I had the lipid test at Berkley about four years ago..and I was told two things..that I had a clotting problem and that I should avoid omega fats..that I had the type cholesterol that omegas were not good for.
I can't get into see my records at berkley and my cardiologist died a couple weeks ago and I can't get any response on my records. My current doctor and I am midwest instead of south east now..is asking about these and I don't know how to answer him. Why would omega be bad?

sorry I sent the question about omega fats and cholesterol. danellerene@ymail.com

Dr. Davis,

I have tried  "bioidentical" female hormones from a compounding pharmacy and ended up with sky high blood pressure and blood sugar. I do very well on the pharmaceutical yam-based estrogen. So I would caution people not to assume these hormones are benign.

I also have supplemented pregnenolone for a while and had to stop as I also started to see bad results with blood pressure and a hint of masculinizing.

So I would warn older women to be very careful with these hormones. The doses seem to be set very high and some of them may be optimized for males.

Dr. Davis, do you recommend any particular brand of pregnenelone?

Dr. Davis,

Ordinarily I would have no interest in the ultimate " bioidentical" hormone" but, my daughter is going through her changes and is having a bad time with them.  Could pregnenelone be used to alleviate problematic symptoms? She is dead set against hormone therapy because she has a fear of  cancer.

Bioidentical hormones have been a godsend for me... after "toughing out" a particularly long and difficult perimenopause I was in pretty dire straits.  I found a doctor who uses both mainstream Big Pharma hormones and bioidenticals in his ob/gyn practice, depending on the patient and their needs.  He is board certified, highly skilled, and compassionate.  After some trial and error and numerous blood tests, we arrived at compounded estrogen and progesterone as the best for me.  Gone are many horrible symptoms, so of course I would be very upset if the FDA were to "crack down" on "bioidenticals" in favor of manufactured Big Pharma products.

That being said, if the FDA is so inclined... I will roll with it.  There are several prescription estrogen products, both oral and topical that could meet my needs.  They are for the most part manufactured from soy (as are most bioidenticals).  There are also some progesterone products manufactured by Big Pharma companies... and I am betting we can figure out how to get to the combination and dosage I require to feel good and normal.

What won't I take?   Well Premarin and Prem-Pro for starters.  They're not bioidentical... in fact they are foreign to the human body.  Equilin,  derived from pregnant mares urine, or manufactured from soy, is not a requisite of the human body and IMO doesn't belong there. Give women a foreign hormone substance for years and wonder why the alarming results?  Hummm...

As for pregnenolone, I don't think so, at least not for me.  At this late date, I doubt that my body would be efficient in utilizing it, or sending it down the correct pathway.  Why not just use the real things?

madcook

DHEA can cause substantial hair loss in men, it did suddenly and acutely in me.

I'm no expert but it's my understanding that pregnenolone is the raw material for the production of DHEA, which is the raw material for the production of testosterone, estrogen, and progesterone.

It's also my understanding that it's always best to try and supplement "bioidentical" hormones that are closest to the natural target hormone.

If that's true and if pregnenolone is low and DHEA normal (say through supplementation) what's the point of taking pregnenolone at all?

I've been on bioidentical hormones (progesterone) for 18 months and have had incredible success. I'm under the care of a MD who specializes in bioidentical hormones. Bioidenticals are safe and effective if the supplementation is medically supervised.

At 47 yo, still cycling regularly but definitely perimenopausal the past few years.  New cycles start every 14-20 days (normal in every other way) if I don't use progesterone, but with progesterone, cycles are closer to normal length, every 21-28 days.  

I've been using bioidentical OTC progesterone cream for a little over two years with very good results and no side effects that I can detect.  Just this week I switched to a higher prog dose via compounded Rx, as symptoms were returning/increasing the past couple months (especially midcycle extreme breast tenderness and increased lumpiness- negative ultrasound and mammograms though thermogram was suspicious, plus last exam indicated return of uterine fibroid - all suggestive of high estrogen/low progesterone imbalance).  

A recent luteal phase test of estradiol showed it to be twice as high (549 pg/ml) as the upper end of the ref range, which explains the dramatically increased symptoms.  Guess those ovaries are screaming in protest during their decommissioning!  Progesterone levels were in the tank.  So was 8am cortisol level.  

BTW, I've always avoided any supplemental phytoestrogens such as soy, "menopause" herbs, etc.  Numerous lood tests over the past 15 years have indicated no lack of estradiol (esp in recent years), but in fact, chronically low progesterone, despite regular cycles.  

Along with years of undiagnosed hypothyroidism, I think low progesterone and a slightly shortened luteal phase were likely reasons why I had trouble conceiving 8-15 years ago (despite two infertility work-ups and "expert" review of my tests).  Wish I knew then what I know now (don't we all?)

This backlash against biodidentical hormones, orchestrated by Wyett and other Big Pharma patent holders is very disturbing.  Like any other drug, the skill, experience, and knowledge of the doctor is crucial in prescribing them for the best effective treatment.  

I've been cautious about self-treating with OTC hormones without some experienced guidance, including pregnenolone, because I wasn't sure it wouldn't convert to more estradiol instead of the progesterone and testosterone I needed.  But it took a long time to find an MD which the right experience.  Of course, she's not in my HMO-subscribed system so I have to pay out of pocket for office visits or compounded Rx, but it's worth it.  She writes the lab orders on a Rx form, which I take to the HMO lab, so insurance covers any of the lab tests they do.  Results are faxed to the ordering MD, even though she isn't in the system.

I guess I'm just an ignorant old Luddite, but I'm skeptical of all substances that don't come in natural foods. No prescription or OTC stuff for me if I can avoid it.

Anna,

Late 40's are a rough time of life, kind of like being a 13 year old girl in reverse.  Ovaries are cranky as they rev up and as they rev down.  Next they start behaving like loose lightbulbs. They turn off for a month or three then they turn right back on.  It is hard to relie on hormone levels in that phase because things just keep changing.
Late 40's usually screams progesterone deficiency.  First up to treat is usually vitex 500mg whole fruit daily.  Takes 3 months for full effect. Dirt cheap.  It works as a prolactin inhibiter and a progesterone booster.  Second is progest cream.  Third compounded progesterone or prometrium.  Route of prometrium varies with symptomatology.  Can't sleep?  Progesterone needs to be oral.  Still can't sleep?  Take it with food at bedtime to enhance absorbtion or up the dose.  Hung over in the morning?  Take it earlier.  Sleep not an issue but can't stand those early periods?  Use the progesterone vaginally at night.  Just shove it in as high as it will go.  The gelatin capsule dissolves and it goes straight to the uterus.

From my experience, bioidentical hormones really do work! After hearing so many people, like Susanne Somers and Oprah, talk about the
benefits of hormone replacement
therapy, I decided to give it a try. I looked around a lot, and I
finally chose VieNue
Bioidentical Testosterone Cream. All I have to say is, IT WORKS! My mood
is so much better. I feel healthier. I have a healthy love life again - I
used to always feel so "not into it." Now my husband and I are connecting
again like we did years ago. Definitely give VieNue Bioidentical Testosterone
Cream a try, you won't regret it. Here's the link vienue bioidentical testosterone cream

You need to do a lot of reserach before starting hormone therapy... You should always have your hormones tested first! Saliva test is the best way to test your hormones levels. Also you need to use a compounding pharmacy that you can trust and a good doctor. This website helped to show why to choice bioidentcal hormones and you can even find a doctor in your area: http://www.bodylogicmd.com/research/safety-of-bioidentical-hormones

I have been researching the bioidentical hormone therapy topic for a while and would like to see what people's opinions on the health benefits of bioidentical hormones like the reduction of breast cancer as explained in this article,

http://bodylogicmd.com/hormone-articles/review-of-hormones-and-breast-cancer-can-we-use-them-in-ways-that-could-reduce-the-risk

Can you address the cardiovascular risks associated with bioidentical supplementation as compared to typical pharmaceutical hrt?

Bioidentical hormones are products that are chemically identical to what's made in a woman's body.
Some are approved as medications; others are supplements. Learn more about it from professionals in the field.

Why not simply increase dietary cholesterol?

I have watched the video and it's sad that corporate pharmaceutical industries have to chemically alter a natural substance in order to get patent for synthetic medicine or synthetic hormones but I think synthetic hormone should not have been approved for human use in the first place. It must have helped many people but in the long run it did more harm than good.

Bioidentical hormones refer to hormones that are identical to the chemical structure of the hormones produced by a woman’s body therefore it is better and safer than synthetic hormones. Understanding your symptoms will also help you prepare for it and modification of lifestyle issues like healthy diet of organic foods to resist minor signs, light exercise to improve blood circulation level can help regulate the symptoms of hormone imbalance. Compounded bio-identical hormones are pills, creams, gels, suppositories, injectables, sublingual drops or lozenges that are prescribed by health care providers who tailor the dose to a woman’s individual symptoms and concerns.

Pregnenolone is the first biochemical step in the conversion of dietary cholesterol (yes-cholesterol!) to numerous other hormones. Pregnenolone is the source of the hormones that lie at the center of the bioidentical hormone controversy: estrogens, progesterone, and testosterone. We therefore already have our own over-the-counter, non-prescription form of bioidentical hormones.

I find it curious why people don't want to know or talk about their numbers ... blood sugar, blood pressure, blood fats.  My brain tells me it's a form of denial, but choosing not to see it won't make it go away.  I know it's not easy quitting smoking or starting an exercise program, but at least you're alive.
That's all, don't mean to sound bleak  

I'd love to see more studies looking at glycated hemoglobin and heart disease risk. Many of the changes Dr. Davis recommends, limiting fructose  & glucose, wheat elimination,  and even correction of vitamin D levels can reduce a person's glycated hemoglobin levels.

Nephropal has a recent blog on fructose
Fructose Intake and Kidney Stones
I was interested to see the impact of fructose on magnesium status.
I wasn't aware also that
High fructose consumption combined with low dietary magnesium intake may increase the incidence of the metabolic syndrome by inducing inflammation

Stanhope et al is a very interesting study. I'd love to see it repeated with a larger group of subjects as well as with different percentages of fructose consumption and in diets with different macronutrient composition. I'm assuming fructose sweetened drinks were used rather than actual fruit as they are directly comparable with glucose sweetened drinks?

So I guess I've got to give up all fruit now. What is the acceptable level of fructose per day?

"a diet rich in fructose"

OK avoiding ALL wheat seems to be a good idea.  But avoid all/virtually all fructose?  Do you really think that for a healthy active person i.e. someone exercising, that say 1 cup of berries and an apple or 2 per day is too much fructose?

Okay, you make a clear case against fructose and sucrose... and I thank you for making it clear to us, but...

Fructose is in almost everything, including some of the most antioxidant rich, nutrient dense fruits and vegetables.  I'm sure your not advocating we all stop eating fresh pomegranates, apples, berries, tomatoes, peppers, lettuce, cabbage, etc.

We await your guidance on what would be a safe upper daily limit for fructose consumption that would help us avoid its coronary risk factors while we may continue to enjoy the numerous benefits that reside in the same foods.

So it's clear that what is proposed eg in the popular in Europe Montignac diet - use fructose in place of sugar due to its low GI - may be a harmful bs. But if I keep my carbs under 100g, do you think it makes much difference if it's fruit, honey, veggies or just a handful of pure fructose powder?

After watching the u-tube video "Sugar the Bitter Truth" by Dr. Lustig, I concluded that fructose is more a direct cause of heart disease rather than just another risk factor like cholesterol. Fructose actually causes the arteries to become inflamed and inflammation is the beginning of heart disease, right?
Josephine
Hawaii

Can you comment on the role of fresh fruits like apples,oranges,berries,etc?Do they also raise the risk factors?

Sugar Is a Poison, Says UCSF Obesity Expert
This article highlights the main points of Lustig's 80 minute video
Sugar: The Bitter Truth

This is what Lustig has to say on fruit.
Fruit is fine but we should think twice before drinking juice or feeding it to our kids. The fiber in whole fruit contributes to a sense of fullness. It is rare to see a child eat more than one orange, but it is common for kids to consume much more sugar and calories as orange juice.

Eating fiber also results in less carbohydrate being absorbed in the gut, Lustig notes. In addition, he says, fiber consumption allows the brain to receive a satiety signal sooner than it would otherwise, so we stop eating sooner.

The video goes into the biochemistry of fructose metabolism in some detail. I urge you to stick with it although it is quite complex. It gets a bit clearer when you reach the summary slides at the end.

As an answer to your many inquiries in todays comments. You can never go wrong following the lead of our ancient ancestors.  Yes they ate some fruit, mostly berries that were seasonaly availlable only,  very small and not very sweeet by todays standards.  I eat a cup or less of only berries, combined with 2 tablespoons of high antioxident cacao nibs and a tablespoon of ground flax seeds for breakfasy wvwry morning.  This keeps my blood sugar below <100 mg/dl and my A1c levels below 5.  This is a work in progress, because, I am on a constant experimental path of reversing my metabolic syndrom diseases.  As an asside, there is a Dr. Bernstein who wrote several books relative to diabetes, who said that he hasn't had a piece of fruit in 30 years, all without ersity what so ever.  

The few doctors who's advice I follow without question are You Dr. Davis along with Dr. Kenneth Tourgeman M.D. "nephropal.blogspot.com"

For health reasons, I strictly try to mimic the eating patterns of our early ancestors where possible.  Yes they ate fruit, limited by seasonal requirements.  However, the fruit they ate was very small and not very sweet, not like today's farm engineered varieties. Therefore, I limit what fruit I eat to one cup or less daily.  I combine this with 2 tablespoons of the antioxidant rich super food cacao nibs (dark chocolate), and 1 tablespoon of ground flax seeds.  When in doubt I ask myself the question, "what would my caveman ancestors have eaten?"  I live by this health supporting guide.  I find the food delicious and very satisfying.  

Of course, I would not do any of this without the sage advice of a few brave doctors who care only about reversing or curing disease and do not give a whit about following some outdated and wrong dogma. More valiant doctors must step up.  

I have become healthy because of you Dr. Davis, through your fine blog, and the direct care and supervision of Dr. Kenneth Tourgeman  "nephropal.blogspot.com"

The best types of fruit and berries are those with the highest nutrition to fructose ratio, like blueberries and strawberries. If eating an apple, consider just eating the skin and a little farther in; no need to eat all the way to the core.

Billye and StephenB--

Excellent insights into how to keep fruit in the diet without suffering its adverse effects.

Anon--

Yes, Dr. Lustig does an absolutely bang-up job of describing the rationale behind the destructive effects of fructose. It is the best presentation on this topic--and from the principal investigator, no less.

It is a must-see. I watched it last night.

Slides used in a previous presentation by Dr Lustig.
these are mostly the same as those used in his recent You Tube video but may be helpful for people with poor internet connections who are not able to watch the video.

Dr. Lustig's lecture is incredible-- I just finished watching it.

I think he overstates the case for fiber, and is too accepting of glucose in the diet, however. I agree that glucose is much better than fructose, and isn't a huge problem for a healthy person, but given that most Americans are metabolically "crippled" and teetering on the edge of diabetes, heart disease, etc., it would seem wise to me not to go pushing glucose as a great thing.

My quibbles with Dr. Lustig are minor, however. Overall it's a fantastic presentation.

How would you explain the evolution of primate frugivores in relation to human health, and why a diet probably greater than 50% fructose is obviously benign for them?

(Yes, I know current fruit varieties have more fructose.)

My daughter (who is Canadian) is currently in the US doing some research at the National Archives. She mentioned to me that she finds the fruit juice she's had too sweet to drink (she's staying at a hotel, so fresh fruit is hard to come by and the breakfast is all wheat). This was not only some anonymous apple juice, but also a bottle of Tropicana (she didn't check the label to see if there was added fructose), so she has switched to water. She also commented on how ridiculously large the portions were in restaurants.

It's no wonder that Americans are getting larger and larger (Canadians are too, but not as quickly.)

Also note that many foods labeled "heart healthy" because of low-fat, low saturated fat, addition of sterol esters, or fiber, also contain fructose sources, especially high-fructose corn syrup.

Hilarious Billye!

"For health reasons, I strictly try to mimic the eating patterns of our early ancestors where possible. Yes they ate fruit, limited by seasonal requirements. However, the fruit they ate was very small and not very sweet, not like today's farm engineered varieties. Therefore, I limit what fruit I eat to one cup or less daily. I combine this with 2 tablespoons of the antioxidant rich super food cacao nibs (dark chocolate), and 1 tablespoon of ground flax seeds. "

And did our ancient ancestor blend powdered cacao nibs and flax with their berries? SO much for strictly following cavemen.

This is fact. Hepatic metabolism of fructose also differs greatly from that of glucose. Fructose-induced hyperlipidemia has also been hypothesized to be of intestinal origin. That can be risky.