SS Radio #190: Keith and Angie Nichols: Hormone Optimization for Women

[Mark Rippetoe]

Hormone Optimization for Women | Starting Strength Radio #190

[FatButWeak]

Hormone Optimization for Women | Starting Strength Radio #190

Listened. Thanks. Good education base so i can advise my wife.

Did I hear correctly? These fucking scumbags conducted the largest/most expensive government funded study - the womens health initiative - to determine whether a hormonal drug cocktail perversely called "Premarin" (theyre laughing at us, you know) created by researchers by adding foreign horse hormones to normal human estradiol (because just estradiol cannot be patented or otherise legally protected). Is this correct? If so, this is outrageous.

Why or how did they possible believe that adding horse hormones would positively affect humans? Hadn't they seen the Island of Dr Moreau? WTF?!?!?!

[Mark Rippetoe]

I believe you heard correctly.

[J. Keith Nichols MD]

Listened. Thanks. Good education base so i can advise my wife.

Did I hear correctly? These fucking scumbags conducted the largest/most expensive government funded study - the womens health initiative - to determine whether a hormonal drug cocktail perversely called "Premarin" (theyre laughing at us, you know) created by researchers by adding foreign horse hormones to normal human estradiol (because just estradiol cannot be patented or otherise legally protected). Is this correct? If so, this is outrageous.

Why or how did they possible believe that adding horse hormones would positively affect humans? Hadn't they seen the Island of Dr Moreau? WTF?!?!?!

Yes sir you did hear correctly. Premarin and Provera were used because they were the most commonly used drugs at the time and they were produced by the pharmaceutical companies. It is correct that you cannot patent a hormone. Unless you develop a unique delivery system or you change the chemical structure of the hormone. So they did change the chemical structure of progesterone and they used pregnant mare urine which you heard correctly is only about 15% estradiol with the remaining estrogens being equine estrogens. So these equine estrogen were much more estrogenic than estradiol so they did cause an increase in heart attacks and strokes and PEs in women that had pre-existing plaque formation, and those women were greater than 10 years out from menopause or over 60 years of age. It did not occur in younger women. So the horse estrogens caused an increase in clotting events and the synthetic progesterone caused an increase in breast cancer. This is where all of the, bad publicity surrounding hormones originated.

But let me be real clear on this point. Pure estradiol and pure progesterone has never -- let me repeat, NEVER -- caused an increase in heart attacks, strokes, DVTs, PEs, or breast cancer in any randomized controlled trial to date. So pure bioidentical hormones, including testosterone, has never caused any harm in any randomized controlled trial. They all provide protection, not harm.

[HailMary]

Progestin and progesterone are often used synonymously, by the media, medical doctors, and by regular folk. Sadly, the media coverage of the WIH and the subsequent recommendations scared a lot of women off (B)HRT.

Thank you for the podcast. Mark, shut up and let your guests talk more.

[Mark Rippetoe]

Mark, shut up and let your guests talk more.

Mary, no.

[Buffaloguy]

Another great pod. They actually covered a lot of the basic themes from World Link Medical's seminar series (part one) for anyone in the medical field looking for more info.

[Kletsy]

Dr. Nichols, estradiol is a paracrine hormone, so endocrine cells produce it from testosterone through aromatization to be used by adjacent cell instead of distributing through the bloodstream like testosterone. However, if a woman takes estradiol exogenously through gel or a pill , can we just assume it is well enough distributed through bloodstream to reach the receptors in the cells in all the tissues? Would serum levels be a good indicator, even though we do not know what happens at the tissue level?

[J. Keith Nichols MD]

Dr. Nichols, estradiol is a paracrine hormone, so endocrine cells produce it from testosterone through aromatization to be used by adjacent cell instead of distributing through the bloodstream like testosterone. However, if a woman takes estradiol exogenously through gel or a pill , can we just assume it is well enough distributed through bloodstream to reach the receptors in the cells in all the tissues? Would serum levels be a good indicator, even though we do not know what happens at the tissue level?

Estradiol in a pre-menopausal woman is an endocrine hormone, and is produced by the ovaries. In a man, it is produced at target tissues from the aromatization of testosterone. All the studies done in females utilizing estradiol whether it be from a oral or transdermal method of delivery etc. they measured serum levels.

[Kletsy]

Thanks, doc! I didn't think that question through, completely forgetting women have ovaries.