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Price-Pottenger’s former executive director, Steven Schindler, met Dr. Berkson at HEALCon 2023, the 19th annual conference of the National Association of Nutrition Professionals (NANP), in Bellevue, WA. Her keynote presentation, “The Vindication of the Clinical Application and Power of Nutrients and Hormones,” and our previous knowledge of her pioneering work in the field of hormones made us want to learn more. In this interview, she provides vital information on the important role of hormones in helping us achieve our highest possible levels of health and vitality.
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Steven Schindler: Would you share how your life experiences led you to the study of hormones?
Devaki Lindsey Berkson: I had the good fortune of meeting my mentor, Dr. Jonathan Wright, the father of bioidentical hormones, when I was still in school. I did an integrative medicine rotation with him in 1977, and he taught me the importance of hormones and the gut. So, for most of my career, I’ve been focused on both hormones and the digestive system.
Most people get into functional medicine because they have been eating a typical American diet and end up with a frightening diagnosis. Then they start to clean up their diet, take nutraceuticals, and look at things a little bit differently. In contrast, I was always health oriented. I practiced yoga, ate organically, and did meditation and cleanses, but I kept getting cancer after cancer. I was doing everything right but getting wrong outcomes. None of my doctors could figure out why someone like me, who was eating well and living what we would now consider a mindful life, would lose a kidney, an adrenal gland, a breast, my female organs, my thyroid, and more.
Eventually, I began work on Hormone Deception, one of the 21 books I have written. It was to become one of the first breakthrough books published on endocrine-disrupting compounds in our environment. Within a very short period, three books came out on the subject – Our Stolen Future, Hormonal Chaos, and my book – and informed the public that our planet was somewhat under assault by endocrine disruptors. While writing this book, I learned that a lot of animals that had been exposed in the womb to a specific compound had developed similar cancers and other health issues as myself. Biologist Retha Newbold told me that the compound that had created all these health issues was diethylstilbestrol, or DES. I wrote away for my mother’s medical records, and they proved that she had been given DES by injection as well as orally when she was pregnant with me. It turned out that I was a victim of the very thing that I was writing a book on, although I hadn’t realized it.
DES, which was synthesized by Sir Charles Dobbs in 1938, was a synthetic estrogen 50 times more powerful than our natural hormone, and everybody thought it was the bees’ knees. They believed it would improve the outcome of normal pregnancies, so it was put in a large number of prenatal vitamins, apparently up to 365.
It was also given to livestock in feedlots from the 1950s through 1979, and everyone who ate meat during that period consumed some of it. In addition, if a woman experienced spotting during pregnancy, her doctor would give her injections of DES to ward off miscarriage. It is still used in some other countries today for this very reason. I had one American OB/GYN doctor call me and ask me what to say to a pregnant mom vacationing in Mexico who started to spot, and got treated with this. What now to tell her?
My mom, when pregnant with me, began to spot, so she received these injections as well as took DES as a prenatal vitamin. Daughters born to women who took DES, depending on how much of it they had received, had cancers and various other health issues – the same issues as the animals in Retha Newbold’s lab. In one study, Syrian hamsters were exposed to DES and developed the exact kind of rare kidney tumor that had caused me to lose my kidney.
Researchers theorized that when mothers took this drug, it switched off the tumor suppressor genes in the next generation so that their ability to see a cancer cell and fight it off was thwarted. Based on that, I started sleuthing in the literature to find out what could reactivate those tumor suppressor genes, and this led me down a whole new pathway for treating myself. It turns out that there’s a specific metabolite of estrogen that helps reboot your tumor suppressor genes. I’ve been taking that in a bioidentical form for about 18 years, and have now shared this with hundreds of patients and their doctors.
I’ve been on hormone therapies for 27 years now and have not had any cancer in the last 20 years. I’m going to be 75 in a few months, and I’m healthier than most of the people I know who are my age. In fact, in a few days, I’m going kayaking with the dolphins in Charleston. Many people, once they hit their seventh decade, just aren’t the same anymore. Every decade has a different speed of aging, and the seventh decade can be pretty harsh. It can bring accelerated aging if you don’t know how to put the brakes on. Individualized hormonal therapies often can put the brake on aging.
Today, I teach CMEs on hormones to medical doctors and nurse practitioners and try and get the word out. People often tell me that their doctors say that they don’t believe in hormones or that hormones cause cancer – and, as we will discuss shortly, this isn’t what the science says much of the time. I say “much of the time” because, in medicine, you can never say “always” or “never.”
Steven Schindler: What is the true scope of hormones’ impact on our health?
Devaki Lindsey Berkson: Hormones rule your biologic real estate. They are the most powerful signaling molecules in your body. They are like physiologic e-mails that tell your cells and the genes within your cells what to do to keep you healthy. Nothing else can tell your genes what to do, except vitamin D, which is both a hormone and a vitamin. Wherever there is a receptor – which you can think of as a kind of satellite dish – waiting to get a signal from a hormone, the hormone affects that tissue.
You have receptors for hormones throughout your brain. That’s why sex steroid hormones help maintain our cognition, more than anything else that is available to us. Probably 80% or more of the people in neurodegenerative facilities wouldn’t be there if they were encouraged and allowed to have, and had available, hormone replacement. My last book was called Sexy Brain because sex steroid hormones basically rule and preserve the brain. And men and women all have the same hormones, just in different amounts.
Progesterone, which we often think of as a female hormone, is so neuroprotective that young brains make it in six places. Our levels decrease as we get older, but by providing more progesterone therapies as we age, we can continue to protect the brain. When you age without hormone replacement, you’re aging at the regular physiological rate, which picks up speed every decade. But if you take hormones, they slow that aging process down.
Hormone replacement allows you to reduce the speed of aging in all the tissues that have satellite receptors. For example, the kidneys are filled with receptors, and as we hit 40 and our hormones really plummet, we start losing a percent of our filtering rate every year. With hormone replacement, you slow the loss of renal function.
You also have receptors for hormones throughout your lungs. Researchers at Mount Sinai noticed that women were getting COVID more than men but dying from it less, and men were getting COVID less but dying from it more. So, they tried to figure out how hormones protect women against severe COVID. One way is that progesterone helps lungs repair from injury and protects lung tissue. At Mount Sinai, they ran a study giving 100 mg intramuscularly twice a day to males in the ICU, and compared them to a matched cohort of males who did not get progesterone. They found that many of the males who received progesterone injections got out of the ICU with much less lung injury.
In addition, there are hormone receptors in the lining of your gastrointestinal tract, where most of your immune system resides. There are about 159 known autoimmune diseases, and men get all of them less, except for the kind that affects the kidneys. Why? Because testosterone helps protect the gut wall against damage, which protects against autoimmunity. If we give patients with autoimmune disorders some testosterone, it often helps reduce the severity of their disease.
Multiple sclerosis, an autoimmune disease, is associated with brain lesions. In phase one and phase two studies, a mild form of estrogen along with estriol, testosterone, and progesterone was given to men and women with MS. This slowed the disease progression and caused the white lesions in the brain to shrink or go away.
Steven Schindler: Is hormone supplementation mainly important for older people?
Devaki Lindsey Berkson: We’re now seeing hormone disruption in all age groups. Hormones love fat, and the egg and sperm are filled with fat. The placenta that the baby floats in is filled with fat. Mother’s milk is filled with fat. So, babies in the womb and at the breast are potentially exposed to a huge amount of chemicals that block their hormonal development, and we now have younger people with disrupted hormones. Kids today have less hormones than we used to have, and many of them need hormone supplementation for their brains, their bones – everything. The first symptoms of hormone insufficiency include anxiety and depression, which can lead to suicidal ideation, and this is what we’re seeing in our children.
Various studies have been done to test hormone levels in girls. About 30 of these studies have been published in psychiatric journals, the very first being from Harvard. Researchers there have been looking at girls whose periods are a little bit off and who are having issues such as body dysphoria and anxiety. They are seeing osteopenia, as would typically be found in 65-year-old women, and verbal acuity disruption. So they have been giving hormone replacement to 13- to 25-year-old females for a year and a half, just like you would do with an older woman, and finding that this preserves bone mass and verbal skills, and, in just a week or two, can help put anxiety and depression into remission.
I recently gave the very first CME talk on the depletion of hormones in young males and females to a pharmaceutical convention in Houston, and the data I presented comes from around the world. Researchers in Brazil, Finland, and Denmark have all published studies showing that our young men have up to 50% less testosterone than their grandfathers had.
Very few people are aware that girls have less estrogen today. I’ve been in practice for 52 years in one way or another, and we didn’t see polycystic ovary syndrome – a condition caused by hormonal imbalance – in girls when I first got out of school. Early menopause is also becoming more prevalent. I saw one young woman who was going into menopause in her twenties.
In addition, endocrine disruptors are causing infertility, which is on the rise. Hormones rule our ability to procreate and keep Homo sapiens going. If our hormones are no longer working and fertility goes down, what’s going to happen to us? It’s a major threat to humanity that our hormones are under attack.
Steven Schindler: Would you tell us more about modern medicine’s approach to hormonal imbalance?
Devaki Lindsey Berkson: Hormones were first used to treat aging in the 1950s in Britain, and the idea was that women could be “feminine forever.” Through hormone replacement, they could preserve a lot of the things – skin elasticity, muscle mass, etc. – that women tend to lose as they get older, especially the ability to be intimate and maintain vaginal lubrication. Hormones were huge for several decades, but this all came to a halt in the United States in 2002.
If you ask a physician today about hormones, you’re apt to get the wrong answer much of the time, especially if that physician is a gynecologist, urologist, or endocrinologist. That is because, in 2002, the first randomized trials to be done on hormones as part of the nationwide Women’s Health Initiative were prematurely stopped because it looked like hormones were causing the very issues – heart disease and cancer – that we thought they would protect against.
Until the Women’s Health Initiative, many American women had been on Prempro, a combination of Premarin, which is conjugated equine (horse) estrogen, with a synthetic progestin, medroxyprogesterone acetate. After the trials, Wyeth, who made Prempro, was successfully sued by a number of women who had developed breast cancer. They didn’t realize that they probably had a much better outcome because they were on hormones. No one realized this at that time. After Wyeth was sued, that was it. Nobody wanted to write a script for hormones. In the United States, doctors stopped using them, and they stopped teaching menopausal medicine in most medical schools.
Within a few months, however, Dr. Leon Speroff, who is known as the father of gynecology, pointed out that the Women’s Health Initiative findings couldn’t be accurate because we’d seen for decades that women age better if they’re on hormones. He said that we shouldn’t believe two little randomized trials in the face of years of clinical benefit. Speroff wrote many papers on this, and I wrote my book Safe Hormones, Smart Women on this as well. Then, in 2018, Dr. H. N. Hodis published an article showing that the “methodology” of the Women’s Health Initiative had been flawed. It had not controlled for previous estrogen use in the placebo arm.
The following year, the original researchers who conducted the Women’s Health Initiative trials reanalyzed their data and found that hormones actually protect against breast cancer. If a woman has been on estrogen for five years, she has a 23% reduced risk of breast cancer – and if she does get breast cancer, she has a 44% decreased risk of death, compared with a woman who has never been on estrogen. Nothing else has ever been that protective against breast cancer.
They published their new findings in December 2019 and presented them at the San Antonio breast cancer convention that year, yet nobody seems to know about this reanalysis. In America, scary headlines sell – and these weren’t scary headlines. Even the American College of Obstetrics and Gynecologists website still only cites the initial findings of the Women’s Health Initiative from way back in 2002. They have not updated their website or shared this info with American OB/GYN doctors, who rely on them, to be in sync with the latest revision by the original authors.
So, when you ask a doctor about hormone replacement, they will generally say that hormones are unsafe, because they still only know about the faulty initial Women’s Health Initiative conclusion. One of my friends has two daughters who just graduated from osteopathic school, and they were taught never to write a script for hormones because hormones cause cancer. They were given no training in menopausal medicine. I lectured in Chicago a few weekends ago and there were 105 doctors in the audience, 20 of whom were OB/GYNs. Not one of them knew about the reanalysis of the first Women’s Health Initiative data.
Since then, multiple studies have come out clearly showing that women live longer if they’ve been on hormones. There’s the largest study ever run on hormone replacement, put together by the National Institutes of Health and the National Library of Medicine. They went into the bowels of 1.5 million Medicare women who were on estrogen therapy and women who weren’t on estrogen, and found that those on estrogen lived 20% longer. They looked at five types of cancer – breast, ovarian, uterine, lung, and colorectal – and found a statistically lower incidence of each if women were taking hormones (for an average of five years).
Steven Schindler: What are some of the issues pertaining to synthetic vs natural hormones?
Devaki Lindsey Berkson: The incidence of Alzheimer’s disease, Lewy body dementia, and mild cognitive impairment is much lower in women who use hormone replacement – unless they take oral estrogen or a synthetic progestin. A few weeks ago, there was a study in the British Medical Journal concluding that hormones cause dementia. However, if you read the study, you find that the women studied had been prescribed oral estrogens and synthetic progestins. Those are the two unhealthy ways of taking hormones long-term: oral estrogens; synthetic progestins.
Progestins are synthetic versions of our own natural progesterone. The pharmaceutical companies alter the molecular structure of the hormone so they can get a patent on it. But when you futz with Mother Nature and change the position of a methyl group, for example, you create a substance that the human body has never seen before. Consequently, some people’s bodies will be able to handle it, and some won’t. In Europe, on the other hand, they mainly use bioidentical hormones, which are molecules that the human body has seen. When you hear bad things about hormones, it’s frequently because their molecular structure was not identical to what our bodies make.
Functional physicians are trained to use bio-identical hormones, which are exact copies of our own hormones. I have heard some people say that because these are made in the laboratory, they aren’t bioidentical. That’s not true, and they don’t paralyze your receptors, as some have claimed. They dock into the receptors and successfully deliver the signal to the gene. Potentially adverse outcomes from hormones can also stem from taking a hormone orally. But functional physicians write scripts for hormones that are either delivered topically or through the mucosa, which could be in your vagina or the inside of your cheek (ideally not the latter, as some is still swallowed).
This leads us to the topic of birth control pills. I don’t understand why everybody’s so frightened of giving estrogen to older women, yet they’re promoting birth control pills made of oral estrogen and synthetic progestins, the very things we see causing issues nonstop. Birth control pills are causing stroke and hypercoagulable blood in girls, as well as high blood pressure, migraines, poor relationship decisions, and infertility. The longer you’re on birth control pills, the more questionable your fertility might be when you discontinue them. They are also definitively linked to a higher potential incidence of breast cancer later in life.
Steven Schindler: Who will benefit from having their hormone levels tested and what tests do you recommend?
Devaki Lindsey Berkson: I think everyone should get their hormones tested at least once a decade, starting with kids as young as eight or nine years old, so that we will know later where their levels started out. Hormonal imbalances are happening more and more to young people in their twenties and earlier. That means everybody has to get tested now. The problem is that most doctors don’t know how to test hormone levels, because this is no longer taught in medical schools.
With hormones, it’s definitely controversial as to which testing methods are best. The bottom line is that there are some things you have to test in the blood. You can get blood drawn to look at all your hormones, or you can combine blood testing with saliva tests, hair analysis, a 24-hour urine test, or a dried urine spot. But you usually need to also do blood labs.
The most important indicator, however, is how you feel. If you’re losing words or you can’t think clearly, there can be many causes for that. But hormones rule your hippocampus, the area in your brain that functions as the piggy bank for your memories. True anti-aging medicine includes maintaining your hippocampal volume. When the hippocampus has pathologically begun to lose volume, diseases of cognitive decline such as Alzheimer’s start to show up, but if you give hormone replacement to somebody in the early or moderate stages of dementia, the hippocampus can actually revolumize, which is extraordinary. This has been shown by multiple labs from multiple prestigious institutions by functional MRIs. Only hormones can do that.
Sarcopenia, the loss of muscle mass, also accelerates aging. Women in their fifties often tell me they are exercising more but losing muscle mass and gaining weight on their middle. That’s caused by hormone imbalance. The more you maintain your muscle mass, the younger you stay, and you can maintain healthy muscle mass to a much greater extent with hormone replacement.
In addition, hormones, especially progesterone, can help you to sleep again. As they age, most people lose their ability to sleep well, due to hormonal imbalance. When we give progesterone at night, we can improve the quality of sleep. Yet the pharmaceutical companies want to sell sleep medications, which have very poor safety profiles. Most people aren’t aware of the fact that for every three years you take many sleep medications, you have about a 33% increased incidence of Alzheimer’s disease. (It shocks me that often by taking some patients off certain sleep and anti-histamine medications, let alone proton-pump inhibitors, they start to think much better again, and often rapidly.)
It’s a constant sadness in my heart that it’s so hard to obtain quality hormonal intervention. Nothing is going to protect you from mortality – we’re all going to die – but hormones can slow the progression of aging. We now have a neurologist who has written two bestselling books on Alzheimer’s and is reversing the disease in mild and moderate cases. He has trained doctors, and he’s been published in peer-reviewed journals. Hormones are part of Dr. Dale Bredesen’s protocol, but no one is listening to him because allopathic medicine is focused on pharmaceuticals, not on healthy lifestyles and natural answers. Bioidentical hormones are natural answers, but in order to get them, you have to go to functionally trained doctors or naturopathic doctors who practice in this way.
Steven Schindler: Would you tell us about the role of nutrition in hormonal balance?
Devaki Lindsey Berkson: When I was at the estrogen think tank at Tulane University, I had the honor of working with, and mainly learning from, the scientists who discovered the first two hormone receptors. Dr. Elwood Jensen discovered the first, which is called estrogen receptor alpha or estrogen receptor #1, and Dr. Jan-Åke Gustafsson discovered the second, called estrogen receptor beta. They both found that if these receptors weren’t filled with nutrients, the hormones wouldn’t work properly. It isn’t enough to have a hormone in your bloodstream, it has to be able to seek out a receptor and signal it.
As an example, let’s talk about vocal cords. I lecture a great deal, and I want my vocal cords to be healthy. I know that women who take hormone replacement can speak longer and project better than those who aren’t taking hormones. I’ve got hormone receptors in my esophagus and vocal cords, but unless these receptors are filled with a cornucopia of nutrients – such as zinc, magnesium, iodine, and vitamins B6 and A – the estrogen won’t be able to signal the genes, even if my blood levels of the hormone are perfect. That’s why getting tested is not enough. Often, people will run their hormone levels and think that’s the end of the story, but they don’t know that hormones are not just about levels, but about “receptor functionality.”
The required nutrients have to be in the receptor in order for the hormone to park. Think of the receptor as a parking space. The hormone parks, and then it shimmies in space, and in the process, it delivers the message to the gene to tell your cell how to keep you healthy. It won’t do that unless there’s enough zinc, vitamin A, iodine, and more. Each of the nutrients performs a specific action, and you only can absorb these important nutrients from your food if your gut is working well.
In addition, the receptor has to be available for the hormone to dock into. If it’s a parking space, there can’t already be another car there. A growing public health issue with pollutants – phthalates in perfumes, plastics from food containers, volatile organic compounds such as formaldehyde from new laminate floors, chemicals that enter your home on the bottoms of your shoes – is that these chemicals can occupy that receptor. Even if you have enough estrogen, it can’t dock into a receptor that’s already occupied. Receptors can also become “occupied” if you’re chronically stressed out. Cortisol is a bully hormone and can occupy the receptors of other hormones, making them unavailable.
So, first, a receptor has to be available. That’s where detox comes in to clear off your receptors. Then you need to have the cornucopia of nutrients to allow the signaling to take place. Hormonal balance involves a tapestry of events, and what you eat, how well you digest, and what you’re exposed to are important. Yet none of these things are taught in medical schools, crazy as that is.
Steven Schindler: What are some of the most important lifestyle choices we can make to improve our hormonal health?
Devaki Lindsey Berkson: First of all, you want to reduce your exposure to competitors that can sit in your hormone receptors and prevent your hormones from parking. For example, you should take your shoes off at the front door to avoid tracking toxins into your home. The last third of my book Hormone Deception tells you how to reduce exposure in your home, office, and supermarket cart. It’s especially important to reduce exposure in the bathroom, because that’s where we encounter so many of the chemicals that paralyze our hormones. A Berkey shower filter can remove a lot of the endocrine-disrupting compounds in our water. You also want to buy green personal care products because many personal care products contain chemicals that make your hormones not work. Cleaning up your lifestyle and diet is important, but reducing potential exposures in your home is one of the biggest ways to get your hormones healthier. (You can go to my website, drlindseyberkson.com, and click on the Products We Love pull down and find a link to this water filter that’s been the same low price for over a decade.)
Reducing exposure does a lot to protect your brain. We know that people who are exposed to a lot more endocrine-disrupting compounds are more prone to dementia. If you want to have a better brain, you need to reduce exposure and choose a healthy diet so the receptors have plenty of nutrients.
Based on the works of Jensen and Gustafsson, I developed for Biotics Research two products that together can make your hormones work better. One of these, Receptor Detox, clears off your receptors. The other is Hormone Balance and Protect, which is designed to support balanced and safe hormone levels. Both are available at drlindseyberkson.com/store.
You can start taking hormones at any age. It’s not true that there’s an estrogen window and you’ve missed out if you are 75 and have not yet started hormone replacement. I’ve started plenty of women in their late nineties on hormones and in a few years reversed osteoporosis and got them off many of their medications. We have made old age a terrible thing to be feared because many people are so decrepit and on so many medications. With hormone replacement, we can take off 10 to 15 years from their functional age, even if they are centenarians. We can make them feel a whole lot better and often change their lives quite extraordinarily.
Steven Schindler: How can people learn more about your work?
Devaki Lindsey Berkson: They can go to my website, DrLindseyBerkson.com, and subscribe to my Substack, which is called Agile Thinking. That can help them really keep up on nutrition and hormone information. I also have various courses and books that people can buy online.
At my website, I have a free ebook called The Vindication of Estrogen, which summarizes the science around estrogen therapies and even talks about hormone replacement for breast cancer patients. There were 26 studies that gave breast cancer patients hormones and compared them to matched cohorts, all before the Women’s Health Initiative. In many of those studies, women had ER (estrogen receptor) positive breast cancer, and in none of those studies did women fare worse for being on estrogen replacement.
I had breast cancer 30 years ago, and I wouldn’t be sitting here talking to you like this and lecturing all over the country if I hadn’t been on hormones these past 20-plus years. I spend most of my weekends traveling around, trying to educate physicians and nurse practitioners. It’s all about showing the science, not just giving my personal opinion. But much of this science is not being shown to our newer practitioners, and it’s no longer easy to find out what’s actual, factual science – and what isn’t.
When I tell people my age, they cannot believe how much energy I have. They say, tell me what to do and I’ll do it because I want to be like you.
I feel better than I’ve ever felt in my life. I have more energy, vitality, and peace. A lot of people strive for that, and that’s what I hope to help people achieve because, for much of my life, I also strove for it. Even though I had many well-intentioned doctors, it wasn’t until I got my hormones balanced that I felt this fantastic. When your hormones are healthy, it’s much easier for you to feel great, which is a gift. I wish that for all of you.
Devaki Lindsey Berkson, DC, is considered a thought leader in functional medicine. She initiated the first functional nephrology unit at the Naples’ Center for Functional Medicine. Her other focuses are hormones, gastroenterology, nutrition, and the environment. Dr. Berkson is the author of 21 books, including Hormone Deception (McGraw-Hill, 2020), which is used as a textbook in many environmental science graduate courses; and Sexy Brain, one of the first books on the threat of environmental castration (Awakened Medicine Press, 2017). Dr. Berkson was a hormone scholar at an estrogen think tank at Tulane University and has lectured for many decades in continuing medical education courses for medical doctors, pharmacists, NDs, DCs, and nutritionists. She has taught in the gastroenterology module at A4M for many years and has pioneered the relationship between hormones, especially oxytocin, and the gut. She is a regular guest professor at pharmacy symposia internationally. Her website is drlindseyberkson.com. Appointments can be made at the “consult” section of this website. Check out her memberships, mentorships, and Substacks. Dr. Berkson is offering our readers a one-time discount on the Berkson Hormone Biotics Research products at drlindseyberkson.com/store using the code TAKE10.
Published in the Journal of Health and Healing™
Fall 2023 | Volume 47, Number 3
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