Dr. Felice Gersh talks about how to improve heart health in women with bioidentical hormone therapy with Dr. Ben Weitz. 

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 

 

Podcast Highlights

1:52  Prior to menopause, women tend to have a significantly lower risk of heart disease then men because estrogen is protective of the heart.  This is one reason why many doctors were prescribing estrogen and hormone replacement therapy (HRT) to women after menopause. But then in 2002 the Women’s Health Initiative Study was published that showed that HRT was dangerous and raised a woman’s risk of heart attack and stroke, as well as breast cancer, and many doctors stopped prescribing HRT. 

2:58  Dr. Gersh explains that this study was really disastrous for women’s health and amounted to a roadblock in the developing story of estrogen and women’s health. First of all, they did not study human estrogen. The compound studied is Prempro, which is derived from the urine of pregnant horses. It’s not even the estrogen that the horses wanted. It’s the estrogen that they excreted, which is why it is known as conjugated equine estrogen. And the form of progesterone used in this study is Provera, which is a synthetic form of progesterone known as progestin, or medroxyprogesterone acetate, which is actually an endocrine disruptor.  It’s a chemical that binds to progesterone receptors, but it has variable effects, and it turns out in the uterus, in the uterine lining, it acts as a big blocker of estrogen, but when you look at the other parts of the body, you look at the cardiovascular system, and the brain, and so forth, what you find, it actually is a progesterone blocker. The same in the breast, so it actually is like an anti-progesterone. And these were also women who were in their 60s, so most of them already had some pre-existing cardiovascular disease since they were often more than 10 years out from when they actually went through menopause, which we know is a big risk factor for cardiovascular disease.  It turns out that Premarin increases the risk of blood clots by 400%, so it is really disastrous for women’s health!

7:30  Estrogen is very protective for the heart, especially estradiol more so than estriol.  Estradiol protects our arteries through stimulation of the endothelial nitric oxide synthase, which produces nitric oxide, which maintains the dilation and the health of the endothelium (the lining) of our arteries. Without estrogen you get reduced levels of nitric oxide. There are estrogen receptors in the gut, which is why that after menopause you tend to get leaky gut. There are estrogen receptors on the immune cells, like macrophages, neutrophils, and mast cells, which are part of the gut-associated lymphoid tissue, so this sets up systemic inflammation, which is a major factor in arterial problems in heart disease. Also, estrogen reduces platelet aggregation and blood clotting. Without estrogen you have the perfect scene for trouble–platelet aggregation, reduced dilation of your blood vessels, leaky gut, and inflammation. You also get more oxidized LDL because estradiol maintains an enzyme system called the peroxidase 1, PAN1, which reduces the oxidation of LDL. Without estrogen you also get an increase in ADMA, which further reduces nitric oxide. All this is happening very rapidly as women proceed through menopause, which is why women have higher rates of stroke than men and women tend to die more commonly than men from their first heart attack and they actually start to surpass men in terms of percentages of women dying from cardiovascular compared to men, and none of this is recognized by our conventional medical world, and they fear estrogen.

Kiran Krishnan, microbiologist, talks about the benefits and research on Spore-based Probiotics with Dr. Ben Weitz. 

[If you enjoy this podcast, please give us a rating and review on Itunes, so more people will find The Rational Wellness Podcast] 

 

Podcast Highlights

5:49   When Kiran was researching which strains of probiotics are most effective and have the most research, he kept coming back to the spore-based bacillus species. Because these probiotics are encased in a spore, they have the capability to survive through the acid in the stomach and the bile salts and the pancreatic enzymes in the small intestine.  This is why most other, non-spore-based probiotics are killed by the time they end up in the colon.   

6:59  The difference between soil based and spore-based probiotics is that most of the bacteria in the soil have no benefit for us in our gut as probiotics.  Only a few of the bacteria in the soil are bacillus species and have endospores and these are the ones that can survive the trip down our digestive tract and are native to our gut.

9:35  If you do a Google search for spore-based probiotics, mostly negative articles come up that claim that they are new and that there are very few studies on them.  This is the opposite of the truth. Some of the spore-based probiotic strains, like bacillus subtilis, have been used in most of the world (in Europe, Asia, and Latin America) as prescription drugs since 1952 and have thousands of studies on them. In fact, if you go to Pub Med you’ll find that some of these bacillus strains are the most well-studied of all probiotics.

15:32  Kiran explained that it is interesting to note that most people think that the strains like lactobacillus and bifido bacteria that you see in most conventional probiotics are the natural strains found in our guts. But this is not true, since the particular strains of lactobacillus acidophilus in the stores are different than the strains found in your gut.  Many of these strains were first pulled out from a human volunteer 35 years ago and since then, they’ve been growing in a factory and the strain has completely changed and has adapted to life in the factory. And each of us have a unique set of bacteria strains that we first got from our moms.

18:26  Like conventional probiotics, spore based probiotics do not permanently colonize the gut. They do colonize the gut and adhere to the wall and outcompete bad bacteria, but they only last about 20-21 days. Then they form spores and leave the body through defecation and then find another host through being eaten in some dirt. Our primitive ancestors were consistently eating dirt since they could not wash their food before they ate it, so they were constantly getting exposed to these bacilli. Not only do these bacilli crowd out pathogenic bacteria, but they increase microbial diversity in our gut.

22:15  I asked when we do a stool analysis on our patients, why don’t we see these bacillus strains listed as commensal bacteria?  Kiran answered that some of the panels will list bacillus subtilis under dysbiotic flora due to a misunderstanding. The resolution of some of the tests is not good enough to easily pick out the exact species and since we often have over 1000 species in our guts, but the tests usually do not list more than 15 or 20 commensal species, so they are not really a good representation of what’s in our gut. Stool tests that use culture are not very accurate, since 98% of the commensal bacteria are not able to be cultured in vitro outside of the body.

26:51  Bacillus subtilis produces a number of antimicrobial compounds that help get rid of pathogenic bacteria, including H. pylori. During World War II when the German army was in North Africa many of the troops were dying of dysentery. They noticed that when the locals would get sick that they would consume dried camel dung and that would cure them,