I always find it interesting that part of
the role of knowledge is to help overcome prejudice, and all
knowledge is really prejudice. (We judge a new situation based
on our experiences with old but similar situations.)
I am not an authority on Evista by any stretch, but here
are my reasons for my prejudice in favor of natural hormones
(those already in people) or bio-identical hormone replacement
rather than Evista or whatever:
- In my 28 years of patient contact, I have seen the drug
detail men hawking all kinds of products for our patients.
Currently, I see them hawking Premarin, and a wide variety
of other drugs. They really don't seem to care about our
trust, only to sell as much of the product as they can.
- I saw Tamoxifen sold as the "be all, end all"
agent to protect the breast tissue. Now, it is a major risk
factor for endometrial cancers. Seldane was marketed as
a non sedating antihistamine, until they found if you took
it with E-mycin, you could die. Qualuud was brought in as
"a non habit forming sleep aid," until it started
selling for $5 a pill on the street and was taken off the
In brief, drug companies are not benign sources of information
about what is good. They also pay for about 90% of the continuing
medical education. They even ply medical students with goodies.
Now, big companies don't sink 20% of profits into advertising
because it doesn't work. Bringing docs goodies that range
from lunch to ball-point pens and paper really affects the
way docs (people) see products.
When I work with hormones already in a person, I know that
receptors the it will interact with are there, and that the
hormone is the chemical that fits. The mechanisms to degrade
the hormone are already in place, and I know that the hormone
has been tested in almost every living human being. Hippocrates
suggested that one should never be the first nor the last
to try a new treatment. I'd concur.
Hope this helps,
Don Michael, MD
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