By Alicia Stanton, M.D., OBGYN
Chief Medical Officer

June, 2009

Newsweek recently published a scathing article about Oprah titled "Why Health Advice on Oprah could make you sick." In it, Weston Kosova and Pat Wingert criticize Oprah for having Suzanne Somers on her show as the "expert" on bioidentical hormones.

Dr. Alicia Stanton, Chief Medical Officer of BodyLogicMD shares her thoughts on Newsweek's attack on Oprah.

Weston Kosova and Pat Wingert make some good points during their attack on Oprah in this week’s Newsweek article. However, they missed some very significant points as well. Suzanne Somers' passion about the benefits of bio-identical hormones has been appreciated by many, including Oprah.

It is true that Ms. Somers does not have a medical degree. But she has spent countless hours learning about the subject and has interviewed many of the best minds in medicine regarding hormone therapy - likely more than anyone else – but the Newsweek physicians haven’t. So while she is a lay person – at least she is SEEKING out information – as patients are – as other physicians should. Therefore, her opinion is worth something. That being said, her place in the bio-identical hormone therapy debate should be as a lay person sharing her passion and creating a space for others to learn about those options then decide for themselves, with the help of their physician.

I don’t believe that she is portraying herself in any other light. She consistently states that she is not a health professional. The fact that her advice is taken so ardently by so many demonstrates the hunger in the public sector for something that will actually work for them. Our current medical system is failing patients by the millions. The patients know it and the doctors know it.

The article states that “there are no conclusive clinical studies proving that they (bio-identical hormones) are less risky.” As a matter of fact, there are all kinds of data to show that bio-identical hormones are safer than non-bioidentical hormones such as Premarin (conjugated equine estrogens), Provera (medroxyprogesterone acetate) and the hormones in birth control pills. A Swiss study of 23,000 women using bio-identical estradiol or estriol showed a 25% DECREASE in the death rate from breast cancer (Schairer et al, Epidemiology, 1997; 8:59-65). In 2005, a large French study of 54,548 menopausal women showed that women who took estrogen and non-bioidentical Provera had a 40% INCREASE in breast cancer but women who took estrogen and bio-identical progesterone had a 10% DECREASE. It is known that equine estrogens such as those found in Premarin block an important enzyme called glutathione-S-tranferase which is necessary to break down or detoxify carcinogens (cancer causing substances). Bio-identical estrogens do not block that enzyme.

Given the fact that we do know that bioidentical hormones carry a better safety profile, it is very difficult to understand any argument that something different than what your body would naturally make could possibly be better for you then something that is the same. The hormones our body produces have served us well for millions of years. What other rational argument could there be to utilize a hormone with a different structure than the structure our body‘s natural hormones (bio-identical) except that those can’t be patented and sold by pharmaceutical companies? Pharmaceutical companies can patent the delivery systems of bio-identical hormones – and some of them do. Many physicians, including this author, actually use a number of pharmaceutically available bio-identical hormones. We just compound what is not otherwise available.

A major criticism that I have with Oprah’s show is that she has not had a physician on the show that prescribes bioidentical hormones in some of the lower, more conventional doses. Oprah SHOULD have featured a physician that is HIGHLY trained in low dose BHRT. Suzanne Somers is on the Wiley protocol which uses hormone doses much higher than most physicians prescribe and the focus of her protocol is achieving a cycle again. Many physicians who practice Functional Medicine and use bioidentical hormones actually use much lower doses and a lower, steady state of hormones rather than cyclic dosing. It would be helpful to let patients know that those options exist as well. The other problem I have is that when they have shown patients who were in the midst of strong menopause symptoms, started them on hormone therapy and brought them back to the studio 3 days later, they were “all better”. In reality, this is a very dynamic system and it often takes months to get the right balance. This is especially true when you also have to change diet, lifestyle and stress levels to optimize the therapy. Patients need to know that they will not be completely better overnight.

Oprah’s guest, Dr. Christiane Northrup, offers a wealth of information. Her books, The Wisdom of Menopause and Women’s Bodies, Women’s Wisdom, are well referenced and give a great deal of information on hormones, nutrition, diet and stress management. They also focus on the mind-body connection and offer wonderful personal stories that allow the reader to connect to what she has to say. These connections allow patients to move forward with healing. What is impressive to me is the fact that Dr. Northrup has that talent to make those connections and the courage to speak publically about them. The initial consult in my office is 60 minutes long. In addition to the “standard” medical history questions, patients are encouraged to talk about how they got to where they are – their stressors, their fears, their illnesses.

After listening to hundreds of stories, the connections are clear. I don’t use tarot cards, but I believe in the connection that many conventional doctors overlook because my patients tell me they exist. I often have patients tell me, with tears in their eyes, that I am the first person that’s ever really listened to them.

Dr. Northrup discussed thyroid dysfunction with Oprah, who developed thyroid problems after an extensive travel season. The thyroid and adrenals are closely connected and the stress most likely contributed to the dysfunction as well. Dr. Northrup offered a different explanation for Oprah’s thyroid dysfunction as a possible connection to the spirit. Oprah took a month off and recovered in Hawaii which would have helped both body and spirit. Dr. Northup’s advice was helpful – Oprah was not discouraged from replacing the appropriate hormones and was not offered the incorrect treatment. She just got insight to another possible way to heal. Dr. David Cooper criticized Dr. Northrup by stating that “thyroid disease has nothing to do with women being downtrodden. She makes it sound like they bring it on themselves.” In reality, what Dr. Northrup stated was “But your intellect doesn’t know it. This is the important part. It’s not – you’re causing this deliberately…. It’s your soul bringing it to your attention.” Dr. Cooper also states that iodine deficiency is not common. However, with the addition of bromine to baking yeast, which displaces iodine in the body, it is more common. There is testing available to determine if iodine deficiency exists. The data on soy as a thyroid hormone blocker is unclear. In a number of studies including on in the American Journal of Clinical Nutrition, Dr. Persky stated that the effect of soy protein on the absorption of thyroid hormone was of such a small magnitude that it was unlikely to be clinically important (Persky VW, et al.; Am J Clin Nutr. 2002; 75(1):145-53).

Oprah has great resources and tries her best to bring those resources to the public eye. Many of her show’s guests, like Dr. Oz, do a service to the viewers by giving them straightforward, valuable information. Despite criticism for her show with Suzanne Somers, she accomplished what she wanted to do. She started the conversation about bioidentical hormones in America. Her message has always been that you should do your own research and talk to your physician about it. I believe that it is also a call to all physicians to learn more about what their patients are trying to say to them. There IS training available for physicians that really want to learn – training that ALL BodyLogicMD physicians are required to take – and training that is also available to ALL physicians – including the Newsweek physicians.

Read Newsweek’s article: “Live Your Best Life Ever”.