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Question & Answer Dr John Lee, Dr Shirley Bond, Dr David Smallbone, Dr Judy Griffin, Beth MacEoin and Leslie Kenton field questions from the audience

by Dr John Lee, Dr Shirley Bond, Dr David Smallbone, Dr Judy Griffin, Beth MacEoin and Leslie Kenton(more info)

listed in symposium - menopause, originally published in issue 27 - April 1998

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


Question & Answer: Dr John Lee, Dr Shirley Bond, Dr David Smallbone, Dr Judy Griffin, Beth MacEoin and Leslie Kenton field questions from the audience in this, the final question & answer session.

Lee: Yesterday I met Dr Adam Carey and he is at 114 Harley Street and there is a reproductive medical trust and he is looking for women to be part of his studies and out of it will come better treatment and you have to be within a year of your menopause, I don't have the phone number but they like to have people contact them by mail. It's the reproductive medicine trust, so any woman who is in a year from her menopause, they would love to hear from you.

Audience: Dr Lee you mentioned thyroid medication in connection with osteoporosis. Could you say something about that? My interest is because I am on medication for hyperthyroid, overactive.
Lee: Progesterone and the thyroid hormone actually do much the same thing. They both increase metabolism, increase energy able to convert fat that you have in storage, into energy for our life. They tend to support each other, so many women are being treated for hypothyroidism when in fact it's just the lack of progesterone that is not helping the thyroid. Oestrogen tends to interfere with the thyroid hormone and to block that action. The role of the oestrogen is to take the energy in the food you eat and convert it into fat on your thighs and hips. Not to give you access to it, so a woman who's oestrogen dominant cannot lose weight by dieting and exercise. If you are hyperthyroid, something is stimulating your thyroid to make more thyroid than it needs, and I've seen examples of stress do that and I've seen examples of this being a first stage of an auto immune disorder. So I would say the first thing is get your body in balance in as many ways as you can. Emotional, nutritional, hormone-wise the whole thing and perhaps it will come around again.
Goodman: Judy, will you care to comment?
Griffin: I would agree entirely with what Dr Lee has said. It's very much so. If people are oestrogen dominant there is no way they will ever lose weight.

Goodman: Judy did you have any suggestions for thyroid? This has come up a lot, a lot of people have contacted me and said during the menopause they have been diagnosed as being hypothyroid.
Griffin: That is very common in menopausal stages and the way a herbalist would look at that is to work the adrenals, and the adrenals fuel the thyroid and T4 and it's a different process. The adrenals are like the brains of your body, they are working from the butt up. They work with the brain and we would use herbs such as Siberian Ginseng, available in a tincture, you need to reduce stress that may be any other part of your body, but basically, start pumping those adrenals, then you have to bring it up slowly so you won't get hot flushes or some other headache. If you take too much of a Ginseng type product your shoulders will meet your ears. So if you start getting headaches then you need to come down on your dose.

Goodman: Dr Lee, were you suggesting that supposed thyroid problems are being misdiagnosed?
Lee: I believe that over years of practice that 90% of the women I see that have been put on thyroid medication are actually not truely hypothyroid. I call it pseudo hypothyroid because it is a manifestation of oestrogen dominance. It's not that easy to take them off because once you give a thyroid hormone to someone who really didn't need it, their own thyroid will cut down by the amount of thyroid that you give. So if you take the thyroid away then they truly act like they are hypothyroid. It is a gradual process of trying to reverse to get the progesterone correct and the oestrogen dominance, and then I used to use a TSH test, but probably it's just a matter of time, you can gradually reduce the thyroid and get off it and they never needed it in the first place.
Smallbone: I think there is just one other addition to that and that is that thyroxin is not so effectively enhanced by progesterone as natural thyroid itself. There is a difference, it's a bit like the difference between progestogens and progesterone. There are only certain similarities that allow it to work effectively. The normal reaction is for progesterone to enhance the effectiveness of the thyroid hormone itself.

Audience: Could you tell us how we would know if we were oestrogen dominant?
Lee: I forget the page in the book, but I have it listed several times. In brief the signs of oestrogen dominance are weight gain, that it is difficult to lose weight, water retention, people notice that their rings get tight on their hands, when they take their shoes off they can't get them back on. Often they will have larger, more full breasts and each month that the oestrogen surge comes the breasts can become more full, and the period sometimes get heavier and there is quite a list. Fortunately, there is the saliva hormone assay - people should get the oestrogen compared with the progesterone and someday we are going to work out what exactly is the right ratio. One problem with the test, whether it's blood tests or the saliva test, is that the range of normal is about fivefold. It's a huge range of normal.
     I didn't show the slides this morning, but there is a beautiful study done in the seventies by Dr S Ware of France. He took people with fibrocystic breast disease which is a sign of oestrogen dominance, and he compared them with normal women, and he found that all of them had oestrogen and progesterone in the normal range. When he made the ratio of progesterone to oestrogen, they separated into two distinct groups. People who had the fibrocystic breasts were the ones who were oestrogen dominant, progesterone deficient. At that ratio they were totally different groups, so he treated them with progesterone cream that he made up and actually gave them 25 or 50 mg a day, and within 3 months 85% of the 184 women's, breasts had returned to normal, and after another 3 months the remainder did and then people challenged him to do blood tests. He did the blood tests and did not find the progesterone in the blood. He didn't know about the saliva tests and they convinced him that it was all placebo.
     We have lost a full generation of understanding how good progesterone was because 25 years ago they didn't know about saliva.

Audience: What is progesterone derived from?
Lee: It is a synthesis, just as in your body you synthesise it from cholesterol. Synthesis means to put together from parts and nobody is able to do that. It would be wonderful if scientists learned how to do it from cholesterol because there is no deficiency supply of cholesterol. You can get it from all the dairy products. They actually have to do it from fats that are similar to cholesterol but not the same, that are made in plants and it's a chemical synthesis and what they end up with is real progesterone. It's a chemical process but it ends up synthesising real progesterone again. I don't know the exact steps.

Audience: Dr Bond, I've just had a flash because I realised I'm obviously very high in oestrogen and I went to Weight Watchers and couldn't lose weight, went to my doctor who told me to eat less, my wife does this, told me I was stupid and I know what to do. What I want to know is does it apply to men too, who are not losing weight, who are also nearly fifty possibly having similar problems? Dr Lee says about men who have swollen breasts and men who can't possibly lose weight.
Bond: I think it probably is a hormone imbalance in these so called menopausal males as well. Exactly what the balance is and how the balance works I don't know. I think with men it seems to be much more a diet thing and life style.
Kenton: Men have a much easier time in losing weight than women do, sadly. That is one of the frustrations with women and I think that is entirely because women have so much oestrogen in their bodies, wouldn't you say John?
Lee: I agree with that, there is new research on an intracellular cytokine called leptin and you will be reading about it in medical journals and probably in health journals. Leptin is like a hormone in the sense that it modulates what the cell does. However, it isn't necessary to be put in the bloodstream and go to one part of the body to another. It does it in the cell, it is what controls whether you convert food into energy or to storage. A recent discovery about leptin is when they measure it in the arteries going to the brain and measure it in the veins coming from the brain back to the heart they find four times more in the part coming from the brain. It means the brain itself makes it. Isn't that amazing? Leptin looks to be the next piece in the puzzle.

Goodman: What about growth hormone and DHEA for men because that has been touted for weight loss?
Lee: There is so much still to be learned about it but leptin looks to be the next piece in the puzzle to be solved.

Audience: Thank you, for me that is a big light bulb that is flashed, that now I know I can deal with something which has made my day worthwhile.
Lee: The progesterone will help.

Goodman: John, you mentioned this morning that you didn't feel that DHEA was indicated for women. There is a lot being mentioned about DHEA for men and I just wondered if you are aware of any research regarding DHEA?
Lee: Well I have friends in research who want me to say that DHEA is fine and there is enough evidence to say that we should be using it and they keep sending me all of this and I keep reading it, and I keep looking and I still am not sure. I'm not saying it's bad and shouldn't be done. I don't criticise those who do it but I have a lot of friends in the alternative medical societies in the United States, and they are always 4 or 5 years ahead and I remember 5 years ago they were all on DHEA and after 5 years of using it they have all given it up. I consider the marker for age like bifocals and grey hair. I could dye my hair, I could have glasses but it really wouldn't change how I age. I think it is a good indicator, but I'm not convinced that having DHEA is going to change the rate in which I age.
Smallbone: I think it depends a little bit on what you are using the DHEA for. Part of the response of producing DHEA is to increase your corticotrophic hormones. It's one of the pathways of production. To me it's much safer to use, even in the male, because males also produces progesterone. To use progesterone as a source of option for the body to make that conversion rather than putting in the material that can only go one way, because the progesterone can be utilised if the body does not want DHEA for some reason. It can be used for other functions. DHEA as far as we know is a unilateral movement in the direction of production of corticosteroids.
Bond: I've noticed with DHEA levels that often when you get the other hormones balanced then the DHEA comes back up again of its accord.
Kenton: Good point, because I was going to say, to me the major issue, and I'm very familiar with DHEA because I, like John's friend about 5 years ago, took it. I never believe anything unless I take it and see what happens. I don't take it anymore. Not that anything untoward happened. It's just that what I'm aware of is that the bio markers of age are much more directly related to the toxicity in the body than anything else, including by the way, thyroid problems, including underactive adrenals, overactive adrenals.
     Jeffrey Bland, the American metabolic biochemist whose work I have a great respect for, has done a great deal to codify the exact biochemical pathways by which detoxification takes place and there are basically two phases. The first phase takes out a lot of metabolic waste and other toxic chemicals and basically binds them to other substances in the body, and from then they go on to stage two where they have to be released. This is quite a complex process. Particularly nowadays, given the xeno-oestrogen in our environment, and all the other things that we are subjected to. Any of you that seriously have a problem with thyroid, seriously have a problem with any sort of chronic ailment, fatigue whatever. I really think you should look at that. Find yourself a good metalbolic practitioner or nutritionist who knows about Jeff Bland's stuff. He produces two products that I have a lot of time for called Ultra Clear and Ultra Plus. They are not available over the counter, they are only available through practitioners. But they help you go through a process of detoxification where all of these metabolic pathways for eliminating toxic waste from the body are supported, and you go through it without a healing crisis. Within 5 days you will feel different. Within 6 weeks, given the right product, your whole life will change. This, to me, is the way to go, not just rely on DHEA or whatever it is, that is the latest American "jazz- me-up-and-keep-me-going" type thing. It's available from nutritionists and doctors and naturopaths. It is actually available from the Nutri Centre as well.
Goodman: It's also available from Nutri Ltd.

Audience: For Dr Lee: In the morning session Dr Bond was referring to 5 different groups of people who probably would require oestrogen. I think I have identified myself as being one of those. Diagnosed with ovarian cancer 15 months ago I've had hysterectomy and oopherectomy and prescribed HRT in the form of patches, 75 µg. There seems to be some conflict between my gynaecologist and the view of progesterone, I just wondered what Dr Lee would suggest from this situation?
Lee: I'm not technically anti-oestrogen. It's just the body makes sufficient oestrogen and yet the doctors are giving more oestrogen without keeping up with the progesterone so they are creating oestrogen dominance. I suspect your oestrogen may be sufficient. She is on 75 micrograms (0.075 mg) daily of oestradiol applied transdermally. Skin absorption is 10-20 times more efficient than oral dosing.
     To achieve the same oestrogen effect by oral dosing, the daily dose of oestradiol would have to be 10-20 times greater, i.e. 0.75 - 1.5 mg. This is higher than most women need. I'm afraid that whether you need oestrogen or not, the dose you are receiving from the patch is more than needed.
Audience: Would you balance that with some progesterone?
Lee: Well, of course. Also, I suspect the dose, even though it is quite low in microgram range I suspect the patch is really so efficient, that it's really too much.
Audience: Perhaps discuss reduction of that with my gynaecologist?
Lee: Right, when the patches first came out I wrote to the companies to say that all my patients were getting breast swelling, gaining weight and couldn't lose it.
Audience: I've gained 3 stone.
Lee: Right, it's obviously too much oestrogen. I discovered they put so much in the patch they had overwhelmed the red blood cell membrane capacity so some would slot into the serum or the plasma so it would then match the plasma levels that the ovary makes. So you see, when the ovary makes it, it is wrapped in protein and it's only 5 or 10% bio-available and they're putting all this oestrogen into people at the same level but is all bio available because it went through the skin without being protein balanced. Then they came out with a smaller patch, and then I had my patients try to cut the patch, and then all the oestrogen would run out in one day and they would have oestrogen side effects, so then I tried them to get little tape and cutting a little dime-sized hole and put the tape on first and then the patch on top so there was less skin and that worked fine except they all got allergic to the adhesive in the tape. And it was just terrible, trying to find out how to reduce the dose.

Audience: Dr Bond, I would like to ask whether any thoughts have been given to women who have taken the contraceptive pill for many years and are now reaching menopause. Is it more beneficial for them than to consider taking natural progesterone?
Bond: You only take natural progesterone if you need it. If you have symptoms of oestrogen dominance or osteoporosis then you would use natural progesterone. Natural progesterone is a wonderful product but it is not something you take just because it's there. You may need it, you may not need it, it won't have any bearing on whether you took the contraceptive pill in the past although that will probably have put you at a risk of osteoporosis by suppressing your ovulation and there being no natural progesterone around all that time.
Lee: In your practice have you seen any long term side effects in any way from people who have been on birth control pills for a long time?
Bond: Yes, the main problems are infertility, when they come off them, and osteoporosis, and some of them get diagnosed as an early menopause. I mentioned this morning, what tends to happen quite often, people come off the contraceptive pill after many years, it will sometimes take, particularly if they're in their late thirties, several months before a cycle will be established. They go along to their GP who will measure their pituitary hormone, say ah, you've got an early menopause, have some HRT, and that is very common.

Audience: I took the contraceptive pills for about 17 years and there is some concern, I took this pill with things that weren't natural for my body. The only thing I do suffer now I'm going through the menopause is very bad night sweats.
Bond: Well I think our herbalist lady had some very good solutions.
MacEoin: It's quite common for homoeopaths to be consulted by female patients who come along with a history of having used the contraceptive pill who actually respond very very well to a homoeopathic remedy called folliculinum. I'm not suggesting that it is something that is done automatically, but particularly where there are severe night sweats and where it is possible to date back they've never been well since, but it is something to bear in mind.

Audience: Well this isn't a question, actually, it is more an observation. I belong to the WI. I don't know if anybody has contact with them. But a lot of the mores in Britain pertaining to women have their roots in the WI and you are able to put forward suggestions to be put before parliament. So maybe a way forward would be for somebody to contact the WI. Their national magazine is Home and Country, they are always on the fringe of holistic health and nutrition and that sort of thing and maybe that is one of the ways forward.

Goodman: I would like to really keep to our schedule because we have been here the entire day and I would like to thank each and every one of you for attending. You have been a splendid audience. I think that we have all learned a tremendous amount. I would like to especially thank all of the speakers and AnnA Rushton and Kate Neil and the audio-visual technicians and the stewards and everybody who has worked so well today to make this, I hope, a very open and interactive and non-judgmental event and I do hope that this can be carried on in your own lives so that the word can be spread around.


  1. Joan Bowers said..

    Hi Dr Lee,
    I am using Progesterone cream and wonder if I am using the right amount.
    I have had no periods for 3 years and trying the cream for hot flashes and nights sweats plus for my aching bones, I am 53.
    My 40 ounce jar as 50mg/cc vp gm written on . I had to get a prescription for it , and I got it from a compound pharmacy . I use 1/2 scoop 3 weeks of a month. I have your book on progesterone and loved the information.
    Thanks again

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