Raena Morgan: Doctor Scott, the term chemical imbalance, this is a concept that’s pretty broad. Is it real? Did it start with hormone replacement theory?
Dr. Timothy Scott: No, it’s been around for a long time. Where it really got started on the modern era is with Louis Pasteur. He discovered bacteria.
RM: Yeah, he did.
TS: And the germ theory then lead to our understanding that much of disease is caused by a germ,-
RM: Right, that’s true.
TS: -and so that idea spread into the area of mental health. And so if you go even to the twentieth century you have Doctor Joseph Cotton, for example. He was firmly convinced that it’s a bacteria that’s causing mental problem,-
TS: -insanity, and so he began removing teeth that were decayed, he would remove various body organs, and he was convinced by doing so he could cure insanity. And in fact, he published all kinds of papers saying guess what this is really working, and he was praised. You go back to the 1920s, he was a hero to a lot of people; he had found a way to cure mental problems by removing various kinds of infected body organs and teeth and so forth. Of course today it’s fully discredited.
RM: But then how did that account for like the hormone imbalance with women, with menopause?
TS: Well it’s just another example of where, because of poor research design,-
TS: -we were fooled. I look at my own mother’s situation.
RM: Yes, you talk about that in your book.
TS: Yeah. She was on estrogen starting in the mid-80s, started developing breast cancer in 1994. And no surprise in one way, a huge surprise in another way. Here’s a woman who breastfed, who was a daily exerciser, walker, she had a wonderful diet, low fat, lots of fruits and vegetables, no family history, no sisters, aunts, mother, no one had breast cancer, and she develops breast cancer, and you go “what’s going on here?” Well of course today we know exactly what’s going on there; she was on large doses of estrogen. But at that time people believe that it was the answer. I taught it myself, I’m ashamed to say.
RM: Did you?
TS: I taught it myself, because at one time we believed that the answer to reducing the incidence of heart disease was estrogen. It really starts in a big way with Doctor Robert Wilson who is a gynecologist in New York.
RM: All right.
TS: He published an article in 1962 in JAMA, the Journal of the American Medical Association, and he said that if women would take estrogen it would lead to better health, less aging in effect. The pharmaceuticals saw that article, three pharmaceutical companies jumped on it immediately. He published a book that became a best seller. We now know-
RM: What was the name?
TS: Feminine Forever is the title.
RM: Yes, okay. I thought it was.
TS: Yeah, Feminine Forever. And basically he’s arguing once you’re done childbearing, you are over the hill and you’re going to age quickly, you’re going to have saggy skin, your hair is going to get thin, your heart is going to get weak, you need to be on estrogen. And so he promoted it in a big way, and of course with a title like Feminine Forever, you want not to be feminine? And so the book took off.
RM: So we’re talking about the germ theory of insanity, and this person Doctor Joseph Cotton was his name,-
TS: That’s right.
RM: -he was totally honored for this.
TS: That’s right.
RM: And then we’re talking about Doctor Wilson and he wrote Feminine Forever and said estrogen, estrogen, estrogen.
TS: That’s right.
RM: And he honored this.
TS: Yeah, that’s right, and we did. And of course you have the studies on his side. We have studies going back for decades, in fact long before Doctor Wilson, saying that adding estrogen can lead to endometrial cancer. He discounted those studies. He said, “I’ve given it to hundreds and hundreds of women, I’ve had no cases of cancer;” he did not believe it. And then we start getting all the research. We have lots of studies that say hey, women on estrogen have less heart disease, women on estrogen have fewer strokes, we know it prevents osteoporosis, and pretty soon we’re convinced that every woman needs to be on estrogen. His book became the number one best seller at one point back in 1966. We now know that the pharmaceutical industry was buying huge numbers of those books and passing them out to physicians for free, that’s why it got to be number one, and of course it then got attention through Time magazine. And the end result was here is a concept that is very harmful that was accepted by the medical community everywhere. We really believed that estrogen was a good thing,-
RM: Oh yes.
TS: -women for given estrogen. And of course my mother’s surgeon encouraged her to take estrogen; my father said “uh-uh,” and so she did not go on it for more than two decades after she was encouraged to take it. But then she got to that point in life where all her friends were taking it, they were worried about osteoporosis-
RM: My friends are on it, yes.
TS: Yeah, they’re on it. And they need to realize the dangers of estrogen. Your increased risk for endometrial cancer, ovarian cancer, breast cancer, heart disease, strokes, including TIA’s, asthma, twice a chance of developing Alzheimer’s as a result, all kinds of problems come from this; there’s no one to question that today. I mean, the studies today are good studies. The problem was that when my mother got breast cancer, we had hundreds of studies saying that estrogen is a very good thing. 1998, an article in JAMA came out that said guess what? No question, there’s more cancer, more heart disease as a result of estrogen.
RM: So it wasn’t a chemical imbalance?
TS: No. The assumption that our bodies aren’t quite right, we’ve got to add that estrogen is just a fault assumption. It’s true that you have less estrogen as you get older. It’s true that you have less melatonin and you have less serotonin and you have dopamine, you have less testosterone. I mean, these substances, these hormones and other chemicals are dropping as you age. My argument is that’s apparently the way it needs to be, because as you add any of those, you can increase all kinds of problems. Testosterone, a lot of men used to take that, found that also causes cancer. So the reason we had this happen was simply we are doing observational studies. When my mother got cancer, nothing but observational studies have been done. And when we got our first what we call RCT, these are randomized clinically controlled trials using a placebo, using a double-blind design, when you do the right kind of research, we found out guess what, estrogen not only does not reduce the incident of heart disease, it increases it. And so I was out there lecturing saying now folks, we know that it does increase endometrial cancer. I knew that, but I also argued that it reduces the incidence of heart disease; heart disease is more common than the endometrial cancer. And so overall there was a period of time there, and I taught a lot of nurses, and so I was encouraging them to be aware of that research that said hey, there are some benefits here. But those were observational studies.
TS: And as soon as we got our first randomized, placebo-controlled trials, we found the end results were the opposite of the observational studies, the opposite, literally the opposite. We say well how could that happen? And the answer is the subjects in the observational studies taking estrogen are the women who were better educated, they were seeking out estrogen because they had been reading, they were women who had better health habits, they were women who had more money, their whole lives were very different, and so overall it looked like giving estrogen really made sense when in fact we were killing women.
Dr. Timothy Scott discusses how adding estrogen, as well as other hormones as you age, could be a bad idea. Find out how it got this way after being touted as a healthy thing for so many women and men. Find out what the potential dangers of estrogen replacements, as well as others, might be.
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