21 November, 2008
On December 18, 2006, that cheerleader for corporate power and war, NPR, relayed information [sic] from a NIH-sponsored study. Reporter [sic] Allison Aubrey explained that while “many menopausal women [fear] that hormone replacement therapy (HRT) could increase their risk of breast cancer [and] turned to the herbal supplement black cohosh … in recent years [to limit or reduce hot flashes night sweats].[1]
Ms. Aubrey then told us (and Big Pharma) the good news, “a large, NIH-sponsored, carefully controlled study, published in the Annals of Internal Medicine, reports that, unlike HRT, [black cohosh] doesn’t work to help hot flashes or other menopausal symptoms.&rdquo[2]
(Before I go further, let me clarify the record. Aubrey’s claim about other menopausal symptoms is a lie. The report says: There were no statistically significant differences between any of the 4 groups and placebo in the proportion of women with upper or lower gastrointestinal symptoms; nausea and vomiting; fatigue, asthenia (severe muscle weakness), malaise; headaches or migraine. Put another way, according to the study HRT is just as effective as black cohosh for nine menopausal symptoms. HRT does nothing!)
Aubrey’s opening statements in her report were good news to American pharmaceuticals companies that produce pills and creams with equine estrogen – yes from horses – for human consumption and use. The only problem is that Aubrey failed to read the study, ignored the details of the report – as evidenced above, and avoided the most relevant question, “why do American women, but not women in Japan or other parts of Asia, have extreme vasomotor episodes during menopause?”
The article, “Treatment of Vasomotor Symptoms of Menopause with Black Cohosh, Multibotanicals, Soy, Hormone Therapy, or Placebo, A Randomized Trial,” which can be read online,[3] had a little over 300 participants, and divided them into five groups – as noted in the title. The subjects had on average, about seven severe hot flashes and or night sweat episodes per day![4]
Oddly, all five groups, including the placebo group experienced a slight reduction in events over the first three months.[5] Fortunately for those invested in horse hormones, subjects who took equine estrogen, had on average 4.5 fewer events per day.[6]
What were the various groups taking? Group (1) took 160mg per day of black cohosh; Group (2) took a “multibotanical” mix of black cohosh, 200mg; alfalfa 400mg; boron, 4mg; chaste tree 200mg; dong quai 400mg; false unicorn 200mg; licorice 200mg; oats 400mg; pomegranate 400mg; and Siberian ginseng 400mg; Group (3) had the same mix plus “soy diet counseling” (apparently that is a technical term – soy diet counseling); Group (4) was given “conjugated equine estrogen” (0.625 mg per day); and Group (5) took a placebo.[7]
Given that the women were not sequestered, and could eat whatever they wanted, from hormone laden factory-farm chicken, beef, and pork, to processed foods with soy additives, and plenty of artificial sweeteners and alcohol, where was the “careful” control to which Aubrey referred? Note that members of Group 3 were simply told to enhance their diet with soy products. Though the report says that “on average, women in the multibotanical plus soy intervention (Group 3) increased dietary soy by 1.1 servings per day between baseline and 3 months, compared with 0.1 serving per day in the other four groups”[8] we do not know what form of soy these women took, or more importantly, if that one extra serving was statistically significant. In sum, there was no control over diet and the dietary influences on menopause in this study.
Putting aside all these methodological problems, what did the researchers determine about the medicinal effects of black cohosh on vasomotor events? Of course, they declared that black cohosh did nothing. Ms. Aubrey’s failure to read aside, why should we believe that this NIH-backed study is definitive? Read the conclusion which states: “effects of herbal products, such as black cohosh, may be sensitive to dose, extraction method, plant type, and coadministration of other herbs.”[9]
In the vernacular, we can simplify this technical phrase as “duh!” Of course dosage means everything. Why should 160 mg of Black cohosh work to reduce the extreme (as measured by number and intensity) vasomotor symptoms of this group? The women in the study are, from a cross-cultural perspective, outliers. Note, hot flashes are considerably less common in non-Western countries such as Japan, Hong Kong, Pakistan, and Mexico, where studies show that 10% or less experience any hot flashes.[10]
The only rationale given for the dosage used in the experiment was one published study.[11] Reliance on that is what we call the “n of 1 problem” in statistics. Moreover, any real naturopath or homeopath would vary an individual’s dosage as determined by consultations and patient reports.
Why didn’t the researchers start from the assumption that no or slight changes in body temperature are the norm for menopausal women and design their study from there? Could the answer lie in the stock reports and profit margins of American pharmaceuticals?
The relationship between diet and exercise and hormone-relate illness is obvious. (Studies demonstrate that regular exercise for as little as 3.5 hours per week also lowers the frequency and severity of hot flashes).[12] In the United States, women – especially menopausal baby-boomers – eat diets high in animal fat, processed sugars, low in raw vegetables, and high in hormone-laden and anti-biotic feed meat. Need I say more? Studies with Japanese women, even with growing numbers starting to emulate the unhealthy American diet, show that “there is strong evidence that soy and isoflavone intake is inversely related to hot flashes – both intensity and frequency.”[13]
But more importantly, “Asian women tend to have lower levels of estrogen before and after menopause, hence the drop in estrogen levels experienced during menopause is less dramatic, resulting in milder symptoms or none at all. Further as fiber increases fecal excretion of excess estrogen, the low-fat, high-vegetable matter diets of Asian women generally protects them against a variety of hormone-sensitive conditions, including breast cancer.” [14]
There’s the rub ... cancer. As she started her report, Ms. Aubrey noted that many American women fear getting breast cancer in conjunction with taking hormones. Now why would such a wide-spread belief make Big Pharma push a panic button? So, in the face of growing public knowledge about one of Big Pharma’s secret, lo and behold, a study, straight from the government of G. W. Bush (who never politicizes any scientific questions – global warming) and is always out to do right by the people (Katrina, depleted uranium, WMDs in Iraq), tells us that the BEST thing for menopausal women (aka drug-fiending baby boomers) is to receive animal hormones or euphemistically, to get HRT.
That’s right ladies, the bible-thumping administration is bringing the good news. You are now put on notice that you should replace your lost human hormones with Big Pharma supplied equine hormones.
Maybe we can call it faith-based science? Bush’s scientists joined with their corporate benefactors believe that God made every woman in the United States to be perfect – as long as they have insurance or Medicare coverage. God planned it so that each would have a diet so bad that they would endure horrible vasomotor symptoms as God shut down their estrogen production, only to be saved by the profit-mongers who learned that cross-species hormone transfers are essential to limit, but not eliminate, the ill effects of menopause including night sweats and hot flashes. (Note, that the study explains while the equine hormone-using women had four fewer sever hot flashes per day on average, there was no difference in experiences of breast soreness, migraines, fatigue, vomiting and vaginal dryness – well what do you expect from equine hormones, a miracle?)[15]
In truth, God has supplied the formula for healthy and more comfortable transitions for women who approach and pass through menopause. In addition to having regular exercise, women can combat hot flashes by eating more calcium and magnesium-rich green leafy vegetables, cold-pressed oils, raw nuts and other fresh vegetables.[16] Additionally, women generally and menopausal women in particular should avoid alcohol, caffeine, processed sugar, artificial sweeteners (did anyone say aspartame?), dairy products, and animal proteins which rank among the top aggravators of severe hot flashes as well as mood swings.[17]
How can Big Pharma make money if people simply eat a more natural, low-fat, high-fiber, diet? They cannot. How many studies of the benefits of raw food and seasonal diets will NIH fund? Probably as many as the number that NPR and their corporate sponsors want reported. Zero!
John Calvin Jones
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[1-2] http://www.npr.org/templates/story/story.php?storyId=6642911
[3-9] Katherine M. Newton, PhD; Susan D. Reed, MD, MPH; Andrea Z. LaCroix, PhD; Louis C. Grothaus, MS; Kelly Ehrlich, MS; and Jane Guiltinan, ND, Treatment of Vasomotor Symptoms of Menopause with Black Cohosh, Multibotanicals, Soy, Hormone Therapy, or Placebo. A Randomized Trial, 19 December 2006, Annals of Internal Medicine, Volume 145 Issue 12: 869-879. Posted online at: http://www.annals.org/cgi/content/full/145/12/869
[10] Dr. Holly Zapf, "What Can I Do About Hot Flashes And Night Sweats?" http://www.power-surge.com/educate/whatsinahotflash.htm
[11] Newton, et al, cite Howes LG, Howes JB, Knight DC. Isoflavone therapy for menopausal flushes: A systematic review and meta-analysis. Maturitas. 2006.
[12] Dr. Holly Zapf, "What Can I Do About Hot Flashes And Night Sweats?" http://www.power-surge.com/educate/whatsinahotflash.htm
[13] Chisato Nagata, Naoyoshi Takatsuka, Norito Kawakami and Hiroyuki Shimizu. “Soy Product Intake and Hot Flashes in Japanese Women: Results from a Community-based Prospective Study.” Japanese Department of Public Health, Gifu University School of Medicine, Gifu, Japan. http://aje.oxfordjournals.org/cgi/content/abstract/153/8/790
[14] Zapf
[15] Newton, et al.
[16-17] Good news for menopausal women: You can avoid hot flashes by changing your diet. Monday, July 03, 2006 by: Alexis Black http://www.newstarget.com/019538.html
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