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The Frontiers of Natural Medicine

by Dr. Jonathan V. Wright, MD

An Interview with Dr. Jonathan Wright
By David Jay Brown

Jonathan Wright, M.D. is one of world’s leading experts on natural medicine, nutritional supplements, and bioidentical hormone replacement therapy. He is the medical director of the Tahoma Clinic in Renton, Washington, and he has treated over 2,000 patients with natural hormone replacement since 1982.

Dr. Wright graduated from Harvard University, and he received his medical education at the University of Michigan Medical School. He later specialized in family practice and nutritional medicine. Dr. Wright was a monthly medical columnist for Prevention magazine from 1976 to 1986 and for Let’s Live magazine from 1986 to 1996. Since 1994, he’s written Nutrition & Healing newsletter (www.wrightnewsletter.com )

He is also the bestselling author or coauthor of numerous health books, including

  • Natural Hormone Replacement For Women Over 45,
  • Dr. Wright’s Guide to Healing With Nutrition,
  • Maximize Your Vitality & Potency for Men Over 40, and
  • Dr. Wright’s Book of Nutritional Therapy.

Since 1982 Dr. Wright and his colleague Dr. Alan Gaby having been teaching an annual seminar called “Nutritional Therapy in Medical Practice,” based on their experience in medical practice and personal research libraries, which contains over 45,000 medical journal articles dating from 1920 to the present. He also publishes an informative monthly newsletter. To find out more about Dr. Wright’s work visit: www.tahomaclinic.com.

I spoke with Dr. Wright on July 14, 2005. He is a very enthusiastic and entertaining speaker. We spoke about preventing heart disease and osteoporosis, the basics of vitamin therapy, how people can improve their sexual performance, and the importance of treating hormonal decline with hormones that are identical to those found naturally in the human body.

David: What inspired your interest in medicine?

Dr. Wright: I’m not sure. I decided to go into medicine when I was eight years old. I recall a conversation with my parents about the whole thing, and the choices got narrowed down to law or medicine. For whatever reason, I decided that there are too damn many attorneys, and that they spend their time fighting, so I thought I’d go into medicine.

David: Can you talk a little about why you think that hormone replacement therapy is so important for both men and women as they age, and why do you think that taking natural hormones is better than taking synthetic hormones?

Dr. Wright: Hormone replacement therapy is especially important for men and women as they grow older at this particular time in the history of the planet and of the human race. Hormone replacement therapy is something that, in many areas of the world, simply wasn’t even possible until about the 12th Century in China. But even though that was many centuries ago, as far as we know, there have been people on the planet for hundreds of thousands of years, perhaps millions of years, and no one could do hormone replacement for most of that time.

Some people have pointed out that the average person’s life span was shorter in previous centuries, and perhaps people didn’t need hormone replacement because they didn’t live to the point where they needed it, and that may be true in some areas of the world. But we have not only Western Biblical references, but we have other writings that refer to some quite ancient people, in the past, who seem to have gotten by without hormone replacement, and lived to a good long age. The name Methusala, of course, always comes to mind. Then there are some names that–not being a being a Chinese speaker–I can’t pronounce. But in Chinese writing, folks who are said to have lived for two or three hundred years, and it doesn’t appear that they took hormone replacement.

But the differences that may necessitate more hormone replacement in our time than in prior times, include what has happened to the food supply, the water supply, and the 50,000 new chemicals that are introduced into the environment every year–without knowing whether they’re safe or not. There has been terrific demineralizations of the soil, chemical additives to the water, such as chlorine and fluoride, and then there’s all the electromagnetic radiations that folks are exposed to that just simply didn’t exist two hundred years ago. The list could go on and on, and we don’t want do a treatise here on all the enormous environmental changes that have happened. But while we were living in this vastly changing environment, human biochemical systems remained the same.

Therefore, we’re seeing a tremendous rise in such things as Alzheimer’s disease and senile dementia, which was, of course, so rare in the past. A paper on Alzheimer’s disease from a century and a half ago said that people had less than a one percent chance of coming down with the disease, whereas today we’re now told that our chances of ending up with Alzheimer’s disease or senile dementia is fifteen percent. We also have seen the peak of a very large increase in cardiovascular disease, and thank goodness it’s gone down. I believe it was Paul Dudley White who was the first person to actually identify himself as a cardiologist and a specialist in heart matters in the early part of the twentieth century. Before him, we didn’t have cardiologists. We didn’t need them in the prior century, or the century before. And it’s not because people didn’t have heart disease back then, it’s because it was very unusual. Thank goodness–with no credit, I’m sorry to say, to American medicine, but a lot credit to just public awareness–that the large increase in cardiovascular disease seems to have reached its peak in the late 80s, maybe early 90s, and has subsided a bit again.

The other major thing for which people look to hormone replacement for turns out to be osteoporosis prevention, which again, was fairly uncommon until the last century–except for the inuit of northern Canada. Osteoporosis was fairly rare in this country until, again, the early Twentieth Century when the incidence started to rise, and went up and up and up.

So we have those three major problems–osteoporosis, cardiovascular disease, and senility and Alzheimer’s disease are (more or less) one problem. Cardiovascular disease has gone up enormously, and if one tracks it back, a lot of it has to do with the current mismatch between human biochemical systems and the enormously changed dietary and other environmental factors. What has been observed is that hormone replacement therapy is not only perhaps a longevity issue, but it can do a lot to reduce the probability of those three major problems. I think that is fairly definite and very defendable, but only if we use the same hormones that have been found in human biochemical systems for as long there have been human biochemical systems.

I suspect that I’m beating a dead horse, to make a deliberate pun, when I say that putting horse hormones into humans–when those horse hormones are roughly seventy percent different from human hormones, and have never been in human bodies before–was one of medicine’s many grievous errors in the last century. If we had been using bioidentical hormones we very likely would have never ever run into the disaster that the Women’s Health Initiative turned out to be. But we can significantly lower the risk of those three major risk problems that arose in the Twentieth Century, and continue into the Twenty-first Century, with bioidentical molecules.

We need to be extremely careful about not only the types of molecules, and duplicating exactly what goes on in the human body, but we also need to be concerned about quantities, the route of administration, and timing. It’s not very complicated. Actually, the whole thing can be summed up in two words–“copy nature.” If we’re going to replace the body’s hormones, let’s use the same molecules, the same quantities, the same timing, and the same route of administration that nature uses. That is the least likely to get use all into trouble.

David: What are some of the symptoms of low testosterone in men?

Dr. Wright: It’s debatable, but, for example, when testosterone starts to drop, ordinarily if an aging man is exercising regularly, and trying to keep up a certain muscle mass, he’ll notice that it’s more difficult to maintain that muscle mass. And we’ve all heard of ‘grumpy grampa.’ Well, for some men, particularly in their seventies and eighties, some of the just general grumpy mood can actually be attributed to testosterone being lower than it might be. I’ve talked with a number of families who say, oh yeah, Grampa’s a lot more cheerful, and he’s cracking more jokes, ever since he got his testosterone level back up. So that’s one of the mental symptoms, and there are physical ones, such as muscle mass problems. Certainly all men, or at least nearly all men, are concerned about their declining libido and sexual performance as they age, and they have problems that could have to do with low testosterone levels. That’s not always due to low testosterone, but if we combine several things–such as mental decline, a loss in muscle mass, and a loss in sexual desire and performance–and the more of those things we put together, the more likely it is that it’s going have to do with lower than desirable testosterone levels.

David: What recommendations would you make for an aging male to raise his declining testosterone levels?

Dr. Wright: That’s somewhat age-dependent, although one can run into that, certainly, as young as one’s forties. If one is in one’s forties with that, sometimes the problem can be solved by making a reformation in the diet, getting some exercise going, using nutritional supplements in addition to an excellent diet, and bringing in some botanicals. Sometimes a man can bring his own testosterone–internally produced–back up, and it’s always preferable to get our own bodies to do that. But let’s say we’ve tried that, or let’s say we are at an age where that’s not going to work, then we use testosterone as a supplement, and bring the testosterone levels back up. I call the supplement a replacement, only because we always have a little testosterone in us. But if it’s below the critical amount, we’ll bring the testosterone levels back up to–well, you’ve heard of the Jack Benny theory of medicine, have you not?

David: The Jack Benny Theory? No.

Dr. Wright: When Jack Benny was in his sixties and seventies, he used to get on TV, and he’d do a little sketch where he’d go in to see the doctor. He’d tell the doctor about his problems, and then leaning over to pat him on the back, the doctor would say, “Oh Mr. Benny, all these problems, it’s your age.” Jack would stop the doctor and say, “Doctor, that’s the problem, I’m only thirty-nine.” And the doctor would look at him and say, “Oh Mr. Benny, you don’t look thirty-nine.” And he’d say, “That’s the problem, doctor, I don’t even look thirty-nine, and I want to be treated as if I was thirty-nine.” (laughter)

So one may not want to use supplements to bring his level of testosterone back up to what one might call the raging hormones that one had between the ages of eighteen to twenty-five. But shooting for Jack Benny’s area of around thirty-nine or forty is something that a human body of either sex can tolerate quite nicely, and do better with than the levels that are happening as a matter of normal decline by age seventy or eighty.

David: What recommendations would you make for a post-menopausal woman to raise her estrogen and progesterone levels?

Dr. Wright: If she’s gone through menopause, and there are no menstrual cycles, one needs to look at all the factors and reach a decision. Now, there are those who say that menopause is natural. So what is a natural medicine physician doing interfering with a natural process such as menopause? The answer to that is, perhaps sometimes we should and sometimes we shouldn’t.

But again, to go back to the business of all the environmental changes that have put us all at a lot more risk, one of the first things we should do if we’re considering replacing hormones is to ask if there are genetic risks in the family. Have there been heart attacks, strokes, cardiovascular disease? Did someone end up with dementia or Alzheimer’s disease? Did they need care the last ten years of the lives when they couldn’t recognize all their relatives? That sort of thing.

If one does have those risk factors, then the consideration of supplementing the hormones might be a stronger one. Again, we’re not totally replacing the hormones, because women who have gone through menopause do have some hormones. If she has none of those kind of risk factors, and her mom lived to a robust eighty, ninety, maybe even a hundred, then perhaps she doesn’t have to think about it–if, of course, her diet is optimal, her exercise pattern is good, and some dietary supplements are taken.

But there’s one other reason why both men and women will sometimes choose to use bioidentical hormones and that is appearance. There’s just very little question anymore that the use of bioidentical hormones, past the age when they decline, has a beneficial effect on appearance. With bioidentical hormones over the years–not over the days and months–women maintain a slower decline in the appearance of the skin, the appearance of the muscles, and just the appearance of the entire body. Look, we’re all going to get slowly older and die someday anyway, and no one is saying that the bioidentical hormones can even come close to preventing that, but they certainly can slow the rate of decline. If we have a group of women aged seventy to eighty who’ve taken bioidentical hormones since menopause, and a group of women who’ve not, one can almost, not quite, but almost always tell the difference.

So one then needs to balance the risks and benefits, and if there’s a strong family history of any of the risk factors I mentioned, we can reduce that risk and, perhaps, give “appearance points” too. If there’s no family history of that at all, then do we really want to go into it just for the appearance and the antiaging properties? Now that’s every woman’s–and, while we’re at it, every man’s–own decision, because we need to look at risk factors regarding whether bioidentical hormones could somehow be involved in some cancers. We have to admit that even women twenty-five years old get cancer, and women in their thirties get cancer, so one can not say at all that bioidentical hormones are totally without risk.

Now there’s a lot of debate back and forth in the medical literature (and, after reading Shakespeare, one may wonder why medical writings are called literature, but that’s a parenthetical remark) about whether, for example, estrogen in itself triggers the cancer, or whether something else triggers the cancer and then estrogen makes it grow faster. The same thing goes for testosterone, although the case is a little stronger there. It appears that testosterone likely doesn’t cause cancer, but if something else triggers it, it sure as hell can make it grow. So that’s why properly done replacement by bioidentical hormones is so important. We need to as closely as we can mimic the patterns of a young healthy woman with young healthy hormones.

If I could, for a moment, mention that there are certain estrogens and estrogen metabolites that are known to be slightly pro-carcinogenic, and there are certain others that are known to be anti-carcinogenic, or at least neutral. And in a young healthy woman’s body there will be a good balance of those. There will be more of the 2-hydroxyestrogen and the 16-hydroxyestrogen, and more estriol–by far–than the combination of estrone and estradiol. And if we mimic that young healthy pattern as closely we can with the estrogens, and bring in–just as a young healthy woman’s body does–some progesterone, DHEA, testosterone, thyroid, and melatonin, we’re least likely to run into complications with hormone therapies. It’s never ever the supplementation of just one hormone; it’s always a concert of hormones working together.

This requires working with a doctor who is really skilled and knowledgeable in how to do all of them. After they’ve started on hormone therapy the physician will help the individual carefully measure what’s happening, readjust the levels if they need readjustment, and monitor from time-to-time. It’s not something where a person can start in on supplementation willy-nilly at a random dose, and hope everything comes out all right. It won’t, if we go into it that way.

David: What do you think are the primary causes of aging

Dr. Wright: I don’t think anyone has yet proven that aging isn’t something that’s supposed to happen. I know that’s a weasely sort of answer, but I think that aging is basically something that’s going to happen anyway with everyone. There are those of us who think that we can make this lifetime last forever. In addition to doing a disservice to past-life therapists–I mean, what would they do if we all lived forever? (laughter)–I just don’t think it’s part of the natural universe that anyone is going to last forever. So part of it, I think, is just programmed right into our cells and genes, but it certainly can be accelerated. Now, if we reframed the question to ask, What do I think is the primary cause of the acceleration of aging? Oh, there are many of those.

Even mainstream medicine has started in small corners to beat the drums about one of them–the consumption of refined sugar and refined carbohydrates. Scientific American and other publications have published articles written about what they call “advanced glycosylation end-products”–abbreviated cleverly as AGEs. Refined sugar and refined carbohydrates are things that have never ever been part of the human diet before. Perhaps Henry the VIII, who had his little bit of sugar, which actually was more costly than gold at the time, or the ancient Egyptians, who also used refined sugar, were among the first. But we don’t find it anywhere else for several hundred thousand years. That’s just one change, which looks likes it’s always been with us.

AGEs really stiffens tissues. They stiffen arteries and leads to a constellation of end products that are mostly stiffening. They just make everything go down hill faster. So we can improve that right way, but that’s just one island in a whole sea of things that can accelerate one’s aging. There are all the chemicals in the environment–for gosh sakes–some of which interfere with mitochondrial function. We all know that mitochondria are the so-called energy engines in cells, and if we interfere with it’s production of energy then cells are going to age more rapidly. It’s very fortunate that research scientists are putting their fingers on more and more of these chemicals that mess up, not only mitochondrial function, but other cell functions.

So, again, it looks like what accelerates the aging process is a lot of the environmental changes that have come on with food refining, industrialization, lack of exercise–all the same things that I think I’ve been pointing to in a long-winded fashion since the beginning of this interview.

David: Hormone replacement therapy aside, what do you think are the most important nutritional supplements that one should be taking for optimum health?

Dr. Wright: We always have to start with Irwin Stone, Linus Pauling, and vitamin C. It might seem very mundane to be talking about vitamin C as one of the most important nutritional supplements, but if we go to any standard textbooks on genetics or pediatrics they’ll tell us that scurvy is a genetic disease. Okay, so what’s the implications of that? Having a genetic disease means that there’s something missing in the DNA that codes for a certain enzyme that would actually get our own bodies to produce vitamin C–just as dogs, cats, elephants, goldfish, and most other species do naturally. The only species that don’t produce their own vitamin C are some primates, guinea pigs, and a few other species. There aren’t very many.

Other species produce the vitamin C that’s in their bodies. Now, what’s been shown–incontrovertibly, by lots and lots of research–is that species tend to produce more of their own vitamin C when they’re under any kind of stress. For example, when dogs are given carcinogens their livers produce anywhere from ten to twenty times the vitamin C that they normally produce, until that carcinogen is detoxified with the aid of vitamin C. If you put rats in cages, and force them to run round and round and round, their internal vitamin C production goes up. If you cold water shock experimental animals their vitamin C production goes up. Just about anything that puts stress on the body of an animal–whether it’s chemical or emotional–causes the production of vitamin C to go way up. One can actually prove by chemical analysis that when humans are faced with those kind of stresses their livers attempt to make to more vitamin C, but they can’t because of the genetic disease.

Vitamin C is a universal aid to detoxification. That’s why it applies to so many things. Linus Pauling said that we should be at the bowel tolerance intake of vitamin C, but this varies. Is it two grams a day or ten grams a day? Sometimes we need to take more for a few weeks when we’re under greater than normal levels of stress. Whatever that bowel tolerance normally is, we should use that much vitamin C at minimum of two intervals during the day. The way vitamin C kinetics are, it should really be three times a day if we can. This way we’re going to be maintaining our maximum detoxification vigilance.

I recall a moderately obscure study done at one of the universities in Southern California that claimed that women who used as little as one gram of vitamin C per day could expect added longevity of five years. No kidding. And men who used one gram a day–and that’s no where near bowel tolerance–could expect the added longevity of one year. I guess that just allows us guys to catch up with the women. So vitamin C is right at the basis, because it’s actually there to correct a genetic disease problem that all human beings suffer from. We just need to take more of it to stay healthy. So I would ask people to start with that particular supplement.

So far as the other supplements go, probably a very well balanced vitamin E comes next. There’s been a lot of recent bad press on vitamin E–as we all know–and it was bad press in all senses of the term. The studies addressed something that needed to be criticized, but the press was usually bad criticism. The studies looked at the effects of dl-alpha-tocopherol, which is halfway synthetic, or other incomplete forms of vitamin E. Students of vitamin E point out that there are eight isomers known to be useful and effective as vitamin E–the alpha, beta, delta, and gamma tocopherols and tocotrienols. So one needs to balance all eight of those isomers if one is going to do a natural vitamin E.

Vitamin E, in its fat-soluble phase, is as important to the body as an antioxidant as vitamin C is in its water-soluble phase. Even though there are certainly antioxidants that are “more potent,” there are none that are as important to be widespread around the body as appropriate amounts of vitamin C and E. Now, we’ve heard that for years. Take your multiple vitamin, and vitamin C and E. But it happens to be true, even for longevity reasons, to get that bowel tolerance vitamin C in there, and the eight isomers of vitamin E in in a sufficient quantity. Then, perhaps, one can go on from there to some of the more trendy things in anti-aging.

One of the real important ones is adequate amounts of vitamin D. This has come roaring to the forefront in just the last five to ten years. The university research scientists who have been studying vitamin D–such as Dr. Michael Holick at Boston University and Dr. William Grant in Southern California–have been pointing out that we all would be healthier if we had blood levels of vitamin D that would be achieved if we lived in the tropics. That is, if we got out in the sunshine and didn’t burn ourselves to death, but at least got a good tan if we’re Caucasian. Those levels of vitamin D can keep us a lot healthier and cut the risk of a whole bunch of cancers, as well as autoimmune disease. That evidence seems to be incontrovertible, and yet mainstream medicine is still telling us to slather ourselves with sunblock to the point where our bodies make so little vitamin D from sunshine that we actually put ourselves at risk for more cancers.

So I recommend some real basic adequate vitamin D. I happen to live in the Seattle area, and reaching optimal blood levels of vitamin D from sunshine can be difficult from time to time. Sometimes people do well, and sometimes their levels are low, but they’re never in the optimal area without supplements. It’s been pointed out that the amount of vitamin D that’s optimal for adults appears to be three to four thousand units a day. This not only appears to be so, but I think it’s a well established way to prevent a significant portion the prostate and breast cancers for men and for women.

I know I’m really covering basics, but let me do one one more, enough to make it through the fatty acids. I’m just amazed at how many folks who think they’re on good diets actually don’t have enough omega-3 fatty acids in there to act as an overall anti-inflammatory agent. We all know that the omega-3s, combined with vitamin E, are going to quench inflammations all over the body. And I’m not just talking about eating fish, and perhaps taking one’s tablespoon of cod liver oil, although that’s really a good idea. I’m also talking about the whole free-range cattle movement–free-range chickens, free-range beef, free-range whatever–if we eat animal protein. There’s at least a few preliminary studies that have shown that free-range animals have a much better ratio of omega-3 fatty acids to omega-6 fatty acids then do grain-fed animals. Those who do eat meat, if they can, should start switching over to eating the free-range animals. The same thing goes for such things as eggs; when the hens free-ranging there are more omega-3 fatty acids in the egg.

All right, so we have the the omega-3 fatty acids, vitamins C, D, and E–the basic alphabet, but also some very basic longevity-promoting nutrients. Then after that we could go on to such things as acetyl-L-carnitine and alpha-lipoic acid. Acetyl-L-carnitine and lipoic acid are both endogenous (naturally present in the body) antioxidants that have been shown to restore mitochondrial function and reduce free radical damage. Dr. Bruce Ames has shown that when alpha-lipoic acid extends mitochondrial life it also helps to revive rats that are getting senile–and chances are it does that for humans too.

David: What recommendations would you suggest for people who want to improve their sex drive and sexual performance?

Dr. Wright: Believe it or not, humans have not been eating most of the agricultural products that we eat today for the last hundred or two hundred thousand years. I’d refer people to a couple of books on this. One of them is called The Paleo Diet by Dr. Cordain from the University of Colorado, and the other one, written almost twenty years earlier, is called The Paleolithic Prescription by S. Boyd Eaton and others at Emory University. Those two books make it fairly abundantly clear that most of our biochemical systems–I wouldn’t say everyone–but most of our biochemical systems are still adapted to the type of diet that we had as hunter-gatherers.

Now, when I say adapted I don’t want to leave out the Creationists–maybe we were created this way. But most of our biochemical systems are still adapted and/or created to the type of diet that humans have been accustomed to on this particular planet for at least two hundred thousand years as a species that is exactly the same as ours, and millions of years for other species that are very similar to us. Now, this would be diets that do not happen to have any milk and dairy in them–yeah, I’m really talking about sex life folks (laughter)–and they have more in the way of animal protein. There are a lot of studies out there that show that vegetarian men and women have lower levels of sex hormones. And that’s not at all to disrespect an ethical vegetarian choice–it’s just being realistic about it. Animal protein diets are always associated with higher sex hormones and vegetarians with lower ones. These are just the facts. One can make up one’s mind about it.

But getting back to that more or less caveman diet approach–that actually does help to raise the sex hormones if you’re older. All right, then we can bring in our basic vitamin supplements and some of herbals that have been used around the world. Different continents seem to favor different ones that help with sex drive. There is a tradition of using ginseng from China. There’s yohimbe from Africa, ashwaganda from India, and maca from South America. So one can either use one of those supplements or others that our ancestors found useful for that, for literally thousands of years. Or one can use some of the combinations on the market. Some of the marketers have combined many of those things into one supplement, which does make it easier to use. But other marketers have pointed out that you don’t get as much of each herb in one supplement. They say that in China people use more ginseng than is ever in these supplements. In India they use more ashwaganda, and in Peru they use more maca, and so forth. But those traditional things, when studied scientifically, do turn out to have anywhere from a small to intermediate effects.

Just for example, a British researcher actually paid some research volunteers who had inordinate vaginal dryness to have biopsies done. He looked under the microscope, and sure enough the cells had atrophied. But in the study he did not have the volunteers take hormones–he had them all take ginseng. And a few months later–I guess they were well-paid volunteers–they all had biopsies done again. He looked under the microscope, and, well, look at that–the cells were not atrophied anymore. In fact, it looked like someone had fed them estrogen, but nobody fed them estrogen, and they could not find that they’d taken any. But it had that effect. So what I’m saying is that these traditional things from the various continents of the planet are indeed very useful. One can bring those in to improve performance before we even think about replacing, or rather, supplementing hormones. It’s not really a replacement because they’re not totally missing.

David: What do you think are some of the biggest problems with the way that medicine is practiced today, and what do you think can be done to help improve the situation?

Dr. Wright: With your permission, I’ll take that in two parts. First, I’m going to be a little bit hard on myself and my natural and alternative medicine colleagues in the area of hormone replacement. Hormone replacement is being done very erratically, and by all kinds of different means that are going to get us into trouble, give the whole field a very bad name, and just possibly bring on some of the unconstitutional governmental retributions that happen when things go wrong. Even though the retributions are unconstitutional, they happen anyway.

Let’s take the book out there called The Sexy Years by Suzanne Summers. The tremendous service this book has done us all is to bring bioidentical hormones to the attention of millions of people. The disservice that Ms. Summers does in her book is she says that she’s taking two milligrams of estradiol every single day. Now, the laboratory that I work with has done studies of some thirty-five women doing doses of estradiol, ranging all the way from .025 up through .25, .50, 1.0, and up to 2.0 milligrams of estradiol each day. But the dosages in this study were not deliberate. All thirty-five women had different doses because they came in from doctors who were giving them different dosages, so we know it’s very disparate out there. And what we found is that women who take more than .25 milligrams of estradiol have excessively high levels of estrone, because estradiol metabolizes into estrone. They have levels of estrone that are equal to the levels that one would find in the third or forth month of pregnancy, which are well above the levels of estrone that a nineteen year old women would be putting out, never mind a thirty-nine year old women.

The rhetorical question in here is: Can it be healthy for Ms. Summers or anyone else taking a larger than “natural” dose of estradiol? She’s writing about it in her book, and perhaps some misguided natural medicine doctors will be following that lead. Can it be healthy to be going around with a level of a procarcinogenic estrogen that is higher than any young women would have in her body during the normal course of her menstrual cycle, and is only achieved for a brief period of time during pregnancy? That’s a rhetorical question because obviously that’s an unhealthy thing to do, and yet we haven’t gotten to any kind of consensus on even doses of these of these things in the identical hormone replacement field, and many women are being way overdosed.

The same thing goes for DHEA. We see some horrendously high levels of DHEA, and it’s metabolized in men who either self-dosed, or were advised by their doctors to be on very high doses because the doctors are only following their blood levels, and one can’t find the metabolites in the blood. So this bit of venting criticism here is an introduction to say that we have organized something that’s called the Bioidentical Hormone Society. We’ve had one meeting, and we’re going to be holding future meetings. The goal of the organization is to get information out about bioidentical hormones and how people working with them can use them safely. The Web site address is: www.bioidenticalhormonesociety.com. The Web site has the graphics showing the different doses of estradiol and what it does in so far as producing levels of other hormones. You can measure all of this, and make sure it’s within safe levels for all of the presently “replaced” hormones. What we hope to achieve through these Bioidentical Hormone Society meetings is to have people pick up on the information, get organized and copy nature. We’re getting back to those two fundamental words: copy nature.

Here’s another very simple principle that applies to folks with falling estrogen or falling testosterone. Excuse me, but no one has their ovaries or testicles stitched to the inside of their intestines, do they? And yet if we swallow those hormones, what we’re doing is we’re assuming somehow that those hormones enter the body through the gut. Now, that’s an entirely different route of administration then what they really do. When we swallow them they go for the gut, they zing right to the liver, and the liver gets whacked with them. It’s been shown, for example, that even when one of the safer estrogens, called estriol, is swallowed, metabolized, and then endometrial biopsies are done, sometimes there’s abnormalities that show up. But when it’s used in a cream or an ointment that’s rubbed into the vaginal area, which is close to where estrogen is delivered in the body by the ovaries, and then endometrial biopsies are done, no abnormalities show up.

When its taken in the cream that way it’s close to where estrogen is delivered in the body by the ovaries. From the ovaries it goes into the pelvic plexis of veins, then all over the body, and, finally, to the liver, where it’s taken in. So it’s not just dose. It’s not just timing. It’s also the route of administration. Everything we need to do can be summed up in these two words: copy nature. And only when someone does several double-blind, placebo-controlled, crossover studies that demonstrate that nature is wrong–and you can tell I’m doubtful that will ever happen–should we deviate from what nature does. That’s more or less the message that the Bioidentical Hormone Society is to trying to get out.

Now, so far as medicine in general goes, our very biggest mistake has been a century-long mistake. It started in the early part of the twentieth century, and it continues to this day–and that is, relying on patent medicines to heal the body. This has been an enormous mistake, because the condition necessary to patent anything says that it can not occur in nature. But out bodies are made of materials that are entirely natural–a big bunch of water, protein, vitamins, minerals, hormones, essential fatty acids, amino acids, and other things. And then we have adapted to the botanical world. So plant material can certainly cause harm, but not near as much as patent medicines. Patent medicines–by definition–have to be not natural, and if they’re not natural then, in a manner of speaking, they’re space aliens! (laughter) They’re molecules that have never been found on the planet before. Now, what do we think we’re doing trying to heal a body that was created or evolved on this planet with space alien molecules?

It’s not going to work. The best it’s going to do is suppress symptoms, and yet the medical profession has gone along with this for over a century. We do ninety percent of our studies on space alien molecules, and the little bit of benefit that they have, and the enormous harm they can cause. And one after another we have to shut them down because they’re doing too much harm. Then we go on to the next space alien molecule. One of these days the medical profession is going to wake up and notice that even though we have made enormous progress in diagnostics, diagnostic imaging, in surgeries, and so forth, when it comes to things that we swallow or apply to the body, we’re using molecules that have nothing to do with the body that we’re treating, and this has caused so many problems. When medicine gets away from that, when it stops putting space alien molecules in the body, and starts using materials that are natural to the body, then there is really going to be a revolution in medicine at that point.

Now, the people who do that are called alternative doctors, but in the early part of the Twentieth Century conventional physicians were using natural material for natural bodies, and we’ve only been on this detour into space alien molecules for a century. None of our ancestors did that. They applied natural stuff to natural bodies. And with all the science that we have, if we turned our sights to the study of how natural molecules interact with natural molecular structures that are made by our own bodies, we would make some enormous advances, in a hell of a hurry, but we haven’t got there yet.

David: What are you currently working on?

Dr. Wright: As you can tell, I’m working on getting the Bioidentical Hormone Society up and running. I’m teaching courses. Dr. Leonard and I are working on an update of our 1997 Natural Hormone Replacement for Women Over 45, and that update should be out by the end of the year, or the very beginning of next year. That actually was the first book in the field of bioidentical hormone replacement, and it certainly deserves an update, as there’s been enough new information published. So that’s one of the main things that I’m working on. I also do a newsletter every month, and that occupies a lot of my time.

David: Is there anything we haven’t spoken about that you would like to add?

Dr. Wright: You probably have any number of examples to demonstrate where we can use something natural and replace a whole category of medications, and we’re not doing it, but let me just give you one. Something that I worked on for a number of years was the use of D-Mannose for treating urinary tract infections. There are literally millions of folks who end up with bladder infections every year. Most of them are women, but a few are men. Ninety percent of those infections are due to E. coli, and ten percent are due to miscellaneous other factors.

So what does modern medicine–or rather mainstream medicine–do? They use antibiotics and it kills the germ, but, as we all know, it also interferes with gut flora. It kills those normal flora in the gut too. Now we know that the continual interaction between bowel flora and the immune system is one of the things that keeps it strong, and we’re giving people literally billions of dollars worth of antibiotics to clear up urinary tract infections that just keep coming back. Well, there is a simple natural substance that will do the job on urinary tract infections ninety percent of the time with absolutely zero effects–and it’s a hell of a lot cheaper too.

The stuff is a simple sugar called D-Mannose. D-Mannose is, in fact, produced in the human body in small quantities. There’s D-Mannose here and there, and importantly there are D-Mannose residues in the cells that line the bladder. The residues are in the cell walls of those cells that line the inside of the bladder, and that’s how E. coli actually is able to do so much infecting. E. coli has the capability to hook inside of the bladder, onto these Mannose molecules, and that’s the reason that it isn’t rinsed out every time you urinate. It has all these little finger-like projections that attach on to the D-Mannose residues like Spiderman. This allows the E. coli to climb up the walls of the bladder like Spiderman does, where they then set up a happy home and make an infection.

Well, somebody got the bright idea that if E. coli like D-Mannose so much, let’s see what happens if we give it to them. So back in the ’80s I started working with patients with bladder infections, having them take D-Mannose . For adults a teaspoon of the powder, and for children less, every three to four hours. Now, what happens is this. Here’s the E. coli inhabiting the bladder, hanging on to those D-Mannose residues in the bladder wall. Then instead, here come these great clouds of D-Mannose through the uritors. Because D-Mannose is well absorbed. Our bodies don’t metabolize much of a dose like that because our bodies don’t use very much, so the kidneys just throw it out. Then out it goes, through the kidneys, into the ureters, and then the bladder. So here’s the E. coli inhabiting the bladder, hanging on to those D-Mannose residues in the bladder wall. Then here come these great clouds of D-Mannose , and for the E. coli, basically, it’s party time! Because they love D-Mannose . So they literally detach themselves from this D-Mannose residue in the bladder wall, and they surround themselves with clouds of D-Mannose .

So they’re happy, and we’re happy. Now that they have detached themselves from the walls of the bladder, and they’re just swimming in all that fun D-Mannose that they love so much, the next few times we urinate, there goes all the E. coli, and there goes the infection. It works like a charm ninety percent of the time. And all we have to do is take D-Mannose regularly for a couple of days, while we’re awake. We don’t even have to wake up and take it because of course no urine is leaving the bladder, so it stays full of D-Mannose .

The first case I worked with was a four or five year old child who had a long series of urinary tract infections. She had become resistant or allergic to all kinds of antibiotics, and her parents were being told that she was going to need a kidney transplant by the time she was seven or eight, because her kidneys were starting to go. Then they came into see me. I wasn’t so smart; I just knew about D-Mannose dynamics. So I asked mom if she knew what kind of bladder infections her child had had, and she says, well yes, I have this record book. And, my God, she had two scrap books of every single test her child had ever had, and they were all E. coli infections.

So I told mom that there’s a good chance that we could get rid of this whole problem within a few days. Well, dad just about walked out of the office. He thought I was some kind of quack, but he asked me, “Can it hurt anything?” and I said “No it can’t.” So they put her on the D-Mannose , and her bladder infections cleared up. She didn’t have another one for four years, when the family was on vacation and they forgot their D-Mannose . She kept taking it until she was a teenager. Then her estrogen came on, which protected her bladder, and she didn’t need it anymore. So there are now two or three companies that sell D-Mannose in jars that you can find in any natural food store, and as long as you keep that handy then you have a ninety percent chance of not having to take an antibiotic for your bladder infection. I tell all the people that I treat with bladder infections to give it a day or two, and if your bladder infection isn’t gone then you’re going to need an antibiotic.

D-Mannose is inexpensive. It doesn’t do bad things to the body when it’s used that way. It cures up the problem. The mechanism of action is known. That’s the kind of treatment that we need to be replacing the patent medicines with–things that can be researched out, and they have an effect that’s beneficial for us. But also, one might call it an ecological effect if one is into deep ecology, because we make the bacteria happy. Now, if we make the bacteria happy then they just go off and share all their D-Mannose with the other bacteria, and they talk about how nicely they were treated. And if we treat bacteria nicely they don’t develop antibiotic or drug resistance do they? Because any life form, if we try to kill it, is going to resist, and that’s what happens with bacterial resistance to antibiotics. So that’s really the kind of therapeutics we should be looking forward to.

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