SURVIVING HEALTHCARE

Randy’s words from a website about Armour porcine thyroid: I, too, was doing great on Armour. No more. They put me on levothyroxine [synthetic T4] and Cytomel [synthetic T3]. I felt awful, so depressed...Drugmakers fake and suppress their studies. Knoll Pharmaceuticals, the Synthroid maker, hid one showing that their drug was no better than the other thyroids. Knoll paid more than $100 million to consumers after the ensuing class-action lawsuit settled in 2000. Later, the pharmaceutical companies sponsored over ten bogus studies that purported to show porcine thyroid was no improvement over T4. Each trial used only 1/2 grain of the pork thyroid (30 mg), even though the proper dose is one to two grains (60-120 mg) or more (about the same as .075 to .15 mg of T4). Each study concluded that the tiny dose of pig thyroid did not work. With these doses, of course, it could never work. This type of false comparison is a routine strategy used by drugmakers to get FDA approval or to run down a competitor. For more, see Ben Goldacre’s Bad Pharma (2012) and my FDA chapter here.There have been claims that the porcine thyroid manufacturing is faulty, and that this makes it inferior to Synthroid, the branded T4. However, Synthroid was recalled ten times between 1991 and 1997. This involved over 100 million tablets. The FDA requires T4 to fall within 5% of its stated potency, but most samples analyzed had far less active ingredient and some had none. Because many patients need thyroid to survive, there were hospitalizations. In 2001, the Food and Drug Administration (FDA) issued a warning that they might pull Synthroid from the market. There were also two recalls in 2012-13 involving issues with potency, stability, and manufacturing. See Mary Shomon’s website for references, including the FDA letter documenting the story. This link is offline and may have been suppressed by special interests. I had to search for it on the Wayback Machine internet archive (archive.org). Physicians have used porcine thyroid for over a century. It was first approved by the FDA in 1939. In Thailand, it is an over-the-counter supplement. I could find only three recalls for this desiccated pig thyroid, including one started by the manufacturer in 2020 for a 13 percent drop in potency. This might have gone unnoticed, but since thyroid strength is critical, they were doing the right thing.T4 has been available since 1927 without a formal FDA evaluation. It was given “grandfather” status in 1938 because it was assumed to be equivalent to porcine thyroid, which was considered the “gold standard.” The Synthroid brand finally passed a perfunctory FDA review in Support the show

Robert L. Morgan, NP, who practiced in the Houston area, contributed this chapter (edited by the first author). He attracted patients who failed elsewhere. Texas is the tenth most obese state, and we are pitifully overweight. I have been fighting this for over 30 years, and I have been losing. Against my efforts stand big Food, doctors, big Pharma, and meddling government. This cabal wittingly or unwittingly caused the international obesity crisis. They subsidize sugary corn products, oppose fat consumption, and have cold-shouldered effective treatments including diet pills and thyroid hormone. I have had minor victories patient-by-patient, and these have cost me years of struggle.No one is sure about the cause of the obesity pandemic. But the national directive to decrease dietary fat came out at about the time we got really overweight. This is not a coincidence—it is a cause. Other theories went as far afield as blaming bacteria in the intestine, but for me, walking into any grocery store or convenience mart makes it obvious that the core problem is corporate food production. Who can resist the tastes, the color, the packaging, and the marketing? Everything is sweet, fat, and salty.  To put the obesity disaster into context, compare us with people in Korea and Japan. Americans who travel there are shocked—everyone looks fit! You can see their back and leg muscles through the clothes. Food habits must be more powerful than corporate influences. Even within the US, obesity rates vary from 23 percent in Colorado to 37 percent in Arkansas. These cultural differences must be a clue to causes. The corporations are making us fat as well. Many antidepressants, diabetic medications, and synthetic hormones cause weight gain. Paid-up doctors and direct advertising force-feed us these drugs and others. The Food and Drug Administration’s function is to oversee both industries, but big Food and big Pharma control it with funding. Since the FDA is incompetent as well as compromised, it does many wrong things, and all this makes us fatter. (See Born With a Junk Food Deficiency, 2012, for more.) The result is many of us have an addiction to food as powerful as others have to opioids. The morbidly obese die just like drug overdoses. I have no prayer of getting rid of marketing or food packaging. Individual patients’ cooperation limits my ability to get take them off harmful medications. So I do what I can with diet pills, which suppress appetite and aid weight loss. There is a catch. Patients gain the weight back unless their metabolism is normal or made normal using hormone supplementation. Thyroid deficiency is epidemic, and testosterone levels have been falling in our entire population. The decline of these two contributes to obesity. Replacing them for deficient people is the most effective way to keep weight off long-term, but most doctors ignore this.Hormone replacement can kick off a gradual weight loss that continues for a decade. It works without other prescriptions, but some patients benefit from using diet pills. These are not ideal solutions, but our lives are being threatened. My program works—many of my patients have sustained a healthy weight for years. The drug industry dictates the beliefs of traditionally trained doctors, and I have had an uphill battle against them. They vilify thyroid for weight loss and claim it is not the “standard of care.” They push expensive medications and oppose simple solutions. I have suffered complaints to the medical board and have been threatened with lawsSupport the show

To understand this book, you only need to remember a few bio-identical hormone names—estradiol, progesterone, testosterone, and thyroids, which include porcine, T4, and T3. If you read outside sources, you must learn others. Return to this reference chapter as needed. Hormones work by attaching to receptor molecules in the human body, and since the natural ones are identical or nearly identical to those made by our glands, they fit like the real thing. Manufactured medicines are foreign substances never found in the body’s ecosystem that are made from animals or chemicals. These do not match as closely as the bio-identicals, do not work as well, and have side effects. They are still useful in a few circumstances but should never be taken long-term. I call them “counterfeit” or “fake” to help you sort out the issues. For example, progesterone is bio-identical. In contrast, Provera is a synthetic progesterone imitation. It raises the chances of migraines, weight gain, heart disease, breast cancer, depression, and irregular bleeding. Pregnant women taking it get more miscarriages and their babies have more congenital disabilities. Drugmakers invent sexy copyrighted brand names for their profitable patented compounds. This allows patients to harass doctors by saying, “I saw an ad for…” Pharma also creates chemical names that are hard to pronounce and remember. The brand Celebrex, for example, is the chemical celecoxib—try saying that one. The advantage for the manufacturer is that when medications go off-patent and are sold as generics, the chemical is more difficult to recall than the recognizable brand. The drugmakers use the names to confuse. Progestin, progestogen, and Provera, the artificial ones, sound like natural progesterone. And Premarin, the horse-urine estrogen (this name was from PRegnant MAre’s uRINe), gets mixed up with Provera, the synthetic progesterone. These strategies work, so the doctors are just as bewildered as you are:✪ Many journal articles make no distinction between bio-identical progesterone and progestins/progestogens such as Provera. They call both of these progesterone, which implies there is little difference. ✪ Likewise, medical articles call many related substances estrogens, which is accurate but fools both doctors and patients into thinking that they are all alike. Technically, estrogens include bio-identical estradiol, the counterfeits such as Premarin, and the other relatively weak human estrogens, estrone and estriol. These last two are bio-identical but are almost inactive and cause some health issues. ✪ Hormone replacement therapy (HRT) sometimes refers to treatment with bio-identicals and sometimes to treatment with the counterfeits!Support the show

Testosterone is claimed to cause prostate cancer, heart disease, and stroke. This is all false.In 1990, Congress made testosterone and other anabolic steroids class III controlled substances. The penalties for selling and even possessing them became felonies like those for cocaine. At the Senate hearings, representatives for the FDA, DEA, the National Institute on Drug Abuse, and even the American Medical Association all testified that these medications were safe and had important medical uses. But grandstanding about sports use prevailed. Anabolic steroids became the first Schedule III drugs without euphoric or consciousness-altering properties. In 2016, the Food and Drug Administration tightened the regulatory pressure by slapping a “black box warning” on testosterone. It claimed that the hormone caused strokes and heart disease. From then on, they only sanctioned its use for patients with genetic, cancerous, traumatic, or chemotherapy-related damage to the testicles or brain. The FDA also alleged that it should only be used for men with blood levels below 300 ng/dl, confirmed on at least two occasions. In their eyes, other applications were illegitimate. Two clumsily concocted articles supported this stance. But Mark Richards, MD, and Abraham Morgentaler, MD, debunked these with letters to the journals demanding their retraction. Morgentaler is the Harvard physician representing the Androgen Study Group, and Richards is a practicing hormone specialist. Both physicians also wrote letters to the FDA. Dr. Rouzier wrote a review of this issue as well. All this was ignored. Richards’ well-referenced article tells the entire story. He writes that low, not high testosterone is the major risk for heart disease. And according to a comprehensive Mayo Clinic review, testosterone decreases the chance of dying of heart disease.What about prostate cancer? Dozens of studies show no relationship to testosterone, and men with higher levels have a reduced risk. The medical literature says testosterone supplementation is healthy. The Mayo Clinic’s International Expert Consensus Resolution statement ratifies this view. A review in the Journal of the Endocrine Society (2019) describes the hormone as an anti-inflammatory.Testosterone converts to estrogen in the body. This not only suppresses prostate cancer but has been used to treat it. In addition, prostate cancer is much more common Support the show

Thyroid “quarterbacks” the entire metabolism. It regulates and activates many body processes and is essential for energy and weight control. Borderline low or “hypothyroid” conditions are common, under-treated, and seven times more likely in women. Treatment is safe and should be general primary care rather than being stashed in a subspecialty. Judy is 40 years old: When I was 35, I started getting depressed and was chronically exhausted. I was losing my hair and felt cold all the time. I was constipated, grumpy, and had no interest in sex. I had to direct my kids from the couch because I didn’t have the energy to chase them around. All my doctors insisted my tests were normal, and that I was a hypochondriac. They finally gave me pork thyroid. After a month, my energy went from a two to a nine out of ten, and I got my husband back.Treatment benefits: Thyroid supplementation for appropriate patients protects against heart disease, diabetes, and memory loss. It improves hair, nails, and skin. Balancing the thyroid improves menopause symptoms, and studies have shown lower death rates for treated people. When thyroid is low, people get fat, tired, inactive, disinterested in sex, and are more likely to develop heart disease. Erectile dysfunction is more frequent. Other symptoms include dry skin, hair loss, insomnia, brittle nails, constipation, bone and joint pain, poor concentration, trouble getting started in the morning, and cold extremities with cold intolerance. Untreated hypothyroid patients often have medical problems including depression and coronary artery disease. Vertebral fractures are more likely, especially over 50 years old. Hypertension, premature births, rheumatoid arthritis, and metabolic syndrome have all been linked to low thyroid conditions. Two kinds of bio-identical thyroid hormones are used for replacement, and both are vital for health. T3 has three iodine molecules and T4 has four. Desiccated pork thyroid has both types along with a few inconsequential pig thyroids. According to hormone doctors, it is the most bio-identical thyroid medication available. Physicians have used this inexpensive drug since the late 19th century. Endocrinologists and other mainstream doctors mainly prescribe pure T4 made in the lab, which was until 2004 a patented drug. T4 converts to T3 in the body, and they believe that this creates adequate T3. But it does not work well for everyone, especially women over 40. Since T3 is far more active than T4, people who cannot convert properly have poor results when they take only T4.For these patients, endocrinologists prefer to add synthetic T3 to the synthetic T4 instead of using the pork type, which contains both in one pill. When carefully dosed, these manufactured medications work fine, but they may not be as well absorbed as the other one. They are useful for people with a pig allergy and for Jewish or Muslim people who are not supposed to eat pigs.T3 is stronger and shorter-acting than T4, so patients sense its effects sooner than T4. Since getting patients to return for follow-up is sometimes difficult, using a drug containing T3 may help them understand the process is worthwhile. Since the thyroid’s effects are long-lasting, the medication should be adjusted about once a month.  Endocrinologists train for three years in internal medicine after four years of medical school, then spend a felSupport the show

Estradiol has the most dramatic effects of any hormone. Its benefits include:✪ Helps the heart more than other hormones. ✪ Decreases the risks of cataracts, vaginal atrophy, and macular degeneration of the retina. ✪ Reduces the chances of stroke, diabetes, colon cancer, Alzheimer’s, memory problems, and osteoporosis.  ✪ Cures hot flashes and improves sexuality. From the Los Angeles Times, 1999: I could live without my husband, children, or cats. But I could never live without my beloved estrogen. Who should use estrogen and how much? Menopausal women and sometimes men transitioning to women are prescribed estrogen. Men with prostate cancer are also occasionally treated with it. Women in menopause should start at 1.5 milligrams in the morning, then increase to 2 to 2.5 milligrams. This brings blood levels up to about 70 pg/ml, which protects the heart and other organs. We believe this is safe because young, healthy women have estrogen levels in the hundreds during parts of their cycle. Premarin, the horse estrogen, was the first treatment for menopause. It has many beneficial effects, but it causes a slight increase in blood clotting. This makes it obsolete for long-term use. Estradiol, the primary bio-identical type, is safer. Every study on it—KEEPS, EPAT, WEST, CORA, DANISH, and ELITE (those academics love acronyms)—found no increase in blood clotting. Although the estradiol transdermal patch may provide the best relief of hot flashes and does not cause blood clots, it does not protect against heart disease. In contrast, both types of oral estrogen protect the heart. This was proven in many studies, including the CORA, ELITE, WEST, and DANISH. Since many medical authorities think that oral estradiol and oral Premarin are the same things with the same risks, they often recommend using the patch if there are concerns about blood clotting. Doctors should instead prescribe brand name, generic, or compounded oral estradiol. These are safe and protect against heart disease and stroke. Doctors are usually hesitant to prescribe oral estrogens for sick patients or those with heart risk factors such as smoking, obesity, or a family history. They use the patch for them if they recommend hormones at all. However, as I describe in the Be Careful Whom You Trust chapter, these are precisely the patients who need cardiac protection the most. In nearly every situation, their risk to reward ratio favors the oral type. We should accept the minor hazard of blood clotting to protect their hearts. Dr. Rouzier describes these issues in a well-referenced article.Surgeons and anesthesiologists have many responsibilities, and they rarely read the confusing estrogen studies closely. Since blood clots after surgery are such a hazard, most of them tell their patients to stop all replacement before surgery. Some gynecologists are adamant about this. Estradiol is available as generic, compounded, or patented varieties. Hormone doctors mostly recommend a compounding pharmacy's product because generics are less predictable and the patent type is too expensive if not paid for by insurance. Brand names from foreign sources made by major manufacturers are often affordable and of excellent quality. Estradiol patches such as Vivelle Dot (twice a week) or Climara (once a week) may relieve menopause symptoms better than the oral forms. The higher dose of .1 mg a day works best. To help the transdermal patch stick, patients scrub the area with alcohol before they apply it. The device sometimes causes skin irritaSupport the show

PREFACEIf you do not know by now that corporations have disfigured healthcare, you have been living under a rock. For example, hormone therapy is claimed to be hazardous, but a century’s science and experience prove its value. When these natural substances are low or absent, replacing them may be the safest and most effective treatment we have. In contrast, drugs are foreign substances that cause side effects and worse. Hormone supplementation potentially treats or improves:Longevity: Low levels of thyroid, growth hormone, estrogen, testosterone, and DHEA (dehydroepiandrosterone) are linked to premature death.  Cancer: Estrogen, DHEA, testosterone, progesterone, melatonin, and human growth hormone (HGH) all have protective effects against cancer. General health: In women under age 60, long-term estrogen replacement therapy decreases strokes, blood clots, colon cancer, diabetes, and macular degeneration. It reduces the likelihood of tooth loss, depression, osteoporosis, and death because of bone fracture. Breast cancer is unaffected, contrary to common opinion. Avoidance of estrogen was estimated to cause 50,000 excess deaths over ten years in a Yale study. Alzheimer’s disease (AD): When long-term care costs are included, this is the most expensive ailment of all. Estrogen decreases the chances of getting AD significantly when it is started within 10 years of menopause. Heart disease: Over 40 observational studies have shown that giving estrogen to women reduces coronary artery disease, heart attacks, and deaths. When men have higher levels, they have less heart disease. Giving natural estrogen to deficient men improves cholesterol but does not increase blood clotting. Depression: Estrogen, DHEA, progesterone, testosterone, and melatonin all have antidepressant effects. Thyroid has been studied and used for depression for over fifty years. Obesity: Thyroid, estrogen, testosterone, DHEA, and human growth hormone reduce unhealthy belly fat and promote weight loss.“Bio-identical” hormones are the same as those found in humans. These are safe, affordable, and have few side effects. But since these natural body substances cannot be easily patented, they are barely profitable for big Pharma. So the drugmakers concoct proprietary imitations from chemicals or animals. Their prices are extortionate. Stories have been spread that hormones such as estrogen and testosterone cause cancer, heart disease, blood clots, and other diseases. With few exceptions, these are false. And for insulin, growth hormone, and others, we have allowed the drugmakers to exorbitantly increase their fees using proprietary manufacturing. The result is that hormones are overpriced and difficult to prescribe. Doctors are pressured to use toxic, expensive patent drugs instead. These trends are squandering our resources and costing us years of healthy life. Support the show

I am now retired, but I spent the last thirty years in private practice performing cosmetic surgery and sometimes assisting with my patients’ medical care. Most of the women I worked with who were over 50 years old suffered from poor sleep, fatigue, hot flashes, muscle wasting, and irritability. They were all looking for a way to feel better and a lot were taking antidepressants. Many thought that I could improve their spirits with surgery, and sometimes they were right. But since they had hormone deficiency symptoms, surgery alone was not the best solution. Most plastic surgeons operate on a string of depressed people without considering why they are so miserable. My patients were trusting me, and I wanted to help, so I took training. For nearly two decades, I offered appropriate candidates hormone treatment along with their procedures. Those who listened to my advice were usually grateful. Some were not interested, and I respected that as well.I knew women had doubts about hormone replacement. I also knew that patients never take at least a third of their prescriptions, even vital ones like kidney transplant anti-rejection drugs. Since hormone benefits can take weeks to be felt, I used long-lasting, inexpensive testosterone pellets implanted under the skin. If my patients didn’t like this idea, I offered it as a cream. Testosterone transforms into estrogen, so they received this as well.  When I saw them a month later, most were thrilled. I then suggested they consider adding progesterone, estrogen, vitamin D, and sometimes thyroid, DHEA, and melatonin. If their finances were tight, I showed them how to inject themselves once a week with testosterone. (Each shot costs only $2 for women and $10 for men.) I followed blood tests, symptoms, and physical exams, and customized therapy based on patient responses.I saw a few women who felt terrible in their mid-30s. Blood tests showed they were in premature menopause and had estrogen and progesterone levels close to zero. After they began treatment, they felt great again. Many of my patients brought in their friends and husbands, and they responded as well. Hormone replacement should be a “feel-good” story. We have overwhelming proof that it is safe and effective. Most hormones are affordable, and tens of millions of people have used them. Thyroid has been available since the late 1800s, and insulin, estrogen, and testosterone for nearly that long. These treat or prevent heart disease, depression, impotence, diabetes, some cancers, and Alzheimer’s disease (AD).  But misinformation is everywhere: ✪ Doctors and patients “know” that estrogen causes breast cancer and blood clots, testosterone causes heart disease and prostate cancer, and that human growth hormone (HGH) is practically poison. These ideas are false. ✪ We have been led to believe that insulin’s high price is justifiable. Wrong. ✪ Mainstream medicine says that thyroid disease is relatively uncommon and hazardous to treat. This is also incorrect—it may afflict a third of mature women and is under-treated because of doctors’ economic turf wars rather than unusual risks. Hormone therapy is a strange opera with many twists and bizarre characters. To navigate it, patients need physician-level knowledge—a tragic situation. I studied this subject for a decade, but you can learn the basics in a few hours with no prior background. Journalists think every issue has two sides. Law and news stories, for example, are rarely black or white. But medical care is right or wrong, and I challenge you to find the truth here. I present: ✪ What the science says. ✪ Opinions of independent experts. ✪ The collective physician experiencSupport the show

Medicine has become a pseudo-religion; our patients must be gently encouraged into apostasy and renunciation...   [We have all] been enslaved by the medical–industrial complex, and it is time we rebelled. Society needs to reach a new accommodation with old age and death.Seamus O’Mahony, Can Medicine Be Cured (2019)Here is the silver lining: when you better understand your fragile life and the limitations of medicine, you will avoid getting sucked into a lot of useless nonsense. By 60, most people have some coronary artery disease; by 70, most have cancers growing somewhere. Nortin Hadler states the cold facts: “Any claim to a science that offers a path to longevity beyond eighty-five years is fatuous… over 85, you are off-warranty.” My pathologist friend Chris Gonzales adds, “something will get you, eventually.” He cuts up dead people for a living, so he knows.Worrying about your lifespan or expecting medicine to save you will not bring you peace. Instead, focus on your mission and the tasks. Be philosophical about your health as it declines. At the end of life, some people can become more grateful rather than more afraid because they have learned to treasure each moment. Max Ehrmann wrote, “Gracefully surrender the things of youth. Nurture strength of spirit to shield you in sudden misfortune.”My friend Dana understood this. He taught me what he could over his final year, and I loved him dearly. He had coronary artery disease with congestive heart failure, and for months, we knew he might die. He had always been optimistic, but during this period, he ignored all negativity and told me he felt better and better. He knew he had no time for regrets, complaints, whining, or worry. I realized later that we are in the same position as Dana every day of our lives.Support the show

The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. Arnold Relman, MD, former editor NEJM (2002)I wrote about a thousand Prozac-type SSRI prescriptions over my career, which might have been a half-million dollars in drug sales. I screened my patients, as I was trained, by merely asking them a few questions. Peter Kramer's bestselling Listening to Prozac (1997) duped me. He said Prozac could save patients from common symptoms of guilt, fatigue, sadness, sleep disturbance, and even aches or digestive problems. He also claimed it could be a lifestyle drug similar to today's Viagra, boosting ordinary peoples’ performance. I learned later that the SSRIs are toxic, have limited utility, and the hype has produced vast overuse.Industry marketed SSRIs as an improvement on the older tricyclic antidepressants. These cause sedation, and only a month’s supply is needed for suicide. Part of the promotion of the Prozac-class drugs was that sleepiness is mild and even enormous doses rarely cause fatality. Before the drug era, doctors thought depression was rare and most often self-limited to about three months. Now (2020), Wikipedia claims that 17 percent of the US population becomes depressed during their lifetime, making them all candidates for expensive, indefinite medication usage. Legions of paid Wiki contributors, many of whom work for pharmaceutical companies, make this source only a little better than a drug industry link-farm. Support the show