How Did Doctors Not Know About the Risks of Hormone Therapy?

How Did Doctors Not Know About the Risks of Hormone Therapy?
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Women were placed in the way of harm by their physicians, who acted as unsuspecting patsies for the drug companies.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

We’ve known about the role of estrogen in breast cancer going back to the 1800s, when in some cases, surgical removal of the ovaries seemed to help. Ovaries were said to send out mysterious influences to the rest of the body, which, in 1923, we identified as estrogen. The medical profession jumped on this discovery, and started injecting menopausal women by the thousands—shots that gave a respectable hook on which to hang visits to the doctor. Soon, there were pills, and patches, and medical journals—like the Journal of the American Medical Association—regaled doctors with ads on how they can “help women to happiness” by prescribing estrogen. You could turn this into that. “For when women outlive their ovaries,” there was Premarin.

As far back as the 40s, concerns were raised that this practice might cause breast cancer, noting it would have been nice to figure this out first, before we started dosing women en masse. But breast cancer risk didn’t matter, because heart disease is the #1 killer of women, concluded reviews, and because women taking hormones appeared to have lower heart attack rates that would outweigh the extra breast cancer. 

But, women taking estrogen tended to be of higher socioeconomic class, tended to exercise more, and engage in other healthy lifestyle changes, like increased fiber intake and getting their cholesterol checked. So, maybe that’s why women taking estrogens appeared to be protected from heart disease. Maybe it had nothing to do with the drugs themselves. Despite the medical profession’s enthusiasm for the stuff, only a randomized clinical trial could really resolve this question—you split women into two groups; half get the hormones; half get a placebo, and you follow them out for a few years. But, there was no such study, until the 1990s, when the Women’s Health Initiative study was designed.

Wait a second. Why did it take the bulk of a century to decide to definitively study the safety of something they prescribed to millions of women? Maybe it’s because there had never been a female director of the National Institutes of Health until then. Just three weeks after being named NIH Director, she went before Congress to announce, “We need a moonwalk for women.” And, that “moonwalk” took the form of the Women’s Health Initiative study.

The bombshell landed. Summer, 2002. There was so much more invasive breast cancer in the hormone users that they were forced to stop the study prematurely. Yeah, but what about heart disease? Wasn’t that supposed to balance things out? The women didn’t just have more breast cancer; they had more heart attacks, more strokes, more blood clots to their lungs.

The news that women treated with hormone replacement therapy experienced higher rates of breast cancer, cardiovascular disease, and overall harm rocked women and physicians across the country. Estrogen started out as the most prescribed drug in America before the study, but the number of prescriptions dropped immediately, and, within a year, so did the incidence of breast cancer in the United States. Here’s the data from California; a nice drop-off in the rate of invasive breast cancer.

But the most important part of this story was why were we all so surprised? There had been decade after decade of repeated warnings about the risks of cancer. In fact, the reason breast cancer patients had so much trouble suing the drug company was that the drugs contained warning labels for decades. And, having disclosed it, surely, any reasonable physician would have included it in their risk and benefit discussion with their patients. It’s like the warning labels on packs of cigarettes. If you get lung cancer, now, you should have known better. And so, if you got breast cancer, don’t blame the drug company. They warned you about the risks, right there, clear as day.

Why didn’t more doctors warn their patients? Even after the study came out, millions of prescriptions continued to be dispensed. That’s a lot of cancer in our patients we caused, wrote one doctor. How long will it take us to stop listening to the drug companies, “admit that we are harming many of our patients, and…start changing our prescription habits?” Why did this practice continue in the face of mounting evidence of harm?

Well, it is a multibillion dollar industry. Despite an overwhelming amount of evidence to the contrary, many physicians still believe that estrogenic hormones have overall health benefits, a non-evidence-based perception that may be the result of decades of carefully orchestrated corporate influence on the medical literature. Dozens of ghostwritten reviews were published in medical journals to promote unproven benefits, and downplay the harms of menopausal hormone therapy. They’d pay PR companies to write the articles, and then pass them off as written by some expert.

So, “gynecologists must switch allegiance from eminence-based to evidence-based medicine”— consider what the science actually says, and not just what some so-called expert says. One might say the “current culture of gynecology encourages the dissemination of health advice based on advertising, rather than science. Women were placed in the way of harm by their physicians, who acted as unsuspecting patsies for the pharmaceutical companies.”

If we really wanted to prevent heart attacks in women, simple lifestyle behaviors can eliminate more than 90% of heart attack risk. So—instead of being Big Pharma’s pawns—recommending a healthful diet, increased exercise, and smoking cessation would truly benefit women’s health.

Please consider volunteering to help out on the site.

Image thanks to jarmoluk via pixabay

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

We’ve known about the role of estrogen in breast cancer going back to the 1800s, when in some cases, surgical removal of the ovaries seemed to help. Ovaries were said to send out mysterious influences to the rest of the body, which, in 1923, we identified as estrogen. The medical profession jumped on this discovery, and started injecting menopausal women by the thousands—shots that gave a respectable hook on which to hang visits to the doctor. Soon, there were pills, and patches, and medical journals—like the Journal of the American Medical Association—regaled doctors with ads on how they can “help women to happiness” by prescribing estrogen. You could turn this into that. “For when women outlive their ovaries,” there was Premarin.

As far back as the 40s, concerns were raised that this practice might cause breast cancer, noting it would have been nice to figure this out first, before we started dosing women en masse. But breast cancer risk didn’t matter, because heart disease is the #1 killer of women, concluded reviews, and because women taking hormones appeared to have lower heart attack rates that would outweigh the extra breast cancer. 

But, women taking estrogen tended to be of higher socioeconomic class, tended to exercise more, and engage in other healthy lifestyle changes, like increased fiber intake and getting their cholesterol checked. So, maybe that’s why women taking estrogens appeared to be protected from heart disease. Maybe it had nothing to do with the drugs themselves. Despite the medical profession’s enthusiasm for the stuff, only a randomized clinical trial could really resolve this question—you split women into two groups; half get the hormones; half get a placebo, and you follow them out for a few years. But, there was no such study, until the 1990s, when the Women’s Health Initiative study was designed.

Wait a second. Why did it take the bulk of a century to decide to definitively study the safety of something they prescribed to millions of women? Maybe it’s because there had never been a female director of the National Institutes of Health until then. Just three weeks after being named NIH Director, she went before Congress to announce, “We need a moonwalk for women.” And, that “moonwalk” took the form of the Women’s Health Initiative study.

The bombshell landed. Summer, 2002. There was so much more invasive breast cancer in the hormone users that they were forced to stop the study prematurely. Yeah, but what about heart disease? Wasn’t that supposed to balance things out? The women didn’t just have more breast cancer; they had more heart attacks, more strokes, more blood clots to their lungs.

The news that women treated with hormone replacement therapy experienced higher rates of breast cancer, cardiovascular disease, and overall harm rocked women and physicians across the country. Estrogen started out as the most prescribed drug in America before the study, but the number of prescriptions dropped immediately, and, within a year, so did the incidence of breast cancer in the United States. Here’s the data from California; a nice drop-off in the rate of invasive breast cancer.

But the most important part of this story was why were we all so surprised? There had been decade after decade of repeated warnings about the risks of cancer. In fact, the reason breast cancer patients had so much trouble suing the drug company was that the drugs contained warning labels for decades. And, having disclosed it, surely, any reasonable physician would have included it in their risk and benefit discussion with their patients. It’s like the warning labels on packs of cigarettes. If you get lung cancer, now, you should have known better. And so, if you got breast cancer, don’t blame the drug company. They warned you about the risks, right there, clear as day.

Why didn’t more doctors warn their patients? Even after the study came out, millions of prescriptions continued to be dispensed. That’s a lot of cancer in our patients we caused, wrote one doctor. How long will it take us to stop listening to the drug companies, “admit that we are harming many of our patients, and…start changing our prescription habits?” Why did this practice continue in the face of mounting evidence of harm?

Well, it is a multibillion dollar industry. Despite an overwhelming amount of evidence to the contrary, many physicians still believe that estrogenic hormones have overall health benefits, a non-evidence-based perception that may be the result of decades of carefully orchestrated corporate influence on the medical literature. Dozens of ghostwritten reviews were published in medical journals to promote unproven benefits, and downplay the harms of menopausal hormone therapy. They’d pay PR companies to write the articles, and then pass them off as written by some expert.

So, “gynecologists must switch allegiance from eminence-based to evidence-based medicine”— consider what the science actually says, and not just what some so-called expert says. One might say the “current culture of gynecology encourages the dissemination of health advice based on advertising, rather than science. Women were placed in the way of harm by their physicians, who acted as unsuspecting patsies for the pharmaceutical companies.”

If we really wanted to prevent heart attacks in women, simple lifestyle behaviors can eliminate more than 90% of heart attack risk. So—instead of being Big Pharma’s pawns—recommending a healthful diet, increased exercise, and smoking cessation would truly benefit women’s health.

Please consider volunteering to help out on the site.

Image thanks to jarmoluk via pixabay

Doctor's Note

The whole Premarin debacle speaks to the importance of putting purported therapies to the test (see, for example, Do Vitamin D Supplements Help with Diabetes, Weight Loss, and Blood Pressure?), as well as to the power of Big Pharma (Eliminating Conflicts of Interest in Medical Research), and medical community collusion (American Medical Association Complicity with Big Tobacco).

What about Plant-Based Bioidentical Hormones? Check out the video, and find out :)

In general, patients (and doctors!) tend to wildly overestimate the efficacy of pills and procedures; see Why Prevention is Worth a Ton of Cure. And, check out The Actual Benefit of Diet vs. Drugs.

Medical care, in general, may be the third leading cause of death in the United States. See How Doctors Responded to Being Named a Leading Killer.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

222 responses to “How Did Doctors Not Know About the Risks of Hormone Therapy?

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  1. Hello Dr Gregor,

    I found this video very interesting. If hormone replacement therapy is risky, what about the contraceptive pill? It is prescribed so much and not many women (including myself) know exactly how it could have an impact on your health. I would like to know what your opinion is about this.




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    1. I could not agree with Sonia more on this question: “If hormone replacement therapy is risky, what about the contraceptive pill?” I would also sincerely like to know what your opinion is about this???




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      1. Cristina and @sonia, in a quick search of research using the search terms “safety of oral contraceptives” there are over 6,000 scientific journal articles from the last 5 years. It depends on your particular medication (whether or not there are known safety risks) and different medical outcomes. I last took oral contraceptives myself (I know, TMI!) 40 years ago (that is WAY too much TMI) and at the time went off them quickly due to side effects that I found intolerable. Much of the progression of oral contraceptive development has been to use much smaller doses of estrogen to produce the same results to dampen ovulation. However there is a long history of adverse events such as blood clots, cardiovascular events, gall bladder disease, and other health events.

        If it were me – I would research my own specific medication and read the information that is out there available either through PubMed or run down to my local public university and do some research in a campus library. That is just me – I have been a doubter of “medical advice” for over 35 years. OH, and a vegan.

        Good luck! Please of course, don’t discontinue any medications without checking with your physician, or certainly having a reliable back up contraceptive form in place. I believe the risk of an unplanned pregnancy can be much higher than a medication risk.

        –Lisa




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        1. A huge obstacle to obtaining the truth about individual drugs, is the scientific misconduct paid for by drug companies, which intentionally produces studies skewed in favor of drugs being sold, as well as suppresses a large percentage of studies unfavorable to drugs being sold. The safest course: no drugs. Use diet for disease prevention and treatment.




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      2. Cristina, Sonia and all other woman… contraceptives are always and generally not a good idea, like every drug take over a long period. Let me explain it and I’m sorry in advance for my English.
        Please stay a quick step backwards and consider this question from another points. What is the contraceptive doing inside the body of a woman? They switch the hormone status from normal to constantly pregnant without to be pregnant. No body is designed to be pregnant for years. Think about this, if a woman is getting pregnant some things going to happen for example the sense of smell is changing. So, if you take a contraceptive over years you life with a changed sense of smell. And with this sense of smell you also pick out your man. I know in this artificial western world mort of the people thinking the sense of smell to pick up a partner is not important – but if you like to have a good partnership it is important! There exist stats that there are a lots of divorces after woman stopped to take contraceptives to get pregnant – why? Because the sense of smell is changing to normal and the can’t smell the partner anymore. Not every woman registered this but the she registered that there is something changed and the feeling is not good…
        Another exemple. Have you ever ask yourself why there is no drug for men? Not because it’s not possible … it’s because (scientist) men knowing about the risk and protect there buddies, instinctual and it is connected to a very old and bad belief that woman are inferior – so it’s their problem if they go pregnant, not mine. (Men are able to go anytime, the child will stay mostly by the mother, she has the big problem)
        Even if there would be only a small risks for health – if I would be a woman I would never ever take over this risk. Some woman will argue now that the contraceptive has made there life much more easy because of birth or pregnant control, because the menses – but this is suggested (mostly) by the men world. Birth control is also a part of the man (fact) and beliefe me a condom has nothing side effects and disturb no feeling for any man, I use this for more the 30 years now (and when if so, then it’s only in the head of this man and you should consider to give him up because he has a mental disorder).
        A normal, not painful, menses is related to a healthy body therefor use a plant-baed diet ;-) also to a good connection to your own body ( like, to be proud to be a woman). OK, sometimes the pain or bad mood is based on other things (to explain this would be to long here) then you can find help by a good Osteopath or by some herbs or only by a little bit less stress.
        PS.: to get pregnant, as far I know, belongs always a man and a woman – so I think the risk to get pregnant without the knowledge of the woman is nearly impossible. If you give up the contraceptive you should have always a condom with you (don’t count on men). For the worst case of a rape (yes there are still stupid men on this world) are drugs available to protect the woman for a unwanted pregnancy (I think this is the same in the USA like here in Germany)




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        1. The copper IUD is a great non-hormonal reversible method of birth control. Some people do experience issues with it and there is some initial discomfort, but it is an option worth considering.




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      3. OCPs and post-menopausal HRT are not the same drug, and not the same mechanism of action (not to mention a different physiology of women that the drug is acting on).




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    2. Hello Sonia, it does not appear that Dr. Greger has made a video about the pill. As this is a site devoted to nutrition information, this important question is a bit out of traditional scope for Nutritionfacts. I do very much value today’s videos, and would encourage you to view Dr. G’s other videos in this series. I will do a search on “evidence base safety of contraceptives” and get back to you a bit later with some references you can read, and evaluate for yourself. Stay tuned! And thank you for your question.




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      1. I see every reason Dr. G should do a video on the pill. He, of all doctors, might be able to show us the science in truth.

        And he does have videos on this website that do not have anything to do with food. This wouldn’t be the first.
        Hopefully you can encourage him to do this video, as I think lots of us here would be grateful for it. For now, thanks for any info. you come up with, Lisa.




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      2. Totally agree with the posters here. If he did a video about one kind of hormone supplementation (HRT) why wouldn’t it make sense to do one on the Pill (another kind of hormone supplementation)?

        Both involve ingesting a hormone that one’s body didn’t generate on its own. The impact could be similar. (And if the effect ISN’T similar, it would be nice to know why/why not.)




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      3. Sonia is asking a question predicated on a subject that Dr. Greger has brought up and provided a video on, and is in fact highly apt and relevant. In point of fact, subject of poison by pharma is the subtext of this entire set of videos on disease prevention and treatment—– What we ingest has everything to do with life and death matters. Enough said.




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      4. Hello Lisa,

        Thank you so much for your response. I will definitely watch Dr Gregor’s other videos in this series. I will also be interested to hear about anything you find on the most recent research about the safety of contraceptives.




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        1. I had to comment because I agree with 4Baccurate. PIlls are the very weapons that medical doctors use to treat illness and if someone is popping a pill for x then they are subsequently popping the pill to get better and live out a long and healthy life. For example, antidepressants are there for depressed people so that hopefull y after taking it they will feel happy and want to go and do things to help out man/female kind.

          If it increases estrogen and if estrogen is tied to breast cancer then… I’d stop taking the contraceptive. I don’t believe you need to have the doctors permission for this due to stopping an oral contraceptive doesnt have any withdrawal effects… but thats to my knowledge as a man so take that for what its worth. ON second thought, do your due diligence before stopping any medication.

          This is similar to how men taking testosterone to feel more manly and baldness is linked to high levels of testosterone. oh and cancer… I would post the study but id’ have to go and find it so ill just half ass it and post this … http://www.nutraingredients.com/Research/Muscle-building-supplements-linked-to-testicular-cancer-risk

          If my woman has to pop pills because she doesn’t trust me then… why am I with this woman? even better, why is she with me? I don’t know about other men, but I don’t mind a condom… but now im off topic…




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  2. Hello! I am a volunteer moderator from Scottsdale, Arizona and a plant based dietitian! I am deeply moved by today’s video, as should all women be. My mother was a victim of the aggressive treatment of unproven, untested therapeutic treatments in the 50’s, 60’s and 70’s. Today’s video makes me sad, mad, and shocks me (no ECT reference, please!) awake. I urge all women and men who love women to also watch Dr. Greger’s video on plant based hormone therapy. The fountain of youth, sadly, is not real. Women as guinea pigs – now that is real. Thank you Dr. Greger for saving me $1,500 per year out of pocket for my plant based bio-identicals – OH and maybe saving my life, too! :-)




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        1. Have there been studies on bio identical estrogen cycled with progesterone? The study in question used horse hormones and progesterone in one pill. Bio identical may be safe but we don’t know. Men do not understand the pain of menopause, women need a safe solution.




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          1. I agree with Lisa’s comments. I would add that many “bio-identical” products are compounded which adds additional uncertainty to the quality, potency and safety in their use. Women in my endocrinology practice vary greatly in how they manifest menopause symptoms. Some women never miss a beat or have the occasional hot flash and some are nearly disabled by their symptoms. ALL forms of HRT carry risk. When the symptoms of menopause degrade quality of life to a point that some risk of HRT is acceptable then that’s the appropriate time to prescribe them. It’s crucial for women to have a clear understanding of their individual risk and how that risk changes with HRT. Sometimes non HRT therapies help and are worth trying. In my experience with patients it’s less than 50% but that estimation is skewed by the fact that I mainly see women who have symptoms (i.e. they may work more often than I observe in my patients). Always discuss things with the doctors who know your medical history well. I would discourage visiting the hormone boutique clinics which are generally not run by endocrinologists, are expensive, not covered by insurance, not proven to be more effective or safe than traditional medications and at least in my area notoriously overdose patients. Best wishes in health!




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            1. The idea of epidemiologically-based diagnoses and weighing risks vs. benefits, is shot full of holes. No one can weigh risk vs. benefits, when pharmaceutical companies do not disclose risks or actual mechanisms of action to either doctors or patients. Further, tests are non-existent that scientifically quantify or qualify patient response to either drugs or foods for the purpose of predicting or monitoring drug response in the individual patient… (genetic testing for determining rate of metabolism of a specific drug, for deciding dosage, alone, is an exception.). Here, we may as well experiment on ourselves with dietary modifications… At least (as a general rule admitting of exceptions), one doesn’t drop dead from adding spinach to his diet. However, one with autoimmune disease can get much sicker by adding immune-boosting foods to diet, such as kale. And must stay away from alfalfa and garlic and other foods containing sulfonamides. So this is a subject—- diet and autoimmune disease— that awaits Dr. Greger’s delivering a video on this subject.




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              1. Kale is very interesting. Since I added kale to my daily diet my keratosis pilaris has disappeared. I take about 30 grams in a raw green smoothie and another 30 – 60 grams in the form of kale chips. Sometimes I chew on the ribs. I can’t say if the added fiber did something to my gut microbiome (though I’ve always eaten a lot of beans) or there is something in kale that caused my skin to calm down. The only other things that have helped at all were Gaia Herbs turmeric extract with bioperine (I only mention the brand because they vary so much in concentration/extraction method), topical SOD lotion, and tretinoin cream (way too expensive). Topical steroid cream works but it thins the skin and I got bullae when I skipped a couple of days. My only complaint is I now have what I call ‘gorilla gut’ – I’m full of… digesting fiber.

                Immunity/autoimmunity is also interesting. The feedback loops of the immune system are complex and there are a lot of seemingly paradoxical relationships among immunomodulators. Dr. Greger put out an video on how mushrooms can boost immunity while also decreasing inflammation:
                http://nutritionfacts.org/video/boosting-immunity-while-reducing-inflammation/




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                1. I suffer from Keratosis Pilaris and found your comment very interesting. I will be adding Kale to my daily diet and see if I notice the same effects as you have noticed.




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                  1. I hope it works. If it doesn’t, at least you will be getting a lot of good stuff – fiber, vitamin K, carotenoids, magnesium, potassium, etc. Harris-Teeter sells huge bunches for only 99 cents; they seem to be doing their part for public health, or perhaps it is just a way to get the ‘health nuts’ in the door. It takes a while to wash it all, but it lasts the week.

                    Just an FYI: Broccoli sprouts are also another cheap ‘super-food’ that actually merits all the hype. Dr. Greger has a few videos about them; I find he’s really good about pointing out the best ‘bang for your buck’ (and time and calories) food items.




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            2. Sugar_Doc,

              After over 30 years of using compounded pharmaceutical products I would like to suggest that the quality control has been extraordinary and on point from most of the suppliers. Admittedly it took some work to find the excellence but my patients have been consistently happy. To also suggest that one focus on an endocrinologist has me cringe. In my experience they were not interesting in the whole picture and were conventionally trained to use rx approaches regularly, even when supplied excellent published data. On the other side of the coin, I do agree with you regarding the overuse of many of the prescribers. I am of the school of thought that the lowest does that accomplishes the desired outcomes, both clinically and chemically are the best. More is not better….. I would also comment that many of the patients who had limited symptoms did not always fare well over the long term. I did see cognitive impairments, osteoporosis and other classic lower level hormonal signs. Yes you could argue that regardless it would have occurred however I still contend that the normalized hormonal levels do benefit the patients overwhelmingly. Dr. Alan Kadish NF Moderator




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              1. Well, Dr. Alan Kadish NF Moderator I’m glad you have had good luck with your compounded pharmacies. My experience has been less satisfactory. Some patients get good responses, some don’t. Your comment that “it took some work to find the excellence” suggests you also had unsatisfactory results at least early on. Where did I “suggest that one focus on an endocrinologist”? I only pointed out that many “hormone clinics” aren’t staffed by endocrinologists. It would be reasonable for patients to expect that the doctor advertised under the banner of a hormone specialty clinic be an expert in hormone disorders. This isn’t the case and patients should be aware of who they are seeing. Sorry if you find that cringe worthy. Just because the endocrinologists you have worked with in the past didn’t agree with you on compounded HRT doesn’t mean they are disinterested nor does it discount their conventional training. I’ve seen many patients injured by well meaning doctors who decided to get into “lifestyle medicine” or hormone pellet therapy, etc. They come to me, a board certified endocrinologist to fix the mess they were put in. My original post was about patient awareness of what they are buying so they can make good, informed decisions. I don’t appreciate being attacked, especially from a NF Moderator.




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            1. The Women’s Health Study looked at horse hormones in a pill with progesterone. From the Medical Letter referenced in the video:
              From the Medical Letter referenced in the video:

              A reader commented that our recent article on treatment of menopausal
              symptoms(Med Lett Drugs Ther 2012; 54:41)
              should have mentioned
              the potential advantages of transdermal estrogen. Transdermal estrogens
              are probably as effective as oral estrogens in treating vasomotor
              menopausal symptoms, but transdermal administration may have less effect
              on serum triglycerides, C-reactive protein,thyroxine-binding globulin,
              cortisol-binding globulin and sex hormone-binding globulin.
              Observational data suggest that the risk of venous thromboembolism may
              be lower with transdermal administration compared to standard-dose oral
              estrogens, but comparative randomized controlled trials are lacking.

              “comparative randomized controlled trials are lacking”
              This was in 2012 are there new studies?

              Why is the breast cancer risk lowest for women under 40 who have plenty of hormones?




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        2. Thank you. I wish I would have watched the video in your link above much sooner. I was prescribed bio identical hormones earlier this year. I am only 30 years old and was told that my progesterone was low. I administered the hormone therapy for 2 weeks in April and then stopped after having heart palpitations, chest pain, panic attacks, brain fog, and a host of other symptoms. The doctor that prescribed the hormones dismissed my symptoms entirely. Since then I have connected with several other women who have had the same reaction to bioidentical hormones. It has been a horrible experience that I am only now coming out of with proper medical care.




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            1. Not Lynn, but because I was having extremely heavy menses that lasted 12-14 days every month. The hormone, not bio ID, made difference – for a while. D&C help lasted a couple months. After clots, they yanked the uterus at age 36. I believe the problem was the DES (synthetic estrogen) prescribed to Mom to “prevent miscarriage”. The discovering MD warned about giving it to pregnant women, but the greed of Big Pharma had to create a market for the new “Wonder Drug” and it has created thousands of serious illnesses in the children born after swimming in estrogen for months.




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              1. Yes. Similar to patipnuts, I was having heavy menses lasting 7 days and in general felt less energetic. My saliva was tested and it was determined that my progesterone levels were low. I was prescribed bioidentical cream with a blend of progesterone, estrogen and testosterone. After 2 weeks of taking the cream, I started having symptoms that I had never experienced in my life. I still have some of these symptoms now, 4 months after stopping the hormones. I have been to 4 other physicians since the ordeal and have been informed that I never should have been prescribed hormones at my age and with my menses being regular. I was also told that the administration of the bioidentical hormones has disrupted the balance in my body. This has caused mental (panic, OCD type thoughts, suicidal depression, emotional outbursts, brain fog) and physical symptoms (mainly with lungs and heart but also with menses) that have made my life very difficult for the past 4 months. I am slowly getting better and am told that my body will hopefully balance itself out in 6 to 9 months.




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      1. Trust me….the whole histrionics or hysterical prescribing of medication is still going on with male MDs and females. “You should stay on that anti-depressant. Menopause is not easy.” Why not have my patient experience menopause and see if she needs an anti-depressant? Yikes!




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  3. I guess if there is one very dominant theme from today’s comments and today’s videos is that we need to be our own advocates when it comes to physician recommendations, big Pharma, big Food, and our own health. Big Pharma and Big Food do not care about my health – they only care about selling me (and all of us) more junk and medicine that may very well shorten my own life. BE YOUR OWN ADVOCATE – do research, learn how to search medical literature, find people who can help you do this (like Dr. G!), get second, or third opinions, fight for your health. We have the natural tendency (due to psychological factors) to be “led” by authority figures who discourage discussion, asking questions, defending their positions through research. Oh, and the younger generation can do the same for their parents, and older adults that they love and support. Be your own advocate or an ally for others who may have lost (or never had) a voice.
    Off my soapbox now! Thanks again @Dr.Greger!!




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    1. Thank you, Lisa! “We have the natural tendency (due to psychological factors) to be “led” by authority figures who discourage discussion, asking questions, defending their positions through research.” So true. Our kitty died recently and I strongly believe that if I had been more confident around the veterinarians who “knew more than me”, done research BEFORE not after my cat was given a drug, my cat would be here next to me listening to Dr. Greger (she loved his voice) rather than being buried in our yard.




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      1. I am so very sorry for your loss of your beloved kitty. Please take comfort in the fact that you were in crisis, looking for help, and did the best you could given your very difficult situation. And, that you gave your beloved cat a great life, and a dignified death. And a beautiful home in your yard where she is close to you – and you to her. SIGH. Your note is very kind.




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      2. Really sorry…. :S

        I can imagine how you must be now after something so horrible, the only “good” consequences is that now you know. Always do the research prior taking any medicine, going to give you an example, I was born with some tachycardia, a doctor gave a prescription to my mother… fortunately my mother read the package insert (we always do) to only find out that those drops were exactly for the opposite, to make the heart beat faster.

        She went to another doctor (in both cases pediatricians), and told him what happened, he told her that if she ever gave me that medicine, it would very likely killed me. I was just a newborn.

        It’s not the only one I could tell you, happens a lot. They make LOTS of mistakes that kills a huge amount of people (and as you see animals too) yearly.

        Always question everything, and of course authority. Take care. :(




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        1. Oh yes, I have learned and will apply it everyday from now on. This experience has cemented my trust in myself and the necessity for research before drugs & procedures. Doctors, veterinarians and other professionals are just information from their perspective (usually greatly brain-washed by the pharmaceutical industry). I can take what they say, then research it and other options before making an informed decision.




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      3. Oh I am so sorry. Know that she will be there waiting for you when it is your time to go into the LIGHT. I sat for 5 hours holding the lifeless body of my precious little dog the day after I took her to the vet for her annual update on vaccines. I remember the Vets words like it was yesterday, “she is the healthiest dog I’ve had in here in months, just like a puppy.” She died the next day after multiple seizures. I still miss her……




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        1. I’m very sorry about your little dog. Unfortunately I’ve heard of other healthy dogs dying almost immediately after receiving their shots. How many vets and physicians caution their patients about possible adverse reactions of vaccines or other shots? My kitty died from an antibiotic injection.




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    2. Hello long time reader but I dont post much. Im interested in this for my wife who is 64 years old and is taking Estradiol and Medroxyprogesterone in low doses. Are these drugs putting her at a higher risk of cancer? She is very fit and works out everyday but is taking Captopril for high blood pressure also and I have been trying to change her diet to WFPB but its still a work in progress. Thanks for any info.




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    3. I agree we need to do our own research. Fortunately in my training I learned to read medical research. For most reading the actual research is not enlightening and there are a myriad of opinions out there. It’s a quandary.




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  4. Ok, so what’s a woman to do who is suffering with hot flashes that keep her awake at night and thus tired and almost non-functioning all day long. Doctor’s only want to prescribe pills. This video doesn’t address what to do instead of HRT, so where does one turn for help.




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    1. Actually, it does. A healthy plant-based diet, exercise and other healthy lifestyle changes can make a world of difference for peri-menopausal and postmenopausal women.




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        1. I too am vegan and I have hot flashes, not nearly as bad..but I have noticed my trigger foods. Caffeine(from coffee), chocolate, and alcohol. When I don’t have them, my hot flashes is mild 1 or 2 times a day and once at night maybe. The other thing is when I eat more raw then cooked food..they are milder as well. See what you body tells you. I hope that helps




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          1. I don’t drink alcohol but will look into cutting out caffeine and chocolate (sugar). Interesting about the raw foods versus cooked foods for you. Some things to try. Thanks!




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            1. Soy foods might help, but might be a case to try out soy isoflavones: genistein, daidzein and glycitein; approximately in the same amounts that are consumed in Asia, where menopausal symptoms are almost unknown. Of course better as food, but in days where you didn’t reach the right amount, a supplement might work. I didn’t read any risk associated with them.

              In case anyone knows otherwise, please comment.




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        1. @disqus_jzTMuWyOjs:disqus Dr. Greger has a video on the effect of a plant based diet (especially soy) on menopause symptoms. You can find it here. On each posted video page, you can click on the tab next to the video that says “sources cited.” That’s what I do when I want to “see” the research for myself. I think you’ll enjoy the video! Thanks for your great comments today!




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    2. Peri-menopause really sucks, I imagine menopause will be worse. I’m choosing to do HRT. I know the risks and I can make my own decisions about what risks I want to take to improve my quality of life. I’ve been doing topical bioidentical estradriol (Estrace) as needed for around 20 years as treatment for vuvlvodynia/vulvar vestibulitis syndrome. I’ve had a pre-cancerous growth in my urinary tract prior to starting Estrace; the estrogen helps my urinary symptoms, also. The symptoms related to these conditions (severe pain) plus a number of life stressors led to a suicide attempt in my mid-twenties. For me, estrace/estradiol is life-saving medicine. In contrast, I never did well on birth control pills; the best reversible method I found was the copper IUD (I had tubal ligation a few years ago). Unfortunately, even though I have insurance, I have to pay $250 for a 40g tube.

      That being said, I’m sure people on here will have helpful advice on how to deal with hot flashes without hormones. I would say give them all a go before trying any kind of HRT.




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      1. Estrace is a rip off. Here’s what I did: I called around to the compounding pharmacies and found one that would make it for around $80 without the nasty ingredients.




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      2. I’m in the same boat as you. Vaginal bleeding, UTIs, sex with spouse is impossible. Lack of sleep. No way to live. Quality of life is the issue for me.




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          1. I find soy does help a bit, but not enough to take the place of the Estrace. I think it is funny when anti-soy people talk about its adverse effects on fertility. In my first marriage, I followed the food pyramid when trying to conceive; after a year of trying I concluded I was infertile and resigned myself to being childless. That marriage ended, I became mostly vegetarian (some fish) and drank soy milk and ate plenty of tofu. I got pregnant by accident.

            Frozen green fava beans seemed to help, too. I will have to get some more. I don’t like having to peel them, though. I should try a puree. I’ve been eating cooked dried favas all week (ful medames for breakfast – they should call it full medames – very filling and for some reason the peels aren’t an issue), but they don’t seem to have an effect on hormones. Fenugreek is another legume that might have an effect.




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        1. It’s awful, isn’t it? I suspect my problems started when I was so young (I’ve had the urinary tract issues since elementary school) due to DES or other endocrine disruptor exposure in utero (there are additional symptoms that lead me to that conclusion).




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    3. My ND told me to take herbs when I wanted to get off hormones, and they eliminated the hot flashes. I don’t know about the science, but they worked for me. Unfortunately, it’s been so long ago that I can’t remember what I took, other than Dong Quai, but I know there was another. I’m sure Google can come up with information on that subject.

      I feel for you. I had such terrible night sweats that I’d have to get up and change my nightgown, and sometimes the sheets, and of course by then I was wide awake. So I’d finally get settled down and bam! another flash! I couldn’t take it, either, and did at one time take bioidentical hormones, which did stop the hot flashes.

      Many years later I had breast cancer, but it didn’t have receptors for either estrogen or progesterone.

      It was only after the cancer diagnosis that I stopped eating animal foods.




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      1. @rebeccacody:disqus thank you for this comment! Once again, as a volunteer moderator I have to emphasize that it is essential to find a practitioner that will work with you based on your own interests – symptom relief, versus medications, versus food, herbs, supplements. I was trained at Bastyr University, an amazing naturopathic medicine college in Seattle. Those who are seeking different (ancient wisdom, mind body medicine) approaches should seek the services of a naturopathic physician to help with their medical care. Just like traditionally trained MDs, there are good ones, and not so good ones. Ask, seek, try, second opinion. Your health is worth it!




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        1. How accurate are blood tests for hormone level? I have read that they are not really accurate and that saliva testing is more so. Blood testing showed that my hormones are fine except for progesterone. I’ve tried the bio-identical but am not convinced that it does anything. So is it really a problem that progesterone tests low?




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    4. I participated in a doubleblind study for hot flashes. I was fortunate to get the drink that had a soy based product to reduce hot flashes and it did by more than 3/4 a day. I never knew what or if the product would be produced but after that I ate a good source of soy, Edamame Beans every week to help. I wanted to watch the amount of soy due to the possible increase in estrogen it can produce so did not use any other soy products other than the beans. Experiment with Soy to see if that helps you.




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    5. I never understood really what a hot flash was until my wife hit menopause. Man, what a raw deal women get. All the cramps, mess and hassle of monthly periods for 40 or so years, and when that ends your reward can be never ending hot flashes. My wife has them at least once an hour, 24 hours a day, 7 days a week for over 5 years now. Like @rebeccacody:disqus says, they completely mess up her sleep, makes her uncomfortable to be around people because without warning sweat will start streaming down her face and sweat marks show through her clothing in the middle of the freakin’ winter when it is five below zero outside! A little depressing and distressing math says that she has had to suffer through over 44,000 hot flashes. And they aren’t letting up. With all of this, I can understand some women saying cancer be damned, give me the hormones so I can have some relief! My wife did try black cohash in the beginning and that work! But perhaps too well since it caused her period to start back up. She figured anything that powerful is far too close to actual estrogen to be something she wanted to mess with.

      Watching everything that my wife, Mother and Sister have gone through there is no way that I could be a woman, I am not nearly strong enough.




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      1. Not everyone have problems with their period (at all, not even know you are having it, until you see it), nor with menopause. Goes in families, and diet has incidence also.




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    6. I found that SUGAR would cause me to have hot flashes. I do try to avoid sugar but on special occasions I would have dessert. And sure enough I would end up with a hot flash. Although I haven’t had a hot flash in a very long time, I have noticed that when I eat dessert I will have insomnia. I have no trouble falling asleep but two hours later I wake up and then I’m awake for at least two hours before I can fall asleep.




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  5. Is there any evidence that birth-control pills increase the chances of getting breast cancer? (My wife died of breast cancer at 45. She never took estrogen but used birth-control pills intermittently.)




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  6. this is amazing. I am 59 and refused to take any hormone replacement drugs. I can live with the hot flashes…better than cancer or a heart attack.




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    1. So I was talking to my endocrinologist about just that. Asking her why some woman that HRT when we know the link to breadt cancer. She said some woman have hot flashes every 10 minutes. Can you even imagine that?




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  7. What about women who are going through “surgical menopause”? Some women can have their uterus and ovaries removed very young (in their 20s), is HRT then a good tool to be used until their 40s for example? Anyone know of any studies on such cases? All I find are studies involving older women who use HRT to manage menopausal symptoms later in life.




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  8. First let me say I am no medical professional and am only providing personal experience. I was treated for cancer as a teenager who received radiation to both ovaries and heart – direct hit as tumor was on my mediastinum. I was started on HRT at age 26 – a very, very long time ago. As part of my WFPB journey I stopped the medication – along with five others. My hot flashes were unbelievable – like standing in a pillar of fire. Unable to sleep. I learned about Maca root – there is no scientific studies to support the use. Nine days after taking a teaspoon a day, my symptoms were gone. My understanding is that it is plant. There are claims it is safe. I have taken it for five years now and am thrilled. It has a taste like butterscotch and I sprinkle it on my oatmeal in the morning. Again, no scientific evidence. Interesting, when I informed my doctor, he didn’t flinch – as he found it in the list of “medications” in his electronic patient record. He has noticed it there once since in reviewing what I take – he just reads that I take it for hot flashes. As far as I know I’ve not had a single side effect from its use. I also had a heart attack at age 36.




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    1. Forgot to mention I had been on Fosamax for years – one of the five i discontinued myself. Now my doctor agrees with that and despite less than stellar bone density tests – yes I know they aren’t terribly useful other than to him – he continues to agree I should not take Fosamax for risk of fracture.




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  9. This is a discussion I had with my GYN 20 years ago and would not follow his advise. I knew of several friends developing breast cancer shortly after first going on estrogen and I choose not to take it and I have always thought it was the best decision for me. Is there any correlation between estrogen, osteoporosis and menopause that Dr G can give us? I took Fosomax about 5 years about 20 yrs ago ( in my 40’s), and got off after researching that it is not supposed to be taken indefinitely. My T scores were improved for a while, but are at a concerning low score now for hip fracture. I am an active 65 yr old. Yoga and Zumba and some Circuit training, but have not improved my scores. I am healthy, on primarily plant based diet and would probably be in the 1% Dr G describes in his book. According to my PC, I should be taking a biophosphoate (sp?) Any advise?




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    1. Being diagnosed with osteopenia, I started walking with a 20 pound weighted vest I bought at biggest box store (only place I could find it in our area). This was about 10 years ago. The weights can be added gradually to the vest. (First day I overdid it and my knees hurt for a week.) Eventually I worked up to 40 pounds (2 vests). I use neoprene exercise belts to keep the vest/vests close to my body. I started out (after knee episode) walking for 15 minutes and have worked up to an hour or two a day. My osteopenia has totally disappeared, and now the doctor believes I never had osteopenia. I had it, all right. My migraines are almost all gone, as well.




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      1. WOW Maura! Thank you for your note. I would also recommend weight bearing exercise, and your recommendation exceeds what I would have recommended! And of course is a perfect recommendation. As for me, in the middle of the Desert (Scottsdale, AZ) I laugh when I read neoprene! I think I’d pass out! Sounds encouraging, and a great thing to investigate. I love how your Dr believes you never really had osteopenia!!! LOL!




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  10. I’m wondering about the study & graph shown at 3:29-3:37. Since cancer is not something that can manifest in a year, the drop off in diagnoses in 2003 that correlates with a reduced rate of HRT scripts must be indicative of other factors too.

    BTW, I know that women are vastly underrepresented in studies, and that many drugs withdrawn from the market are due to side effects in women specifically. We can do better research!




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    1. Cancer doesn’t manifest in a year, but the growth of ER+ tumors is markedly reduced when exogenous estrogens are withdrawn. In a exponentially growing tumor, even if the growth rate is constant, most mass appears in in the period just before diagnosis. So, without the growth stimulus from HRT, many ER+ tumors that would have grown to diagnosable size under HRT would fall below diagnostic thresholds in the following year’s mammogram. The ER+ tumor is still there, but its macroscopic appearance is delayed.




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  11. As a woman who recently has lived beyond my usefulness, I mean ovaries, I’m glad I’ve lived past the time when the medical profession foisted these estrogen-acting pills on women.




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  12. As a young intern in California in 1970, I admitted for elective surgery a young woman who was, it seemed, unexplainably hostile to me. Finally, it became clear when she informed me she was completely blind due to bilateral retinal vein thrombosis occurring after starting oral contraceptives. Later on in my career I saw numerous young women with deep vein thrombosis who were frequently also on oral contraceptives. It was so common that my first question to a young woman with leg pain or swelling was “Are you on oral contraceptives.” If they were, venography was indicated, a test now unnecessary due to duplex venous ultrasound.




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  13. Despite today’s welcome and well-done video, as a healthy, active 53-yr. old woman, I’m as confused and unsure as ever as to whether to try to get off the bioidenticals I’ve taken for the past several years, dosed based upon labs ordered by my wellness doctor. I started a WFPB diet a couple of years after starting the hormones, got my total cholesterol down to 125 (a number many plant-based doctors consider to be protective against most Western ailments) and would love to wean off the testosterone cream, pregnenolone, DHEA, oh and the Synthroid and Cytomel I take for subclinical hypothyroid symptoms, but my doctor has convinced me that all of these were important tools in protecting me against osteoporosis (which ironically I was just diagnosed with following my first DXA scan), heart disease and cancer. Dr. Greger references his last video on bio-identicals from 2012; since nothing new is mentioned in today’s video, he must still be not in favor, right?




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    1. Yes, Heidi, that would be my assessment as well. Congratulations on your TChol numbers; most impressive.
      Incidentally, when I was making my own decision about risks/benefits of bio identicals I considered myself to be an ok candidate due to no family history of CVD, stroke, or other issues, and my own robust health indicators due to my long standing lifestyle approach. I have changed my mind recently (I am older, and interested in moving away from medications). Today’s video and the older one that Dr. G did on bioidenticals has iced the cake (as if I actually EAT cake!) and I’m discontinuing those treatments. Hot flashes, here I come!!!! After all, I pay to go to hot yoga – what will a few possible hot flashes be???? Stay tuned, I may change my tune!




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      1. Lisa Schmidt, MS, CN: I have an older relative who talks about how she once got some hot flashes while sitting outside during a very, very cold day at a football game. Everyone else in the stadium was shivering and freezing, but she was doing just great. :-) It’s not always bad… ;-)




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      2. Lisa, your reply is so helpful and hopeful!! I identify with all that you wrote, and in my heart, think it’s time to follow your lead. Nothing ventured, nothing gained; if we don’t try, we won’t know. So, I’ll be speaking with my doctor to see how to wean off. Love your yoga pun–so darned true! Thanks so much for your insights, and best of luck to you (us!)




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      3. Lisa,

        You might want to revisit this decision given. Let’s be clear as the hormone therapy used in the Women Study was using horse mare urine products and progestin, an artifical progesterone. In Dr. Greger’s comments on bioidentical hormones I agree that some pharmacies are less accurate than others. A number of the compounding pharmacies have gone to full pharmaceutical levels of production equipment, equal to the best your can get with a non-generic product. The comment of the 30% should be held in question as it’s about those checked not everyone…..and I have had excellent experience with 4 pharmacies specifically.

        The single reference to the bio-identical is five year old and new information has superseded it suggesting just the opposite. Indeed this is an ongoing issue that will never see clarity due to too many interests and how you interpret the findings of the many studies. I believe firmly that the patient’s quality of life considerations should be one of the leading concerns and of course keeping up with the literature, as it changes telling us what might be most appropriate is in order. At present it does appear that BHT is indeed at appropriate low doses an excellent means of maintaining ones health. Dr. Alan Kadish NF moderator




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  14. So I had a question regarding this..I am on HRT because I had a hysterectomy due to severe endometriosis and am pretty young for menopause. What are the repercussions of HRT in regards to age? Are there safe alternatives?




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      1. Lisa,

        This should always be ones MO, as a practitioner, regardless of the hormone. If you want to explore the issue of limited use, check the antacids. Eye opener when you dig deep and realize many drugs are inteded for very limited, 1-2 week use and are prescribed for years. Dr. Alan Kadish NF moderator




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        1. You are 100% right. A few weeks ago, my husband visited his PCP due to a swallowing issue – he is under care of an endocrinologist for a serious health condition, but started with the PCP. Who prescribed, immediately, Prilosec, saying he had GERD. No questions about diet, no questions that would have narrowed the diagnosis, no recommendation to check with his gastro doc regarding the additional script. Long story short – got a referral from the gastro to see an ENT – and guess what? No GERD (perhaps some post nasal drip). I have clients coming to see me regularly (I am a dietitian) who are having digestive problems, and they have been on reflux medication FOR YEARS. People, you cannot digest food without stomach acid!!! Your point is a great one. Lowest possible dose for shortest period of time. OH, change your diet, folks!!!




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    1. I have found that a Whole Food Plant Based diet has completely eliminated my Inflammation (one week), Fybromyalgia (two days), Diabetes (two weeks), and Obesity (six months). Your physician is a twerp who needs to take a nutrition class if he is unaware of the fact that these problems can handled through diet. You can resolve your problems by eating plants and eliminating animal products from your diet.
      This is a better choice than taking hormones and risking cancer.
      Look at the moderators on this site. They are professionals in their field.




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  15. Would love Dr. Greger to respond to positive effects for inflammatory disease…

    Arthritis Research & Therapy
    Hormone Replacement Therapy In Rheumatoid Arthritis Is Associated With Lower Serum Levels of Soluble IL-6 Receptor and Higher Insulin-Like Growth Factor 1
    Helena Forsblad d’Elia Lars-Åke Mattsson, Claes Ohlsson, Elisabeth Nordborg, Hans Carlsten
    Disclosures
    Arthritis Res Ther. 2003;5(4)
    http://www.medscape.com/viewarticle/459098_5?pa=aN7mPNNcCt6d9QbeJxnhPnjmXi2VXqg4%2BnUlF3jojY943zuEasR8zKWN66A2NK7p56MI7dGTgNawPfsOtJla9Q%3D%3D
    Conclusion

    In summary, we found in this controlled clinical trial that the increase of E2 levels in serum was highly correlated with improved BMD. We have tried to elucidate possible ways, in the network of proinflammatory cytokines and IGF-1, by which HRT exerts its effects on the skeleton in long-lasting active RA. We found that HRT reduces serum levels of sIL-6R, whereas IGF-1 levels were observed to be increased. Both of these results – the effects on the IL-6/ sIL-6R pathway and on IGF-1 in the endocrine system – may be involved in the mechanisms mediating the beneficial effects of HRT. There is a need for larger, controlled, long-term studies of combined treatment in RA – estrogen plus progestogen, and estrogen alone – to support our results and to investigate the effects of the various hormones.




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    1. Or people could eat a whole-food, plant-based diet and directly address what appears to be the underlying causal factors associated with rheumatoid arthritis. I recommend these videos as a group and perhaps this video in particular. The effectiveness of a WFPB diet in the treatment rheumatiod arthritis is such that it should be the primary treatment modality with additional pharmacological treatments viewed more as adjuncts to the therapeutic diet.




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      1. This video by Dr Greger is confusing as he blasted out hormone therapy in general. Hormone Therapy is required in breast cancer cases to prevent … cancer.

        Jim, my post will be deleted by the cop within seconds and so I post it to you so that you can read it and explain to others.

        http://www.breastcancer.org/treatment/hormonal

        http://www.breastcancer.org/treatment/hormonal/for_you

        It’s important to know that hormonal therapy IS NOT hormone replacement therapy
        (HRT). HRT isn’t used to treat breast cancer. HRT is taken by some
        women to treat troublesome menopausal side effects such as hot flashes
        and mood swings. HRT is used to raise estrogen levels that drop after
        menopause.




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  16. This still goes on with medicine. With NO symptoms for a stroke, I had a stroke in April. I have a birth defect in my brain. This could have happened at any time. I experienced the perfect storm for a clot to affect me. I followed religiously Dr. Greger’s advice and still do. One hospital nurse suggested that my diet may have saved my life. Immediately doctors prescribed two medications for me in the hospital. They had to blame something, but not the truth. Later, during rehab I discovered that both medications were 1) double usual levels and 2) CAUSE STROKE AND MUSCLE WEAKNESS as side effects. One week after I discontinued usage of both drugs (my conventional doctor still has no idea that I quit him and his drugs), my strength went up precipitously. That was June. I still take no medications; I am 61 years old; I have lost 90 pounds since 2009 and weigh my high school weight. :-) I tell everyone who asks that I have felt fine, except for some muscle weakness, since the night of my stroke. I return to public speaking this weekend. I returned to my employment July 11th. I returned to driving my car on July 8th. God is good! :-) The truth is: my stroke may not have been as bad as it could have been. That’s how God and diet work together.




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    1. Hi Terry. Your story is interesting. My 62 year old partner also had a stroke in April. We are pretty certain that his was a result of stopping Warfarin which he had been prescribed a number of years ago when he was diagnosed with Atrial Fibrillation. As a result his heart threw off a clot that went to his brain and it was 12 hours before he received treatment. He’s unable to speak very well and has very restricted use of his right arm and some cognition issues. So he’s back on a blood thinner and also a statin. Were you talking about a statin when you mentioned a drug causing stroke? He is vegan and has a very healthy diet and was exercising regularly. This has been devastating for him.




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    1. What is the most important information I should know about Vagifem® (an estrogen hormone)?

      Using estrogen-alone may increase your chance of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are using Vagifem®. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find the cause.
      Do not use estrogen with or without progestins to prevent heart disease, heart attacks, strokes, or dementia (decline of brain function).
      Using estrogen-alone may increase your chances of getting strokes or blood clots. Using estrogens with progestins may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots.
      Using estrogens with or without progestins may increase your chance of getting dementia, based on a study of women age 65 years or older.
      You and your healthcare provider should talk regularly about whether you still need treatment with Vagifem®.
      Who should not use Vagifem®?
      Do not start using Vagifem® if you currently have or have had certain cancers. Estrogens may increase the chances of getting certain types of cancers, including cancer of the breast or uterus. Also, do not start using Vagifem® if you have unusual vaginal bleeding, had a stroke or heart attack, currently have or have had blood clots, currently have or have had liver problems, have been diagnosed with a bleeding disorder, are allergic to Vagifem® or any of its ingredients, or think you may be pregnant.

      How should I use Vagifem®?
      Estrogens should be used at the lowest dose possible for your treatment only as long as needed.

      What are the possible side effects of Vagifem®?
      Vagifem® is only used in the vagina; however, the risks associated with oral estrogens should be taken into account. The most commonly reported side effects of Vagifem® include: headache, breast pain, irregular vaginal bleeding or spotting, stomach/abdominal cramps, bloating, nausea and vomiting, hair loss, fluid retention, and vaginal yeast infection.




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    2. Donna,

      Safe is a relative term, sorry the doc in me.

      It depends on your situation from many perspectives. As your aware as a reader of this forum there are no lack of opinions in medicine, including hormone therapy. In my practice we prefer to use compounded products as they can be made without the use of polyethylene glycol a component of Vagifem (http://www.novo-pi.com/vagifem.pdf) and found to containing some toxic contaminates (http://www.ewg.org/skindeep/ingredient/704983/POLYETHYLENE_GLYCOL/) which would not be something I would place in your body. I think that the best approach is indeed to use a typical estrogen, when adequate progesterone, not progestin’s are present, and topical vs systemic use is often times a good choice. But only when the complete picture of the patient’s health and desires are known. Dr. Alan Kadish NF Moderator




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  17. As a medical student from 1990-1994, I wondered if it was a good idea to mess with the normal postmenopausal drop in estrogen levels. There was never a discussion of the side effects. We were doops, trying to help decrease coronary artery disease and osteoporosis with a pill.




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  18. I was on some kind of estrogen for over 20 years due to a hysterectomy and went off of them the day I was told I had breast cancer. I tried for years to go off of them but every one around me said to stay on them because I was much more irritated without them. After my mastectomy I did chemotherapy which included Taxotere. The manufacturer did not let the providers know that it can cause permanent baldness in about 8% of the users. So because of the pharmaceutical companies lack of transparency I not only got cancer but now am bald for the rest of my life.




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    1. It’s just for a short period of time, not well over ten or so years, which is the case with post menopausal women, and if you are eating a whole food plant based diet there is protection in that behavior as Dr. Campbell pointed out in “The China Study.” Carcinogens like to have animal products to grow.




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  19. In the 90’s I had a bad round of thyroid disease, after which my doctor put me on estrogen for my bone health. In the spring of 2002 (just a few months before the study mentioned by Dr. G) I was diagnosed with breast cancer. I had a radical mastectomy, chemotherapy and radiation. Fourteen years later I am still here, thank goodness. I live with the scarring and the lack of my breast–funny how I still miss having two. I wear mastectomy bras and swimwear, and silicone breast forms. The other result of the anti-estrogen drugs I took for 7.5 years afterwards is the loss of my sex life. Intercourse is very painful due to the drying up of my cervix. This article just touched a nerve for me, and I felt the need to tell people the price I paid so big-pharm could line their pockets.




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        1. I take a small amount and push it up into my vagina at bedtime. It does wonders to restore the tissues. My doctor told me she would never know my age by my tissues and that she was going to recommend it to her other patients. I keep my oil in the freezer so it stays solid long enough for me to wash my hands before I pop into bed.




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  20. Yes, well I missed this hormone replacement bullet. And the bone drug(s), which induce cancer in rats and mice, only just grazed me. The stuff acts like hormone therapy.




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  21. I have noted those side effect warnings (including the possibility of cancer) for years and never used HRT…however, after menopause, I did develop urinary problems for which a vaginal cream and later an estrogen ring was prescribed. The doctors have assured me that since it is low-dose and slow release, and very localized, that this is helpful without being harmful. Any information or opinions out there in NutritionFacts world about the E-Ring? I tried to quit using it once, but developed issues with UTIs.




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    1. There have been two studies that found no increased risk of breast cancer in Mirena users, according to section 3.4.10 of this review. In a small case control study, Mirena users who continued to use it after a breast cancer diagnosis had “a higher risk of recurrence of borderline statistical significance.”




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  22. In other words, occasionally Doctors, scientists, the FDA etc. etc. can be wrong about their conclusions despite their best intentions (degrees and credentials). This is why I find Doctors who talk with certitude offensive. Yes, you have to make the best decision you can with the information you’ve got, but be humble enough to recognize that your opinion may someday be proven “dead” wrong (pun intended). Once people realize that ultimately their health rests on their own research , experience and advocacy they will have taken the most important step in their health. If they rely on Doctors who say “trust me, I know what I’m talking about and nobody else does, I’ll do the thinking for you, you don’t need to think” is the second they should move to Guatemala and drink the kool-aid.




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    1. I think that Premarin is a horse hormone. You can get a generic bioidentical estrogen cream made from plants instead. The big study used the horse hormone.




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  23. OK, here’s another angle to the story. I had a hysterectomy at age 52 ten years ago. Took estrogen for a while until the scary breast cancer stories came out. Stopped taking it. Got vaginal bleeding, constant UTIs, and was generally miserable. Sex with my husband? Impossible. Tried estrogen creams. A tiny bit of improvement. Not enough. Tried an estrogen suppository (Vagifem) with the cream. Some improvement Not enough. Finally settled on 1 mg systemic estrogen, combined with the suppository. So much better. Next, after a few years, I tried weaning myself off the systemic estrogen again. Horrible. Bleeding, UTIs, painful sex. The word “miserable” is the only word for it. it literally hurt to sit on my lady parts. I went to a uro-gynecologist who treats women like me day in and day out. She said some of us need to be on estrogen till the cows come home. I eat flax every day. I have my broccoli sprouts sprinkled with mustard powder nearly daily. I stopped drinking alcohol. I get my mammograms. I’m losing weight (twenty pounds down, twenty to go) and exercising. I’m doing everything I can to prevent getting breast cancer. But I’m going to keep taking my estrogen.




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      1. Are you asking about the estrogen that our body produces? That’s because we are making it and it should be in our body at that time. Right? Dr. Greger is discussing the use of hormone supplementation that women take after menopause.




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          1. Actually, it’s not. Women are prescribed Premarin . . made from pregnant mares urine (Pre-mar-in). There is discussion about the fact that this form of estrogen is not bio-identical. Compounding pharmacies can make a bio-identical estrogen for human females (not horses) as another estrogen choice. I would love to see a Dr. Greger-researched on this topic of Premarin vs bio-identical estrogen for women needing some support.




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          2. Yes, yet it seems that the biological reality is that what has developed in nature (us) has a way of working to complete the purpose of the sentient being without necessarily killing it (unless you are from the insect branch of the family tree like a male spider). It’s a remarkable thing, evolution.

            If the estrogen molecule that we produce is causing cancer then a WFPB diet is even more important because that causal factor needs animal products to help create an environment that the cancer can grow in. This was pointed out in “The China Study” and it is one of the other reasons I’m glad I’ve quit eating animal products and that I focus on whole plant foods.

            I hope the rest of the planet wakes up. It is probably a bigger factor in global climate change than we even realize. I don’t think the machine (us again) works very well when it’s running on the wrong stuff. It’s probably as true about our mental health as it is our physical health.




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      2. The breast cancer rate seems to follow lifetime exposure to estrogen. Both the absolute amount of estrogen and length of exposure are a factor.
        Breast cancer, like all cancers, starts out as a single mutated cell. The number of cells in the cancer doubles at a steady pace. The rate of doubling is dependent on how much estrogen and other cancer cell growth promoters such as IGF-1 the cancer cells are exposed to. It can thus take decades for a single cancer cell to go through enough doublings before it is large enough to be detected. So it might not be that fewer women under 40 have breast cancer. Rather it is more likely that that the cancer which started as a microscopic tumor when the women were in their twenties, didn’t grow fast enough to be detected before they were in their 59s and 60s..

        And this is why the exogenous estrogen in HRT seems to increase the cancer rate when given after menopase while the same level of endogenous estrogen doesn’t seem to cause the same increase in cancer rate in women in their 40s. By keeping the estrogen levels high after they would normally have plummeted at menopause HRT basically extends the “growing season” for the tumors that are right on the edge of detection and gives them the chance to go through just a few more rapid doublings and become a detectable tumor.

        Without HRT estrogen the doubling rate would likely have plummeted and the slower doubling times means that the tumor won’t become detectable
        nearly as soon as it would have if it had been fertilized by HRT estrogen.

        This also helped to explain why women in China have (or perhaps it is now used to have) about 1/8th the rate of breast cancer as American women. In China the age of puberty is several years older and the age of menopause is several years earlier, and in the years in between they have about half the circulating levels of estrogen as compared to American women. All told they have about 30% of the lifetime exposure to estrogen that American women have. Thus any tumor that does get started grows at a much slower rate during the years between puberty and menopause and then the growth ends much sooner. Thus more Chinese women die with undetectable breast cancers rather than from breast cancer.




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    1. I just went to the National Cancer Institute site and found out that those of us on estrogen-only therapy due to hysterectomy (in other words, no progesterone) actually have slightly lower risks of both breast and colon cancer. I wonder if Dr. Greger would comment on this, please? I simply have no quality of life without systemic estrogen (1 mg estradiol) used in conjunction with Vagifem suppositories. I’ve tried twice to wean myself off it, but both times resulted in the kind of problems that go way beyond mere hot flashes. (See my post above.) https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/mht-fact-sheet




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    2. This video by Dr Greger is confusing as he blasted out hormone therapy in general. Hormone Therapy is required in breast cancer cases to prevent … cancer.

      http://www.breastcancer.org/treatment/hormonal

      http://www.breastcancer.org/treatment/hormonal/for_you

      It’s important to know that hormonal therapy IS NOT hormone replacement therapy (HRT). HRT isn’t used to treat breast cancer. HRT is taken by some women to treat troublesome menopausal side effects such as hot flashes and mood swings. HRT is used to raise estrogen levels that drop after menopause.




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  24. I don’t know if this relates to hormones, but has anyone else experienced tiredness after taking sublingual B-12? How did you fix it? Thank you!

    I take the Spring Valley brand B Complex with B-12 that contain 20,000% of your daily value of B-12 from cyanocobalamin and often feel lightheaded when I stand up from being on the floor. Should I not be taking it every day? And if not, how often? Thank you so much for reading this and helping me.




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    1. The cheapest way to get our B12 is probably one 2500 microgram sublingual, chewable, or liquid supplement of cyanocobalamin once a week. This stuff is dirt cheap. You can find a twenty-year supply online for 40 bucks. All the B12 our body needs for $2 a year! Of course, the stuff doesn’t last twenty years. It has a four-year expiration date, so share it with some friends.

      For those mathematically-minded who are thinking, wait a sec. If you only need 4 to 7 micrograms a day, why do you have to take 2500 a week? Well, it’s a little complicated, but let’s do it. Our B12 receptors become saturated at as little as 1.5. So we can only absorb 1.5 at a time through our receptor system. But about 1% of the rest passively diffuses right through our gut into our bloodstream. http://nutritionfacts.org/video/cheapest-source-of-vitamin-b12/




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        1. Joy, First thing, we need about 4-7 mcg of B-12 a day for optimal B-12 functioning. But the B-12 dosing rates are weird, so figuring out what to take and how often to get that 4-7 mcg takes a bit of math. The first 1-2 mcg are fully absorbed through the B-12 receptors in the ilium portion of the small intestine. Then about 1% of any B-12 after the first couple of mcg directly diffuses through the intestinal wall, bypassing the B-12 receptors. And last relevant fact is that the B-12 receptors are available again about 4-6 hours after the previous intake of B-12.

          So the amount of B-12 absorbed in a given B-12 dose is:

          B-12_absorbed = 1.5 + (B-12_dose – 1.5) * 0.01

          So say you ate something fortified with a 2 mcg of B-12, which seems so tiny next to the 1000, 2500, even 5000 mcg supplements as to seem worthless. But you ate that something 3 times a day. Your daily absorbed B-12 would be
          .




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          1. Jim Felder, boy is this post helpful! I’ve always been confused by B12 dosing; now I understand (even took notes). The 2 mcg, 3 times per day sounds like the most natural way to get B12 to me.




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            1. I agree it would most closely mimic how primitive humans obtained their B-12. After all we evolved in a contaminated environment suffused with bacteria cranking out tiny, tiny amounts of B-12 in the water, soil, on our unwashed hands, etc. And so we only needed B-12 receptors capable of handling this constant trickle of B-12.

              With respect to untreated surface waters, I have rummaged around a bit and found a number of papers like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC380342/pdf/applmicro00043-0159.pdf"<this one, that measured the amount of B-12 dissolved in lakes and rivers, the sediments and in the algae growing in them. The papers mostly were trying to solve the puzzle of the source of B-12 for freshwater and marine algae, which require B-12, but which don’t make it themselves. The answer to their question was a symbiotic relationship with bacteria. For our purposes this work measured the total B-12 content per liter of water as high as 1-2 mcg/liter. Since humans need to drink about 2-3 liters of water a day, our ancestors could get something close to what we need from pond and river water. Here is a YouTube video from Mic. the Vegan that I found very interesting on possible natural sources of B-12 that could have sufficed for primitive humans that didn’t require them to eat animals in order to get sufficient B-12.

              One potential source of B-12 he didn’t mention was insects, which because they would have been eaten whole including all the bacteria and icky stuff in the digestive track, are a good source of B-12. Insects are animals not plants, but I think it goes to rebutting the B-12 only is found in meat argument of meat eaters that is used to say that humans prior to “artificial” supplements had to eat meat (read large amounts of muscle tissue, preferably BBQ with a baked potato with all the toppings) in order to get sufficient B-12.




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  25. Every physical problem can be “solved” by taking the best available chemical pill. Says the current medical doctrine. But what if the “best pill solution” worsens (deadly) the original problem? Maybe using a hammer for every problem is not a good idea. Maybe people need to start believing in other solutions other than pill$. Maybe people need to be aware that the product they buy from a company is not a solution, but a lateral transfer of the problem that generates revenue. Because the problem is not about buying a pill. That comes from an engineered constrained point of view designed to generate revenue.




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  26. The more I watch Dr. Greger’s videos the more I realize just how corrupt the American Capitalism system of medicine is. Since monopolistic, capitalistic medicine in the USA is so corrupt, I am wondering if medicine practiced in countries like China where there is very little profit motive, and which is state run might come closer to true science and using only those therapies that really work. For example, in Russia it is legal to use laetrile to inhibit the growth of cancer cells. But, in the United States and in England it is almost illegal to even say that laetrile might have some beneficial use in the fight against cancer. However, in Mexico in many other countries laetrile is legal.




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  27. 2:22 “Maybe it because there never been a female director”

    Feminism is nothing more than religion as i see it.
    Your argument simply based absolutely on nothing, other than self belief.
    You simply ignored the fact , that million of middle aged men
    Prescribed hormone therapy as well,
    Testosterone treatment is even more potent and harmful than estrogen.
    It’s not gender war, It’s only business, men don’t treated better because they are men.




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    1. As Dr Greger often points out, the lobbyists pay to have the studies flawed. Dr. Gregor has no skin in the game to make up information. Perhaps your new to this site. He studies the studies and follows the money and exposes the corruption.




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      1. The initial funding was through the National Institute of Heath (NIH). The second round of funding was through the National Heart, Lung and Blood Institute. This article is not an expose or investigative journal piece on corrupt funding.
        I was referring to scientifically valid limitations in the data that make it’s broad, generalizable appicability problematic in many instances.




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  28. This video was posted 4 years ago. Dr. Greger, would you please report on what the current science reveals about the use of estriol for managing long-term effects of menopause (e.g., vulvovaginal atrophy)? Does this weaker form of estrogen, applied topically, carry the same risks as estradiol? This article mentions a few studies: http://www.medscape.com/viewarticle/811948_3. And Jonathan Wright, ND cites many studies in his claim that estriol is safe: http://www.lifeextension.com/magazine/2008/8/estriol-its-weakness-is-its-strength/page-01. Please tell us if Wright is right!




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  29. Hi, my name is Brenda Bongetta, 27 years old, and I would like to share my story. I was taking birth control pill (BCP) for 10 years and I suffered a stroke on August 29th, 2015. I couldn’t move my right side and I lost my speech. Now I am better, but not 100%. There were a lot of blood tests done and all came back normal, with the exception of the gene Methyltetrahydrofolate Reductase (MTHFR DNA). I am heterozygous of this gene, with single copy being normal (A1298C) and the other copy being mutated (C677T). I had increased risk of thrombosis with this gene, with the combination of estrogen. Every time I go to a doctor’s office and I tell them about my story, they already knew it. So, why didn’t they tell me about this before? I might or might not have stop taking the BCP. Who would have thought it? I was healthy! My BMI was and is 19kg/m2, I was and I am eating a plant-based diet, I was a former athlete and I was into running, I never took drugs (only the BCP), I never smoke. It is so dangerous that 30% of the population has this mutation. Live at your own risk! @strokesurvival_bongetta




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  30. Wow, talk about good timing! The following “Breaking Medical News” report just out from our friends at PCRM.
    ——————-
    “Animal Fats Increase Risk for Type 2 Diabetes

    Fats specific to animal products increase the risk for type 2 diabetes, according to research presented last week at the 52nd Annual Meeting of the European Association for the Study of Diabetes (EASD). Researchers followed the consumption of various types of omega-3 and omega-6 fats in the diets of 71,334 women and tracked diabetes incidence rates. Those who consumed the most fats increased their risk for diabetes by 26 percent when compared to those who consumed the least. Specifically, omega-3 docosapentaenoic acid (DPA) and omega-6 arachidonic acid (AA), both of which are mostly found in meat, ***FISH*** [emphasis added], and eggs, almost doubled the risk for type 2 diabetes, and, when controlling for weight, by as much as 41 and 49 percent, respectively.

    Dow C, Mangin M, Balkau B, et al. Fatty acid consumption and incident type 2 diabetes: evidence from the E3N cohort study. Poster presented at: the European Association for the Study of Diabetes (EASD) 52nd Annual meeting; September 14, 2016: Munich, Germany.




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  31. It is true, it has been well known for years that Premarin, a Horse Hormone, a foreign protein in a Human body, increases Cancer Risk. The Vegan form of HRT, is totally Plant-Based and has not shown to cause an added Cancer Risk. We do not do well with Horse Hormones pulsating thru our bodies….




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  32. The amount of misinformation by the folks commenting is, well, frightening. I am a bit disappointed (but not that surprised), that Dr. Greger would say (I’m paraphrasing) “So why were these hormones being prescribed to women, because of advertising rather than evidence.” etc. These women are sat down, as the risks of HRT are well known, and are clearly articulated to the patient, by the doctor. Last time I checked, no doctor held a gun to a patient’s head and told her that she needs to take estrogen. This is the same with ANY medication. So, I am not sure why doctors and even pharmaceutical companies are being blamed, when the best available evidence of the SIDE EFFECTS are clearly known to physicians and are written down on the drugs themselves. Stop making this into an “us vs. them”. Without modern medicine and technology, you may not have made it to your first birthday or died from a simple childhood URI.
    All drugs carry side effects, and most of my clinical colleagues communicate these to a patient, and let her decide whether she wants to be on the medication. She isn’t forced to do anything — this isn’t North Korea. Some women’s post-menopausal symptoms were so bad, they are very willing to accept any increased breast cancer or cardiovascular risk. “Please doctor, I cannot take these symptoms, for the love of god, just make them go away!!”. This is heard in medical offices every day by the thousands. So stop blaming pharma and physicians, who have nothing to hide and (in my experience), we are looking out for the best interests of the patients. Take some responsibility in life, and you will be happier and more successful.




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    1. Part of the problem is some MDs have huge egos which makes it very difficult for patients to talk with them. They literally get nervous. Luckily and hopefully medical schools are correcting this in their training programs. I have to review with my patients before they go the questions they have because they are nervous and many times MDs have their hand on the knob to leave. I steer my my patients away from MDs like that. As I am sure you do too.




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    2. Wait you are completely ignoring the roll that a medical doctor plays in a patients life. There is a lot of power there which is why as WFPBRunner was able to point out the huge ego problem

      You, Dr. Yusupov need to talk to someone with a little more perspective on this subject, like a psychologist. You are angry enough to yell that all drugs have “side effects” (plants don’t) when consumed but you did not take the time to construct a sentence that addressed women and their health issues as a gender. You had to break it down to that one woman who is talking to her doctor when you speak about our choices when we face menopause. The “she” in your sentence is us and we make up a huge portion of the population and we make a lot of money for doctors and pharmaceutical companies when we take their drugs.

      You take responsibility for what you do when you talk to a woman and you remember how you make her feel. You make sure that she knows that if she eats a whole food plant based diet her chances of ovarian and breast cancer will be greatly reduced. You tell her that she can reduce or eliminate her menopausal symptoms if she eats a whole food plant based diet. You tell her that animal products, all of them, are bad for her. Tell her to reduce her intake. You take responsibility for the fact that you are on the front line dealing with individuals every day who’s lives and all life on the planet will be permanently changed if your patients quits eating animal products. If you can’t convince them of this simple truth, then the very least you can do is eat a whole food plant based diet yourself so that you can be a living example of the benefits of this diet.

      You remember that you can change everything. Your only problem is that it is not going to make you rich. So what are YOU going to do about it doctor?

      Oh there’s another guy with the same dream: http://nutritionfacts.org/video/food-as-medicine




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  33. I love the wealth of nutrtuon information here. It is much appreciated.
    This [HRT] is a very complex topic and the research is ongoing. While there was useful data gained from these initial findings from the WHI, there were numerous weaknesses and limitations in the study that are not addressed here. In addition, subsequent studies have found topical estrogen not to have the thrombotic complications as did the oral formulations conjugated in the liver that were addressed in the study. Follow-up has also found in women taking estrogen only, starting at the onset of menopause, there was a lower risk of breast cancer.
    Some alternative opinions:
    https://www.google.com/amp/amp.livescience.com/35645-5-experts-hormone-replacement-therapy-safe.html?client=safari




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    1. NonaMuss,
      I was thrilled to see your earlier posts. I’m 56 and went through menopause at age 52. Is it too late for me to safely start bioidentical estrogen creams for vaginal atrophy? If so, how long is considered safe to use it? Also, do you need progesterone with the estriol? If you have references that address this, please include them. I’m trying to decide between the cream and the new Mona Lisa Touch laser treatment.
      By the way, what type of medical professional are you? I hope I didn’t ask too many questions.




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      1. Hello Birt. I have never looked into these issues specifically since I opted for hrt when I became peri-menopausal. A very quick google search led me to this article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354766/#S7title
        If you still have your uterus and therefore endometrium, the article indicated you may need progesterone. It stated it is controversial among providers but in the article it shows there was a tenfold increase in estradiol concentrations in vaginally administered drug as opposed to oral administration. Risks and side effects with progesterone are not that great. I take micronized progesterone (prometrium) which is a bioidentical oral form.
        http://www.lifeextension.com/magazine/2006/4/report_progesterone/page-01 (Not s scientific article.)
        I have also used topical progesterone but stopped because the data on compounding shops shows wide variability on true dosages compounded.
        I have not looked into the laser either but a brief glance seems it looks promising but I would review randomized controlled trials and investigate long-term effects if I could find it.
        My background is in critical care and anesthesia (with a few OB friends lol).




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  34. Dr Greger, You are not completely correct on this topic.
    As a practicing Ob/Gyn for 22 years, it is true that hormone replacement therapy (HRT) was over marketed, and at first was sold to patients as a panacea and fountain of youth for all menopausal women.

    But the fact still remains that some women need HRT as they go through menopause. The short term use of bioidentical (my definition- the same hormones biochemically that the patient is lacking) menopausal hormones, defined as less than 5 years of use, has no negative effect on any endpoint, including breast cancer.

    Furthermore, the WHI study was a poorly designed and executed study in many ways; It was done to study the effects of premarin and provera (Prempro), as a primary preventative for cardiac risk, and definitely NOT bioidentical. We don’t use hormones this way, for the same reason we don’t use thyroid hormone replacement to lose weight!!

    The WHI study design was such that patients were included in this primary preventative study if they had no history of CAD: they were simply asked, so in reality, as you know, with our SAD diet and general poor health in this country, the women, who were on average in their early 60s, had roughly a 50 % risk of CAD yet to be diagnosed. Hardly a primary preventative study.

    Lastly, Prempro couldn’t be a worse drug to use- The provera (progestin) part of the drug is a nor-testosterone derivative, and as such, retains some nasty characteristics, like being mitotically active in breast and other tissues. The Premarin, derived from pregnant mare’s urine (hence the name), is certainly not estradiol, what a woman lacks at menopause.

    The WHI study is on going in the estrogen-only arm of this long term research: do you know why? Because to date, and now over many years, the patients in that arm have no excess risk of anything, and in fact have a reduced risk of breast cancer!!

    The jury on hormone replacement is, in my eyes, still out. Certainly I encourage, as I am a believer and participator in you philosophy of nutrition, exercise and eating a WFPBD as the first line of defense for menopausal symptoms, and it definitely helps to greatly mitigate symptoms. But in those patients, who are so symptomatic with vasomotor symptoms, sleep issues, anxiety, etc, there is nothing that makes them better than natural progesterone orally (not mitotically active!!), and estradiol given transdermally, for 5 or less years. There is simply no risk in using this physiologic doses in this very patient -centric, need based way.

    Dominick LoBraico, DO, FACOG




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    1. Thank you for this information Dominick. My Doctor said that there have been studies done since the WHI mentioned in the videos that have shown women taking hormones are living longer. She mentioned studies from Sweden and France. She is a fan of bioidenticals. How would I know when to quit?




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    2. Thank you Dr. LoBraico! I am a medical professional and have many friends and colleagues in your field. In addition I am recently menopausal and I have done my own research. Fortunately being in the medical field, being capable of reading the research, and having access to it through a university medical center I was able to make my own informed decisions and did opt for topical estrogen and oral progesterone.

      I made an earlier comment referencing the weaknesses of the WHI that are not addressed in the video. My concern here is two-fold. The video gives an incomplete picture of the issues and current evidence. It presents it in such a way that proffers a bias against the medical community which in some cases is deserved but was much more so in prior generations than today. I guess what I am saying is it sort of comes across as a wholesale bias against trusting medical advice. Even the title speaks to this.

      The other aspect I am concerned about is a potential diminishing of the valuable information and resources here. I mean, I have been telling everyone I can about this site and the wonderful information here. A psychologist friend (who has worked in a women’s health clinic and whose sister is an OB) went to check out the site and it happened to be the day this video was posted. She immediately texted me and said “i’m not impressed. People just don’t understand the WHI study.” I couldn’t understand why she was disappointed in the site so I watched the video and I understood. I believe in the healthy lifestyle, WFPBD espoused here but I feel if Dr. Greger is going to take on the subject of HRT it should be addressed with the detail and complexity required to dessiminate the up-to-date knowledge on the matter and that can not be done by relying on the earlier conclusions of the WHI fraught with its weaknesses and limitations. Thank you Dr. LoBraico for weighing in!




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  35. Dr Greger, thank you! Great video. Now when are Doctors going to read the package insert on vaccines? NEUROTOXINS Aluminum, Thimerasol-Mercury, Formaldehyde, MSG, Polysorbate 80, Human, Chicken, Monkey, Egg cells…these work synergisticly together to be far more toxic. Seizures, Encephalitis, SIDS, Death. 1 in 45 children are now on the Autism Spectrum- 1 in 20 boys, we now have no hope of gathering an army here in the future. At the current rate, 1 in 2 by 2032.
    Dr William Thompson, head of Autism Research at the CDC, has come out with Whistle-blower Status and requested audience before Congress since 2011. When will they let him tell the story of bringing in a huge trash can into the CDC and shredding data that showed the Autism connection. The Movie VAXXED is out to alert everyone, but has been kept out of most theaters. When is someone going to tell the parent and the doctors that the CDC is a FRAUD, a pawn of the drug companies who only care about PROFIT. WHO IS GOING TO BE BRAVE ENOUGH TO SAVE THE CHILDREN?




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  36. hi. my question isn’t exactly related to the topic here but i couldn’t find a more relative video. next week i am scheduled for RAI, 30 millicuries of radioactive iodine as follow up to a total thyroidectomy for cancerous nodules. my concern is whether or not radiation therapy is really safe. i’ve seen various reports saying it could increase chances of cancer in the future. thanks for your help.




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  37. From Virginia Hopkins Website on bioidentical hormone replacement

    The latest release of information from the E3N, published in the Journal of the American Heart Association, examined the risk of stroke among women using oral (pill) estrogen, transdermal estrogen (patch or gel), different kinds of progestins, and progesterone. Bottom line, estrogen patches and gels are much safer than estrogen pills, and progesterone is safer than any of the progestins. In fact, women using estrogen patches and progesterone (in pill form) had a slightly lower risk of stroke compared to women not using any type of hormone replacement.

    A nice little study recently published in the African Journal of Biotechnology compared endogenous (made in the body) hormone levels in women and men who had an ischemic stroke (blockage of an artery in the brain). The study measured estradiol and progesterone levels in 15 men and 15 women within 12 hours after an ischemic stroke, and compared them to a similar healthy group. The stroke group as a whole had lower progesterone levels than the control group, and a significantly lower progesterone to estrogen
    Research References

    Canonico M, Fournier A, Carcaillon L, “Postmenopausal Hormone Therapy and Risk of Idiopathic Venous Thromboembolism: Results From the E3N Cohort Study,” Arteriosclerosis, Thrombosis, and Vascular Biology. 2010;30:340.

    Sheikh N, Tavilani H, Rezaie A, “Decreased endogenous progesterone and ratio of progesterone to estrogen in stroke ischemia,” African Journal of Biotechnology Vol. 9(5), pp. 732-734, 1 February, 2010




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    1. I found this very interesting considering that it’s after menopause that we are more prone to chronic diseases – vascular, diabetes, Alzheimer’s – could it be that we are missing that critical component … hormones, but we need something that is closer to what our bodies make ( instead of urine from a horse?!)

      MAYBE what needs to happen is doctors need to be taught by what’s in their textbooks instead of pharmaceutical companies.




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      1. Maybe, when a woman menstruates every month, she is cleaning her body of toxic uncessary compounds, excess malformed proteins, etc, a =nd whe she stops mesntruating, these toxins start to acumulate..
        Maybe?




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  38. My coworkers are pre-menopausal or menopausal. One of my coworkers (tge one that is pre-menopausal) has a cyst on her ovary–her last ovary. She is so confused with what to do. She is so uncomfortable and wants relief. I shared a little bit about Dr. Gregor and his work. But she asked what to do if hormone replacement drugs are unsafe. I shared how important flax seed is to lower your breast cancer risks, but I honestly do not know, being that I am young and not going through menopause, and so I have not looked into this subject. Thoughts please?? Thanks so much




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  39. Could Dr. Gregor start making a Maca root file? There’s all these millions of people making wild claims about maca root. Many women claim it helps balance the hormones helping with PMS or fertility or energy levels. Would love to see some videos on Maca so I could know if it’s a scam or not. U
    Plus what if it has too many impurities like heavy metals.




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  40. Since we are talking about hormone therapy, What are factors, if any, cause hormone imbalances, spacficially in women who are vegan? I’ve been experiencing a lot of problems and have stuck to a strict plant based diet for about 7 years. Will diets high in fat cause this? Maybe too much coffee every day? I definitely stay under the recommened daily soy intake.




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  41. HRT is different from ERT and different from OCPs. The evidence is different as well. The route of delivery also plays a role. While I love Dr. Greger’s passion for nutrition and health, his focus is just that, how nutrition impacts our health. In your video you clearly stated estrogen when the studies sited were HRT. If you are going to tackle this topic, please provide the full breath of evidence on hormones, and in the future, we’ll expect you to tackle all other perscription durgs with as much passion.




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    1. Hi, I’m one of the site moderators. Dr. Greger has not addressed this in his videos. Black Cohosh has been used for years and usage increased after the Women’s health study recommended stopping exogenous hormone replacement therapy. Two NIH studies were done that showed no improvement of symptoms with the use of Black Cohosh. Additional studies have shown some reports of liver injury with the use of this botanical, therefore it is recommended to be very cautious if this is something you want to try.




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  42. What about HRT with testosteron in men, for example; keeping “optimal” testosteron levels of a 40 year old through the years as one ages through supplementation. Are there studies available? All I can find is a book written by dr. Life.




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    1. You are right there is a real dearth of good information on this subject. There was a large study started awhile ago to study the effects of testosterone on older men. The trial was stopped in 2009 after finding a significant number of men experienced cardiovascular events. Here is the reference if you would like to read more about this subject. “Adverse Cardiovascular Events Reported in Testosterone Trial in Older Men, US National Institutes of Health June 30, 2010.




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  43. There are many articles on erectile dysfunction in men on this site but I haven’t been able to find any articles on vaginal dryness in women which occurs after menopause. This is a problem that women have been embarrassed and silent about for too long. The drugs that GYNs prescribe have so many warnings but they do work. What do women do when faced with the choice of taking the drugs and gambling with their health or dealing with painful intimacy in a marriage? Neither choice is appealing. Menopausal women need help in this area.




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  44. Hello. I have a question, if anyone can help…
    I’m 34 years old and been on a HRT for 17 years. I do not have ovaries but my uterus is ok and, soon, I hope, I would liko to do IVF. If I stop using HRT, whats going to happen with my uterus? Please help! :(
    Also, few years back doctor found something really small on my left breast and he even sent me to CT scanner (the huge one) to other country, because there wasn’t one where I live… The scan showed something that needed to be checked once a year. That moment I turned plant based and been on it for two and a half years. Last year I’ve been on ultrasound breast check again, and is showed nothing… I’m sure it’s because I’m not consuming animal or processed food, anymore.
    Thank you Dr Greger for everything… these 2,5 years have been really eye opening, thanks to you.




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  45. I am currently on low-dose HRT and wonder if I should be using flax seeds to mitigate any risks. Or, would flax seed consumption increase risks?




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  46. Hi Dr. Greger,

    I am experiencing very intense perimenopausal anxiety and rage. I have electrical surges down my arms that can only be relieved through pressure or push-ups. Yes, I’m having trouble sleeping and hot flashes… but the anxiety and rage and mood swings are like my worst PMS x 100 and my swings can come out of nowhere. I have heart palpitations and extreme irritability. I was given a low-dose anti-anxiety drug… but I need something else. My doctor is suggesting HRT or a lose-dose birth control pill. I don’t really want to be taking anything, but I need to get some help. Can you advise Dr. Greger? What could be my least-worst choice between those two? Or is there something else?

    I also realize that these choices will probably not be vegan. In the least, they are tested on animals… :(

    I am completely vegan, on a very healthy, mostly whole-foods, all plant-based diet. (I follow your daily dozen.) I exercise regularly. I meditate (some) and have a spiritual practice. I do not smoke or drink or “do drugs.” I only drink 1 to 2 cups of coffee a day. I just don’t know what else to do.

    Thanks for any advice you or anyone else can offer.




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  47. I am sorry to hear you are struggling with these symptoms. While we cannot give medical advice on this site, your symptoms certainly warrant thorough medical attention. Are you working with a doctor familiar with menopausal issues? Has your doctor considered other potential causes for your symptoms? It sounds like you hormonal solutions which you are reluctant about. Have you discussed alternatives with him, or even a second opinion?
    You are clearly making efforts to be healthy with both your diet and exercise and how frustrating now to have these mood swings and anxiety. One obvious question is what seems to trigger these episodes and have your hormone levels been checked? I’d encourage you to write down several questions to explore with your present doctor and if necessary with other doctors until you can feel satisfied with a treatment plan that will be reviewed in an appropriate time frame. Knowing you’re being closely monitored will help.

    Continuing to exercise will help with both your sleep and stress. Should those feelings of rage get totally out of control you need to have a plan so you do not hurt yourself or someone. Again, knowing what to do should you feel overwhelmed may help. Speaking with a counselor while you get these medical issues evaluated and treated might be helpful.




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  48. After my sister was diagnosed with breast cancer at age 32 and was found carry the BRCA-1 gene I decided to under go the genetic testing as well. Sure enough, I carry the BRCA-1 mutation. I opted to have preventive surgeries to decrease my chances of getting cancer. From the the research that I have done along with the advise from my doctor I decided on using a HRT patch. From what I have read, BRCA-1 is not an estrogen-receptive gene. What are your thoughts on this?




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  49. So what is a woman that no longer has hormone producing ovaries to do to reduce or eliminate severe hot flashes?? Please advise. Thanks!




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  50. Hello Lori, thanks for your question. I am a family doctor and also a volunteer moderator for this website. Dr. G. has done several videos that discuss treatment for menopausal symptoms. Here is a good general video about the benefits of soy consumption: https://nutritionfacts.org/video/who-shouldnt-eat-soy/.

    This one specifically looks at whether or not soy consumption helps with hot flashes: https://nutritionfacts.org/video/soy-foods-menopause/ — answer is yes, most likely.

    There are also supplements sold which help many women with hot flashes: look for ones containing “black cohosh”. This contains so-called “phyto-estrogens”.

    If you gave a gynecologist you trust, see her (him). I hope this helps.




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  51. I found this video fascinating, but I still feel so stuck (if not more so now) when it comes to making a decision (which has already been difficult!). Like a lot of other women in this thread, I’m going through menopause at the moment (going through? Fighting through? Struggling through? *shrugs*), and this list of hormone imbalance symptoms is basically one long checklist for me and I don’t know where to go from here. I’ve made an appointment with my local GP, but iwth so many conflicting reports on the risks / downside / benefits that hormones provide – as well as the wealth of information and misinformation in this thread – it’s difficult to know what the right option is.

    As someone who’s trying to read up as much as they can before they go in for their appointment (hi Dr Google), does anyone have any recommended reading? Any reputable sources you trust? Hormones aside, any go-to methods for dealing with ro at least lessening these symptoms would be great. Hot flashes suck :(




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