May 1998

CyberHealth Index

CONTENTS:

1. Dr. Zava on the action of genistein and estriol in the presence of estradiol
2. The puzzle of Dong Quai and breast cysts
3. A reader’s report on Progesterone cream, soy, seaweed
4. When experts disagree on hormones, diet: the case of Ray Peat
5. Effective facial exercise: Dr. Vangor’s dark secret
6. Can a man be a woman’s supportive angel?

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Genistein, Estriol and Estradiol: an impossible balancing act?

Ivy’s introductory comments:

Genistein and estriol are of great interest to women as weak estrogens that have the promise of helping to prevent breast cancer. Recently, however, strong evidence has emerged for BIPHASIC, or DOSE-DEPENDENT action of most steroids. In to genistein in particular, it’s been shown that in certain concentrations it can stimulate the proliferation of both healthy breast tissue, of breast tumors.

Yet in the body genistein never acts in a hormonal vacuum, but always in with whatever native estrogens are present — and even in the “post-post” menopausal women, the breast tissue can be surprisingly rich in , since the fatty tissue in the breasts is loaded with aromatase, and the local production of estrone actually increases with age. Some portion of can then converted to estradiol, and soon we have the whole metabolic cascade. Yet endless articles in alternative health magazines urge women to keep genistein-rich foods as if we already knew all there is to know about genistein and its interactions with human estrogens, and, furthermore, as if the were always anti-proliferative, regardless of dosage.

I’ve decided to ask Dr. David Zava, Ph.D., a noted biochemist and breast research scientist, to discuss some of the complexities of this issue.

Ivy: Pondering some research I’ve found on the interaction of lignan-derived with estradiol, I’m wondering if the action of genistein has been studied in the presence of estradiol, rather than by itself. Do you know about COMBINED effect of genistein + estradiol on breast tissue proliferation, tumor proliferation, or cardiovascular effects?

It seems to me that the combined effects with different concentrations of would be of more relevance than the activity of a phytoestrogen by .

DR. DAVID ZAVA WRITES:

Tough question. In my genistein publication in Nutrition and Cancer 27:31-40, 1997) I did look at the interplay of estradiol and genistein.

Adlercreutz had published that genistein blocks the actions of estradiol. To this in more detail I incubated estrogen-sensitive breast cancer cells with a physiological amount of estradiol with increasing amounts of genistein, the estradiol concentration constant. What I found is that GENISTEIN SLIGHTLY INHIBITED THE GROWTH-PROMOTING ACTIONS OF ESTRADIOL AT A WHERE BOTH LIGANDS WERE PROBABLY JUST ABOUT EQUALLY SATURATING ESTROGEN RECEPTOR SITES (Ivy: emphasis mine). In other words, half of the receptors were filled with estradiol and half with genistein.

THE GROWTH INHIBITION WAS ONLY VERY MINOR, AND WHEN GENISTEIN CONCENTRATION INCREASED FURTHER THE GROWTH RESUMED.

New work from Notides group published last year suggests that estrogen is a dimer, made up of two very similar subunits. WHEN EACH OF THE TWO ESTROGEN RECEPTOR SUBUNITS BIND ESTRADIOL, GROWTH STIMULATION IS MAXIMAL. However, if other estrogens are present, such as estriol or probably also like genistein, then the subunits dissociate, preventing growth .

With regard to genistein and growth promotion, my work and that of others shows that at physiologically achievable concentrations of genistein it is a pro-estrogen, and not an anti-estrogen like tamoxifen. Several abstracts at the Belgium meeting in 1995 both indicate that in humans consuming genistein-rich soy products the phytoestrogens stimulate breast cell .

What I am referring to is not the alpha and beta subunits of estrogen . Estrogen receptors must form a complex consisting of two of the same receptors before this complex can bind to DNA sites and initiate the readout of that tell the cell to divide or make structural proteins, etc. If half of the estrogen receptor molecules are bound to estradiol and the other half are to estriol, or some other estrogen (phytoestrogen), then the receptors are much less able to form a dimer (complex of two estrogen receptor molecules) and prevents DNA activation.

Estriol needs to be present at about 10 times higher concentration than to have half of the estrogen receptors occupied by estriol and half by estradiol. The reason for this is because the binding affinity of estradiol to receptor is about 10 times greater than the binding affinity of estriol to estrogen receptor. When the estrogen receptor sites are equally occupied by different estrogens, such as estriol and estradiol, then the estrogen receptor dimer can not form, and DNA is not activated (meaning cells will be likely to be stimulated to replicate).

However, estriol by itself at a high concentration forms a dimer that acts like estradiol by itself and activates DNA and cell replication. I suspect phytoestrogens are no different — high levels would act like estradiol and cell proliferation. This is essentially what I found working with cancer cells in test tube studies.

The key to preventing excessive growth promotion is to get two estrogen forms in approximately equal concentrations as regards binding to estrogen receptors. FOR ESTRIOL, THIS WOULD MEAN 10 ESTRIOL TO EVERY ONE PART ESTRADIOL. FOR PHYTOESTROGENS THIS WOULD MEAN 1000 PARTS PHYTOESTROGENS TO 1 PART ESTRADIOL.

The problem with a 1:1:8 triestrogen formula is that what you take either in oral or transdermal form is not necessarily what ends up in your circulation or bioavailable to the estrogen target cells of your body.

Most people don’t realize that a triestrogen cream containing 1 part , 1 part estrone, and 8 parts estriol will be very different once it is applied to the skin. Estrone penetrates the skin ten times faster than estradiol, penetrates the skin ten times faster than estriol. Once these hormones enter the bloodstream they have different binding affinities to blood proteins SHBG (sex-hormone binding globulin) and albumin.

Estradiol binds much tighter to these blood components than estrone or estriol, so it is less bioavailable to target tissues. Estriol is less readily metabolized than the other two estrogens, so this will also ultimately affect how much and what type of the three estrogens are bioavailable at any one time.

To make things even more complicated, these parameters are going to vary among individuals.

Ultimately, it would be ideal if the bioavailable estradiol to estriol ratio was 1 to 10. I don’t think it is possible to determine this from serum measurements of these hormones.

References:

Melamed M. et al. Molecular and kinetic basis for the mixed agonist/antagonist activity of estriol. Mol Endo 11: 1868-1878, 1997.

Zava DT and Duwe G. Estrogenic and antiproliferative properties of genistein and other flavonoids in human breast cancer cells in vitro. Nutrition and Cancer 27: 31-40, 1997.

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Ivy: When concentrations rise to somewhere near 50%, but not quite, could we say that there is LESS PROLIFERATION than there would be with only a single species of estrogen? Not a complete inhibition of proliferation, but just less than expected for a given type of estrogen?

Dr. Zava: True.

With regard to the cardiovascular system and genistein, new work using monkeys indicates that the combination of estradiol and genistein is cardioprotective and prevents fatty buildup in the aorta. THE COMBINATION OF ESTRADIOL AND GENISTEIN WAS BETTER THAN EITHER ESTROGEN ALONE. So the conclusions were to take your estrogen replacement therapy and soy.

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Ivy comments:

What particularly disturbs me is a study on the effects of low-dose genistein that found epithelial hyperplasia (overgrowth of glandular breast tissue) in some women consuming soy protein isolate (Petrakis NL, Cancer Epidemiol Biomarkers Prev 1996; 10: 785-94). Those women consumed only 38mg of genistein per day. The authors started out with the hypothesis that genistein was an anti-estrogen that would inhibit the effects of estradiol. Not in the dose they used!

Nevertheless, I don’t want women to panic and conclude that genistein actually promotes cancer. Genistein is definitely not a carcinogen (neither is estradiol). Remember, proliferation and cancer are not synonymous. Premenopausal women experience constant cyclic proliferation of breast tissue, yet premenopausal breast cancer is quite rare. Eighty percent of breast cancer cases are diagnosed after the age of 50.

How come premenopausal women are so protected? The answer appears to be the action of “high-dose” progesterone, naturally produced during the luteal peak. High concentrations of progesterone suppress proliferation, and in fact cause excess tissue to die off and be reabsorbed.

Can we mimic this action? Yes. For instance, we know that the application of a potent progesterone cream directly to the breast produces very high concentrations of progesterone in the breast tissue.

If your breast progesterone levels are high enough, the dose of genistein or estriol probably doesn’t matter all that much.

The obvious conclusion is that rather than rely on guesswork about what dose of genistein or estriol to take, if you want to protect your breasts, don’t skimp on progesterone.

But note: this doesn’t mean that you shouldn’t use estriol or genistein. Just the fact that they contribute to the estrogenic protection of our blood vessels is an important reason in their favor. >

My worry is that many women experiment with soy and herbs without opposing them with progesterone. They imagine they can do the very difficult and perhaps impossible balancing act of using estrogens against estrogens.

Linda McCartney, a strict vegetarian, probably ate soy. If so, it didn’t save her.

Another troublesome issue that needs to be resolved is the potential impairment of thyroid function due to soy. Hypothyroidism changes the estrogen metabolism in the direction of the more stimulating 16-hydroxyestrone. What we want is more of the anti-carcinogenic 2-hydroxyestrone, another very promising and terribly under-researched estrogen.

And it’s also entirely possible that we may get different results with different doses of genistein depending on whether the woman is slender or androgenically obese (abdominal obesity, the “apple” type). Androgenic obesity, with its high insulin, elevated unbound sex steroids, elevated cortisol and prolactin, is a high-risk endocrine milieu.

Also, if the information on genistein frightens you, and now you don’t feel you want to touch the stuff, please remember that there are a lot of other anti-carcinogenic compounds that can be safely used. Garlic and turmeric are in that category. Resveratrol, quercetin, and all the good polyphenols in tea, coffee, and chocolate. (If you’re wondering about caffeine, it too is a strong antioxidant and helps prevent breast cancer– we’ll soon have an article on that.) Even beer (hops) has been found to be anticarcinogenic. And don’t forget the humble cabbage family!

Or exercise, or the protective effect of keeping your insulin low through a low-glycemic diet. Or folic acid for DNA protection. Or getting enough sleep.

Or using olive oil and fish oil.

Or choosing to be happy, since nothing enhances the immune system as powerfully as positive emotions. (Abraham Lincoln: “People are about as happy as they choose to be.” Lincoln was hardly a shallow think-positive sloganeer. His wisdom came out of long battle with despair.)

Nature has provided us with plenty of anti-cancer resources. Even if we don’t eat soy, there is still almost an embarrassment of anticarcinogenic riches for us to use. Simply eating plenty of vegetables and fruit (especially berries) will go a long way.

And I wouldn’t worry too much about phytoestrogens; what you really need to watch out for is the tumor-promoting polyunsaturates: margarine, corn oil, safflower oil, and the hydrogenated oils so omnipresent in processed foods. That, and a high-carbo (bread, cereal, pasta) diet that raises insulin and piles on excess pounds.

As for the HDL-raising properties of genistein — or estriol for that matter, in doses of 4mg or more — I am impressed. And it has also been found that women with the highest HDLs have the lowest breast cancer risk (Hoyer AP, Enghold G. Serum lipids and breast cancer risk: a cohort study of 5,207 Danish women. Cancer Causes Control 1992; 3: 403-08).

In addition, genistein has been found to lower the risk of prostate cancer and colon cancer. But this article is already complicated enough as is . . .

Let’s raise a toast to Dr. Zava — and not with soy milk, either.

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Lynne comments:

This stuff is so much fun! I love this receptor stuff — can’t get enuf. I wonder how many people are as interested as you and I are?

Ivy replies:

The assumption is probably no, no way would women be interested in a fact such as ” Estrogen receptors must form a complex consisting of two of the same receptors before this complex can bind to DNA sites.” But hasn’t women’s scientific curiosity and intellectual capacity to grasp complex information always been underestimated? You know, “don’t worry your pretty little head over this technical stuff.” Translation: stay ignorant and powerless, helplessly deferring to the knowledge of “experts.”

Like the amazing assumption that there is no point trying to explain to women the distinction between progestins and natural progesterone. Let’s just call them all “progesterone.”

Gail comments:

Maybe we should concentrate on educating the health professionals first!!

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Lynne comments:

It’s seems odd to me that that LEF is stressing soy so much when Vit D3 (the vitamins are cheaper than the bottle it comes in) seems so promising.

Still the advisors have talked me out of their phyto estrogen tabs and recommended estriol instead.

Ivy:

Makes sense. All you need is several milligrams of estriol vs several hundred milligrams of genistein to achieve the same effects. And estriol is probably more beneficial in a lot of ways, I suspect, being so prevalent during pregnancy.

If a woman is taking only estradiol as her estrogen replacement, she might want to consider adding 6-8mg of estriol/day for a more balanced mixed replacement. Below 6mg, I don’t think you’ll notice much effect.

And of course don’t skimp on progesterone regardless of whether or not you take estriol. Progesterone is your real security blanket.

As for trying to hit on just the right dose of soy, it may be a pretty impossible balancing act. The whole idea of trying to balance estrogens with estrogens is precarious at best. What makes sense to me is opposing estrogens with high-dose progesterone and androgens. But I don’t want to get started again on how fast testosterone can suppress estrogen receptors.

Monica writes:

I know several breast cancer patients who are pounding down the concentrated soy drinks ($20-$30 per day) as alternative treatment.

Ivy:

Talk about playing with fire! I don’t normally like to use the classic, evasive-sounding statement “We need more research,” but in this case it strikes me as the best response. And, as with any hormonal therapy, and especially hormone therapy for breast cancer, we need controlled human trials, not just animal research. Until we have some solid answers, that money would be better spent on some proven preventive measures like mega-garlic, mega-CoQ10, and D3, iodine, possibly high-dose melatonin.

It bothers me that breast cancer patients are being exploited by soy peddlers, and are falling for the sales pitch without any real knowledge of genistein research, especially the dose-dependent effects. The assumption that genistein can never promote proliferation is so naive — estrogens are estrogens. Even tamoxifen can cause proliferation under some conditions, changing from an anti-estrogen to an estrogen. But with taxomifen, at least we know the effective suppressive dose, and know for how long it can be used before it ceases to act as an anti-estrogen.

I don’t think there’s as yet any reliable knowledge about what dose of genistein would be the equivalent of mega-estrogen therapy for breast cancer, and in any case, it’s so much easier to do hormone therapy using potent estrogens, or even estriol (under-researched).

Whether it’s DES, estradiol benzoate, estriol, or tamoxifen for that matter, the response rate hovers between 30 and 40%. It goes up if other agents are used simultaneously. Use of tamoxifen together with melatonin, for instance, seems very promising. The two appear to synergize.

Actually Megace (a progesterone analog) is more commonly used as treatment per se, rather than for prevention of recurrence, as is the case with tamoxifen. But Wren’s research suggests that progesterone and progestins might be more effective.

Given our dysfunctional medical system (prescription drugs are supposedly the fourth most common cause of death), given how atrociously mainstream medicine treats women, I don’t blame people for attempting do-it-yourself hormone replacement, or, in the case of cancer, experimenting with shark cartilage, soy, or apricot kernels. But I want to stress the importance of becoming as informed as possible.

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THE PUZZLE OF DONG QUAI AND BREAST CYSTS

Monica writes:

The most estrogenic side effect I ever had was taking Donq Quai. I grew benign breast cysts viewable on a sonogram plus little shooting pains in the breasts. Two days after I stopped DQ, they went away.

I don’t get this, if phytoestrogens are supposed to trick the receptors from E, then the DQ must have fooled them a lot!

Ivy: I directed this to Miranda, who had previously warned us about the cyst-promoting effect of licorice.

Miranda writes:

I think I tried dong quai a few years ago and decided that it was a cyst stimulator, so bagged that. It goes to show that nothing operates in a vacuum. In the context of a certain type of diet, or low-calorie regime, dong quai may be great. It may also depend on the genome. I am not Chinese, and the stuff does not agree with me.

DR. ZAVA WRITES:

My experience with Dong Quai is that it contains no phytochemicals that bind estrogen receptors and is not converted to phytoestrogens in the human body after consumption (based on estrogen radioreceptor assays of saliva of women taking Dong Quai).

Dong Quai, in every case I looked at (about 15) significantly lowered the estradiol level of saliva.

The controlled Kaiser study showed that DQ did not relieve vasomotor symptoms any better than placebo.

Licorice, that’s a different story. Licorice has quite high levels of phytoestrogens. Licorice also affects adrenal synthesis of hormones and it also blocks cortisol and aldosterone metabolism to inactive metabolites.

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Ivy comments:

Well, here we go again: another hormonal mystery. We just don’t know how dong quai acts, and on what basis it’s been called “female ginseng,” with the implication that it’s estrogenic.

A phrase such as a “hormone balancer” promises a lot, but doesn’t explain anything.

If anything, based on Dr. Zava’s research, it appears to be anti-estrogenic, in which case it should not have stimulated breast cysts.

A possible clue, however, may be found in the most recent issue of Life Extension Foundation Magazine, however, has an article on various phytoestrogens with a brief discussion of dong quai. According to the article, DQ stimulates the production of progesterone.

The only Medline study of dong quai that I was able to find was the Oakland Kaiser study that found no estrogenic effect of DQ on vaginal maturation, endometrial thickness, or relief of menopausal symptoms. The effects of DQ on breast tissue were not examined.

But if the progesterone-stimulating hypothesis is correct, then it is possible that in some women DQ may increase progesterone concentration to just the level that stimulates the proliferative activity in the breast tissue (a reminder: at low concentrations, progesterone appears to facilitate the proliferative action of estradiol in the breast tissue; only the higher doses are suppressive).

This is just a speculation, but intuitively it makes sense to me. For one thing, I too tried out DQ right after it first appeared on the market, lured by the vague nonsense phrases such as “it nourishes your hormones.” And I too pretty soon ended up needing to have a cyst aspirated — though at the time I made no connection. I stopped taking DQ after concluding that it did nothing for me that I could notice.

A babe in the woods.

It shocks me now that I was willing to naively play with herbs that were supposed to have a hormonal effect, but back then I was totally ignorant of hormonal health.

Miranda’s point about diet is very interesting. Chinese herbal medicine evolved in the context of Chinese diet, which is very different from the Western diet. An herb might have different effects in a slender woman who eats a lot of rice and semi-raw vegetables as opposed to a high-insulin obese woman eating junk food and mostly low-fiber diet.

Also, the Chinese prepare herbs very differently. They always combine them for a synergistic effect. And the famous healers also disagree, I’ve been told by a San Diego acupuncturist who studied in China: one master may recommend one kind of diet and/or herbal remedy, while another master may say that you should never use this diet and/or remedy for this particular condition. Medicine is regarded as an art more so than a science. So the notion that the Chinese got it all nailed down thousands of years ago is a myth.

Where does it all leave us? With a warning, I think, that if you have fibrocystic breasts you should be very cautious about using herbs. At least don’t use anything that contains licorice! I’m sure there are women for whom licorice is outright dangerous.

There is now a new menopausal supplement: the red clover extract. My question is: what kind of testing, if any, has been done? Has anyone looked at the effects on breast tissue?

What has been found effective in normalizing breast tissue is high-dose progesterone. Not low-dose progesterone — remember the warning in CH 12. Only the high dose is suppresive.

As for having to find a good nhrt doctor in order to obtain high-dose progesterone, I say that the sooner you do it, the better. What greater gift could you give to yourself?

P.S. A friend suggested that women interested in the use of herbs contact a non-profit organization called The Herb Research Foundation. They are allied with the American Botanical Council, and supposedly have the most up-to-date information. The number is 800-373-7105.

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A READER COMMENTS ON 
PROGESTERONE CREAM, SOY, SEAWEED

Denise writes:

I had a benign breast lump that, coincidentally or not, COMPLETELY DISAPPEARED. It did so at the same exact time as I was beginning the use of progesterone. The doctors cannot explain its disappearance, but I wonder…

Just how much is enough? I don’t do soy products, and won’t until I need more estrogen. I use progesterone during the last two weeks of my cycle. It’s a godsend.

I can’t believe it, but the stupid people at Prevention magazine told a woman to keep using soy products even though she wrote in and said she had had much worse, heavier periods since she’s been on soy!

Did anyone ever think that maybe it’s not the soy that helps Oriental women, but the sea greens they eat? I take kelp tablets.

Ivy replies:

I wonder if the woman who wrote to Prevention was unfortunate enough to ingest just enough genistein to hit on the proliferative dose. Again, a warning that phytoestrogens can be potent stuff.

As for the dose of progesterone that’s optimal for you, you are the best judge. Basically, a higher dose will make your periods even lighter. But you also need to see if you like the somewhat sedative properties of higher doses of progesterone. (By the way, after a while progesterone becomes less sedative with chronic use.)

Generally 200mg/day is enough, unless you are trying to shrink large fibroids or heal endometriosis.

I’m glad you brought up the high Japanese consumption of seaweed. Some scientists believe that the protective effects of genistein are due chiefly to prepubertal exposure (through promoting the differentiation of breast tissue without affecting the genital tract — an example of tissue selectivity that some estrogens exhibit). They don’t think that taking genistein in the postmenopausal years will do much for breast cancer prevention, especially in the context of a diet heavy in n-6 tumor-promoting fats and excess calories. The anticarcinogenic nutrients in seaweeds, on the other hand, should provide protection regardless of when you begin to consume them.

Seaweed contains omega-3 fatty acids, which have been found to be strongly anti-carcinogenic (a reminder: olive oil and fish oil inhibit tumor growth; linoleic acid, found chiefly in corn oil and safflower oil, promotes tumor growth). In addition, seaweed contains IODINE AND SELENIUM, two minerals strongly associated with protection against breast cancer. Kelp is the richest natural source of iodine.

And this is not the end of the story: kelp (Laminaria) has been found to contain special carbohydrates called fucans. Fucans are also anti-carcinogenic and in addition help nourish the good lactobacteria in our intestines.

The success of macrobiotic diet against certain kinds of cancer has been attributed in part to its great emphasis on “sea vegetables.”

Thus, while we are still unsure about soy, it seems that seaweed can be recommended wholeheartedly.

Since rice and fish oil are also anti-carcinogenic, sushi sounds like excellent dietary chemoprevention.

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WHEN EXPERTS DISAGREE ON HORMONES, DIET: 
THE CASE OF RAY PEAT

Elaine writes:

When you read Ray Peat’s article on estrogen it sounds correct. I tend to get crazy when first I read one thing then I read another and end up switching back and forth to different ways of eating, hormones, etc.

Ivy replies:

Your frustration is shared by millions who are first told to eat carbohydrates, then protein; not to use salt, then to use salt; never to use hormone replacement because it kills, then to start hormone replacement early, even before menopause, before atherosclerosis and bone loss get a headstart, since it’s hormone deficiencies that kill. It’s easy to get cognitive whiplash from all the changes of position. And the hidden agenda of the hormone wars and the nutrition wars isn’t scientific; it’s a lot more about cultural values.

Does grandma have the right to enjoy sex now that she is truly free, or should she graciously accept vaginal atrophy? Do we have the right to eat animal food, or anything that tastes good and is known to increase energy and sex drive? Is is really OK to encourage people to drink “sinful” beverages such as red wine and coffee now that evidence of beneficial effects is mounting? Is pleasant exercise enough, or must we truly ache, sweat, and run marathons?

One problem is that our culture is very suspicious of any kind of pleasure, and yet the experience of pleasure is very good for health.

If hormones are equated with sex, pleasure, and preserving youthful looks, then they come under heavy suspicion of being just a sinful self-indugence. I suspect that if we’d put emphasis on greater productivity due to hormone replacement, there’d be less opposition.

If we didn’t think that becoming more cheerful thanks to what we imbibe was somehow sinful, would it be imaginable that a doctor would say, as a CyberHealth reader just reported to me, “If we ever told patients just how good alcohol is for the arteries, that would unleash a plague of alcoholism.”

But I admit that that’s hardly the whole answer. The Protestant work ethic enters into the cultural attitudes toward hormones and diet, but the inconclusive and sometimes even contradictory nature of scientific evidence and the different ways in which it can be interpreted constitute the biggest problem.

Remember that it’s easy to present correct information, but present it selectively, omitting all kinds of other vital information. Then the picture that emerges is false, and usually conforms to the presenter’s ideological bias.

If Peat is right about the “toxicity” of estrogens, then I don’t see how any woman could survive pregnancy, much less 15-17 pregnancies, as may happen when no birth control is practiced. During pregnancy, the serum levels of estrogens go through the roof, into several thousand picograms! Yet a woman’s body can cope with these levels beautifully.

Several women have written to me asking what dose of estradiol would be dangerous. On the other hand, one of CyberHealth subscribers, Dr.McWherther, a reproductive endocrinologist with extensive clinical experience using nhrt, has stated that “there is no such thing as a toxic dose of estradiol.”

Peat is so extreme that he expresses worry over all the estrogens in women’s urine getting out there into the environment. I resent the implication that I’m committing genocide every time I pee.

For me the big convincing factor in favor of the overwhelmingly beneficial effects of estrogens was a look at male vs female cardiovascular mortality statistics. Up to age forty, female cardio deaths are minute, male already considerable. It’s something like 3,000 female deaths vs 45,000 male deaths (just ballpark; I don’t have the graph in front of me). The gap isn’t subtle; it’s like the Grand Canyon. When you’re looking at this Grand Canyon in terms of cardiovascular disease, it’s difficult to doubt that estrogens have something to do with it.

Then when you look at the cardiovascular mortality figures after 55, or better yet after 65 years of age, there is that terrifying “leap toward equality” and even beyond. This happens with all major diseases: more or less up to meno women have a low mortality, much lower than male mortality, and then there is the sudden dramatic increase. This is called “ACCELERATED SENESCENCE.” Only women display the sudden accelerated senescence after about the age of 55; for men the graph is pretty smooth, a steady climb with age.

To be sure, it’s an overall hormonal crash, not just estrogens. But because heart disease is #1 killer, estrogens figure strongly.

You see the hormonal difference between the sexes in one very visible area: the waistline. Women tend to have one. Practically all premenopausal women have a distinct waistline, while men of the same age often are thicker around the waist than around the hips. A lot seems to follow from that. Once the postmenopausal waistline is as thick as the hips, and instead of a waistline we see love handles and a pot belly, forget it: now women not only have equality with men in terms of heart disease; now they are in worse shape because their arteries aren’t as wide to begin with, so they clog up faster.

Pears age more slowly than apples, and have a lower morbidity and higher life expectancy. It’s sufficient estradiol that keeps a pear a pear, by ensuring that the majority of fat receptors are safely below the waist. Peat’s lips are sealed when it comes to solidly established benefits like this, and that’s just too bad. He’s not someone to turn to if you want impartial information on hormones.

When it comes to hormones, always get a second opinion — and a third and fourth also. And steer clear of what Dr. Vangor calls “alternative schlock” — sales-pitch type books and articles that do not quote any studies, or very few studies, or only a few very old ones.

PEAT IS PROBABLY CORRECT IN HIS STAND AGAINST VEGETABLE OILS

On the other hand, voluminous and unequivocal research validates Ray Peat’s stand against the immunosuppressive omega-6 PUFAs (polyunsaturated fatty acids in seed oils). The strong connection with cancer has been found again and again. Here is where the real experts do not differ, although misinformation still gets perpetuated in the popular media.

For example, here is what Udo Erasmus says about the omega-6 fatty acids: “These are amply supplied by the Western diet. In fact, their consumption has doubled in the last 50 years. From omega-6 fatty acids, the body makes series 1 and series 2 prostaglandins. Excess of the latter can cause inflammation, water retention, increased blood pressure, sticky platelets, and decreased immune response.” (p.433)

The consumption of excess omega-6 fats has also been implicated in autoimmune diseases.

We can also look at traditional cultures that for millennia used only butter, olive oil, coconut oil, or a small quantity of something like sesame oil which has strong antioxidants. In other words, traditional cultures always used NATURALLY STABLE FATS. This experiment has passed the test of time to the maximum.

Is butter safer than corn oil? You bet. And talk about better taste.

Is coconut oil safer than the hydrogenated seed oils that are now used in its stead? You bet. Coconut oil has powerful natural antioxidants and, like chocolate, it can sit on the shelf for a year or more without getting rancid. It’s also rich in medium-chain triglycerides, which are thermogenic (divert calories into heat production) and hence help with weight maintenance.

Statistics show that natives using coconut oil every day have the lowest rate of heart disease in the world are pretty persuasive also.

Thanks to Peat’s eye-opening article on coconut oil, I began using it, and find it wonderful.

So while Peat may sound like a radical, calling vegetable oils “toxic,” the scientific community has known for many, many years that the addition of even 5% of corn oil to the diet promotes cancer very efficiently. It’s only the popular media and the American Heart Association with its dangerous, discredited dietary recommendations that have perpetuated the sales pitch for margarine and corn oil and other seed oils. Do you think that economic factors might be involved?

I know what you mean about “experts” driving you this way or that on dietary or hormonal questions. That’s why we need to read many sources, never only one, and to go beyond the popular media. A Latin proverb says, “Cave ab homine unius libri” — beware the man of one book.

Pamela comments:

There is a very important treatise on Medscape regarding the relationship of hormonal imbalance and female susceptibility to autoimmune diseases. This information is not common knowledge . . . but if early and judicious application of hormonal therapy could inhibit and/or prevent the occurrence of these diseases in women . . . just imagine how much preventing arthritis, lupus, cataracts and other diseases of aging women would ease the burden of Medicare.

Ivy replies:

Peat would probably want to treat all you’ve mentioned with progesterone and pregnenolone, but it wouldn’t work. It takes the antioxidant properties of estrogens to protect the eyes and the brain, for instance. Or cut the risk of colon cancer in women by half. Or have fast wound healing, or mount a strong immune response against bacteria and viruses (premenopausal women have an advantage over men in several respects here). Or keep the synovial fluid in the joints from drying up; one could go on and on. All hormones need to be studied without prejudice; their interplay needs to be studied too, not just the properties of each hormone taken separately.

The potential for preventing disease is immense, as Pamela points out. The government would be smart to fund this kind of research as aggressively as it did the moon race, rather than feeling threatened by the idea of people living longer. If people stay vigorous enough to keep on working until 75 or 80 or beyond, surely that beats the prospect of maintaining millions of elderly women (it’s mostly women) in nursing homes for years (sometimes a decade or more for those who develop Alzheimer’s disease fairly early).

It’s interesting that any time there is an important discovery about the benefits of this or that hormone, right away there are editorials full of dismay that we may actually use this knowledge! Certainly clinical mistakes will be made, but trying to reject this knowledge a la Dr. Susan Love, or a big part of this knowledge a la Ray Peat is in my eyes a greater mistake.

Gail comments:

I think it is also the extremely focused nature of much research which is problematic . . . It’s like you’re seeing one tiny piece of a large puzzle, and trying to visualize the whole picture from that one piece. As more pieces are added, everything changes . . .

THOSE MAGNIFICENT BLUEBERRIES

USDA nutritionist, Dr. Ronald Prior, has examined fruits and vegetables for antioxidant properties. Here are the top five antioxidant vegetables:

1. kale
2. beets
3. red bell pepper
4. brussel sprouts
5. broccoli crowns

But when fruits and vegetables are combined, this is what emerges in terms of antioxidant power:

1. blueberries
2. blackberries
3. garlic
4. kale
5. strawberries

How do blueberries love you? Let me count the ways:

• BLUEBERRIES PROTECT AGAINST CANCER. They contain ellagic acid, an anti-carcinogen that helps block four different types of carcinogens, including nitrosamines and aflatoxin (a mold toxin found in grain products and peanut butter).
• BLUEBERRIES LOWER CHOLESTEROL. Blueberries contain pectin, a soluble fiber known to reduce cholesterol. Blueberries contain about as much pectin as apples, peaches, and pears.
• BLUBERRIES HELP PREVENT URINARY INFECTIONS. Their action is similar to that of cranberries.
• BLUEBERRIES PROTECT THE BRAIN. It’s been found that just a handful of blueberries every day protects neurons against free radicals.
• BLUEBERRIES PROTECT THE EYES. Many of you may be taking bilberry extract in order to protect the tiny capillaries of the eyes. Blueberries provide similar benefits. They are especially recommended to diabetics for preventing diabetic retinopathy.
• BLUEBERRIES PROTECT BLOOD VESSELS. All berries are rich in bioflavonoids, which have multiple benefits, including the strengthening of blood vessel walls.
• BLUEBERRIES HAVE AN ANTI-DIARRHEAL EFFECT. My grandmother used them in this manner. In Sweden a dried blueberry powder is used as an anti-diarrhea remedy.
• THE EXTRACT OF BLUEBERRY LEAVES LOWERS HIGH BLOOD SUGAR. This, again, has a special application in the treatment of diabetes.

Think of the difference it might make if we could eat lots of blueberries! All that antioxidant power that largely goes untapped . . .

Fine, you’re probably saying, sure, blueberries are wonderful and I’d gladly eat them every day, but that’s not possible. Even when fresh blueberries are available, they tend to be very expensive.

That’s certainly true: these fabulous health-giving berries, the top antioxidant plant, are expensive and difficult to get. These days, however, DRIED BLUEBERRIES can be obtained at places like Trader Joe’s. You need only a tiny amount to derive some benefit. Try them in a salad.

For better taste, use FROZEN BLUEBERRIES when fresh ones are out of season. I use them in my non-alcoholic wine jello, a special all-natural super-antioxidant dessert that I’ve developed.

Remember: ounce for ounce, apparently nothing beats blueberries for antioxidant power. What a delicious surprise from Mother Nature. Enjoy!

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*** THE BEAUTY CORNER * * *

DR. ANDREA VANGOR’S DARK SECRET OF FACIAL EXERCISE

Dr. Vangor writes:

My Secret Weapon: a book called Eva Fraser’s Facial Workout.

The facial muscles phylogenetically are related to whisker-twitching muscles lower mammals, in turn related to certain gill bar movers (of the 7th branchial arch) — really, you have not LIVED until you have contemplated the and development of the head and neck.

Bottom line: some fatuous know-nothings have held that the facial muscles be strengthened because they are innervated by the 7th cranial nerve (Facial by name) and/or because they fasten to dermis. Too bad for you, Grandma, your face collapses after a stroke. But the Eva Fraser book (she inherited her technique from a pioneer) is based on the premise that these teeny weeny can beef up like any other muscle if you figure out a way to APPLY A LOAD to them. Like tiny little weights! Resistance! Anything that works on the muscles has to apply some resistance. This is tricky for some facial muscles because they insert into relatively moveable parts of the face at both . So the trick is to stabilize some areas from inside the mouth, using little white gloves . . . of course.

What you want to do is grab your cheeks inside and out and hold them, so that can work the paranasal muscles and cheek lifters against resistance. Hence the gloves; it’s slippery work without them.

I credit this little book for the fact that my undereye shadows disappeared, lids droop not, my nasolabial fold is minor, nothing sags or pouches, my brow furrows are modest, my upper lip lines are at bay, and I have more of an upper (and closer to my nose too — the older face tends to lengthen just there) than I did 15 years ago. This gal claims that you can take, and keep, a good 15 off your face with this stuff. So why not, I say.

Ivy:

I’m speechless with admiration. I’ve seen various resistance gadgets for exercise advertised for close to $100 — while all you really need is your fingers. So let’s get our whisker-twitching muscles beefed up.

Seriously, simply placing your palms on your forehead and pressing them hard you try to lift your eyebrows as high as you can against resistance is quite a workout. Try it for that undroopy look.

It also clears your sinuses.

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* * * CARE OF THE SOUL * * *
CAN A MAN BE A WOMAN’S SUPPORTIVE ANGEL?

These days women are encouraged to achieve. Here, for instance, is Dr. Laura:

–Dr. Laura Schlesinger

And here is Sonya Friedman on the joy of gaining more competence:

Did you note the statement, “What woman hasn’t confronted her husband’s ?” Sonya Friedman takes it for granted that while women typically support a man’s ambition, a male mate is automatically threatened by a woman’s to accomplish something in the world. There are certainly exceptions, but I suppose we’d agree that in the main this is still the cultural pattern.

It’s been said that a woman’s greatest fear is that she won’t be loved, while man’s greatest fear is that he won’t be needed.

Sadly, some women really choose to play a dumb, incompetent little wifie “don’t you worry your pretty little head over that”), afraid that learning skills and achieving something in the world would destroy their marriage.

I don’t think that Sonya Friedman gives a really satisfactory answer. It’s always possible to include your mate in your interests and activities. But it’s still possible to make him feel needed AS A PROVIDER OF EMOTIONAL .

Just as a man can achieve more with the right woman behind him (“the woman behind the man”), so a woman can turn to her mate and ask him to be “the man behind the woman.”

If you can say to your mate “I need you” — and there are hundreds of ways to it — chances are that instead of trying to resist your attempts to gain more education, start a part-time business, etc, he’ll become your greatest ally supporter.

Don’t fight him; enroll him in the cause of your advancement as your ally.

It’s true that many women rely exclusively on female friends for this kind of support. But men are part of our world too. And once they feel emotionally secure because they are needed, you may find them quite as capable being supportive as a woman friend can be.

Let us not waste this precious resource by taking the negative attitude that have big egos and are emotional klutzes and cripples who will always try to prevent women from achieving. A big feminist mistake is teaching women the “I don’t need a man to be happy.” Taken too far, it’s counter-productive. It’s easier to be happy with the right “man behind the woman,” a man who feels and important.

One of the themes that we’ve been exploring is how women change as they leave reproductive stage of their lives and gain a new freedom to be creative in the world. It seems to me that one of these changes is that women stop being in aloof narcissists. Once they have some idea of what they want to accomplish, they start really appreciating supportive men.

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ON BEING AN ANGEL

Chris from England has sent us this marvelous piece:

I love the opening of this: “they don’t hold things against you; the only thing they hold . . . is you.”

That’s the kind of support we can all use. Compassion, not criticism; the sense that the person is on our side and wants whatever is best for us. Someone who makes us feel we do matter.

I’ve put these two pieces together because they both turn around a central fact: that each person needs constant signals that say, “You are loved. You are important. You are needed.” Every cell in our body needs those signals. Without them, we wither and sicken and die.

Practice being an angel, and you’ll find there are a lot of angels around who won’t hold things against you . . . they’ll hold you.