estrogen Archives - Page 3 of 3

Of BPA and Endocrine Disruptors: New Research, Same Flaws

Published on April 3, 2013

7.4K views

Bisphenol A or BPA is the ubiquitous estrogenic compound used to create plastics. It leaches into our food stuffs and because of its hormone-like qualities elicits a myriad of health issues in adults but especially in children and most especially when exposed in utero or during key developmental phases.

As we cover the expanding research base on BPA, it becomes increasingly clear that traditional methods of toxicology do not work for understanding endocrine disruptors – the man-made chemicals that alter our hormone pathways . A case in point, the latest research on BPA.

Exposure in Adults

A report published online in June of 2011 and presented at a prominent toxicology conference in February 2013, measured BPA exposure levels over a 24-hour period in adults fed a high BPA diet (lots of canned food and water from plastic bottles). The report showed that the concentration of BPA measured from blood was below the level of detection in most of the study participants, even though urine concentrations were extremely high and indicated exposure levels above the 95th percentile of the US population.

From urine tests, researchers were able to detect an average 84% – 97% of the dosed BPA and its metabolite, BPA glucuronide – indicating a high rate of clearance from the body. The ranges varied widely by time of day (morning tests showed significantly less clearance) and gender of participant (women did not process the hormone as well as men).

The researchers argue that their failure to detect BPA in blood, combined with the high concentration in the urine meant that risk was minimal. Their reasoning, even though BPA exposure was high, most of the BPA was cleared from the body rapidly and efficiently; no harm, no foul.

Medical and science marketers latched on to this and soon every major and minor media outlet was reporting that risks were minimal. Here are just a few headlines.

No Ill Effects Found in Human BPA Exposure, says the Wall Street Journal

Majestically Scientific Federal Study on BPA has Stunning Findings: So Why is the Media Ignoring it? – says Forbes

No toxic effects from controversial food packet, says expert – the Guardian

Ahh, where to begin?

Flaws in the Research

Conflicts of interest. Always look for industry sponsorship of for research, see my previous post on evaluating endocrine research for details. The relationship between the investigators in the present study and industry are muddled, but they do exist. For more information, click here.

Below the level of detection. When researchers report that their tests are unable to detect a visible pathology or measure a particular compound that any reasonable person would expect to be present, the test is likely at fault. Below the level of detection, means just that. It does not mean the compound was not present or that it was not exerting effects, only that the tests were not sensitive enough to measure the compound. This was case here and I suspect as testing methods improve, we’ll see higher detection levels in blood.

High clearance is not the same as never exposed. In this study, not all of the hormone was recovered in the urine, only an average of 84% – 97%. That sounds like a lot. With hormones, however, small amounts do great damage. Why? Because steroid hormones are stored in fat (and other tissues). They accumulate over time and metabolize into a myriad of different hormones (metabolites), some more potent than the parent compound. After the initial exposure and certainly after repeated exposures, our bodies become little (or big) hormone factories, storing and creating more and more hormones and hormone metabolites.

Metabolites matter. Hormones are shape shifters. Every time they meet an enzyme, the interaction between the enzyme and the hormone creates a new, similar, but differently shaped hormone. Hormones are never ‘one and done’ metabolizers. Even though a large percentage of the original hormone and its primary clearance metabolite were measured from urine in the present study, one cannot assume that there were not still other metabolites circulating within the body and wreaking havoc.

BPA has metabolites. This is critical and often ignored in toxicology research. BPA is a hormone like substance and as such, it metabolizes into many different forms. BPA has metabolites that are more potent than BPA itself. New research shows that BPA metabolizes into a compound called 4-methyl-2,4-bis(4-hydroxyphenl)pent-1-ene or MBP for short. MBP is 1000-fold stronger than BPA in its estrogenic effects. MBP binds strongly to both types of estrogen receptors (ERa and ERb) and may change the activity of the cell, displacing native or endogenous estradiol. So within that 3%-16% range of BPA not cleared, comes a compound 1000 times stronger than the BPA itself. As the research progresses, who knows how many other active and potent metabolites from BPA or MBP we’ll see. With hormones, nothing is simple or straightforward.

What this Means

Avoid medical marketing, it’s usually incorrect. Learn how to evaluate endocrine disruptor research. Once you get the hang of it, you’ll be able to dismiss faulty research at a glance. More importantly, learn about hormone systems and environmental hormone disrupting chemicals. Otherwise, our children will bear the brunt of our ignorance.

A good review article: Bisphenol A and the Great Divide: A Review of Controversies in the Field of Endocrine Disruption.

What is DES and Why You Should Care

by Chandler Marrs, PhD

Published on February 6, 2013

12.9K views

Diethylstilbestrol or DES is synthetic estrogen developed in the late 1930s. It was initially approved by the FDA in 1941 for vaginitis and as an early hormone replacement therapy for menopausal women. It was later approved a variety of low estrogen indications. In 1947, the FDA approved its use in pregnant women with a history of miscarriage. DES had been used off-label for miscarriage prevention since the early 1940s, despite the fact that little evidence supported its use and animal studies indicated clear carcinogenic and congenital reproductive abnormalities in the offspring.

After 10 years of widespread use and marketing, a double-blind, placebo-controlled study on the efficacy of DES was finally conducted. As one might expect, it was found ineffective in preventing miscarriage. In fact, women on DES had a higher risk of miscarriage. Later studies in the 1960s began detailing the adverse events associated with this drug. Despite mounting evidence of the dangers of diethylstilbestrol, it remained on the market and widely used through the early 1970s in the US and into the 1980s in some European countries. In the US alone, it is estimated that between 5-10 million women and their children were exposed to DES. Because the compound was never patented, 287 drug companies sold DES under a multitude of brands and for an array of low-estrogen conditions.

In addition to diethylstilbestrol use in humans, it was used widely in farm animals to fatten up the chickens and cattle, beginning in the early 1950s and through the 1970s. DES was found to cause cancer and interestingly enough, cause gynecomastia (man boobs) and sterility in the poultry workers. Well before DES was banned in humans, the FDA banned it in poultry under the newly enacted Delaney Clause to the FDA 1958. It seems man boobs and sterility was all it took to ban the product in chicken farms. Miscarriage, congenital abnormalities and cross-generation cancer risks, on the other hand, were not sufficient to initiate its ban in large cattle or humans. It was another 20 years before diethylstilbestrol was banned in cattle or humans and many years after before it was removed from the food chain (if it even is now). “In 1980, half a million cattle from one hundred and fifty-six feedlots in eighteen states were found with illegal DES implants.” Even upon FDA’s decision to withdraw its approval of DES in cattle and feed, it did so on grounds of the procedural non-compliance of the manufacturers, erstwhile maintaining the safety of diethylstilbestrol, “because there is no evidence of a public health hazard.” Despite its clear carcinogenic and teratogenic risks, it is still used in veterinary care.

Diethylstilbestrol Risk for Humans

Amongst those suffering the most from DES exposure are men and women who were exposed in utero as developing fetuses. DES was given to pregnant women from the 1940 through 1971 in the US and into the 1980s in some European countries. If you were born anytime between 1940 and 1980, ask your mom if she was given DES to prevent miscarriage. It was sold under dozens of brand names (click here for brand names).

Sons and Daughters of DES

The range of depth of reproductive abnormalities, endocrine and health issues found in the children and grandchildren of DES moms, is expanding regularly. If your mom or grandmother was given DES, here is a list of health issues to look for:

DES Daughters

In a large cohort study comparing the reproductive health of the daughters of women prescribed DES during pregnancy to the health of women whose mothers had not been given DES, researchers found a 2-8 times higher incidence of the following conditions:

Infertility
Spontaneous abortion
Ectopic pregnancy
Second trimester pregnancy loss,
Preterm delivery
Preeclampsia
Stillbirth
Neonatal death
Early menopause
Breast cancer
Cervical neoplasia
Clear cell adenocarcinoma

The increased risk of miscarriage and adverse pregnancy outcome in DES daughters is overwhelmingly linked to structural abnormalities with uterus. Fully 69% of DES daughters who have had difficult with infertility and miscarriage have an abnormally shaped uterine cavity or structural changes to the cervix (44%).

DES and Endometriosis

Of particular interest to Hormones Matter followers, DES exposure in utero is linked to an 80% increase in endometriosis. We will be digging deeper into the DES – endometriosis connection in the coming weeks.

DES Sons

Sons of women given DES during pregnancy are three times more likely to have structural abnormalities of the genitals including:

epididymal cysts
undescended testes
extremely small testes
hypospadias (misplaced urethral opening)
micropenis (some, but not all)
increased risk of infertility
increased risk of testicular and prostate cancer (although the research has just begun)

In the animal research, offspring of DES exposed mothers shows a vast array of structural and morphological changes across multiple physiological systems ranging from sex reversal in male fish to structural and functional changes in pancreatic cells. The full scope of damage from DES is yet to be determined.

DES Grandchildren

Yes, there are third generation effects from this drug. Researchers are just beginning to untangle the third generation effects. In women, menstrual irregularities appear more common as do the various forms of cancer, but the data are unclear. In men, hypospodias may be more frequent, but again the data are mixed.

Endocrine disruptors like diethylstilbestrol impact human health in ways we are only just beginning to understand. The current methods for measuring and calculating risk for endocrine disruptors is out-dated and based on standard, linear, dose-response curves that not only fail to account for how hormone systems work, but also fail to address possible transgenerational effects. Hormones matter and sooner or later we must address the broader endocrine system in pharmaceutical and environmental regulation. As women, we ought to be fighting for sooner.

The Soy Connection

by Jordan Davidson

Published on December 31, 2012

6.1K views

As a firm believer in natural and holistic health, I believe that the food you eat can have a direct impact on your health. For those dealing with reproductive and or endocrine disorders simple dietary changes may help prevent or relieve a number of troublesome symptoms. For women across the board, especially those with estrogen sensitive diseases (e.g. endometriosis) minimizing soy in one’s diet can provide a lot of relief.

But, isn’t soy good for you? That’s not an easy question to answer. In moderation soy can provide a lot of benefits to one’s diet. However, soy should not be a staple in your day to day meal planning. To better answer the question we need to break it down.

Phytoestrogens

Soy is filled with phytoestrogens also known as “dietary estrogens,” which mimic the hormone estrogen that is naturally produced by the human body. Research has shown that phytoestrogens are beneficial for women going through menopause, since menopause is marked by a reduction in estrogen levels. Some menopausal women say that eating soy products helps relieve some symptoms of menopause such as hot flashes. Research has shown that phytoestrogens help maintain cholesterol levels and bone density in post-menopausal women. In addition phytoestrogens also help protect against a number of different cancers, such as prostate and breast cancer, cardiovascular disease and help with cognitive functioning.

However, soy being filled with phytoestrogens, can also be bad for you. Estrogens are female sex hormones – estradiol is the most common. Estradiol promotes the growth of female sex characteristics. Soy is also high in phytic acid which if consumed in high quantities can affect the absorption of other minerals. That is why third world countries that survive on grain and legume based diets have high rates of mineral deficiencies.

Too Much Dietary Estrogen

Increased estrogen consumption can be particularly detrimental to a number of people (i.e. babies, children, men, women sensitive to estrogens). Studies have shown that giving babies/infants soy formula is the estrogenic equivalent to giving them daily birth control pills. Obviously, such small children shouldn’t be on any form of contraception. It has also been suggested that this increased ingestion of estrogen can lead to estrogen sensitivities, earlier onset of puberty and reproductive diseases/disorders such as endometriosis. For older children increased amounts of estrogen also cause pubertal issues. Large quantities of estrogen can delay puberty for boys and lower the age of menarche (first menstruation) for girls. The average age of menarche decreases every year and a lot of researchers and medical professionals hypothesize that is has to do with the environment, toxins and the estrogen that comes from outside sources. Early puberty can also lead to short stature in women.

Estrogen in abundance is also bad for grown men. Men produce both testosterone and estrogen, with testosterone being the predominant hormone by far, and responsible for masculine features. Too much estrogen in males can offset their testosterone to estrogen balance, causing hormonal deficiencies. Lastly, estrogen is bad for women who are sensitive to estrogen, such as women with endometriosis. The endometrium that builds up in endometriosis responds to estrogen. The more estrogen you give your body the more the endometrium can build up, which leads to additional inflammation and bleeding.

Not all Soy Products are Created Equal

If you are still confused as to how soy can be both ‘good’ and ‘bad’ for you consider this: soy products come from a soy bean – however, if you take a good look at your soy-patties or chips made with soy you won’t see mashed up green beans. The invisible soy you eat come from processing the beans. ‘Asian’ soy which is usually quoted as being “good” soy is fermented soy. The process of fermenting soy can reduce a lot of the detrimental qualities of soy, but not entirely. Unfermented soy contains antinutrients such as tripsin inhibitors which can produce serious gastric distress, reduced protein digestion and create chronic deficiencies in amino acid uptake. When soy is processed and manufactured it isn’t always fermented. There are two popular forms of processed soy:

Soy Lechitin: Soy lecithin is basically a waste product of refining soybean oil. In small amounts it isn’t harmful, but if you look at food labels it is found in a large amount of products. Putting soy products in everyday foods provides a lot of nutritional benefits (lower fat, lower calories, higher protein) while being cost effective to the manufacturers. Unfortunately when you process soy it also increases the levels of estrogens and goitrogenics. Goitrogenics decrease the productivity of the thyroid and are bad for those with thyroid disease. Although ironically enough lecithin by itself (not soy lechitin just plain old lechitin) is good for you, it is a natural product high in choline.

Soy Protein Isolate: Soy Protein Isolate is the key ingredient in most imitation meat and dairy products. It is also found in other manufactured goods and protein powders. To make soy protein isolate, the soy beans must first be mixed with an alkaline solution to remove fiber, then rinsed and separated using an acid wash and, lastly, neutralized in an alkaline solution. The resulting products are finally dried at high temperatures to produce a high-protein powder. A similar process is used to make textured vegetable protein which is a high-temperature, high-pressure extrusion processing of soy protein isolate. With natural almost always being better for you, a process like this is by no means healthy. It doesn’t sound good for you and it isn’t. This process can also increase the amount of trypsin inhibitors.

So… Is soy good for you? Studies show that a glass of red wine at dinner is good for you. But we all know that washing dinner down with a bottle of red wine every night would not be good for us. Approach soy in the same way; some soy products several times per week, especially if it is fermented, organic soy (think tofu cubes and not ‘fake pepperoni’) will provide more benefits than detriments. In general be smart about what you put in your body, be an educated consumer and read your labels. Just because it has soy doesn’t make it good. But, that doesn’t mean you need to take all soy products out of your life.

Forty Years of Pain and Still No Diagnosis

by Louise Heiner-van Dalen

Published on November 12, 2012

9.4K views

I am Louise Heiner-van Dalen, 63 years old. I live with my husband André in Elim, a little village in the east of the Netherlands.

The Pain of Puberty

From the moment my periods started at age 15, I had a lot of cramps and stomach pain. I went to the practitioner, and he did screenings of my blood and urine. Nothing was found. This was in 1964. The doctor told my mother that I was making it up to get attention. So my mother and my younger sister started telling me that they were strong and never complained, while I was weak and always had something to complain about.

Every two weeks I had a lot of pain, and I felt so bad; I really was ill. My mother and sister started to call me names and to tell everybody how childish I was.

Miscarriages and Endometriosis

I got married in my 25^th year, and after two years, in 1976, we really wanted to get pregnant. In those years I lost two ‘babies’ during the first part of pregnancy.

We went to the gynecologist and examinations started. Fertility examinations did not seem to be possible for some reason, and in those years the only option was a diagnostic laparoscopy. Then they found that there was a kind of flap mechanism, which was why they couldn’t do the first examination.

During this surgery they also saw that there was a lot of endometriosis in the abdomen. They had to tap off a lot of infection. When I woke up the doctor told me it was impossible to get pregnant because the ovaries were shriveled up by the endometriosis.

He gave me medicines that should have stopped my periods for a longer time, but after a couple of months enormous bleeding started. I was not able to take a step because of the bleeding and there was no way to stop it.

My husband and I talked about it, and with pain in our hearts we decided to that I should have surgery to take out my uterus and ovaries. We were afraid that going on like this could cost me my life, and I didn’t like to live like this. I was only 29 years old, it was 1978.

Hysterectomy

After we talked with our practitioner and with the gynecologist, my surgery was planned. The gynecologist told us that they would inspect everything, and it maybe it would be possible the take out the endometriosis and to keep the uterus.

When I woke up after surgery, I felt the incision with my hand, and it felt empty. I knew. In those years, the gynecologist thought that leaving a tiny little piece of one the ovaries would be enough to prevent problems with estrogen hormones.

Post-Surgery- Cycles of Pain

I could no longer have children. We planned on adopting before we got married, so we started the process before my surgery. In the mean time, I didn’t feel well, but it was hard to tell what it was. My muscles and joints started to give problems, and I had a lot of headaches. Every four weeks I had several days of physical discomfort and mental instability.

In 1980, we adopted our first baby boy and we were so happy, but I was still in pain.The doctors kept on telling me that I needed medicines because of mental problems. I refused that, because I was sure that there were other problems. The abdominal pain returned. Another gynecologist did a laparoscopic examination again, and again he found endometriosis and a few chocolate cysts.

Our second baby boy came in 1981. The gynecologist monitored my condition.

Premarin, Other Hormones and Psychosis

In 1992, after another surgery, doctors conducted an intra-uterine inspection and discovered that my mucus membranes were very thin and sometimes bleeding. He decided to give me Premarin, an estrogen hormone.

In a short time, I felt better than ever before. We were so happy and the gynecologist told me that I had to take this for the rest of my life. But then more and more the doctors found out that using this medicine could cause a greater risk of developing breast cancer.

Because of my husband’s job we had to move every four years or so. This meant every four years I had to find a new house doctor. In 2004, our new house doctor forced me to stop the Premarin. I refused. Then he refused to give me a new prescription. Day by day, my situation got worse. There were signs of psychosis. I had a lot of pain in my legs and seven nightly perspiration in 15 minutes, so I never slept. We asked the doctor to send me to an endocrinologist, but he refused saying it was all mental problems and I had to see a psychiatrist. I refused, and my husband went to the doctor to tell him that he wouldn’t leave before he had a referral letter for the endocrinologist. The doctor gave him the letter, and my husband told him that we would never come back to him.

The endocrinologist agreed with my need for the medicines. He did screenings of my blood and wanted to monitor my progress. We had to find another practitioner.

Prescription Mishap – Pseudo Pregnancy and Leg Pain

In 2010, I planned to travel to Québec, so I took my new prescription for Dagynil, a hormone, to the pharmacy four weeks before I left. I told them that it was important to have them in time.

Shortly before leaving, my husband went to the pharmacist to get my Dagynil, but they didn’t have to correct dosage by mg. They gave him a splitter and told him that I could simply split the tablet. I always thought that it was not good to split this kind of medicines, but the pharmacist said it was safe.

During my stay in Québec, I felt more and more sick, especially in the morning, with nausea, and my daughter-in-law joked that I seemed pregnant. After the month long trip, I came home and a week later I felt another psychotic attack coming. I knew for sure that the pharmacist and the house doctor had made an enormous mistake.

My husband called for the doctor, and he didn’t believe us! I had so much pain in my legs, I felt so bad, and was really panicking. I asked the doctor to make a phone call to the endocrinologist, but he refused. Again the same story!

It took three weeks; by then I was so upset that I started to shout at the doctor as soon he entered my room. I lived in a strange world that wasn’t mine. I wanted to die to be with the two little babies I had lost. It was horrible. I kept on shouting at the doctor, and he was trying to make a phone call for a psychiatrist.

My husband told the doctor that it would be better to make a phone call to the endocrinologist. Finally he agreed, and the next morning he made a phone call to us to tell us that we had to go to the hospital immediately. Thank God!

The endocrinologist felt so sorry for me. Again the same story. He agreed that I was pregnant – at least I had all the signs – but there was no baby, of course. It took several weeks before I was feeling better after this bad adventure. I was prescribed the correct dosage of Dagynil and slowly I felt more myself.

Today

In 2011, we moved again, and we found a good, friendly doctor. We told him openly about the problems we had in the past, and he listened very carefully.

About six months ago, I woke up and felt strange, like another psychotic attack was coming up. I made an appointment with the doctor and told him that there seemed to be something wrong. He looked through blood tests from the last few months, since I needed monitoring because I have collagen/microscopic colitis. Then he saw that my thyroid numbers were going up slowly but still within the margin that is normal.

I asked the doctor to make a phone call to the endocrinologist, which he did immediately, while we were sitting there. The endocrinologist explained my hormone troubles, and he advised him to prescribe Euthyrox. I was happy and felt better within a couple of weeks.

My abdominal pain is still there, and nobody knows if it is the endometriosis or the colitis, but another surgery will give more scars and troubles inside. Forty years of pain and problems and I still do not have a diagnosis and my treatment plan changes often.

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