Plant-derived estrogen replacement-Wren Study
Question:
Pat, Can you explain how these -new- tests can predict something that takes decades to manifest? How long have they been tested to see if they accurately correlate to the type of osteoporosis that is truly debilitating, rather than the typical bone density loss that is normally associcated with being post menopausal and is self-limiting after a few years? Will most women get scared unnecessarily by this type of micro testing for this surrogate end point that still has not been shown to be diagnostic at low levels for a disease, that even today remains of unknown etiology? I can see this a as useful research tool to monitor the effectiveness of various attempts to alter bone chemistry. But is this really ready to be used as a diagnostic tool for hormones? Will patients also be advised to attempt to change their bone density by diet and exericse or are only hormones going to be advised? Where has it been difinitively determined that bone density is the be all, end all when (1) artificial increases in bone density with mega fluoride and didrinal led to more brittle bones and (2) there is still some unknown correlation between higher bone density and breast cancer rates? Are we really ready to make bone density, by itself, into a god? And finally, why are you against bone scans and what do these new tests cost? Joan L.
Response:
Thanks for your questions Joan, and by no means can I totally answer them, as I am not a biochemsist nor a laboratory person. These two tests are being offered by labs I feel as an alternative to the Bone Density x-rays. My understanding is that as we are able to detect more and more things chemically, we can begin to work toward prevention, as you suggest. Individual providers will use these tests differently, of course. I see them as screening tests. I would use them not so much to encourage women to use HRT, but rather support for the woman who is choosing not to use HRT for all of the reasons we discuss on this newsgroup. If a woman can prove her bones are not reabsorbing abnormally quickly, she could opt to not take hormones. As you know, many of the tests done are to prove to the provider, and to the woman, that she does not have cancer (eg endometrial biopsy) or does not have deteriorating bones. The suggestion is: this test be offered during the premenopause period as a baseline. At least it is a non-invasive test, and simply tests urine. This is much more appealing to me. If I received a low score (low level of NTx), I would continue to supplement my ca, exercise, soy products, etc, etc, and avoid the use of HRT. If I had a high level, indicating that I am reabsorbing bone more quickly, I would need to reevaluate my options and make an informed choice about my lifestyle habits and medication choices. There has been very little said about these tests, other than reputable labs offering them. In this day of cost containment, I doubt labs would promote a test of dubious value. Though I am sure it happens, and you probably know more about this than I do. I believe the intent was to give guidance about the state of the woman’s health. I am interested in anything that supports preventative health and screening. Personally, I am cautious about any x-rays, and mammography being overused in myself. I do not like the unknown risks, and am concerned we’ve been exposed to too much already. I don’t like using ultrasound in pregnancy, however it has given us much helpful information. Twenty years from now will we find our daughters/sons sterile because we used it during pregnancy?? Hopefully not. On the flip side, in my own practice, there are times and places when specific tests have a place. A woman who is in premature menopause at age 35, whose mom and grandmom also went through premature menopause, and who has a small, bony frame, might find a Bone Density Scan, or the urine tests reassuring right now. A woman who is bleeding at odd times. As I’ve mentioned to you before, I support choice and information, and do the best I can to provide the information to women. Cost? My understanding is: around $100. Of course, this will differ between labs, and lower as it is used. I imagine the research is still pending re: how the results can be interpreted. Again, I appreciate your comments, and questions. A good option would to be to call your local lab, or the lab used by your insurance, and ask to speak to the professional in charge and get the biochemical answers for yourself. My purpose in presenting this information was to inform women about some other options they have available to them. That is the main reason I gave the information about the name of the test, etc, etc. Also, Susan Love mentions these tests on page 82 in The Hormone Book. << Can you explain how these -new- tests can predict something that takes decades to manifest? How long have they been tested to see if they accurately correlate to the type of osteoporosis that is truly debilitating, rather than the typical bone density loss that is normally associated with being post menopausal and is self-limiting after a few years? Will most women get scared unnecessarily by this type of micro testing for this surrogate end point that still has not been shown to be diagnostic at low levels for a disease, that even today remains of unknown etiology? I can see this a as useful research tool to monitor the effectiveness of various attempts to alter bone chemistry. But is this really ready to be used as a diagnostic tool for hormones? Will patients also be advised to attempt to change their bone density by diet and exercise or are only hormones going to be advised? Where has it been definitively determined that bone density is the be all, end all when (1) artificial increases in bone density with mega fluoride and didrinal led to more brittle bones and (2) there is still some unknown correlation between higher bone density and breast cancer rates? Are we really ready to make bone density, by itself, into a god? And finally, why are you against bone scans and what do these new tests cost? Joan L. >> Pat Sonnenstuhl, CNM,ARNP,RH/CH Midwifery Correspondant OBGYN.NET Olympia, WA cnm…@aol.com www.obgyn.net/webs/ or home.aol.com/CNMPAT/index.html July 4, 1997 6:06 pm
Response:
Thank you Cheryl for posting the entire text of the Wren "study." There is nothing of substance in this entire report to justify the use of progesterone in human subjects. The premise as I read it is to attempt to counter act the cancers caused by the self-inflicted use of unopposed estrogen. "Lab studies on chunks of dead breast tissue in a test-tube does not translate as a wonder cure preventive for breast cancer by any stretch of the imagination. Continuing the "Big Lie" about heart disease benefits for estrogen that the product insert discredits does nothing for the credibility of the Wren "study" either. And additionally the only cite for the osteoporosis "benefit comes from a medical "Bulletin." Take this study line by line and you end up with sound and fury signifying nothing. Fancy conclusions with absolutely no premise. Yet we have one vocal proponent of NP concluding on the basis of this work that "you can never use enough NP. It can save your life." This is medical quackery at its worse. If someone is looking for increased longevity for breast cancer patients, it was found by Simonton that merely belonging to a support group extended lives significantly. This work was reported in the Bill Moyer’s PBS series (and book) "Healing and the Mind." Again the premise of the Wren study is to attempt to find a way to counteract the increased cancer risk associated with self-inflicted estrogen use. The study is all speculation and hypothesis based up test tube conclusions and a very few actual human surveys of very small numbers, short term and no known subject selection criteria. IMHO, this is NOT science. It is only a very pathetic attempt to again have the tail wag the dog in order to justify the use of NP or any hormones. I am open to discussion on this issue if you can show me the error of my judgment on this Wren "study." Meanwhile, just say no to drugs in the first place and you don’t have to worry about trying to counteract estrogen caused cancers. BTW: The FDA has not approved the use of progesterone in any form, synthetic or "natural" for any conditions. This does not mean it is not available, as of course it is. But even Provera and its expensive patent never went through any FDA scrutiny. We have unopposed synthetic estrogen (Premarin) being live tested on human subjects until it was found to increase uterine cancer. Then non-FDA approved synthetic progesterone (Provera) is added to the chemical soup with more live testing on human subjects only to find most women can’t stand Provera. So rather than throw this whole massive hormone experimentation out the door as a failed attempt to corrupt Mother Nature, we now have a new pack of charletans selling "natural" estrogen (Estradiol) and "natural" progesterone (Progest and micronized progesterone) based upon no research what so ever of any legitimacy and only coat-tailing the hysterical HRT drug dependency created by Madison Avenue in the first place. Caveat Emptor. A search on InfoSeek, the CD data base of medical articles showed only a few articles on NP, mainly reviews of Dr. Lee’s book, Charletan Number One of this present yam scam. No "studies" specifically on the drug were found, only commentary on the claims and distortions of studies where it was used in the PEPI trials. Just say no to drugs. Individuals may get symptomatic relief for some conditions in an anecdotal manner, but STOP dressing up this wholesale use of untested drugs as a universal, life time need for all women the way the Wren "study" attempted to perpetrate. This is irresponsible medical quackery with absolutely no foundation. Joan L.
Response:
Thank you for your informational post!!!!! Victoria v…@usa.net Cheryl A. Snider wrote: > Here is the article which I assume Lynne is talking about. It pasted here > from Medscape
snip body…
Response:
Here is the article which I assume Lynne is talking about. It pasted here from Medscape. ________________________________________________________________ >Hormonal Replacement Therapy and Breast Cancer
Author: B.G. Wren k>Abstract: The relationship between estrogen usage and breast cancer is reviewed. Evidence suggests that the risk of breast cancer increases by a factor which appears to be dependent on the length of time the breast is exposed to unopposed estrogen. In vitro studies involving progestogen and breast cell activity suggests that continuous administration of a medium dosage progestogen (norethisterone 5 mg, medroxyprogesterone acetate 50 mg) will reverse the increased mitotic activity associated with estrogen. One thousand five hundred and fifty two women with breast cancer were involved in a study at the Royal Hospital for Women. Two hundred and eleven women with Stage I breast cancer took some form of hormonal replacement therapy following treatment of their breast cancer. Of these, 147 used a regimen of estrogen with continuously administered medium dosage progestogen. Compared to matched controls, the women on combined estrogen/progestogen had a much reduced risk of recurrence or death. [Eur Menopause J 2(4):13-19, 1995] ———————————————————————— Contents
