People’s Pharmacy: Is natural HRT safer than Prempro?

Q. When I read the news about the link between HRT and aggressive breast cancer, I discovered that it related only to Prempro. That’s the drug that was used in the Women’s Health Initiative study.

Prempro is not a natural hormone replacement. It is a combination of Premarin (pregnant mare’s urine) and Provera (medroxyprogesterone).

I believe that the “bioidentical” estradiol and progesterone hormones I receive in a transdermal patch are much safer and give better results.

A. We spoke recently with Susan Love, M.D., one of the country’s leading experts on breast cancer. She points out that women who have naturally high levels of hormones are at greater risk for breast cancer. You can’t get any more “bioidentical” than your own hormones. Dr. Love points out that very little research has been done on such formulations, and there is no evidence that they are safer than other types of estrogen and progesterone.

Q. I have read that taking aspirin can lower the risk of getting cancer. When I asked my doctor about this, he dismissed it as a chance finding and not a controlled study. What’s the story?

A. The most recent analysis of aspirin’s protective effects against colorectal cancer was published in The Lancet (online, Oct. 22, 2010). The investigators followed more than 14,000 subjects from five randomized trials over 20 years. They found that people who took 75 mg of aspirin daily for five years reduced their risk of colon cancer by about 70 percent.

This kind of study is the gold standard in that subjects were randomized to receive either aspirin or placebo. Of course, no one should start taking aspirin daily without medical supervision. Even low doses can cause ulcers.

Q. After years of frightening, rapidly increasing bone pain and weakening muscles, I read about the effects of vitamin D deficiency. I had the grown-up version of rickets.

A daily 1,000 IU dose of D helped within a week, but to get rid of all of the pain and weakness, I ended up taking more than 10,000 IU daily with no toxicity for about two years. I gradually lowered the dose to 6,000 IU daily. It’s wonderful to be able to move without pain, climb stairs without pulling on the handrail and walk on uneven ground without fear of falling. My grandchildren think I’m getting younger.

A. A daily dose of 10,000 IU vitamin D could be excessive. To find the correct dose, a person should ask the doctor for a vitamin D test.