What to believe these days....medical literature not what it seems.

The NY Times has revealed that Wyeth Pharmaceuticals hired writers to emphasize the benefits of hormone replacement therapy versus the risks to prop up sales of its hormone drugs Premarin & Prempro. These articles were published in 18 medical journals between 1998 to 2005 and did not disclose that Wyeth initiated and paid for this work.

Unfortunately, many health care practitioners rely on these medical journals in making judgements as to what to recommend to their patients.

You can read more about this practice in the NY Times.


Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Breast Cancer & Hormone Replacement Therapy: What we know now - The good news

By now, a lot of people know about the increased risks of getting breast cancer when a woman goes on hormone replacement therapy (HRT). The Women's Health Initiative - a large scale study - was stopped in 2002 when it was noticed that estrogen and progestin users had a noticeably greater risk of developing heart problems and breast cancer. Statistical analysis shows that at the peak, the breast cancer risks for women on HRT were twice that of women on a placebo pill.

Fortunately, retrospective analysis shows that these risks dropped quickly once the HRT group stopped using the pills. In fact, this group's risk levels returned to normal in about two years. Very good news indeed considering it takes about 10-15 years for a smoker's risk profile to go back to normal levels.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Hormone Replacement Therapy (HRT): New Risks Revealed

Years ago, there was a debate about HRT. Should women be taking these hormones to help them combat menopausal symptoms such as hot flashes, night sweats, vaginal dryness and in some cases, to prevent osteoporosis? In 1991, the U.S. National Institutes of Health (NIH) launched the Women's Health Initiative (WHI) - the biggest and most robust study of its kind - to investigate the potential benefits and risks of HRT. Five years after the start of the study, the NIH prematurely ended one arm of the study. It was found that those women taking combined estrogen and progestin pills had more health risks than benefits. Analysis of the data found that for every 10,000 women on HRT vs. placebo during a one year period:

Risks:

• Seven more cases of coronary heart disease (37 on combined HRT versus 30 on placebo)
• Eight more cases of strokes (29 vs 21)
• Eighteen more cases (34 vs 16) and a twofold greater rate of total blood clots in the lungs and legs
• Eight more cases of invasive breast cancer (38 vs 30)
• 23 more cases of dementia (45 vs 22)

Benefits:

• Six fewer cases of colorectal cancer (10 vs 16)
• Five fewer cases of hip fractures (10 vs 15)

After 7 years, the estrogen only arm of the WHI study was discontinued. They concluded that this therapy:

• did not increase or decrease the risk of coronary heart disease;
• did not increase risk of breast cancer;
• increased the risk of stroke similar to the findings reported from the WHI estrogen and progestin arm of the study; and
• decreased the risk of hip fracture, in women who have undergone hysterectomy.
• shows trend toward increased risk of probable dementia and mild cognitive impairment

The researchers continue to follow-up on the patients in the study and the latest news shows that:

• heart problems linked with the pills seem to fade after women stop taking them
• the health benefits of decreased hip fractures and colorectal cancers also faded after women stopped taking the pills
  
• however, surprising new cancer risks, in particular lung and breast tumours, seem to have caught scientists off guard. Those who'd taken the hormones and stopped were 24 percent more likely to develop any kind of cancer than women who'd taken the placebo. That amounts to three extra cases per year for every 1,000 women on hormone pills vs. placebo.
  

As the years go on, we'll learn even more from this study as follow-up data is accumulated and analyzed. But for now, health risks from estrogen-progestin pills seem to outweigh their benefits. Some doctors continue to prescribe these pills to relieve hot flashes and other menopause symptoms, in addition to building bone strength. For those women who continue to take these pills, I definitely recommend the lowest possible dose for the shortest duration possible. But if I were you, I would exhaust all other safe, more natural alternatives before going on these synthetic hormones. There are many ways to build bone density and to decrease your menopausal symptoms. Of course, go to a knowledgeable health care professional that you know.

Yours in Health as always.