A 45 year old female presents to you complaining of fatigue, loss of energy, weight gain, muscle pain, and weakness in exercising.
She read about the benefit of hormones in treating her condition, but her PMD is against the use of hormones. Although she is open to taking hormones, her PMD scared her into thinking that testosterone is somehow harmful. You assure her that testosterone is not harmful and that many of her symptoms will improve on testosterone supplementation.
We have explored the pandemic of chronic illness that patients are experiencing. We have also explored how hormone replacement therapy can safely and effectively prevent or even treat many chronic illnesses by delving into the robust medical literature supporting hormone replacement. After learning how Bioidentical Hormone Replacement Therapy (BHRT) can help patients fight chronic disease, providers may ultimately desire to add this form of medicine to their practice, so how do they go about doing that? The answer: training, of course.
Previously, we discussed how patients are taking more medications and experiencing an endless conundrum of health issues. The systemic failure to address the root causes of disease is a huge part of the problem. Along with the proven benefits of a healthy diet, exercise, and stress management, we can greatly improve health outcomes by utilizing another evidence-based strategy: bioidentical hormone replacement therapy, or BHRT.
The previous course on thyroid optimization was intended to contrast and explain how and why the endocrine societies and the ATA frighten us into not using thyroid hormone. I introduced the concepts that the endocrinologists use when treating hypothyroid patients as well as their reluctance to prescribe thyroid hormone to SC hypothyroid patients. Despite the plethora of data and studies proving that patients DON’T improve on T4-alone therapy, the ATA and AACE reject all the studies demonstrating that patients DO benefit when T3 is added to T4, but also when DTE is used preferentially in place of T4-alone or T4 and low dose T3. When used correctly, most recent literature overwhelming proves that patients prefer DTE over any other thyroid preparation.
The last medical journal article that was presented in the last course, Treating T3 Deficiency: The Evidence You Need (Part 6), stated that exogenous hyperthyroidism (TSH suppression) with thyroid hormone administration was not associated (causative) of any adverse effect. “There is no scientific evidence that the clinical impact of TSH suppression is significant.” This meta-analysis proving no harm with thyroid hormone administration (along with TSH suppression) is in direct contrast to the opinions of the other papers/authors opinions reviewed in the last course. I reviewed many papers and opinions that TSH suppression was harmful. However, I emphasized that the studies cited were all studies that reviewed baseline TSH levels in patients with Graves’ disease. Not one study was an outcome study in patients that were prescribed/treated with thyroid hormone. However, the results of all these baseline observation studies demonstrated/proved that suppressed TSH levels (in Graves’ patients) were associated with harm, sudden cardiac death, a-fib, osteoporosis, etc. The authors of the various opinion papers went on to extrapolate that thyroid hormone administration resulting in suppressed TSH levels (biochemical hyperthyroidism) was just as bad/harmful as that seen in those studies citied in patients with Graves’ disease. Nothing could be further from the truth. That which is observed in treatment trials can be completely the opposite of what is observed in baseline observation studies. Another perfect example of ODNPC.
We continue to prescribe medicines that make IR, DM, CVD, and cancer worse, but we ignore the harm due to the therapeutic illusion that the benefits outweigh the risks. Yet we continue to ignore the plethora of data and studies demonstrating how to avoid these risks and protect against DM, CVD, and cancer.
Recently, a new cholesterol lowering drug was approved in the U.K. The press-release heralded Inclisiran, simply another PCSK-9 inhibitor, to be a game changer as it will save thousands of lives by lowering cholesterol. No, there are no outcome studies yet, only studies that demonstrate it lowers serum cholesterol 50% more than statins alone. The authors assume and extrapolate that lowering LDL cholesterol with this drug will result in thousands of lives saved. That is termed therapeutic illusion.
Controlling HgBA1C with Medications Does not Make Diabetes Disappear – It Lowers the Surrogate Marker HgBA1C
Although the pathophysiology is simple, the treatment and reversal of CVD and cancer is what is so confusing, complex, misunderstood, and ignored.