PRAISE FOR DR. PLATT
“Dr. Platt is an expert and renowned for his work with natural hormone
replacement to enhance wellness. The findings in this thoroughly reader-friendly book are presented skillfully and clearly, making the informationthoroughly accessible for the general reader. This book can substantially aidmen and women, with the help of their physicians, to seek effective hor-monal solutions to health conditions considered insoluble.”
– MIDWEST BOOK REVIEW
“Make no mistake—this is NOT a book just for menopausal women. Men, women, and children with a myriad of chronic conditions and debil-itating illnesses will finally find answers in their quest to just feel better.”
– ELLEN PARRIS, reviewer, Palm Springs Life
“As a practicing orthopedic surgeon in Jakarta, Indonesia, with immense
interest in preventive medicine, I strongly recommend this book, as it is afantastic one, the only kind of book that prompted me to fly from the otherside of the globe to meet the author in person.”
– HENRY SUHENDRA, M.D ., F .I.C.S . “I’m very proud, and at the same time relieved, that we have doctors
like Dr. Platt, truly interested in patients’ complaints and devoted topreventive medicine.”
– DR. LUIS CESAR ANZOATEGUI ,
professor and physician, Mato Grosso do Sul, BrazilALLBOOKS REVIEWS 2008
Best Health Book Award
“Dr. Platt’s book is an excellent source of information on health issues
facing many people. His book was the most enlightening, educational,and well-written amongst all our “Health” Submissions.”
– SHIRLEY ROE ,
Allbooks Review Managing Editor
READER VIEWS 2008
Best Alternative Health Book Award
“We are pleased and proud to have discovered Dr. Platt’s pioneering health
book and to have been able to honor it with an award.” 
– IRENE WATSON ,
Reader Views Managing Editor
IPPY 2008
Most Progressive Health Book Award
USA BEST BOOK 2007
Alternative Medicine and General Health
finalist in both categorieshow i lost my: fatigue, hot flashes, adhd, 
add, fibromyalgia, pms, osteoporosis, weight , 
sexual dysfunction, anger, migraines... 
MICHAEL E. PLATT , M.D . CLANCY LANE PUBLISHING
californiaClancy Lane Publishing
72-785 Frank Sinatra Drive, Suite 100Rancho Mirage, California 92270
Copyright © 2007 Michael E. Platt
All rights reserved. No part of this book may be reproduced (except for inclusion inreviews), disseminated, or utilized in any form or by any means, electronic ormechanical, including photocopying, recording, or in any information storage andretrieval system, or the Internet/World Wide Web without written permission fromthe author or publisher. The author and publisher assume neither liability nor responsibility to any person
or entity with respect to any direct or indirect loss or damage caused, or alleged tobe caused, by the information contained herein, or for errors, omissions, inaccura-cies, or any other inconsistency within these pages, or for unintentional slightsagainst people or organizations. Publisher’s Cataloging-in-Publication Data
Platt, Michael E.
The miracle of bio-identical hormones : how I lost my: fatigue, hot flashes,      
ADHD, ADD, fibromyalgia, PMS, osteoporosis, weight, sexual dysfunction, anger, migraines... / Michael E. Platt. -- 2nd ed. -- Rancho Mirage, Calif. : Clancy Lane Pub., c2007. p. ; cm.ISBN: 978-0-9776683-2-8
Includes index. 1. Hormones--Health aspects--Popular works. 2. Hormone therapy--
Popular works. 3. Health--Popular works. 4. Medicine I. Title. QP571 .P56 2007            2007902535
612.4/05--dc22              0707
Printed in the United States of America
1 0 9 8 7 6 5 4   Second Edition
This book is printed on acid-free paper
DESIGNED BY JESSICA STEVENS www.design-savvy.com NOTE TO THE READER
Please be advised that this book contains my own views and
approaches to various medical conditions in men, women,and children. It is based on years of clinical observation and feedback
from my patients, and is tempered by intuition and logic. This book is not a substitute for any treatment prescribed
by your physician. Any recommendations made in this book should be
discussed with your physician, who can order any necessarylaboratory evaluations and follow your progress, makingadjustments in your treatment as required. Hormones and how to balance hormones varies from
person to person. Although natural bio-identical hormones aresafe, their misuse can produce adverse effects or consequencesfor which the author and publisher cannot be responsible. This book is not a medical textbook. However, it may
provide you with enough information to guide you to wellnesswith the aid of your physician. –
MICHAEL E . PLATT , M .D .This book is dedicated to my mother,
Bernice Platt,
whose lifelong battle with hormonal imbalance 
ultimately led to her untimely death
at the age of 61 of breast cancer
and belatedly sparked my interest in
natural bio-identical hormones Doctors give drugs of which they know little
into bodies of which they know less
for diseases of which they know nothing at all. VOLTAIRE CONTENTS
Foreword xiii
Acknowledgments xv
What Are Bio-Identical Hormones? xvii
CHAPTER 1    Why This Book? 1
CHAPTER 2    Estrogen Dominance and Brenda J. 13
CHAPTER 3    Thyroid Hormones—T wo Types                29
CHAPTER 4    Hormone Fatigue and Rhonda Y. 35
CHAPTER 5   Migraine Headaches and Karen H.               47
CHAPTER 6   Postpartum Depression and Susan B. 53
CHAPTER 7    Fibromyalgia and Janet L.                          59
CHAPTER 8   Osteoporosis—Myth versus Reality            67
CHAPTER 9    DHEA—Key to Well-Being                      75
CHAPTER 10 Menopause and Perimenopause                 79
CHAPTER 11 Hormones for Women— 91  
The “How- T o” Chapter
CHAPTER 12 Andropause—The Male Menopause 103 
CHAPTER 13 Adult-Onset Diabetes and Louis R. 115CHAPTER 14 Psychogenic Medication and Greg C.        123 
CHAPTER 15 ADD and ADHD—The Silent Epidemic  131
CHAPTER 16 Hormonal Imbalances in Children          141 
CHAPTER 17 Thoughts on Cholesterol                         149
CHAPTER 18 Morbid Obesity and Roger P . 153
CHAPTER 19 Weight Loss—                                       161
How Medications Can Prevent It   
CHAPTER 20 Permanent Weight Loss                           165
CHAPTER 21 Human Growth Hormone—HGH          177 
CHAPTER 22 Doctors Don’t Always Listen—                181
Shirley M.’s Story            
CHAPTER 23 Battling the Medical Establishment—      191  
Margaret O.’s Story
CHAPTER 24 Why We Don’t Have                              199  
Preventive Medicine in This Country        
Bio-Identical Issues                                 205
For More Information                             211
Index                                                     213xiiiFOREWORD
In the summer of 2008 I met Dr. Michael Platt by chance in
California. He was the treating physician of a very dear friendof mine, whose health was failing when I saw him in spring ofthe same year. Visiting him that summer I found that hishealth had miraculously improved. When I asked him whatcaused that unbelievable improvement in his health, he simplyanswered: “I am being treated by Dr. Platt and he is treatingme with bio-identical hormones”. Being of a very skepticaland curious nature, I was questioning his approach, beingeducated as a traditional doctor in Germany. I just had tomeet this doctor. Dr. Michael Platt met me in his office andtreated me as if I was an old friend, he took a long time to talkto me, more than one hour, and he explained to me his way ofthinking. He talked about his experiences and his strategiesfor treating his patients. This conversation has changed the way I think about
medicine. Never before, in all the thirty years, that I have beenpracticing medicine has a subject captivated me as much as this.I devoured his book “The Miracle of Bio-Identical Hormones”.I became painfully aware that I must have misdiagnosed andmis-treated many patients in the past. In order to make his book available in Germany, I askedDr. Platt to allow me to translate his book. His book is not
only brilliantly written, but very easy to read. We as doctors must have the courage to make more time for
our patients, treat patients instead of blood tests, concentratemore on preventive medicine, think twice before we prescribemedications or synthetic hormones, and quit bowing to thepowerful influence of pharmaceutical companies. Furthermore, we should have the courage to include alter-
nate therapies without hesitation in treating and diagnosingpatients, and use natural, bio-identical substances that cannotbe patented. It is my opinion that Dr. Platt is a very brave and important
pioneer in the field of bio-identical hormones. I am thankful to him. He changed the way I practice
medicine. JOCHEN ARMBRUSTER, M.D . Darmstadt, GermanyxivACKNOWLEDGMENTS
Many people have contributed to the making of this book. I
will attempt to provide credit to them as due. My wife, Victoria, has always been my strongest supporter
and advocate. More than anyone, she has instilled in me howimportant it is to share my wellness thoughts with the world.Her insight, feedback, and prodding have kept this book alive. My graphic designer, Jessica Stevens, contributed her
admirable talents toward the cover design as well as enhancedthe book’s readability. I owe a great deal to Carolyn Bond, whose exceptional
expertise as my editor resulted in a book eminently morereadable and coherent. This book has encouraged many to visit my office and they
are always treated graciously and warmly by my incrediblytalented and supportive staff. They include: 
Cynthia Arreola – Office ManagerSelene Berumen – Medical AssistantMonica Chavez – ReceptionistTheresa Grippi – Patient CoordinatorErica Lopez – Medical AssistantAmanda Mallett – Office SupervisorDiane Weeks – Nutritional Counselor
xv Natalie Weeks – Shipping Coordinator
and
Victoria Platt – Director of Advertising and Marketing
Although I do not know her personally, I must also give
Suzanne Somers some credit for this book. The main thrust ofmy book was finished several years ago—and I did nothingwith it until Ms. Somers’ book 
The Sexy Years was published. After reading it, I realized that women had to be made awareof an alternative approach to hormone replacement besides theone she proposed. This was my strongest incentive to publishthis book. However, the most important acknowledgment I would
like to give is to the thousands of my patients who haveprovided me with insight and feedback, allowing me to learnhow to help them.xvi WHAT ARE
BIO-IDENTICAL HORMONES? Bio-identical hormones are hormone supplements whose
biochemical structures are identical to those produced by thehuman body—a fact that offers important therapeutic advan-tages and minimizes potential risks. Bio-identical hormones are initially prepared as powders by
pharmaceutical companies, such as Upjohn and Pfizer, from anatural base, usually soy or yam. They are FDA-approved. Thepowders are then sent to compounding pharmacies, where theyare formulated according to doctors’ prescriptions. Companieslike Upjohn have been manufacturing bio-identical hormoneproducts for 70 years. An exceptionally important advantage of utilizing bio-
identical hormones is that dosages can be tailored to theindividual’s unique hormonal requirements. Oral bio-identical supplements go directly to the liver,
which converts them into a different hormone. Thus thepreferred method of delivery for bio-identical hormones istransdermal—in the form of creams, gels, and suppositories—so the hormones are absorbed directly into the bloodstream. xvii 1WHY THIS BOOK? chapter ONE
My name is Michael E. Platt, M.D. I am an internist with a
practice devoted mainly to natural hormone replacement, alongwith wellness and metabolic weight control. I am writing thisbook to offer the benefit of my 35 years of clinical experienceto people who are unaware of the importance of balancedhormones for health and well-being. My fundamental approach to illness has always been from
the standpoint of dealing with its cause. Since hormonescontrol every system of the body, it is easy to see how founda-tional they are to people’s health. Giving a woman some Motrinfor menstrual cramps may relieve the pain, but giving her thecorrect natural hormone prevents the cramps in the first place.In this book I will be dealing with a wide range of healthproblems that can be attributed to hormone imbalance—menopause, diabetes, asthma, obesity, migraine headaches,fibromyalgia, arthritis, cancer, fibroids, endometriosis, ADHD(attention deficit hyperactivity disorder), and more. Hormones are exceptionally powerful substances that have
the ability to make you well or make you ill. They affect everycell in the body. It is fairly easy to appreciate the importance ofnatural rather than synthetic hormones in terms of healthmaintenance, so it may be a surprise to readers that most doctors have almost no knowledge of natural hormones. Almost everything doctors learn in medical school is basedon research done by pharmaceutical companies. Drugcompanies cannot patent natural products and thereby haveno interest in spending hundreds of millions of dollarsevaluating natural hormones for which they cannot receive apatent. Most endocrinologists, who specialize in hormones,are familiar with the synthetic hormone compoundsproduced by drug companies; few of them utilize naturalhormones because no drug companies recommend them.Contrary to what many doctors think, bio-identicalhormones are obtained in the form of powders frompharmaceutical companies, such as Upjohn and Pfizer, andare FDA approved. I take a non-traditional approach to medicine because I
deal with the cause of disease rather than the symptoms.Some people might say that I practice “alternative” medicine.However, since I utilize natural bio-identical hormones,which match the hormones the body produces, I believe I ampracticing “real” medicine. One might argue that thosedoctors who use synthetic drugs to treat patients are the onespracticing “alternative” medicine. The term “bio-identical”when applied to hormones simply means that the entirehormone is molecularly identical to the hormone producedby the body. And all bio-identical hormones have a naturalbase, most commonly soy or yam. They can be obtained byprescription from a pharmacy that is specially equipped toformulate and dispense compounded medications—that is, acompounding pharmacy. The number of compoundingpharmacies around the country is on the increase.2 THE MIRACLE OF BIO-IDENTICAL HORMONES  THE NEW (NOT SO IMPROVED) MEDICINE
The whole idea of preventing disease makes sense to most
people—who can argue with it? In the old days, HMOs suchas Kaiser and Ross-Loos (the first HMO in the country) werespecifically designed to provide preventive health care. In theearly 1970s I worked for both organizations at various times.In those days, every lab test and procedure was covered, everymedication available was on their formularies, and I was seeingonly one patient per hour. Initially, HMOs were run byphysicians who understood patient care. Somewhere along theway, insurance companies took over; preventive medicine waseliminated and “managed care” took its place. This perhapswas their way of saying, “What’s the least amount of money wecan spend and still keep the patient alive?” It’s a situation thatneither doctors nor patients like, and pretty soon even theinsurance companies won’t like it as they too become more andmore legislated. With the intervention of the insurance companies,
medicine began to change. Increasing specialization eroded thestatus of family practice. Insurance companies drove up priceswhile clamping down on the availability of lab tests. I came tofeel that medicine was failing to serve the public. In particular,patients’ access to appropriate preventive medicine was beingsidetracked. Expensive procedures, which yield higher profitsthan simple remedies, became the standard of practice. Hugecapital outlays were made for purchasing the latest medicalequipment, which then had to be justified—and sure enough,patients somehow ended up “needing” to utilize theequipment. Doctors became technologists. They lost interestin natural, non-invasive procedures. Another change was that pharmaceutical companies began
funding most of the major medical studies, which are3 WHY THIS BOOK? 4
published in medical journals. Thus the pharmaceutical
companies began having a lot of say in what doctors readabout and also what they are trained to do in medical school.The drug companies’ motive for underwriting these studieswas not altruistic. It was part of a strategy for marketdominance, similar to what happens in any other big business. However, this book is not intended to be an exposé of
American medicine. My purpose is to offer a logical andsensible approach to treating various conditions that differsfrom traditional practices. Along the way, the book provides abasic understanding of how the body operates, so the readercan understand why something has gone wrong, along withhow to fix it. My observations and advice in this book are based on 35
years of clinical practice. Therefore, you won’t find footnotesor a bibliography or references to “double-blind” studies. Noneof the information here is secret, but much of it is revolution-ary. Many doctors today are finding the same faults withconventional medical practice that I have found. Agroundswell is starting that, I believe, will, in the next tenyears, profoundly alter the way doctors go about treatingpatients. Most of these changes will be brought about byunhappy yet informed patients who will be asking theirphysicians to treat their conditions by balancing theirhormones utilizing natural bio-identical protocols. WHAT ABOUT MENOPAUSE? Perhaps the most controversial, mystifying, and inadequately
approached area of medicine today is hormone replacementtherapy (HRT). Only relatively recently have women come toquestion the safety of estrogen and other hormones whoseusage has been entrenched in medicine for the past 40 years.THE MIRACLE OF BIO-IDENTICAL HORMONES  Estrogen can cause aggressive cancers, heart attacks,
strokes, and more. In light of recent studies, particularly theWomen’s Health Initiative of 1997 to 2002, women are beingadvised to “discuss their individual needs with their health carepractitioners.” However, all too often the physicians knowlittle more than their patients. If they were well-informedabout hormone replacement therapy, especially estrogenreplacement therapy (ERT), they might never have prescribedthese drugs in the first place. Often the best advice thesedoctors can give women is: “Don’t worry about it,” or “Thebenefits outweigh the risks,” or they hand the issue back to thepatient: “It’s your decision.”
Into this wasteland of limited knowledge has walked a new
lineup of hormone gurus who propose new alternatives. Forthe first time women are becoming aware of bio-identicalhormones. However, there is a tremendous misconception:that the term “bio-identical” equates with the term “safe.”Nothing can be further from the truth. I devote an entirechapter to the correct use of bio-identical hormones for reliefof menopausal and perimenopausal problems. SOMETHING IS WRONG
I am concerned that estrogen is still being prescribed frequently,
even though it is associated with six different cancers. It isrecommended for patients with osteoporosis, yet there are nostudies to show that it benefits women with osteoporosis. It isrecommended to help prevent heart disease, yet the last fivemajor studies demonstrate higher incidences of stroke andheart attack while taking estrogen. And don’t forget, estrogenis lipogenic: it creates fat and cellulite. I am concerned that the primary drugs prescribed to treat
osteoporosis are also a common reason why people are referred5 WHY THIS BOOK? to gastroenterologists; they have toxic side effects on the gastro-
intestinal tract. I am concerned that the number one drug beinggiven to prevent recurrence of breast cancer, a drug currentlybeing used by about 700,000 women, has never been adequatelydemonstrated as effective for breast cancer prevention. I am concerned that doctors may be blaming the wrong
hormone for prostate cancer—a condition that ultimatelyaffects most men if they live long enough. In the course of thebook I address these issues and concerns. With the correctapproach to hormone replacement, all of them can becomenon-issues. LISTENING
One of the most common complaints I hear from patients in
my office is that their doctors don’t listen to them. When I didmy training in medical school, I was taught that 90 percent ofa diagnosis is sitting down and talking to the patient.Nowadays, most doctors rush through their day trying tosqueeze in as many patients as possible. They don’t have time totruly listen. The average time a doctor spends with a patient isfour minutes. And even when a doctor does take the time tolisten to a patient, he or she still tends to treat the symptomsand not the cause of the problem. So the patient is still not well. My patients are amazed when, on their first visit, I sit
down and talk to them for an hour, delving into not just theirown health backgrounds but the health backgrounds of alltheir family members. I do this for a very good reason: themore I know about my patients’ bodies, their genetic history,the medications they have taken in the past, how they haveresponded to various interventions, and so on, the better I amable to help them. By listening deeply I can detect hormoneimbalance in the particulars of people’s lives, I can see clues to6 THE MIRACLE OF BIO-IDENTICAL HORMONES  metabolic problems in certain kinds of behavior. My talks with
patients are invaluable. Often, the lab tests that are doneafterward merely confirm what I have already inferred fromour talk. A side benefit of the long initial conversation is that my
patients develop trust. They feel attended to. Bodies arecomplex, intricate mechanisms. The only way to understandthem is in depth. My patients sense the rightness in myprobing deeply into their health backgrounds. Conversely,they sense something is wrong when a doctor dismisses themafter a four-minute discussion and dispenses a one-size-fits-alltreatment. They feel discounted. The medical community has, in my opinion, become com-
placent. By and large, we physicians are not showing a deeppersonal commitment to the people who create our  livelihoods.We accept all too easily that increasing numbers of our patientsare over-weight, that women are having miscarriages and devel-oping breast cancer and other cancers, and that coronary arterydisease and other cardiovascular ailments are running rampant.We accept the fact that many of our patients are taking multiplemedications with a range of unpleasant side effects. Prescriptiondrugs are known to be the second leading cause of death; Isuspect they may actually be the primary. Our patients are suffering, and in many cases their suffer-
ing is preventable. But before we can treat them at the causallevel and ease their suffering, we must learn to listen. HOW THIS BOOK IS ORGANIZED 
Throughout this book you will be meeting some of my
patients, hearing how they felt when they first came to myoffice and how they felt after being restored to health. As youread their case histories you’ll see how I managed to heal7 WHY THIS BOOK? ailments that had been dogging them for years just by balanc-
ing their hormones. Conventional doctors had treated theseailments with prescription drugs, many of which had sideeffects that brought on more symptoms and more disease. Iwas able to halt this negative progression by bringing thebody’s own natural endocrine system back into balance. After my patients tell their stories, I comment on how I
conducted their treatment and why they got the results theydid. There is a certain amount of overlap across chapters. Mostpeople have multiple hormonal imbalances, so many of mypatients share similar clusters of symptoms. /Iswashsee many protocols in medicine today that aren’t in the
patients’ best interest, and the public’s only defense
against these practices is awareness. Besides the case histories, there are other chapters that
offer simple, non-technical explanations of a variety of topics.For instance, while discussing weight management, I talkabout medications that cause weight gain and the thyroidsupplements that do and don’t work to regulate metabolism,that is, I present information that may help readers find thekey to their own weight management. In another chapter I putthe topic of cholesterol into perspective in a similar way. I seemany protocols in medicine today that aren’t in the patients’best interest, and the public’s only defense against thesepractices is awareness. There is, of course, an important chapter on bio-identical
hormone treatment of menopause in women. Another chapterdiscusses bio-identical hormones and andropause in men.Armed with this information, patients should be able toquestion their doctors and insist on proper care. One of mypurposes in writing this book is to help those pro-active, intel-8 THE MIRACLE OF BIO-IDENTICAL HORMONES  ligent readers—and I know there are many of you out there,
far more than when I first started practicing—who take pridein being conscientious, informed medical consumers. Patients have often told me that what I say is different
from anything they’ve heard prior to coming to me. They haveoften encouraged: “Doc, you should write a book.”
Well, this is that book. I cannot prove any of the opinions
I’m putting forth here in a way that would satisfy the demandsof objective science, such as double-blind studies—but I knowthey are sound enough to consistently create results for mypatients. Perhaps in time they’ll be shown to have the scientificbacking I can’t claim for them today. Drs. Semmelweiss andLister were ridiculed in their day for suggesting that doctorswash their hands and wear gloves prior to operating onpatients. They were telling doctors that they were infectingtheir patients, but very few believed this. Doctors, like mostpeople, resist change. AMAZING HORMONES
Many people are amazed to find that balancing hormones has
such wide-ranging effects on patients’ health. But why not?Hormones regulate every aspect of our physical being. For thevarious hormones our bodies produce there are thousands ofreceptor sites distributed all over the body. Each kind ofreceptor site has the power to alter the body’s behavior inprofound ways. I believe the benefits of natural bio-identical hormone
therapy should be available to everyone, and this book isdesigned to teach the reading public about those benefits. I amnot writing this book for doctors, although I would welcometheir readership. I am speaking to the public directly because9 WHY THIS BOOK? I’ve observed again and again how people committed to their
own health can change the system. In the past 35 years I’veseen dozens of “unconventional” medical solutions broughtinto the mainstream by patients who insisted that doctors(and insurance companies) should give them what they want.Acupuncture, herbal remedies, meditation, and other “fringe”ideas have bubbled up into popular consciousness and earnedcredibility. I would like to see natural hormones come into themainstream in the same way. By writing this book, I hopeto join the chorus of voices focusing attention on naturalbio-identical hormone therapy. PERMANENT WEIGHT LOSS
I have placed the weight loss chapter toward the end of this book
for a very good reason. I don’t think the world needs anotherdiet book. I don’t want this book to be confused in any way witha diet book. Delaying my weight management theory until latein the book is a way of asking that the reader develop an under-standing of hormones before embarking on my weight lossapproach. The reader who skips the information in the early chapters
of this book, intent only on finding out how to lose weight, maybe disappointed. There is nothing in chapter 20 that can helpthe reader lose weight until he or she understands the role ofhormones in regulating metabolic health. As you will see when you get to that chapter, I have a very
different approach to permanent weight loss. Simply cutting out“carbs” is not the answer. I have observed that for many patients,no matter what they do to lose weight, sooner or later it comesback on again. Why? Because no one has helped them deal withthe underlying reasons for weight gain in the first place.10 THE MIRACLE OF BIO-IDENTICAL HORMONES  Ninety-nine percent of the time there is a hormonal prob-
lem. Keep in mind that hormones control every system of thebody—including metabolism, which factors into weight. Themajority of people with weight problems produce too muchinsulin. In these cases, reducing carbohydrates is mandatory.This is not a new concept—as of this writing, it is 157 years old.It is the basic approach utilized by the Atkins Diet, SugarBusters, the South Beach Diet, the Carbohydrate Addicts Diet,Protein Power, and others. What makes my approach differentis that I address the underlying reason why the body is produc-ing excess insulin. Without this, the fat comes right back afterthe person discontinues the low-carb meal plan. This book’sapproach to weight, then, is actually a step beyond the Atkins orthe South Beach diet. FINDING MY AUDIENCE
I find it impossible to fit my ideas into pat formulas. This book
is not a diet book or a self-help book, although it does containelements that should be useful to people seeking both kinds ofbooks. What you will find here is a strong point of view aboutthe role of natural hormones in restoring and maintainingwellness, along with some thoughts about the state of the healthcare industry at this time. My hope is that serendipity will bring this book to the
people who need it most. I offer some guidelines on how to usehormones with the help of your doctor. A prescription canbe obtained and filled at a compounding pharmacy. I don’tpublish food lists, menus, tables (such as the glycemic index),and so on. These aids to the daily process of planning healthymeals can be found in other books. My goal here is to set forthbasic principles.11 WHY THIS BOOK? “IT CAN’T BE THAT EASY” 
Often after I’ve talked to a patient about their lifelong medical
problem and outlined a course of treatment, the patientresponds—sometimes teary-eyed—“Doc, it can’t be that easy.”They’ve gone from doctor to doctor; they’ve read book afterbook. Many find me in the second half of their life—theirquest has gone on that long. The tragedy is that it 
isthat easy. T oday’s medical model
has turned health care into a complex, expensive enterprise.Specialists treat symptoms with great technical wizardry andpharmacological sophistication—while ignoring causes.Behind all the sound and fury lies a simple, overlooked truth:bodies in hormonal balance can reach a level of optimumhealth in a natural manner. PLEASE NOTE  
In this book, whenever I use the term “natural” for hormones, I
am referring only to bio-identical hormones. Any hormonedescribed as “natural” may not always be bio-identical; forexample, Premarin is technically natural, since it is made from anatural substance (pregnant mares’ urine), but it is not bio-identical. “Bio-identical” means the hormone supplement hasthe same biochemical structure as the hormone made by thehuman body.12 THE MIRACLE OF BIO-IDENTICAL HORMONES  ESTROGEN DOMINANCE
AND BRENDA J.
chapter TWO    
Brenda J., 57, visited my office primarily to discuss a weight
problem. As we talked, it became clear that her “bloat,” as shecalled it, was actually a minor factor in a constellation ofsymptoms whose roots were hormonal. Far more serious thanher weight were complaints that had begun surfacing when shewas in her late 20s and thereafter accelerated rapidly: an inabil-ity to focus, constant headaches, chronic fatigue, aching bonesand joints, and disorientation. I am going to let Brenda tell her story, after which I’ll
answer the questions you might ask if we were at a workshoptogether and you wanted to understand how I treated Brenda.I’ll explain how unbalanced hormones hurt her and howbalancing her hormones healed her. I believe her situation isnot uncommon. Readers with similar afflictions may see some-thing of themselves in the way Brenda experienced a 30-yearbout with estrogen dominance. I’ve had a lot of female problems since I was very, very young. My first child was born when I was 17 years old. Paul was borna severe quadriplegic with cerebral palsy. When I was 18, mysecond child was born and died after three months. At 22, my
13daughter, Sandra, was born. She was normal but very, very tiny:
three pounds. All of my children were born prematurely. When I was 23 I had to have a complete hysterectomy. I had
fibroid tumors, and one night I went into a very severe hemor-rhage and was taken to the emergency room where doctorsperformed the hysterectomy. Estrogen replacement was recommended by my gynecologist
after the hysterectomy. I was told I would need to take estrogen forthe rest of my life, since my body no longer produced it. As soon as I began taking Premarin I felt that something was
wrong. I just didn’t feel right. I told my gynecologist about thisfeeling and I suggested it might be the estrogen. But he told methat wasn’t the problem and that I had to be on estrogen. That waswhen I began gaining weight. For the first five years after my hysterectomy my only symptom
was this gradual weight gain. But then other symptoms beganappearing. I began feeling fuzzy in the head. My vision started toblur, I wasn’t sleeping well and my joints started hurting. When my first gynecologist retired, another doctor took over
his practice. I tried talking to this doctor too, telling him how Ifelt. But he had the same response to my complaints as the firstdoctor. In fact, he thought my symptoms indicated that I mightnot be getting enough estrogen and he increased my dosage. Thisdoctor put me on Synthroid, a thyroid drug, and kept increasingthe amount of Premarin I was taking, so that by the time I was inmy 40s I’d been taking 2.5 mg, the maximum dosage of Premarin,for 10 or 12 years. The gynecologist would explain away mydepression by saying, “Of course you’re depressed. You have ahandicapped child. You had a child that died. Your depressionis normal.”
I got divorced in my 30s, and about a year after the divorce
my physical problems started in earnest: the aches and pains, thefuzzy thinking, the deep fatigue, the headaches, and of course the14 THE MIRACLE OF BIO-IDENTICAL HORMONES  bloated body, which got worse every year. I honestly don’t know
how I managed back in those days after the divorce. I was soexhausted all the time I didn’t know which end was up. A typical day would start with my getting up and my body
hurting so badly that I would get into the shower and stand underthe hot water until I could bend my arms and legs and move alittle. Then I would get dressed and I was already exhausted. Butsomehow I’d do my work; you just do what you have to do. During this whole time I tried getting second, third, and
fourth opinions about the Premarin from various gynecologists.When I moved to Lake Arrowhead, California, I tried a gynecol-ogist there. This doctor told me to keep taking the Premarin andthat the only problem I had with weight was that I had to stopeating so much. I told him, “I don’t eat. I starve myself to deathand I exercise until I fall on my face and almost pass out.” He said,“Well, I never saw a fat woman in a concentration camp.” I gotso mad I got up and walked out of his office. Shortly after that Iread about this program at Duke University where you could geta total medical workup. I flew to Raleigh, North Carolina, andentered the program. I filled out endless forms and had blood testsand a hormone panel and all kinds of testing done. I lived therefor six weeks and spent almost $20,000. At the end of the whole thing they told me there was nothing
wrong with me and that I should go home and visit a psychiatrist.It was the same old song: you’ve had a hard life, you’re stressed out,keep taking your Premarin and see a counselor. The doctors at Duke University increased my dosage of
Synthroid and put me on a high-carbohydrate diet. I was eatingbagels and fruit in the morning, pasta for lunch and dinner, andnow I started really bloating out. My metabolism was slowingdown even more. I have photographs of myself from this period,and it takes my breath away to look at them. I was so huge! I wasa size 14.15 ESTR OGEN DOMINANCE AND BRENDA J. I developed a new symptom. I started having disoriented
moments when I’d be on the freeway and I couldn’t rememberwhere I was going or why I was there. The turnaround came when I talked to a woman who was
having some of the same problems I was having—achy joints,weight gain, puffiness, fatigue. We’d commiserate with each other,blaming it on our age. “Getting old isn’t what it’s cracked up tobe,” we’d tell each other. I didn’t see her for about four or fivemonths, and then one day I was out walking my dog and ran intoher. I hardly recognized her. “My God, what are you doing?” Iasked. She told me about Dr. Platt, and I went to see him thefollowing week. The first thing I noticed about Dr. Platt was that he really
listened to me. Most doctors don’t hear you, but Dr. Platt makesyou feel like you’re talking to your best friend. He did my hormonepanel and told me he was taking me off Premarin. My firstreaction was shock. All of my life doctors had been telling me thatI needed estrogen replacement. I thought, “Maybe this isn’t goingto work.” A few times I’d tried to wean myself from Premarin,and the hot flashes and headaches were unbearable. And the way he was telling me to eat! Meats and vegetables,
bacon and eggs for breakfast—it went against everything theculture was telling us about cholesterol and everything else. But atthe end of our first meeting he said something that made me trusthim. He said, “None of this is your fault. You’ve just never receivedproper treatment.”
So I started taking progesterone, two different thyroid
hormones, and eating what he told me to eat. I was eating meat,eating eggs, eating three meals a day. I never ate so much in mylife. And the results happened so fast I couldn’t believe it. I couldjust see the weight dropping daily. And my energy shot up. I don’tever remember feeling the way I started to feel. I felt wonderfuland happy and energetic.16 THE MIRACLE OF BIO-IDENTICAL HORMONES  I can’t even describe it, it all happened so fast. I was thinking
clearly, my vision cleared up, my headaches stopped, I started sleep-ing at night. In about a month I had to buy a new wardrobe. Iimmediately got rid of everything in size 14. I went down to a size4 in two months. The aches and pains started going away gradually. At six
months I realized that my arms didn’t hurt. I could get up in themorning and move my arms. By this time I felt so great that my new husband couldn’t keep
up with me. I had more energy than he could handle. So he wentto see Dr. Platt, and he got amazing results, too. He’s 11 yearsolder than me and has always been very healthy, but now he feelslike 40 again. When I see friends, they’re shocked at how well I look. They
think I’ve lost 90 pounds (I’ve actually only lost 47 pounds). Myvitality is unlike anything they’ve seen in me before. You know, when it comes right down to it, it isn’t even the
difference in how you look … it is how you feel. I wouldn’t giveup how I feel for anything. MIRACLE OR SIMPLE CHEMISTRY ? The transformation Brenda J. testifies to may sound incredible,
but the truth is that it’s not an unusual occurrence in my prac-tice. I attribute every bit of it to the power of hormones. Theyregulate activity in every cell in the body, including the braincells. As miraculous as Brenda’s healing sounds, it was nomiracle—it was a matter of chemistry, pure and simple. When Brenda first came to see me, she showed all the
classic signs of estrogen dominance. She’d been laboring underthe burden of excess estrogen her entire life, even before she wasprescribed estrogen in the form of Premarin in her 20s. The17 ESTR OGEN DOMINANCE AND BRENDA J. reason for her over-production of estrogen was a lack of
progesterone. This deficiency of progesterone was the majorcause of her problem pregnancies, and certainly the causeof her fibroids, which ultimately resulted in the need fora hysterectomy. Just putting her on natural bio-identical progesterone made
her feel better right away. Progesterone is a natural anti-depres-sant; it’s the feel-good hormone for women. With the properamount of progesterone in her body, Brenda’s mood brightened.Progesterone is the hormone that balances out estrogen andtakes away its worst side effects. Progesterone is also thermogenic. It helps fat to burn by
helping the thyroid gland to function better, as well as byraising body temperature. And it helps prevent the over-production of insulin, the main hormone that creates fat andkeeps it stored. So Brenda’s metabolism improved and shebegan to see her weight melting away. She was more comfortable inside her own body. That alone
had to make her feel much, much better. Her fatigue startedlifting, too. She had energy she hadn’t had before. Part of her weight loss was related to a reduction in the fluid
retention caused by too much estrogen, too much insulin, andthe wrong thyroid medication. THE UNFRIENDLY EFFECTS OF ESTROGEN 
The improvement I saw in Brenda just a month or two after
starting her on progesterone is something I see again and againin my practice. People have to understand that in many casesestrogen is toxic to the body. You can think of progesterone asan anti-estrogen hormone. Progesterone is there to protect thebody from the negative effects of estrogen. 18 THE MIRACLE OF BIO-IDENTICAL HORMONES  Which negative effects? Estrogen is very damaging to blood
vessels. This is why it causes migraine headaches. Doctors arevery much aware of estrogen’s effect on blood vessels. It’s whythey warn women on birth control pills to be on the lookoutfor signs of phlebitis, which is an inflammation of the veins.Birth control pills contain two synthetic hormones—anestrogen and a progestin. (Progestin is a synthetic form ofprogesterone. It is a chemical that is unrelated to naturalprogesterone and has the same side effects as estrogen.) Estrogen causes six different cancers in women. It’s been
known for over 50 years that estrogen causes breast cancer. T omy knowledge, estrogen and the drug Tamoxifen are the onlyknown causes of cancer of the uterus. Estrogen is also a cause ofovarian cancer, cervical cancer, vaginal cancer, and cancer ofthe colon. For years an effort was made to place estrogen on the list of
cancer-causing chemicals. Once a drug is on this list, specialwarnings are supposed to be given. Estrogen was finally put onthis list in 2003; however, you wouldn’t know it because it isnever mentioned. Morning sickness is only caused by too much estrogen. But
doctors don’t realize that. They don’t know that you can preventmorning sickness and also prevent miscarriages by prescribingbio-identical progesterone. Natural hormones can help womenwith common problems like these, but doctors are generallyunaware of it. Estrogen has always been promoted for the treatment of
osteoporosis, and it appears that in some studies it may preventosteoporosis temporarily. Yet there have been no studies toshow that estrogen reverses osteoporosis. In fact, it is primarilya lack of progesterone that causes osteoporosis. Studies are nowfinding that women on birth control pills, which suppressprogesterone production, have an earlier onset of osteoporosis.19 ESTR OGEN DOMINANCE AND BRENDA J. In women, progesterone is one of the hormones of choice
in the treatment of osteoporosis. It stimulates osteoblasts in thebone to make new bone. Estrogen does not do this. STANDING UP TO ESTROGEN DOMINANCE
I am not the first doctor to point out the over-use of estrogen
in medicine today. The term “estrogen dominance” was coinedby Dr. John R. Lee in his 1996 book, 
What Your Doctor May
Not T ell You about Menopause. He was the first physician to
go public decrying the use of estrogen to “cure” women’smenopause. Unfortunately, the concept of estrogen dominance is not
widely accepted in the medical community—a result of the factthat many doctors have very little understanding of hormones atall. This is a point I’ll come back to again and again. It’s one ofthe primary themes of this book: the conventional medicalcommunity is largely unaware of how important hormones arein regulating every aspect of our physical well being; or rather,they understand its importance intellectually but do not applythis in their practices. Most doctors were never taught in medical school that a
person can have too much estrogen. T o the medical communitythere’s no such thing as a disease caused by too much estrogen.They know that there are conditions called fibroids andendometriosis, they know that women get fibrocystic disease intheir breasts and so on, but they don’t seem concerned aboutestrogen’s role in causing these conditions. Women with theseproblems should never be given estrogen because they are at riskfor even more serious complications from estrogen dominance. It is very difficult for people, doctors included, to separate
the hype associated with estrogen from the reality. Most of the20 THE MIRACLE OF BIO-IDENTICAL HORMONES  research on estrogen has been bought and paid for by drug
companies, who have almost 100 percent control over what getspublished and, more importantly, what doesn’t. It’s long been proposed by drug companies, and therefore by
the doctors who tend to believe what these companies have tosay, that estrogen is good for the heart. Yet five recent majorstudies have indicated that women starting on estrogen havehigher incidences of heart attacks and strokes. For this reason,estrogen is now contra-indicated for women with coronaryartery disease and women who have had strokes. Anothernegative side effect of estrogen is that it elevates levels of homo-cysteine, the substance that makes blood vessels sticky, leading toclot and plaque formation. The American Heart Association isnow telling doctors to be much more selective in givingwomen estrogen. This is a good place to make a comment about the term
“estrogen” as it is used throughout the book. There are threebasic types of estrogen: estradiol, estrone, and estriol, listed herefrom the strongest to the weakest. Estradiol is the one associatedwith most of the unpleasant side effects women experience, aswell as the hormonal cancers that occur in both men andwomen. (However, using it transdermally appears to provide alevel of safety in this regard.) Accordingly, when I mention thenegative aspects of estrogen, I am usually referring to estradiol. Estriol, the weakest and thereby the safest estrogen, does not
cause cancerous changes in the cells. In fact, it is so safe that ithas been used to treat breast cancer, since it occupies estrogenreceptor sites and blocks stronger forms of estrogen. It is also thebest type of estrogen for vaginal dryness. T ransdermal estrogens, even estradiol when applied
transdermally, are basically safer than estrogens taken orally.However, they should never be used without concomitantprogesterone cream to counteract the estrogen and avoid21 ESTR OGEN DOMINANCE AND BRENDA J. potential side effects. And keep in mind that all estrogens are
lipogenic—they all create fat. THE HEALING POWERS OF PROGESTERONE
When you realize that there are over 300 receptor sites for
progesterone throughout the body, you can begin to appreciatethe powerful effects patients can experience when they aregiven this hormone. In general, progesterone is wonderful for brain tissue. In
fact, progesterone levels are higher in brain tissue than anywhereelse in the body. So progesterone influences memory function,and some studies indicate that it’s very good for preventing andpossibly even treating Alzheimer’s disease. Progesterone is also wonderful for nerve tissue. I’ve used it
with diabetics who have a burning neuropathy in their feet.Sometimes the neuropathy is gone within three days.Progesterone also stimulates the Schwann cells that line the axisof a nerve and produce myelin. Multiple sclerosis (MS) is acondition associated with the demyelinization of nerve cells.Most of the patients with MS who I have treated have beenestrogen dominant. Could this condition possibly be related tolow progesterone levels? Progesterone also has a healing effect on blood vessels. It
undoes all the damage that estrogen causes. That’s why it worksso well for preventing and treating menstrual migraines, andwhy it’s effective in preventing coronary artery spasm. One of the best treatments for osteoporosis happens to be
progesterone. It’s much better than estrogen in this regard. Andbecause progesterone reduces the level of insulin—the numberone hormone that causes the accumulation of fat in mostpeople—it can be used to help control weight.22 THE MIRACLE OF BIO-IDENTICAL HORMONES  Being a feel-good hormone, especially for women, proges-
terone is also a natural anti-depressant. As the antidote toestrogen, it helps prevent breast cancer, cancer of the ovaries, andprobably cancer of the colon. In my view, it can also preventcancer of the prostate, which I believe is another cancer causedby estrogen. Brenda would have had a completely different life if the
benefits of progesterone had been understood by the medicalcommunity. Instead, she was estrogen dominant, which ledto her hysterectomy and brought on a surgically inducedmenopause. At that point, Brenda became a victim of thePremarin trend, also known as estrogen replacement therapy(ERT), which began in earnest in the 1970s. Before the1970s, there was nothing in the gynecological canon thatdictated giving women estrogen at menopause. I discuss thestory of Premarin and ERT in chapter 10, the chapter onmenopause and perimenopause. FIBROMYALGIA
The pain that Brenda began to experience in her 30s was due
to fibromyalgia. In my practice I come across many patients inwhom physical pain—arthritis, fibromyalgia, and so forth—isintermixed with symptoms of hormone imbalance. Just gettingtheir hormones in balance often leads to relief. Thosehormones most often involved include progesterone, insulin,adrenaline, cortisol, and thyroid. For the most part, these people are angry. Their hormone
imbalances are allowed to go on year after year. They take partin expensive, time-consuming efforts to treat their symptoms,and the symptoms stubbornly persist. It’s understandable thatthey’d develop anger about their lot in life. I’ve found23 ESTR OGEN DOMINANCE AND BRENDA J. fibromyalgia to be present in many of the people who seek out
my services, and, as with Brenda, it usually has not beenproperly diagnosed. Anger can cause muscles to tense. When you tense a
muscle, it produces lactic acid which causes pain, and thepersistent tensing of the muscles utilizes a lot of energy, whichcauses fatigue. Although Brenda doesn’t mention it in her story, she told
me during her intake interview that she was also operated onfor TMJ, or pain in the temporomandibular joint. TMJ iscaused by tensing of the jaw muscles, which occurs usually atnight and is always associated with anger. Brenda had a lot ofgood reasons to be angry. She was being misled by the medicalcommunity, and she had—let’s face it—a hard life raising herchildren on her own. I find her situation almost tragic. She wascrying out for help, exhibiting classic symptoms that shouldhave been impossible to miss, yet no one would listen to her. In chapter 7 I discuss the way I treat patients with
fibromyalgia, which is to deal with the underlying cause oftheir anger and to get their hormones back in balance. /Iswashf
If you can balance a patient’s hormones,
you can often treat their problems at the source
without resorting to surgery and drugs. I cannot emphasize enough the importance of utilizing
hormones correctly. Some women are more sensitive to foreignsubstances than others. Brenda was a woman who sensedsomething wrong the moment Premarin was introduced intoher system. She communicated this to her doctor, but herefused to give credence to her intuition. Ironically, when shetried to wean herself off Premarin, she suffered hot flashes andheadaches. This is because foreign substances, once they are24 THE MIRACLE OF BIO-IDENTICAL HORMONES  established on the cellular level, are difficult to flush out. For
many women, coming off Premarin is like coming off heroin.A woman may go through severe withdrawal headaches,nausea, hot flashes, night sweats, and so on in the process. The hot flashes and night sweats may be caused by
luteinizing hormone (LH), a hormone secreted by thepituitary gland. The pituitary sends this hormone to stimulatethe ovaries to produce more estrogen, progesterone, or otherhormones. Anything that elevates luteinizing hormone—alack of estrogen, progesterone, and perhaps even testos-terone—will produce the vasomotor effects that women get,that is, hot flashes and night sweats. Thus taking someone offestrogen can precipitate hot flashes. Or sometimes thepituitary is reacting to the fact that progesterone is low. So justgiving progesterone can take away hot flashes. In another chapter I address how to wean someone off of
Premarin. As you can see, balancing a person’s hormones is adelicate juggling act. WHY DUKE UNIVERSITY MEDICAL
CENTER FAILED BRENDA J. The medical center at Duke University is one of the most
respected in the world. Brenda went there and told them she justdidn’t feel good, so they put her through $20,000 worth oftesting and at the end of six weeks said, basically, “There’snothing wrong with you. You have to speak to a psychiatrist.”
How could this happen? How could a major medical
research center fail to diagnose someone properly after$20,000 worth of tests? One of the reasons is something I witness over and over
again among conventional doctors: they don’t treat patients,they treat lab tests. Few doctors sit down and talk to patients25 ESTR OGEN DOMINANCE AND BRENDA J. any more. If the doctors at Duke had taken the time with
Brenda, it would have been hard for them to miss the constel-lation of symptoms she was exhibiting. Moreover, when most doctors do blood tests, they don’t
always test for hormones. If they do, they don’t always test forthe correct hormones. I have worked with enough cases ofhormone imbalance that even before seeing the results ofBrenda’s blood tests, I knew that she was suffering from estrogendominance and hypothyroidism, her symptoms were so classic. It’s not surprising to me that a medical center like Duke
could miss Brenda’s symptomatology. The doctors at DukeUniversity are no doubt good doctors. However, most of themare academically inclined and simply won’t consider non-tradi-tional approaches that have not been verified by double-blindstudies. Universities, and the hospitals and clinics associatedwith them, tend toward medical conservatism. They’re alsoheavily influenced by pharmaceutical companies, which fundall the big medical research studies, creating an aura oflegitimacy around their products. In these settings, doctors’view of the wellness movement and natural products is skewed.They tend to dismiss both. AN UNDER-ACTIVE THYROID
Excess estrogen and low progesterone weren’t Brenda’s only
hormone problems. She also had an under-active thyroid.Once her body received the correct type and dose of thyroidsupplement, her metabolism increased and she was able toburn fat. She had more energy. As her fat reserves shrank, shefelt lighter and more optimistic. The doctors at Duke University diagnosed Brenda as
having an under-active thyroid, but they used an inappropriate26 THE MIRACLE OF BIO-IDENTICAL HORMONES  thyroid approach. Doctors, for the most part, fail to realize
there are two different thyroid hormones and both have to beassessed. In spite of $20,000 worth of testing, the physicians atDuke did not see that Brenda was not making enoughtriiodothyronine (T3)—the thyroid hormone responsible for90 percent of the thyroid’s activity. They gave her Synthroid,which is thyroxine (T4), basically a storage hormone. T4 mustbe converted to T3 to be effective, but Brenda’s body wasunable to convert T4 into T3, so Synthroid did not help her. Idiscuss thyroid function and treatment in more detail inchapter 3. The influence of the pharmaceutical companies is also a
factor to some extent here. Synthroid is so well-publicized thatit’s all that most doctors know when it comes to supplement-ing the thyroid gland. Six weeks after her first visit to my office, Brenda came in and
we sat down and talked. “Doc,” she said, “I’ve never felt better inmy entire life.” That shows you the power of hormones. AN OUNCE OF PREVENTION
T o my mind, Brenda’s life and her battle with estrogen teach
one very important lesson: it’s easier to prevent disease than itis to cure it. That’s why it’s essential that doctors educatethemselves about hormones. They’re foundational. If you canbalance a patient’s hormones, you can often treat theirproblems at the source without resorting to surgery and drugs.Brenda is a perfect example of the miraculous power ofbio-identical hormone therapy.ESTROGEN DOMINANCE AND BRENDA J. 27 THYROID HORMONES —
TWO TYPES
chapter THREE
The thyroid gland controls metabolism in every cell of the
body. A thyroid deficiency can cause a multitude of symptoms,the classic ones being weight gain, dry skin, poor nails, lowbody temperature, sluggishness, and memory problems. Inwomen, other common symptoms are blood clots during theirperiods and hair loss. Thyroid hormone controls the rate atwhich calories are burned to produce energy. Dr. Atkins,originator of the Atkins Diet, has stated that the number onereason for “metabolic resistance”—the term he uses to describethe inability to burn fat—is a thyroid deficiency. THE WRONG THYROID HORMONE 
Although most people don’t realize it, there are actually two
thyroid hormones, triiodothyronine (T3) and thyroxine (T4).The thyroid gland produces and releases T4, which goes to theliver, where it is converted into T3. T4 does not perform mostof the tasks of the thyroid hormone—it is essentially a storagehormone. T3, the active form of thyroid, is responsible for
29most, but not all, of its functions. Obviously, any problem
resulting in a lack of T3 will create low thyroid symptoms. Unfortunately, in the medical community today, when
testing and treating thyroid disorders most doctors test onlyfor T4 and regard it as the barometer of a person’s metabolichealth. They don’t realize that some people can have a perfectlynormal T4 level and still be hypothyroid (lacking in sufficientthyroid hormone) because of an inability to convert T4 to T3.Unless their bodies can convert T4 into T3, they will lack theessential ingredient for a properly acting metabolism. The most commonly prescribed medications for low
thyroid conditions are Synthroid, Levoxyl, and levothyroxine.These are T4 preparations—which means that most peoplewho exhibit low thyroid symptoms are being given somethingthat may or may not address their problem. In my practice Iconstantly come across patients who have been takingSynthroid for years without getting any relief from theirhypothyroid symptoms. Their doctors continue to prescribethe T4 preparation despite the lack of results because theirblood tests show normal T4 levels. As I’ve said before, toomany doctors treat blood tests instead of patients. T3 preparations are available, but for the most part they
are ignored by the medical community. Possibly aggravating the problem are any of a number of
medications that interfere with thyroid metabolism andprevent or slow the conversion of T4 into T3. These includecholesterol-lowering statin-type drugs such as Lipitor andZocor. These lower coenzyme Q-10, a factor necessary forthyroid conversion. I talk about these again in chapter 19,which discusses the medications that prevent weight loss. Ironically, one of the most common reasons for an elevated
cholesterol level is an under-active thyroid. This means thatpeople who take statin-type drugs for cholesterol are taking a30 THE MIRACLE OF BIO-IDENTICAL HORMONES  thyroid-blocking drug to treat a condition that may be caused
by an under-active thyroid in the first place. When I seepeople with high cholesterol, my first thought is that theymight be low in thyroid. In fact, in the old days, cholesterolused to be called “the poor man’s thyroid test.”
Beta-blockers such as atenolol, Ziac, and Lopressor also
block the conversion of T4 into T3. These drugs are often pre-scribed by cardiologists for their heart patients to reduce theworkload of the heart. However, they almost guarantee weightgain, which is, ironically, one of the most significant riskfactors for coronary artery disease. THYROID STIMULATING HORMONE
I apologize if the discussion is getting a little long and technical,
but one cannot underestimate the importance of knowingabout thyroid metabolism. My sense is that millions of peopleare being improperly treated, or not treated at all, for anunder-active thyroid condition. The reasons are twofold: thefailure of many doctors to listen to what their patients aresaying, and the failure of many doctors to interpret laboratorytests logically. Most physicians regard the test for TSH, or thyroid
stimulating hormone, the most sensitive of all thyroidtests—in fact, it’s often the only thyroid test that’s ordered.If the pituitary gland detects suboptimal thyroid levels, itsends out TSH to stimulate the thyroid to make morehormones. “Normal” levels of TSH are considered to fallbetween 0.3 to 5.5. If your TSH level is within this range,your test is considered normal and no thyroid will beprescribed. However, the fact is that any TSH level greaterthan 1.0 can mean your pituitary is saying “you needthyroid.” The normal range was arbitrarily established by31 THYR OID HORMONES—TWO TYPES determining the TSH levels of 100 medical students, with
no concern as to how their thyroids were functioning. Doctors usually wait to see a TSH level higher than 5.5
before they prescribe treatment. But patients with that higha level are severely hypothyroid. My goal when I treatpatients is to get the TSH level close to 0.3, at which pointI know they are getting close to 100 percent of the thyroidthey require. However, I use two different thyroid hormonesto achieve this—both T3 and T4. A low TSH in a patientwho is taking only Synthroid or Levoxyl may indicate thatthey are taking too much of the medication, especially if thepatient also shows a higher than normal heart rate. WHAT YOU CAN DO 
A proper thyroid evaluation should include taking the patient’s
history, looking at the patient, and ordering the proper tests.Signs and symptoms of low thyroid, as I mentioned before,include: dry skin (without using moisturizers), brittle or softnails, cold feet, blood clots with periods, low body temperature,fatigue, poor memory, dry and brittle hair, elevated cholesterol,and weight gain. Sensible thyroid testing would include:
• Free T4 
• Free T3 • TSH 
Note: Free T4 and free T3 does not mean there is no fee
involved. Rather, “free” refers to thyroid that is unbound andbiologically active and so is not affected by levels of thyroidbinding globulin.32 THE MIRACLE OF BIO-IDENTICAL HORMONES  T3PREPARATIONS
T o my way of thinking, proper thyroid dosing is likely to
include both thyroid hormones. There are various T3 prepara-tions, such as Armour, Thyrolar, and Cytomel. The first twoare combinations of T3 and T4. However, the T3 isshort-acting (three hours), and neither preparation has enoughT4. Cytomel is a synthetic T3 and is also short-acting. My preference is giving a sustained-release form of
bio-identical T3 (obtainable only through a compoundingpharmacy) to be taken once or twice a day. If the free T3 levelis below 280 pg/dl, I prescribe 7.5 mcg of T3-S/R. In additionI prescribe the proper dose of L-thyroxin (Levoxyl orSynthroid), usually 0.125 mg, corresponding to a free T4 levelof 1.1 ng/dl. Note that people with ADHD always have low thyroid
levels. They are also low in progesterone, which is required forproper thyroid functioning. If a patient has undiagnosedADHD (a common occurrence) and the doctor is onlytreating lab tests and not symptoms (also a common occur-rence), the patient may experience uncomfortable side effects,such as palpitations, headache, or a rise in blood pressure, afterstarting on thyroid. Both adrenaline, which is part of theADHD causation, and thyroid are stimulants, so ADHD mustbe treated, by lowering the adrenaline levels, prior to startingthyroid. The decrease in energy level that ADHD patientsexperience as their adrenaline levels are lowered is balancedagain with thyroid, which brings their energy levels back up. My approach to ADHD is presented in chapter 15.33 THYR OID HORMONES—TWO TYPES HORMONAL FATIGUE
AND RHONDA Y . chapter FOUR
Fatigue is a common symptom in bodies that are out of
balance. For Rhonda Y., 38, hormonally induced fatigue haderoded the joy of raising her family.
The_Miracle_of_Bioidentical_Hormones_by_Platt.txt
Summarize the following text section accurately and concisely. Maintain specific details and numerical information, and use anti-repetition mechanisms:

        PRAISE FOR DR. PLATT
“Dr. Platt is an expert and renowned for his work with natural hormone
replacement to enhance wellness. The findings in this thoroughly reader-friendly book are presented skillfully and clearly, making the informationthoroughly accessible for the general reader. This book can substantially aidmen and women, with the help of their physicians, to seek effective hor-monal solutions to health conditions considered insoluble. ”
– MIDWEST BOOK REVIEW
“Make no mistake—this is NOT a book just for menopausal women. Men, women, and children with a myriad of chronic conditions and debil-itating illnesses will finally find answers in their quest to just feel better. ”
– ELLEN PARRIS, reviewer, Palm Springs Life
“As a practicing orthopedic surgeon in Jakarta, Indonesia, with immense
interest in preventive medicine, I strongly recommend this book, as it is afantastic one, the only kind of book that prompted me to fly from the otherside of the globe to meet the author in person. ”
– HENRY SUHENDRA, M. D. , F. I. C. S. “I’m very proud, and at the same time relieved, that we have doctors
like Dr. Platt, truly interested in patients’ complaints and devoted topreventive medicine. ”
– DR. LUIS CESAR ANZOATEGUI,
professor and physician, Mato Grosso do Sul, BrazilALLBOOKS REVIEWS 2008
Best Health Book Award
“Dr. Platt’s book is an excellent source of information on health issues
facing many people. His book was the most enlightening, educational,and well-written amongst all our “Health” Submissions. ”
– SHIRLEY ROE,
Allbooks Review Managing Editor
READER VIEWS 2008
Best Alternative Health Book Award
“We are pleased and proud to have discovered Dr. Platt’s pioneering health
book and to have been able to honor it with an award. ” 
– IRENE WATSON,
Reader Views Managing Editor
IPPY 2008
Most Progressive Health Book Award
USA BEST BOOK 2007
Alternative Medicine and General Health
finalist in both categorieshow i lost my: fatigue, hot flashes, adhd, 
add, fibromyalgia, pms, osteoporosis, weight, 
sexual dysfunction, anger, migraines. MICHAEL E. PLATT, M.
Michael E. Platt, M.D.
Who wrote the book "The Miracle of Bio-Identical Hormones?
Dr. Platt's approach focuses on addressing the underlying cause of a patient's condition, rather than just treating the symptoms.
What is the main focus of Dr. Platt's approach to medicine?
The author aims to provide a logical and sensible approach to treating various health conditions, and to raise awareness about the importance of natural hormones in maintaining wellness.
What is the author's purpose in writing this book?
Dr. Platt's approach emphasizes the importance of listening to patients and addressing the underlying hormonal imbalances, whereas traditional medicine often focuses on treating symptoms with synthetic hormones.
What is the main difference between Dr. Platt's approach and traditional medicine?
The author believes that the medical community is complacent and often ignores the importance of hormones in maintaining overall health, and that many doctors are influenced by pharmaceutical companies.
What is the author's opinion on the medical community's handling of certain health issues?