Risks of HRT
Recently the media has created a scare campaign against estrogen stating it causes breast cancer. Unfortunately this over simplification on the subject has created much confusion in many women, not to mention their doctors. Estrogen is not evil as it is made out to be by the media. In fact estrogens have over 400 different biological functions in the body such as skin and blood vessel maintenance, prevent bone loss, effects lipid metabolism, protects cardiovascular system, improves blood coagulation, nervous system modulation, controls activity of enzymes and levels of circulating proteins and hormones, increases metabolic rate, aids sleep, prevents cataracts, improves magnesium uptake, maintains collagen and skin moisture content, regulates body temperature, maintains mood and memory functions by influencing neurotransmitter production, to name a few. Therefore it is important that sufficient estrogen levels are maintained for a healthy normal physiological function.
The problem related to the increased risk of breast cancer while on HRT involves a number of hormonal imbalances which may be responsible for triggering breast cancer formation. The correct balance of the three types of estrogens and then the balance of these estrogens with progesterone is vital to reduce the risk factors. To complicate things even further the correct metabolism of the estrogens is also of vital importance as certain estrogen metabolites have been found to be carcinogenic and increase the risks of breast cancer. Hypothyroid has also been implicated in breast cancer, not to mention low melatonin and the presence of insulin resistance.
The female body produces three estrogens:
(1) Estriol – 90% of total estrogens produced by a healthy female is estriol. A considerable amount of research on estriol has proven it to be a “good” estrogen. It is a weak estrogen which appears to block many of the effects of other pro-carcinogenic estrogens. The more estriol means less risk of cancer.
(2) Estradiol – About 7% of total estrogens produced by a healthy female is estradiol which is considered a weak pro-carcinogenic estrogen if not correctly balanced by estriol.
(3) Estrone – The remainding 3% of total estrogens in a healthy female is estrone which is also considered a pro-carcinogenic estrogen if not correctly balanced.
What is of importance is not only the absolute amounts of each of these estrogens but also the balance of estriol compared with the sum total of estradiol and estrone – that is your estrogen quotient (EQ). Your EQ is calculated by determining your 24 hour urine levels of the three estrogens and then doing the following maths :
EQ = estriol/(estradiol + estrone)
EQ levels below 1 are considered unfavorable and increase the risk of breast cancer considerably. This means there is an excess of estrone and estradiol compared to estriol. If your EQ is below 1 then there is a simple solution. Take six to eight drops of a saturated solution of potassium iodide (SSKI) in a glass of water daily for two to three months. The iodine reliably promotes the metabolism of estrone and estradiol into estriol thus increasing your EQ. Retest your EQ after three months to ensure it has increased over 1. If so you can then taper down you dose of SSKI to the smallest amount needed to maintain your EQ above 1. Although SSKI is safe for the majority of people there are a few individuals sensitive to it and with long term use it may suppress thyroid function. Thyroid blood tests are essential to pick up if this occurs.
Many HRT products on the market contain either estrone or estradiol, or their synthetic derivatives, as their only estrogen or as their main estrogen. Although there is some interconversion of estrone replacement into estradiol and estriol, and estradiol replacement into estrone and then into estriol it is usually inadequate in a majority of cases in order to provide an appropriate estrogen balance or EQ. Therefore many products on the market do not provide a healthy and normal estrogen balance. Whichever product you chose to take you should ensure that it provides a healthy estrogen balance or EQ.
In healthy women the correct balance of progesterone to estradiol is approximately 100:1 by blood tests. We therefore should aim to achieve this balance in HRT patients to minimise the risks of breast cancer as an estrogen dominant state has been linked to an increased risk of developing breast cancer. Studies have shown that most women with breast cancer have low progesterone levels.
Again many combined estrogen and progestin HRT products on the market do not adeqately provide an appropriate balance. The synthetic progestins used in these products cannot be tested for so there is no way of knowing if an appropriate estrogen:progesterone balance is maintained with these products! Research indicates that non-bioidentical progesterone is unable to provide the protection offered by its bioidentical counterpart. In addition research implies that the synthetic progestin, metdroxyprogesterone, has been linked to actually increasing the risk of breast cancer.
The estrogens in your body are metabolized by your liver into several different metabolites. Estrone is easily converted back and forth into estradiol. These two estrogens are then converted by three different enzyme systems. Over 20 years of research has determined that the 2-hydroxyestrone metabolite is “good” while the 16-hydroxyestrone and 4-hydroxyestrone metabolites promote cancer cell growth. Research indicates that if the ratio of the good estrogen metabolite (2-hydroxyestrone) compared to the bad estrogen metabolite (16-hydroxyestrone) is low then an increased risk of breast cancer results. If on any form of HRT both of these metabolites should be measured by urine analysis to determine the ratio (or balance) between the two. A 2/16 ratio below 1 is unfavorable and ideally should be above 2 or greater if possible. If the ratio is found to be below 1 then you should consider using 60mg a day of a natural supplement called diindolylmethane (DIM). It promotes the formation of the good estrogen metabolites while inhibiting the bad one. A diet rich in brassica vegetables (cabbage, broccoli, cauliflower, bok choy, brussel sprouts) which contain indol-3-carbinol and di-indolylmethane also help promote favorable estrogen metabolism.
The 2 and 4 hydroxyestrone metabolites can be further metabolized into the corresponding quinones. The 4-hydroxyquinone metabolite can cause permanent DNA damage and is associated with increase risk of breast cancer. The use of an antioxidant called glutathione will help “mop up” any 4-hydroxyquinone and thus may help reduce your risks some what of developing breast cancer.
This evidences implies that it is important to monitor your estrogen metabolites if on any form of estrogen replacement to ensure a healthy balance occurs and fix any imbalances that may be found in order to reduce any risks involved.
Studies dating back to the 1950’s indicate a low thyroid function predisposes women to breast cancer. When thyroid is low your estrogens are unable to activate appropriate amounts of sex hormone binding globulin (SHBG) in the liver. SHBG in the bloodstream binds to estradiol and estrone preventing too much from entering cells and stimulating growth of tissue in the breast and uterus. Thyroid function tests that include measuring free T3 and T4 levels can determine if a hypothyroid state is present which could be fueling the cancer or increasing the risks of getting it.
Melatonin is a hormone produced by the pineal gland in the brain responsible for our bodies circadian rhythems. Several studies have associated low melatonin levels with an increased risk of breast cancer.
The many causes of insulin resistance ultimately results with ongoing high levels of insulin in the bloodstream. High insulin levels cause the pituitary gland in the brain to produce too much luteinizing hormone relative to follicle stimulating hormone which results with dysfunctional estrogen and progesterone production as well as underdeveloped follicles producing excessive amounts of testosterone. It also produces body fat which in turn elevates estrogen levels. This results with an increase risk of breast cancer and also polycystic ovary syndrome. A glucose tollerence test will indicate if insulin resistance is present and if so dietary and lifestyle changes are necessary to rectify the situation.
Listed above are several tests you can perform to estimate your own risks of developing estrogen-related cancers such as breast and uterine cancer while on HRT. In addition we also recommend breast mamorams and uterine ultrasounds for early detection.
Energetic/Emotional Causes of Breast Cancer
The cause of breast cancer from an energetic/emotional point of view is that women in society today have been forced to resort to a more male driven energy to simply win back some form of equality, and in doing so have lost their inner-instincts to self-nurture. This lack of self-nurturing is the actual energetic cause of breast cancer. It should also be noted that if the breasts are effected then so too are the ovaries, which emanate the ‘’light of Femaleness’, and hence they too are suppressed and contracted from their natural way of impulsing. More self love and self nurturing is required to heal this energetic imbalance.