Michael Uzick, N.M.D.

Naturopathic Physician

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As we age our production of sex hormones (estrogen and testosterone) dramatically declines. In many men and women, lower levels of sex hormones can lead to a myriad of symptoms that are simply intolerable. In women, these symptoms which typically manifest after the menstrual cycle ceases, are called menopausal symptoms (e.g. hot flashes, night sweats, fatigue, insomnia). A similar phenomenon, which has only more recently been recognized in men, is termed Andropause.

For years conventional doctors have treated menopausal symptoms with synthetic hormone replacement therapy. The theory is simply; to add back those hormones, which are no longer being produced in sufficient quantities.

Recent large studies have made it clear that synthetic hormone replacement therapy significantly increases the risk of breast cancer and heart disease.

Fortunately, natural hormone replacement therapy appears to be a safer and more effective alternative to synthetic hormone replacement.


What is the difference between Natural Hormone replacement and conventional hormone replacement therapy?

Conventional hormone replacement generally consists of synthetic forms of estrogen, progesterone and testosterone. These drugs are similar to the hormones our body naturally produces, except they have been chemically altered. Synthetic hormones also have altered actions in our tissues, compared with naturally produced hormones. For example, synthetic estrogens persist in the body longer and become stored in the tissues to a much greater extent than natural estrogens.

Natural hormone replacement, as the name suggests, consists of the natural forms of estrogen, progesterone and testosterone. In other words, these hormones are identical in structure and function to the hormones that the human body produces. This is where to term "Bio-Identical" comes from.


Why do conventional medical doctors use synthetic hormones?

They might not realize there is a choice. Synthetic hormones are chemically altered making their structures unique. This means the pharmaceutical companies that created them can patent these unique structures. Exclusive patents enable drug companies to earn substantial profits which also finance the research and marketing of synthetic hormones. Conventional doctors learn about these medications through the medical journals that publish the research funded by drug companies as well as their sales and marketing efforts. Thus, they are the only medications these doctors tend to be familiar with.


Are Natural/Bio-identical hormones safer than synthetic hormones?

In 2005 the International Journal of Cancer published a large study looking at various hormone preparations used by over 54,000 women and the incidence of breast cancer among them. They found that women who used estrogens combined with synthetic progestins had a 40% increase in their risk of breast cancer. These results confirmed those found in the landmark 2002 Women's Health Initiative study. However, this more recent larger study also looked at women taking a combination natural estrogen and natural progesterone. They found the risk of breast cancer was actually reduced by 10% among women using natural hormone preparations. Int J Cancer. 2005 Apr 10;114(3):448-54.

There are several reasons why natural hormone replacement doesn't appear to increase the risk of breast cancer the way synthetic hormones do. Firstly, research has shown that the body easily metabolizes natural hormones. On the other hand, synthetic hormones remain in the blood longer and are stored in our tissues to a far greater extent.

There are conventional preparations that contain natural estradiol. However, the dose of estradiol is 2 to 4 times greater than what an experienced Naturopathic physician would typically use. Studies have suggested that much lower doses of conventional hormones are just as effective as the standard dosing used by conventional doctors. However, this information has not been commonly adopted by the average conventionally trained physician.

Further, synthetic hormones are metabolized by the liver in an unfavorable way in comparison to Bio-Identical hormones. Some studies suggest, when estrogen is broken down by the liver it becomes either 2-hydroxy-estrone - which is protective against breast and cervical cancers - or 16-hydroxy-estrone - which promotes these cancers. Synthetic hormones almost exclusively are metabolized to the harmful 16-hydroxy from of estrogen. Many studies show increased risk for breast and cervical cancer in women with higher levels of 16-hydroxy estrone.


Cancer prevention

While there is good reason to believe the cancer risk with Natural hormones is significantly less compared to synthetic hormones, I think that it's essential for anyone on hormone replacement therapy be on a cancer prevention protocol as well.

For example, a simple dietary change may  very dramatically alter the metabolism of estrogens in way that can significantly reduce the risk of breast and prostate cancers. Additionally, there are a few essential dietary supplements that research has suggested may powerfully help to reduce cancer and heart disease risks.


My approach

I do not prescribe natural hormones for every man or woman with symptoms suggestive of hormone deficiency. For woman with mild to moderate menopausal symptoms, complete relief is often easily achieved with the appropriate diet and lifestyle changes in addition to specific herbal therapies.

However, in my experience, woman with more severe symptoms typically do not find adequate benefit from nutritional approaches. In these woman Natural hormone replacement is nothing short of a godsend.

In men with symptoms of Adropause I wouldn't consider prescribing hormones without documenting a hormone deficiency on blood tests and ruling out any significant risks for prostate cancer.

When assessing hormone levels I only use blood testing. I realize that many "authorities" on natural hormone replacement therapy recommend saliva testing. They even claim that it's superior to blood tests. However, this has not been my experience. I have found saliva testing to be highly inaccurate and no longer use this method.

In patients that are candidates for natural hormone replacement therapy I use the lowest dose that relieves their symptoms. When it comes to the issue of osteoporosis, there are better and safer therapies than unnecessarily high doses of estrogen.

In additional, I always consider ways to help reduce potential health risks with diet, lifestyle and nutritional supplementation which have evidence for potentially reducing the risks of hormone dependent cancers and heart disease.










































































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            Michael Uzick, NMD, FABNO           

            3920 North Campbell Avenue

            Tucson, Arizona 85719