Wallace Integrated Health Centre
Newsletter – Winter 2010
New Developments
• The WIHC has become cell phone free! In the wake of recent studies, showing increased brain and salivary cancers among long term cell phone users, and increased risks to children’s health, we are asking all staff, patients and visitors to turn off their cell phones, blackberries and other electronic devices before entering the clinic. Thank you for helping us to protect the health of our staff and patients. To protect your family, limit cell phone use to less than 6 minutes per call, charge your phones away from bedrooms and turn off your phones when they are not in use.
• This years Naturopathic Flu Clinic was incredibly busy, likely due to the H1N1 flu virus circulating in the North Bay area. Yes, our homeopathic remedies do help protect you and your family against this virus, as well as many others, and it isn’t too late to get your “shot!”
• Kelly Wallace, N.D. recently attended the Ontario Association of Naturopathic Doctors’ annual convention in Toronto. This year the convention featured Dr. David Suzuki and other top environmental health experts from around the globe. Dr. Wallace returns to North Bay with a renewed sense of how critical a role the environment plays in determining our health. Every day we are exposed to thousands of chemicals and toxins, which can adversely impact our health. Ask us how you can minimize these risks for yourself and your family!
• The holiday season is here and gift certificates for Massage Therapy, Craniosacral Therapy, or Naturopathic consultations make great gifts!
Upcoming Events
• Kelly Wallace, N.D. will be hosting another information session for Healthy & Active, The Metabolism Program, on Monday, October 19th, at 7:00 p.m. at the WIHC. Please check out www.wallacehealth.com, or www.healthy-active.com for more information on the program. The information session will run for approximately 1 hour. Please call 474-2727 to reserve your seat.
Articles
Bio-identical Hormone Therapy by Kelly Wallace, N.D.
Bio-identical hormone therapy (BHRT) is becoming a heavily discussed issue among women these days after having been featured by Oprah several times, and also as the subject of a best-selling book by Suzanne Somers. In the wake of the Women’s Health Initiative findings, women have more concerns about conventional hormone replacement therapy (cHRT). Bio-identical hormone replacement therapy is now a fairly common treatment in the US, and more and more women in Canada are requesting it as an option to deal with menopausal symptoms and other age-related conditions.
Bio-identical hormones are a general term technically used to describe any man-made hormone that exactly matches a hormone naturally produced by the body. However, bio-identical hormone therapy as it is most commonly used includes the main female sex hormones: estrogen (including estradiol, estrone and estriol) and progesterone. Testosterone and dehydroepiandrosterone (DHEA) are also fairly commonly used. Most bio-identical hormones are derived from plant compounds, usually soybean or wild yam (Dioscorea), and are formulated in such a way as to be identical to our natural hormones. In contrast, the most common form of estrogen replacement therapy (ERT), Premarin, contains over 10 different types of estrogen alone, as well as various progestins and androgens, which are all a little bit different from the hormones that our bodies make. It is likely that this complexity of Premarin’s composition accounts for the some of the differences that we see between its’ effects and those of bio-identical estrogens.
Why would I want to use Bio-identical hormones?
The indications for the use of bio-identical hormones are similar to indications for the use of cHRT and include severe menopausal symptoms and women at high risk of bone fracture, who have not responded well to other therapies to stabilize bone mineral density. They are especially indicated in women who may be at risk for adverse effects from cHRT, since the side effects are usually much less frequent and severe.
The benefits of bio-identical hormones are similar to the benefits of cHRT, in that by replacing declining levels of estrogen, progesterone and other hormones, women may find relief from common menopausal symptoms such as hot flushes and night sweats, mood changes, low libido, vaginal dryness and cognitive changes, as well as positive influences on various conditions such as cardiovascular disease and osteoporosis. The other major benefit is the flexibility of dosing. Since most bio-identical hormones are compounded individually in a compounding pharmacy, infinite possibilities regarding dosage and method of delivery are available, which can significantly minimize any risks. Creams are a very popular method of delivery for bio-identical hormones, since the side effects are minimal and a very low dose is usually all that is necessary.
Are there risks with BHRT?
Yes, as with any therapy, there are risks. The risks associated with BHRT are also similar to those of cHRT, and include an increased risk for breast and other hormone dependent cancers, blood clots, etc… For this reason, my general recommendation for patients is to first try diet and lifestyle modifications, possibly with specific nutrients, herbal support and acupuncture where indicated, then, if necessary, proceed to the least risky hormone therapy, namely bio-identical hormone replacement. I always recommend using the lowest effective dose, for the shortest possible time.
However, research indicates that the risks and frequency of adverse effects are less than those associated with cHRT. Risks can also be minimized by choosing certain preparations of BHRT, including certain types of estrogen and using trans-dermal (creams, patches…) applications of bio-identical hormones.
Are there any people who should not use BHRT?
Any hormone therapy should not be undertaken lightly and a full work-up should always be done on the patient prior to initiating therapy, and regular monitoring should be performed throughout the course of the therapy. As with cHRT, there are few absolute contra-indications to bio-identical hormone replacement, but with the following conditions: breast cancer, endometrial cancer, endometriosis, unexplained vaginal bleeding, liver and/or gallbladder disease, history of vascular thrombosis or other risk factors for cardiovascular disease, or a history of seizures, serious consideration should be taken to ensure that the benefits outweigh the potential risks before initiating therapy.
How do you monitor BHRT?
Blood tests are the most common method of testing hormone levels in peri-menopausal women. However, more and more doctors are turning to salivary hormone testing, to test and monitor patients using bio-identical hormones. Saliva testing has the advantage of being non-invasive and easily done in the home. However, the main reason to consider saliva testing over conventional blood tests, is the fact that saliva testing measures the actual bio-available level of hormone, that which has been able to penetrate the tissues, providing more accurate information.
I am interested in learning more about bio-identical hormones, and finding out if they are right for me. What do I do next?
In Ontario, bio-identical hormones can only be obtained by prescription from your family physician or specialist, however many M.D.’s are not trained in the use of BHRT and are not comfortable prescribing it. Many Naturopathic Doctors, including myself, have special training in BHRT. We have been awarded prescribing rights by the Ontario government, but the legislation is still being finalized and it may be several years (yes, years!) before we can actually prescribe bio-identical hormones. Until then, I am working closely with the family doctors in town to help people access this important treatment option. I do an assessment, order salivary hormone testing, make prescription recommendations and provide follow-up care. We are very fortunate now to have a compounding pharmacy in North Bay that is able to make any type of bio-identical hormone preparation necessary. If you would like more information on this subject, please call us at the WIHC at 474-2727, speak with someone at Dean’s Pharmasave, or talk to your family doctor.
