About Dr. Wendy Ellis
Dr. Wendy Ellis is a naturopathic physician and hormone expert based in the Seattle, Washington area. In this episode, she shares her top nutritional and hormonal replacement strategies to help men and women combat hair loss, increase energy, and burn fat.
2:00 Dr. Ellis’ Journey to Becoming a Hormone Expert: Dr. Ellis wanted to do preventative care and became a naturopathic physician. There was an opening at Jonathan Wright’s Tahoma Clinic, so Dr. Ellis decided that she wanted to be their fertility medicine expert and interviewed as such. Jonathan Wright is the father of Bioidentical Hormones. She had the benefit of having him review every one of her cases for the first year she was with them. It was a great mentor experience.
6:10 The Need For Hormone Replacement Therapy: Many people say that replacing hormones in a post-menopausal woman is not natural, but Dr. Ellis is seeing patients going into premature ovarian failure in their 20s or 30s. She sees male patients in their 20s and 30s with testosterone levels of 70 year old men. We don’t live in a natural world and natural hormone decline is accelerating because of that. You have to examine the risk to benefit ratio.
7:05 Where Do We Start? We start with botanicals. You can encourage an ovary to produce more estrogen or progesterone. But with a post-menopausal ovary, you cannot stimulate the pituitary gland produce more hormone from that gland. Botanicals may work for some and not for others. Often patients have already tried black cohosh, other herbs, topical progesterone, eating clean, avoiding alcohol, and drinking more water.
8:03: Progestin vs Progesterone: Progestin is in birth control pills, in Depo-Provera, and it is given to children as young as 12 years old for hormonal dysfunction. There are a lot of studies that say that progestin is dangerous. Because progestin was the go to drug for so many years, and there are few studies on progesterone. Many doctors do not know if it is safe.
8:52 How Do We Know Which Articles and Studies are Correct? The literature on hormones is constantly changing and conflicting. You have to be very careful with studies because the study could be funded by groups that could benefit from certain outcomes. In addition, sometimes the title and/or the summary of the study do not reflect what was in the study.
10:11 How Hormones Are taken Make a Difference: Women in the US are often given oral estrogen. In the women’s health initiative studies, women given oral estrogen were dying of strokes and breast cancer. Bioidentical or not, if you swallow estrogen in a pill, it increases stroke risk. Transdermal can have an increased cardiovascular risk, but not nearly the increased risk of oral. Oral progesterone does not carry the same risk. Oral estrogen increases C-reactive protein, an inflammatory blood marker. We want to avoid this. Although C-reactive protein is not specific to cardiovascular health, we correlate it to cardiovascular health.
11:50 The Problem with Oral Progesterone: Oral progesterone does not always give adequate uterine protection. Your liver passes it through twice; it conjugates it and excretes it through the kidneys. There are progesterone receptors on the brain, bone, lungs and many different places on the skin. This means that your uterus may not be fully protected and could end up with a thickened wall and you might tend toward post-menopausal bleeding. When Dr. Ellis prescribes oral progesterone to a woman with a uterus, she also prescribes a vaginal progesterone cream to protect her uterine lining.
12:28 The Benefits of Oral Progesterone: Oral progesterone stimulates GABA receptors, so it has anti-anxiety properties. Women on oral progesterone have an improved mood; they feel less anxious and get better sleep.
13:08 Oral Progesterone Dosage: Typical pharmacies carry only 100 and 200 mg progesterone. So Dr. Ellis uses compounding pharmacies. For the sleep component, must people do well on 25 to 50 mg. Too much progesterone can cause people to feel puffy, bloated, depressed, and feeling hungover the next morning. Dr. Ellis does not use oral progesterone on male patients. She might recommend pregnenolone. A man with insulin resistance or a big belly might convert that pregnenolone into estrogen.
15:51 Hormones and Autoimmunity: There is a great deal of research on DHEA. DHEA is a hormone that improves your more anti-inflammatory cytokines and sends your cytokines away from the more pro-inflammatory cytokines. Most studies have been done on a 200 mg dose call Prasterone. Estrogen and testosterone are inflammatory to autoimmune conditions.
16:59 Liver Function and Hormone Metabolism: If we provide liver support, we can better metabolize and utilize our hormones. In many cases, if people are taking nutrients to support liver function, they have better outcomes for hormonal deficiencies.
19:07 DHEA: If you have plenty of estrogen on board, you can take DHEA without a problem. DHEA is in the same family as testosterone. So, if you have very little estrogen and take DHEA, you will have facial hair growth and acne. You will get great results, but you’ll look like a teenage boy.
19:31 OTC Hormones May Not Be Dosed Correctly: The FDA did a study in which they measured 15 different over-the-counter DHEA supplements. Seventy-five percent did not have the amount of DHEA listed on the label. Some had 0% and some had150%. Many botanicals on store shelves do not contain what is listed on the label. When you are using hormones like DHEA, pregnenolone or progesterone, you have to use a very reputable source to ensure proper dosage.
20:44 DHEA Dosage: If women are taking estrogen or are pre-menopausal, DHEA doses goes from 5 mg to 25 mg. Dr. Ellis sticks to the standard 12.5. With men, it would be 25 mg to 50 mg.
21:00 Aromatase Enzyme: If you have a lot of adipose tissue around the middle, you have a lot of aromatase enzyme activity. In women, aromatase can make create more dangerous estrogens and in men aromatase can take all of their testosterone and convert it into estrogen. Men who take DHEA or testosterone must to take an aromatase inhibitor to avoid making lots of estrogen.
21:35 5-Alpha Reductase Enzyme: The other important enzyme is 5-alpha reductase. Men, who have bald heads and a lot of hair on the rest of their bodies, have a lot of 5-alpha reductase activity. When they take DHEA or testosterone, they convert it to dihydrotestosterone, which is linked to prostate cancer and causes hair loss that can be permanent. Men who have a lot of testosterone have a lot of hair on their bodies and little on their heads. Women, who have too much testosterone and a lot of 5-alpha reductase enzyme activity, may have hair loss, hair growth on the face and acne.
22:14 You Need Professional Help with Hormone Therapies: Hormone therapies are very complicated. If done incorrectly, they can cause damage, and it may be permanent.
22:58 7-Keto DHEA is Different from DHEA: Dr. Wright calls 7-keto DHEA a space alien molecule. The biggest selling point of 7-keto DHEA is that it does not convert to estrogen. However, when Dr. Ellis conducts a 24 hour urine test for bioidenticals, 7-keto DHEA does not appear. Where did it go?
25:17 Combating Androgen-Driven Hair Loss: Dr. Ellis says we can try to block the testosterone and dihydrotestosterone receptors on the scalp. At a few compounding pharmacies, you can get an effective topical formula of spironolactone and estradiol. Rogaine, used even once a day, completely blocks 5-alpha reductase. Propecia is another 5-alpha reductase blocker. Anything that is blocking your 5-alpha reductase is also blocking your good testosterone. You might keep your hair, but you might lose some of your sexual function. In addition, the prostate gland does not like full suppression of 5-alpah reductase. Natural reducers of 5-alpha reductase include saw palmetto (about 160 mg), zinc (about 30 mg) or boron (about 3 mg).
27:19 Blocking Aromatase Enzymes: In a patient with prostate cancer, you would want to block all estrogen and testosterone. You limit all aromatase so you are not feeding the prostate cancer. The typical daily dose of Arimidex anastrozole is 1 mg/day. Dr. Ellis might use a half or one quarter mg twice a week to block some estrogen. The prostate needs a little estrogen. There is an herbal supplement called Myomin that is used as an aromatase inhibitor, that she feels does not work well. Chrysin is a 5-alpha reductase inhibitor, that she also feels does not work well. Chrysin oral or sublingual works better than Chrysin in cream form.
30:40 Detriments to Your Endocrine System: Dr. Ellis recommends the book Hormone Deception by D. Lindsey Berkson. It is important to use environmentally friendly laundry detergent and dishwashing detergent and stay away from dryer sheets. Some speculate that women have a higher incidence of autoimmunity because of all the chemicals we put on our bodies. Years ago they put lead in makeup. When that was halted, they replaced it with cadmium, which is more dangerous than lead. Makeup and lotions are dangerous. The Environmental Working Group’s Skin Deep function, at http://www.ewg.org/, can help you determine whether your products contain known carcinogens. Don’t microwave foods in plastic or put hot foods in plastic.
32:50 Pesticides/ Herbicides and Your Hormones: Some speculate that the rise of gluten sensitivity is from Roundup that has been sprayed on wheat prior to harvesting. Occurrence of Celiac 10 years ago was around 1 in 250 and now it is 1 in 77. Autism rates are climbing. Avoid chemicals as much as possible. They impact our endocrine system, our immune system, and the expression of our genes. Chemicals are in our clothing, in our furniture and nearly everywhere else. People become overwhelmed at trying to minimize exposure. Drink clean water. Eat close to home. Eat whole foods and organic as much as possible. Wear used clothing.
37:58 Hormone Testing: Blood testing is protein bound and correlates well. However, in blood testing, you are limited to estradiol in most circumstances. In urine, you can see 8 different metabolites of estrogen. How we metabolize our hormones is important to our long-term safety. Women who exercise have much better hormone metabolites than women who do not. You get a lot more information from a urine test and you see the adrenal function as well. If someone is taking hormone replacements, Dr. Ellis advises that they take a urine test at least once. She does not recommend annual urine testing.
40:33 Dr. Ellis’ Favorite Supplement is Vitamin D: A level of 50 to 80 is vitamin D’s good range. For every 1,000 units of supplementation, you improve your vitamin D levels by 10 points. If your triglycerides are low, at around 50 or so, usually you would need 5,000 units of vitamin D. If you have no absorption issues, 2,000 or 3,000 may be enough. Vitamin D is great for immune function, seasonal affective disorder, bone density, and depression. She believes that for overall health, we need to exercise, eat clean, eat quality whole foods, stay away from simple carbohydrates and anything in a package and get enough sleep. Good sleep and exercise are paramount to good health.
43:21 Dr. Ellis’ One Health Tip for Americans: If people just moved their bodies more, we would reduce a great deal of illness. It is one of the most difficult things to get people to do.