President's Desk

October 2003 - Is Conventional Medicine Evidence-Based? Part III

By Robert Watson, President

• Conventional Medicine teaches there is no human or animal evidence that progesterone builds bone. The evidence is that progesterone promotes new bone formation and that estrogen merely delays bone loss.
  
• Conventional Medicine believes that Fosamax is a good treatment for osteoporosis. The evidence is that Fosamax is less effective than Premarin plus progestin and has considerably more undesirable side effects.
  
• Conventional Medicine claims that raloxifene (Evista) is good treatment for osteoporosis. A major 3-year study in 1999 found, however, that raloxifene may reduce the incidence of minor vertebral compression fractures but the occurrence of osteoporotic nonvertebral fractures (including hip fractures) in raloxifene-treated women was no different than that of placebo.
  
• Conventional Medicine believes fluoride is good for preventing and/or treating osteoporosis. A major NIH consensus panel (11 pages) makes no mention of fluoride, but does include the important role of sex hormones.
  
• Conventional Medicine believes that the presence of progesterone receptors (PR +) in breast cancer cells is a contraindication for progesterone supplementation. The evidence is that PRs are produced by estrogen and that the effect of progesterone is to prevent breast cells from becoming cancer cells. The more PRs found, the greater is the estrogen dominance, and the greater is the need for more progesterone.
  
• Conventional Medicine believes that testosterone causes prostate cancer. The evidence is that estradiol causes prostate cancer, an opinion shared by the NCI. My hypothesis is that progesterone decreases in aging men, leading to a fall in testosterone levels. Also, testosterone is converted into dihydrotestosterone (DHT) by the action of 5a-reductase, an enzyme normally inhibited by progesterone. As testosterone levels fall, estradiol’s effect increases. Estradiol promotes the oncogene, Bcl-2, whereas progesterone promotes the protective gene, p53. The evidence is that prostate hypertrophy and prostate cancer are correlated with estradiol dominance, i.e., the ratio of estradiol/testosterone is increased in men with these problems.
  
• Conventional Medicine believes that total androgen blockade is the treatment of choice for advanced prostate cancer. The evidence from an overview of 27 trials involving 8000 prostate cancer patients is that addition of total androgen blockade improves 5-year survival by only 2% and 10-year survival by only 0.7%. Further, total androgen blockade greatly increases the incidence and severity of side effects such as depression, dementia, and diarrhea.
  
• Conventional Medicine believes that serum cholesterol levels are the result of dietary fat. The evidence is that the glycemic index of the diet (sugars and refined starches) is a stronger predictor than dietary fat of serum HDL-cholesterol concentration.
  
• Conventional Medicine believes that dietary egg consumption contributes to elevated serum cholesterol concentrations and to the risk of cardiovascular disease in men and women. The Health Professionals Follow-up Study (1986-1994) and the Nurses’ Health Study (1980-1994) found no correlation between egg consumption (from 1 egg/week to >1 egg/day) and the risk of CHD or stroke in either (non-diabetic) men or women.
  
• For years Conventional Medicine believed that estrogen would be good treatment for women with Alzheimer’s disease. Now, a randomized, double-blind, placebo-controlled trial finds that it is no better than placebo.
  
• Conventional Medicine assures women that tubal ligation does not alter their hormone status. A 1979 study found that midluteal mean serum progesterone level in normal women in whom unstimulated conception occurred is 18.6 ng/ml and all above 10 ng/ml. In normal women after bilateral tubal ligation, the midluteal mean serum progesterone is only 9.4 ng/ml (50% less).
  
• Conventional Medicine teaches that progesterone plays no role in PMS. The facts are that PMS patients have significantly diminished concentrations of a progesterone metabolite, allopregnano-lone (an anxiolytic), and a blunted response to GnRH prompt, compared to normal women. It is the ratio of these factors relative to estradiol that is important, rather than simply their individual absolute values.