Are bio-identical hormones a better option?

Keri Brenner

A hormone is a hormone is a hormone - or is it?

According to area holistic physicians, the answer is no. Some hormones - such as bio-identical versions of the hormones estrogen, progesterone and testosterone - are far superior to synthetic versions, says Dr. John Walck, a former Olympia physician who now practices in Gig Harbor and Port Orchard.

Walck says bio-identical hormones, made from soy or wild yam, are a perfect match to the body's own hormones. Synthetic hormones such as Premarin, a form of estrogen made from the urine of pregnant horses, are foreign to the body and can cause side effects.

In a 2002 Women's Health Initiative study, Premarin combined with Provera, a synthethic form of progesterone, doubled the risk of developing breast cancer in the study participants.

"Before the WHI, Premarin was the top-selling drug in the U.S. for 30 years," Walck said.

After the study, many women, spooked by the widely published results, stopped taking all hormones.

That left few options for women with menopausal symptoms such as hot flashes, mood swings, brain fog, vaginal dryness, migraines, tiredness and sleep disturbances.

Although no major research has been done on the effects of the bio-identical hormones, Walck says that in his patients, bio- identicals address the symptoms and have almost no side effects.

"If you look at our youth - the people with the highest levels of hormones, and the most healthy - is there any problem with taking people back to those higher levels?" Walck says.

Although some observers have been skeptical of the safety claims for bio-identical hormones, interest has been rising in Thurston County.

Richard DeGarmo, one of two compounding pharmacists in Olympia, says he has filled prescriptions for the bio- identical hormones for more than 20 years and has seen "no pitfalls at all." Compounding pharmacists are so named because they formulate the prescriptions from herbs or other natural substances.

The bio-identicals can benefit women as young as 30 suffering from premenstrual syndrome to post-menopausal women in their 50s, DeGarmo says.

They are available by prescription from holistic physicians such as Walck, naturopathic physicians, nurse practitioners and physician assistants.

DeGarmo of DeGarmo's Compounding Pharmacy in Olympia and Randy Mentzer of Randy's Compounding Pharmacy in Olympia both keep referral lists of area health-care practitioners who prescribe the bio-identical hormones.

Bio-identicals are available in creams, gels, capsules, suppositories and lozenges t o be dissolved under the tongue. Walck said he prefers the creams because the dose does not go directly to the liver and instead sits on the skin and is absorbed more gradually.

DeGarmo said about 60 percent of his bio-identical prescriptions are for creams, about 20 percent are for capsules and the rest take other forms.

"It depends on what a woman wa nts," DeGarmo says.

Although the bio-identicals cost about the same as synthetic hormones, they usually are not covered by health insurance.

Both DeGarmo and Walck recommend blood tests before and after taking bio-identicals to monitor hormone levels. Saliva tests also are available, DeGarmo says.

At least two out-of-town women's health and bio-identical hormone specialists are scheduled to visit Olympia this fall.

* Dr. Cheryle Hart of Spokane-based Hormones by Hart will give introductory seminars on her bio-identical hormone program at 7:30 p.m. Sept. 19, Oct. 4 and Oct. 30.

* Registered dietician Bevery White of Concord, Calif., will present a day-long seminar on women's health and hormone therapies Oct. 12 at Red Lion Hotel in Olympia. White's program is designed for health practitioners but also is open to the public.

Detractors of bio-identical hormones say they are no better t han synthetics and carry the same health risks.

The National Institutes of Health is financing studies on bio-identicals, but until the NIH studies are completed, the jury is still out.

Meanwhile, however, Walck believes bio-identicals offer the best option for women.

"It's a raging debate," Walck says. "I don't think that we need to throw the baby out with the bath water."

Keri Brenner writes for The Olympian. Brenner is the author of "Sleep Disorders: An Alternative Guide" and a contributing editor to "Alternative Guide to Women's Health, Vols. I and II." She can be reached at 360-754-5435 or kbrenner@theolympian.com.