Thank you for engaging in a discussion of the issues.
Originally Posted by
fls
I think the following points need to be made.
Natural and synthetic hormones act by binding to estrogen receptors. Estrone and estradiol are the hormones that are produced in humans. Exogenous hormones have an estrogenic effect by either being metabolized to Estrone or Estradiol, by sharing an identical core structure (the steroid ring plus a phenolic hydroxy group and a hydroxy group (estradiol) or a ketone group (estrone)), or by imitating the structure of the estrogens. Premarin is a conjugated estrogen which survives the process of digestion to be absorbed and converted to estrone. Phytoestrogens share the core structure or imitate the structure.
It is disingenuous (or sometimes even wrong) to claim that plant estrogens are identical to those found in humans or that they are more similar than other pharmaceuticals - Premarin in particular. Also, if one divides hormones (or any chemical) into "those derived from plants", "those derived from animals" and "those synthesized in a lab", one cannot assume any of the relevant characteristics (active, harmful, safe, etc.) can be applied to one group over the other, or to all the members of the group (even if one accepts the use of fuzzy qualifiers like "most" or "many").
I'm not qualified to argue this point.
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There is no clinical data of any type supporting T. S. Wiley's idea.
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This information is critical to obtain since we know that the placebo effect will have a tremendous influence of the types of symptoms and conditions that she claims to help. The observations of doctors using the medication in an uncontrolled manner fails to be a form of evidence.
I'm not sure which idea you're referring to. In point of fact, she has said many times that she isn't sure "synthetic" hormomes are the problem, that it is the administration that matters - timing, dose, rhythm, etc.
Also, finally, there is a university that is conducting a true clinical trial of the Wiley Protocol. This trial has no connection to Wiley at all. The details will be announced January 3.
There is, however, some "clinical" evidence. Dr. Taguchi did a chart review at ACAM a few weeks ago of her 58 cancer patients who have been on the Wiley Protocol for up to three years. I won't characterize the results, because the flamers here will not believe it. Check with ACAM. I think there will be a release by Dr. Taguchi to the media. Not sure, she is part of a large medical practice, not in private practice, and she is an onocologist. Giving hormones to people diagnosed with cancer is unprecedented. [/quote]
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the assumption in the absence of data has to be that the Wiley Protocol is harmful until proven otherwise. There is no reason to assume that varying the doses of the hormones will avoid harm. It is a reasonable idea to test in a systematic manner, but no assumptions can be made about what the results will be beforehand.
Actually, there is no template in nature for ANY OF THE EXISTING HORMONE THERAPIES. Including, especially, birth control pills. Dru8g companies sell pills and patches, compounders prepare all sorts of crazy concoctions and not one of them matches one of the five templates found in humans. The core of the Wiley protocol is the peaks and valleys of the therapy over the course of a month. I can't quite understand why you would single out one. Wiley is the first and only therapy that attempts to mimic a template that exists in nature. Static doses are unnatural.
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The physicians that use the Wiley Protocol are not practising evidence-based medicine. Since the current standard of care is to use evidence-based medicine, they will be unable to defend themselves if legal or professional charges are brought against them. They have been fortunate so far, perhaps helped by the tendency of people that buy into the "natural" fallacy to be uncritical.
I think that is a fair statement, but you overlook the favorable experience people, AND SOME OF THE DOCTORS ON THE PROTOCOL, are having. At least some of the disgruntled women on Rhythmic Living were not following the protocol and pursued alternatives that Wiley warned against. On the other hand, there are hundreds of women jsut here in Santa Barbara who have been on the protocol for some time and have no intention of changing.
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The credibility of T. S. Wiley is a major issue in this debate as she is making claims that are unsupported by evidence. The credibility of Bent Formby is not relevant except in his role as a witness to her expertise (or lack thereof).
Agreed.
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Physicians are not compensated for prescribing HRT.
Oh yes they are. Many receive kickbacks one way or the other from the compounding pharmacies they (illegally) direct their patients to. Others, like Erika Schwartz, charge $850 for a 15 minute telephone interview and then prescribe without ever seeing the patient, directing them to a pharmacy THEY OWN which dispenses at inflated prices. Most "wellness" doctors sell supplements directly from their offices. Part of the reason so many of the "natural" BHRT docs are up in arms with Wiley is that she threatens their livelihood. She is down on the supplements and strongly suggests (she can't set) that the registered pharmacies not charge more than $37.50 per hormone per month.
Also, there is a notion in BHRT that each patient needs a "customized" hormone preparation. The doctors charge an arm and a leg to do this, which usually results in a Rx from a short list of templates that they've worked out with their pharmacist.
Thanks for your thoughts Linda.