A Transcript     Contents     Introduction: Dr Goodman     Dr Bond (Intro)     Dr Lee

Dr Bond     Q&A: Drs Lee and Bond     Dr Smallbone     Dr Griffin     Beth MacEoin

Q&A: Smallbone, Griffin & MacEoin     Leslie Kenton     Q&A: All     Exhibitors & Speakers




Introduction: Dr Sandra Goodman

I would like to introduce the next speaker, Dr David Smallbone who is a GP, homoeopath and nutritional physician and who also specialises in the treatment of menopausal problems, including the use of natural progesterone. He is going to talk about the other components that Dr John Lee mentioned this morning; nutrition, herbal medicine and homoeopathy.

I think it is important that we understand a little bit of what is behind the other aspects of hormone disturbance. One of the most important things to bear in mind, and it has been said several times already this morning, is that the cessation of the monthly periods in a woman is a natural progress. It is expected to happen and should occur at the appropriate time naturally. It shouldn't theoretically be accompanied by any disturbance of function. For many of you here that is certainly or hasn't been true or may not be true. Part of the reasons for this is our own life style or environment and we can only expect as individuals to remain fit and healthy and go through the normal processes without disturbance, if our life styles and our basic nutrition allows us to. In other words, we need to prepare.

One of the most interesting aspects that I find is that we really have very little control over what our parents did to us even before conception. There is no doubt that parents who smoke, jeopardise their unconceived children. They lay down situations that dictate what that child is going to be, even in the undeveloped egg. So I think that the first role that we have to accept, is that we do need parents who understand nutrition and lifestyle and, of course, for many of us here that was an unknown thing in most of our parents' cases.

Changes in Agriculture and Food Storage
Life has really changed since the last World War. We didn't have to think about nutrition prior to the last World War, we ate what we were given. We ate what we grew and it was grown in ways that allowed the plant life to take on board what it needed and what we need. The onset of intensive farming, the onset of intensive agriculture and the prospect of maintaining food for long periods of time in a relatively edible state, have come on to us since the second World War, basically. 

We now store food for a lot longer. We expect a shelf life of at least two or three times on foods that before the War were thrown away well before that date, and in the process of this there is a price to pay. The plants don't mind, plants are very easy things to live with, they don't need a lot of different substances, they probably need excluding the proteins, fats and carbohydrates, about 15 or 16 essential materials, those that they cannot manufacture themselves. Whereas we know of 55 different mineral elements that are required for life, albeit some of them in very small quantity. We now have to think along the lines of – are we getting in our food what we expect, and the definite answer to that is we are not.

Importance of Genetics and Lifestyle
Another aspect that we have to bear in mind is the good fortune of being born with a genetic background that allows us to live a normal life. Again we have no control over that, we have to use what is given to us and part of that is learning to adapt, getting the best of what we've got, and we all have to do that from time to time in certain aspects of our life. Another aspect that we don't have a lot of control over but which makes a difference to how we react, is how our parents teach us, how we are brought up. How we are brought up to look at food, at nourishment, mentally and physically, because we cannot separate bits of us out. We are a living being, we are a person at one, and any bit that goes wrong with us is going to reflect on nearly every other bit and this unfortunately is a thing that medicine has learned to forget.

The old GP you know, the first thing he did was look and listen. The first thing the average doctor does now is to suggest a blood test or an X-ray. A person doesn't matter any more for a lot of doctors. It's not their fault, they are not taught to let it matter and it is time to go back a little step into the past and realise that we are a functioning unit of 30 trillion separate life forms – we have 30 trillion cells in us. Each one of those is a life unto itself. It has dedicated its life to the cause of the common good, and that is what makes us, those 30 trillion cells metaphorically say, I will lose some of my quintessential self in order that I can work with the other 29 trillion and so on.

Major Effects of Hormones
So we have to satisfy each of ourselves to keep us happy as a whole and one of the major aspects of keeping ourselves happy is to have some degree of control. For us to have that we need every cell to understand what they should be doing at any given moment. There are two particular hormones that are involved with this, one of them is something that has come in very recently, melatonin. This is the hormone that is produced basically in the pituitary, also in the hypothalamus and also in the pineal gland. It is the hormone that acts as the clock mechanism; it tells every cell of our body what time of the day it is, whether it should be functioning or resting.

The other hormone that has a major far reaching effect on nearly every cell of the body is progesterone. Without those two hormones our body would become a discontinuous collection of individually acting cells. Now the other hormones that each cell produces then passes on the message to its neighbour and we start to now build up a picture of complexity and obviously with that sort of complexity, if you get one cell that is not happy it will pass its message on to all the others and it is a bit like Chinese whispers, the wrong message may get passed on in the process.

Nutrition should be Nutritious

One way we have of minimising this is to ensure that all the cells have what they need, that means all their requirements: nutrition should be nutritious. Much of our food is not nutritious now. It provides some of the materials we require, it doesn't provide them all by a long way. What do we do about it? First thing, we have to become educated. We have to, and we are becoming educated. As individuals we are learning more about our bodies than humanity has as specialists in the past. Most people who are in this hall, I can guarantee, probably know more about nutrition than their own GPs do. Which makes it very difficult if you are the GP trying to advise, and I think this is one of the reasons why so many hospitals and so many clinics say that nutrition isn't important. A common thing that I still hear now, is when a person goes into hospital and the person says, "What should I be eating doctor?" and the doctor says, "It doesn't really matter."

It doesn't if your food is containing what it should contain; it matters an awful lot if it doesn't contain those materials. The first quintessential principle that we have to understand is that nothing works in isolation, if we can get that principle across to ourselves, then we can be fairly confident that we are going to at least have some concept of that cohesiveness that is required and this is what the whole of the hormone structure is about – it is messengers, passing messages on, giving information, ensuring co-ordination.

Getting back to food, because of this diverse nature of our individual parts we need to have some comprehension of what is essential, what levels of nutrients we require in our food. This is not easy, we again are all individuals, we are all people with a different need to the next person, so there is no normal. It is a common term that is bandied around, but there is no real such thing as normality; we are all desperately abnormal in some way or another. It is just how badly abnormal we are that makes a difference whether we are healthy or not. So normality of nutrition is a myth, what we have is a range of nutritional materials that our body needs to maintain health.

Nutrients Vital for Health
This to some extent is not what the recommended daily allowance is. We have all heard of RDAs, those are the levels that most governments set as being the minimum requirement to maintain health. That isn't strictly true, the RDA is the minimum requirement that prevents disease processes from showing, this is not the same as maintaining health. Maintenance of health is a positive matter. Maintaining a level that doesn't allow you to prevent your disease is not very positive, it is a very negative state and many of us in this hall will need far more than the levels that are said to be necessary.

There are specific materials that become essential if we are going to maintain that cohesiveness of all those cells. Again, I find it very difficult to isolate any given material as a nutrient that is necessary in its own right because again it doesn't work as a separate entity. You put magnesium into the body and it has to have all sorts of other materials to work with, it doesn't just work as magnesium. Again it is a problem that science has tended to make us believe that because you can quantify how much magnesium is going into a system, therefore, if an amount doesn't go in, disease will ensue.

This is not strictly true either, there are many processes in the body where something like magnesium can have other materials that can work for it, but not as well and here again you start to produce the first process of disease. The body hasn't ceased to function, it just isn't functioning as well as it could do, given the right materials. What do we do about that? I am going to assume here that we have investigated as much as we can and found out as many causes for the condition that we are looking at, whatever that condition may be; disturbed menopause, an early menopause, it can be infertility, it can be a whole host of things. The disease in progress is purely the manifestation of a disturbance within your body. It is the most likely outward event that is going to happen given those set of circumstances. We can add to those circumstances, we can make life more difficult for ourselves by simply not following certain ground rules. By taking in disturbing materials, we are all doing that.

Toxins Polluting our Health
There is a fascinating article that was written some years ago now. Comparing the so-called toxic materials that might be available to the Victorians, compared to the toxic materials that are available to the modern day man or woman and the list is horrendous. The things we come into contact with. The smog that the Victorians had to put up with, the local problems were pretty bad, but the general problems that the modern population has to put up with are even worse and they are hidden, they are unseen – the aerosol sprays, the perfumes, the scents, the chemicals that are meant to mimic other chemicals that we may or may not need. Pollution has become such a problem that we are now affected by it, every single one of us. So we have to minimise that in order to stand any chance at all. As a converted smoker to a non smoker, I am probably one of the worst to object to people smoking. I don't object to people doing what they want to themselves, I do object them doing it others. It is unthinking. There are very many acts that we perform that are unthinking that jeopardise other peoples' health and we can't be responsible for all the difficulties that we come into contact with. We just must avoid as many as we can.

Necessary Supplements
(See Table 1). What supplements are likely to be necessary if we have to supplement because we can't get them in our food. This is a very simple list because it could be almost anything and this is the difficulty. This is a simple list that we persistently find missing from our diet, or in inadequate quantities. There is enough written about vitamin C for us all to know that it is totally insufficient. If you take almost any animal and take in the quantity of vitamin C, a hamster a guinea pig, call it what you like, that they take over the day and compare that with humanity, even the most fruitarian type of human individual is taking in her body weight far less vitamin C than any other animal on this planet. We all know that hamsters are very frightened animals, they are not half as frightened as most human beings, I can tell you. They are certainly not half as stressed as most human beings. The process of life for a human being is very stressful. I suppose it must be for a hamster but I think it is as stressful in a much more different way. So certainly we need extra vitamin C. 

Supplementation that may be required throughout the stages of development as a result of poor food sources.


Vitamin C

Vitamin B6


Folic acid

Vitamin B12


Omega-3 oils




Insufficient in modern foods for needs of a modern society

Not present to any extent in modern refined foods

Not present in modern refined foods

Often inadequate amounts in modern non-fresh vegetables as prepared by modern standards (Fresh plant source only)

Often absent from current vegetarian/ vegan diets. (Animal source only)

Modern life-styles and stress place a  much higher demand on our needs which often cannot be met

Modern fat-free diets ensure inadequate supply of essential fatty acids especially Omega-3s

Most soils of the Western industrialised world are selenium deficient and plants grown on them are deficient in selenium

Many soils in areas with heavy rainfall are boron deficient and plants grown here will be boron deficient

Daily dose (adults)

2-3g (min)

20mg (min)

50mcg (min)

400mcg (min)

Up to 10mcg (min)

300 mg (min) in addition to food supply

1 tablespoon Flaxseed oil (also provides Omega-6 oils)

200-400 mcg

Up to 3mg

These are the main nutrients that will almost definitely require supplementation in the average Western diet to prevent ill-health.

Vitamin B6. Now in all the medical text books it says, vitamin B6 is present universally in life. It is, no difficulty about it at all, except for one thing – the process of refining foods virtually removes vitamin B6. Any refined food, any food that has gone through any processing is likely to have lost most of its vitamin B6 content and you don't know whether it has or it hasn't, you can only make a guess. How many of us actually eat raw foods nowadays as part of our regular daily intake for at least two thirds or three quarters of our daily requirements? We don't, it is difficult in time to prepare raw foods, it is difficult in a whole host of activities that we want to accomplish, so we tend to make it easy for ourselves and use prepared foods. Foods that have been isolated and manufactured for us. We are going to be vitamin B6 deficient in that case.

Chromium for the same reason is removed by refinement, chromium naturally occurs wherever sugar occurs and chromium is something that sugar requires to be used properly. Chromium is required by insulin to work properly. Folic acid. I am not going to go through this list, because it is unending but these are the general materials that we are going to find almost certainly lacking from our average western diet.

How many of these play a part in how we feel, how our hormones work with us and I'm talking about us, men and women here. We all have all the hormones represented in us, it is just the different levels that they are at, that makes the difference between us. The first almost essential supplement that we are going to have to look at is an across the board vitamin and mineral. To ensure that we get the protection of the nutrients we need we can't go into every single one and find out how much we need, we do need a base line to work from. My suggestion to anyone who is having any sort of hormone problem, male or female, is get yourself on to a very good, broad vitamin mineral supplement as a starter because we are so complex and because we are so interdependent within us we cannot possibly know what the effect of a milligram of something missing here might be or a micro milligram missing there might be.

We have no ability to work that out ourselves, we don't even sense it in ourselves. So in our modern day and age, if disease or what goes for disease, a process that isn't working properly starts to manifest itself then we must at least put a broad insurance policy together. What should those vitamins and minerals be? To get the best response we should have them as close to nature, or as close to the food that we find them in.

Table of relative bioavailability of different presentation forms of vitamins and minerals as supplements.

 Type of presentation

Conjugated with organic substrate

Attached to organic or pre-organic bases

Admixed with various organic or food compounds

Simple inorganic compounds


True chelate 


False chelates


Stage of value

1st class

2nd class

3rd class

4th class

This a table which appears in Issue 27 of Positive Health just simply outlining that fact (see Table 2). The first class, this particularly applies to minerals. A first class mineral should be a true chelate. A true chelate is a mineral that is attached to a substrate, to another material that carries it. It may not be the one you want but it is much easier to detach that unit and put it on to something else or break it up into parts and reform it than to have to build it up from scratch around that mineral. Many so called chelates that we get as supplements are not, they are simply admixtures and are not truly chelated so you have to be aware of that, ask the manufacturer.

Then there are some pre-organics – these are the next best thing, things that could be very easily incorporated, citrates, orotates, arginates, there are a whole range of them. Not the simple material. The third class is what we have already mentioned, the false chelates that together with organic foods but not actually bonded to them. The fourth class is what most supplements are, simply inorganic minerals, all isolated chemical vitamins. The body has difficulty using and working with those.

Vitamin B6
If we look at one or two of the particular important minerals and vitamins particularly associated with the menopause, you notice I have hardly talked about the menopause, this is because most of the menopausal problems are not menopausal. They are related around deficiency problems subclinical though they may be and progesterone is one of the most important of those deficiencies but there are others. B6 is one of them. Vitamin B6 comes in three basic formats, the one that we look at in the laboratory, pyridoxine hydrochloride isn't really a starter. It is the plant format of vitamin B6 and it doesn't occur as straight pyridoxine hydrochloride it occurs as a true chelate in plants but it is very easy to isolate pyridoxine hydrochloride to turn vitamin B6 into it. The two other forms are pyridoxal 5 phosphate or P5P as it is sometimes called and pyridoxamine.

All three of them work differently in the body, a bit like the 3 forms of oestrogen and it is no good taking the wrong form and on the whole most of the supplements of B6 are pyridoxine hydrochloride. Now we all know the controversy there has been about vitamin B6, and strangely enough, although the research the government used was faulted and should never have been used, they just about got it right. 10 mgs of pyridoxine hydrochloride is about all the body can cope with in one lump sum because pyridoxine hydrochloride has to be taken to the liver before it can be turned into the active form P5P. Then it is trans shipped into the blood supply for use in the cells. If large doses of pyridoxine hydrochloride get absorbed by your cells they prevent vitamin B6 from working inside the cell, with all the consequences that that might produce. B6 plays a major role in controlling the effects of oestrogen. Without B6 oestrogen would not work effectively, it would run amuck and very quickly we can see how.

This shows you very briefly what happens to pyridoxine when it is put into the system. It should be taken to the liver for processing to be released back into the circulation and then be used by the cell. If you put a large quantity of pyridoxine hydrochloride in it stays as pyridoxine monophosphate which can't even leave the cell, it is worse than useless, it has to be broken down again, so that takes energy from the cell.

We all know about the actual role of production of depression in menopausal situations and all sorts of other things. Here is a very simple explanation of it. We have physiological occurrences where oestrogen are increased, we also have pharmacological occurrences where we put them in deliberately. It doesn't matter which or both are used, and here is the important factor, the production of serotonin that actually allows our mood to be light. If the production gets pushed across the threshold we start to get depressed and we can see very quickly that these six are important for forcing the reaction to produce serotonin, and oestrogen makes it work the other way.

One of the simple ways we can produce problems for ourselves is by lack of vitamin B6. I am not going to go into all the other materials at all. The list is endless. We can almost be certain that you think of a material, if it is missing we can find a pathway when it becomes important in the production of menopausal symptoms and all hormone imbalance symptoms. It would take a whole weekend to go through them.

How to Correct Hormonal Imbalances
One issue that is important that is coming up, and I am going to finish on this point, is often one of the imbalances and manifests that we don't seem to be able to do anything with. It is not a simple one related to a vitamin or a mineral but the fact that our body produces most hormones at different rates. At any given stage of our life we are stuck with what is being produced. Sometimes we have to supplement the hormones themselves to get us over that particular period, we may have to go on indefinitely if elements were packed in entirely, because without that replacement we run into all sorts of problems of other knock-on effects.

We heard how progesterone can be replaced very simply by using the cream, very simply we can replace the oestrogen by using natural plant oestrogens. They can be very effective by means of supporting our oestrogen lack and we can get oestrogen deficiency as well as being oestrogen dominant – we can be both at the same time. We may need oestrogen to support that progesterone we are putting in, it may become apparent, it does happen. The first thing to turn to are the phytoestrogens, there are many. Most plants have phytoestrogens in them that can be used that way.

Most important probably that we are seeing emerge at the moment is soya. The one important fact to remember about soya is that the oestrogenic activity of soya is multiplied by a factor of up to 10 providing it is fermented first. The first fermented soya is available at this moment in time. If you go to the Higher Nature stand you will find a material called Soyagen, which is a fermented soya material with a high oestrogenic activity. The advantage to oestrogens used from plants, even when they have a high activity is if your body level of oestrogen rises the effect becomes non-oestrogenic it becomes anti-oestrogenic. If the level of your oestrogen falls there is sufficient oestrogenic activity to take over so it is a self-regulated situation.

I'm sorry I have only had time for some of these bits and pieces but I hope it has given you a flavour for the areas where you have got to be looking to support yourselves. Thank you for listening.


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About Dr DF Smallbone

Dr David Smallbone M.B., CH.B., L.R.C.P., M.R.C.S., M.F.Hom., F.C.O.H. Senior Medical Advisor and Senior Lecturer in Medical Sciences to the College of Natural Nutrition.

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