioidentical hormones are NOT synthetic hormones. The word synthetic is intended to mean a chemical structure which is different from the human hormone, allowing the drug maker to obtain a patent for the altered structure.

5) To determine whether hormone therapy is appropriate and safe, one’s risk factors must be assessed based on personal and family medical history, as well as personal preference. There is no "one size fits all."

My Comment: Personal and family medical history is always part of any medical evaluation. However, the above statement is nonsensical. The important fact to remember is that Bioidentical hormone therapy is safe and effective while synthetic “monster” hormones cause cancer and heart disease.

6 Low dose hormone therapy, used judiciously, still remains the most effective way to treat the troubling symptoms of menopause for those who need it and who can use it safely.

My Comment: Since mainstream physicians know that synthetic “monster” hormones are dangerous, causing cancer and heart disease, they shrug their shoulders and accept “low dose” synthetic hormone therapy as more desirable than higher standard dosage. Less of the harmful monster hormone is given to the patient.  Synthetic chemically altered hormones are “Monsters” at any dosage. Stay away.

7) There is no need for testing of hormone levels, either in saliva or blood. The science has shown that there is no predictable correlation between hormone levels in saliva or in blood and severity of symptoms. Unless there are unusual complications, it is the standard of care to treat symptoms if needed and adjust medications according to response, not saliva levels.

My Comment: There are no blood tests for synthetic hormones, so proponents of synthetic hormones pretend that lab testing is not needed. The reality is that very useful blood, urine and saliva testing is available for the entire range of bioidentical hormones. If your doctor doesn’t do some sort of testing, you need a new doctor.

8 ) Standard prescription hormone therapy is the safest form available. It has been tested by the FDA and manufactured in a highly regulated manner. Doses are consistent.

My Comment:“Standard Prescription hormone therapy” is coded language for chemically altered synthetic “monster” hormones shown to cause cancer and heart disease in the Women’s Health initiative study. That’s not so safe. “Tested by the FDA” is a misnomer and error. The FDA doesn’t do any testing. The drug company pays for testing and then submits the results on paper to the FDA for approval. The testing has to show drug efficacy over placebo. That’s all. Sometimes the testing is fudged. Ten percent of FDA approved drugs are later banned . Another 10% receive a black box warning.

9 ) There are also FDA approved non-hormonal therapies available to treat menopause symptoms for those who cannot take hormones.

My Comment: The above statement a reference to the use of SSRI antidepressants for menopausal symptoms. These drugs were recently shown to be no better than placebo for depression (Newsweek ) (Jama Jan 5, 2010 ) Regarding efficacy for hot flashes, drug company funded studies done by academic physician like Dr Klein showed efficacy over placebo was marginal. Synthetic altered hormones are bad enough, they cause cancer and heart disease. Effexor and Pristiq are even worse, they are chemically addictive with horrendous withdrawal effects. The use of SSRI antidepressants for menopausal symptoms is not about health, its about money, and is a grotesque caricature of what real medical care should be.

10 ) Whether hormone therapy is needed depends on severity of symptoms, including hot flashes, night sweats, vaginal dryness and irritability. Hormone therapy should be individualized, which may mean trying different doses and schedules, as well as different routes of administration.

My Comment: Many mainstream doctors will ask patients to “live with it” if they deem the menopausal symptoms not severe enough to warrant treatment. Millions of smart women have rejected synthetic hormones, and SSRI antidepressants, and are finding success with bioidentical hormone programs.

Unregulated formulas and inconsistent compounded dosing can be dangerous and has jeopardized the health of many women, including myself. I wished I had known the dangers involved with compounded-hormones. After my menopause symptoms were stabilized with a standard prescription of bioidentical estradiol, I found a new way of eating, lost 30 pounds and updated my beauty regime without cosmetic surgery or alterations. I have never been healthier.

My Comment: The author clearly blames inconsistency in her compounded formula for an episode of hormonal excess. I would disagree, and suggest the hormonal excess was due to her body’s resumption of hormonal production after stopping birth control pills. A resumption of hormone production in addition to using the estrogen cream results in hormone excess.

To avoid hormonal excess, we monitor patients closely, and alert them to watch for signs of hormonal excess. At the earliest sign of hormonal excess, the patient stops using the estrogen cream. This type of program very safe. In my experience prescribing compounded hormone preparations and monitoring patients, the formulas have been very consistent and standardized, and patients have been happy with the results.

In the end, the author confesses she returned to bioidentical hormones, namely Estradiol. Yet the author omits the historical information that Estrogen alone (Premarin) causes endometrial hyperplasia and cancer. That is why progesterone must be given with the estrogen to prevent endometrial hyperplasia.  Omitting this information is a disservice to women and potentially harmful for readers.

In Conclusion

This "10 Facts" article is a mixture of nonsense, falsehood and half truth. The quality of information reflects the authors credentials, which are none, other than briefly visiting a few doctors for symptoms of hormonal imbalance. The medical information appearing in the article comes from Dr Wendy Klein, regurgitated drug company propaganda advocating synthetic chemically altered “monster” hormones and SSRI antidepressants for menopause, performing a disservice to women.  A safer, more effective alternative is bioidentical hormone therapy.

A Plea to Staness Jonekos

Rather than rely on biased advice from Wendy Klein, who advocates synthetic hormones and SSRI antidepressants for menopause, I suggest you find a more balanced viewpoint by interviewing well known medical experts such as David Brownstein, Kent Holtorf,  Bruice KentonSangeeta PatiC. W. Randolf, Erika Schwartz, and Jonathan Wright . Read their books, web sites and call them.

A plea to Dr Wendy Klein and all other supplicants to the drug companies:  Join with Marcia Angell in her crusade to free medical academia from the drug company money which has corrupted medical eduication and research.  Read Marcia Angell’s talk given at Harvard University on December 10, 2009, outlining the way forward.  I call on you to renounce synthetic hormones and antidepressants for menopause as a disservice to women.  Join with thousands of your colleagues who have embraced bioidentical hormones. 

A plea to all others: The history of modern medicine is replete with the medical victimization of women.  A few discarded examples are: radical mastectomy, excessive hysterectomies, and bone marrow transplant for breast cancer.  Synthetic hormones belong on that list. The latest medical hoax is SSRI antidepressants for hot flashes.  Take back control of your bodies. Do not allow yourselves to be victims of synthetic hormones and antidepressants for menopausal symptoms.  The proper treatment is bioidentical hormone therapy. To find a bioidentical hormone doctor in your area, click here for the doctor’s directory, AHMA , ACAM , A4M .  

Articles with Related Content:

The Safety of Biodientical Hormones

Bioidentical Hormones According to Chris Woolston LA Times

BioIdentical Hormones Trashed by Marilynn Marchione AP News

More Articles with Related Content:

The Importance of Bioidentical Hormones

The Safety Of Bio-Identical Hormones by Jeffrey Dach MD

The Battle for BioIdentical Hormones by Jeffrey Dach MD

Breast Cancer Prevention and Iodine Supplementation by Jeffrey Dach MD

Links and References:

10 Hormone Therapy Facts Every Woman Should Know by Staness Jonekos
http://www.huffingtonpost.com/staness-jonekos/10-hormone-therapy-facts_b_615199.html

http://www.ncbi.nlm.nih.gov/pubmed/19179815/
http://www.iacprx.org/site/DocServer/HoltorfStudy_Jan09_PostgraduateMedicine.pdf?docID=5841

Postgrad Med. 2009 Jan;121(1):73-85. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?
Holtorf K. Holtorf Medical Group, Inc., Torrance, CA 90505, USA

http://bostonreview.net/BR35.3/angell.php

MAY/JUNE 2010 Big Pharma, Bad Medicine-
How corporate dollars corrupt research and education by Marcia Angell

The boundaries between academic medicine—medical schools, teaching hospitals, and their faculty—and the pharmaceutical industry have been dissolving since the 1980s, and the important differences between their missions are becoming blurred. Medical research, education, and clinical practice have suffered as a result.

To a remarkable extent, then, medical centers have become supplicants to the drug companies, deferring to them in ways that would have been unthinkable even twenty years ago. In addition to grant support, academic researchers may now have a variety of other financial ties to the companies that sponsor their work. They serve as consultants to the same companies whose products they evaluate, join corporate advisory boards and speakers bureaus, enter into patent and royalty arrangements, agree to be the listed authors of articles ghostwritten by interested companies, promote drugs and devices at company-sponsored symposia, and allow themselves to be plied with expensive gifts and trips to luxurious settings. Many also have equity interest in sponsoring companies.

Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
www.jeffreydach.com
www.drdach.com
www.naturalmedicine101.com
www.truemedmd.com

Disclaimer click here: www.drdach.com/wst_page20.html

The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician — patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.

Link to this article:
http://jeffreydach.com/2010/06/27/10-ten-bioidentical-hormone-fallacies-of-staness-jonekos.aspx

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