Dr. Mercola's Comment:
I still strongly endorse progesterone, however I think the cream version has potential complications particularly by the way it accumulates and contributes to disruptions in the adrenal hormones such as DHEA, cortisol, and testosterone. I have learned that although progesterone cream is an enormously useful tool, it needs to be used very cautiously. So, if one is going to use the cream they absolutely need to be monitored with a saliva test on an annual basis. The saliva value should be below 300. I have seen numbers over 10,000 and it may take up to two years for this level to normalize as the progesterone is stored in the fat and comes out very slowly. One should not resume progesterone (in any form) until the level drops below 300 again.
I had the great privilege of dining with Dr. Lee on Friday and lecturing with him on Saturday. I was expecting to learn some exciting new information and I was not disappointed. There are two major highlights to review. I am even more convinced now of the value of natural progesterone for women and even for men as I will discuss later.
The most exciting information though has to do with progesterone's ability to PREVENT and REVERSE many cancers. The newer studies show that estrogen, specifically estradiol, does not increase the risk for breast cancer but it actually CAUSES breast cancer AND prostate cancer. There is not any debate left about this issue. All major researchers have found this. The information on the prostate is new.
Let me attempt to explain the relationship for prostate cancer in more detail. Men also make estrogen and estradiol, but in much lower amounts than women. The male hormone, testosterone, is antagonist to estradiol.
Testosterone prevents estradiol from causing prostate cancer by destroying the prostate cancer cells it stimulates. Testosterone does NOT cause prostate cancer. If this were true 19 and 20 year old males would be developing prostate cancer as these are the individuals with the highest levels.
This is obviously not the case. Males also produce progesterone, although about half as much as females do. The progesterone prevents the body from converting testosterone to di-hydro testosterone. It does this by inhibiting the enzyme 5-alpha reductase. Progesterone inhibits 5 alpha reductase far more effectively than Proscar and Saw Palmetto which are the more standard agents employed in traditonal and natural medicine.
As a male ages, his progesterone level decreases just like it does in women. In women this decease occurs about the age of 35 and men about ten years later. When progesterone levels decrease, the male's 5 alpha reductase converts the testosterone to di-hydro testosterone which is useless at removing the prostate cancer cells that estradiol stimulates.
Estradiol also stimulates the enlargement of the prostate. This allows the prostate gland to swell and enlarge and in many cases transform into prostate cancer.
The prostate is embryologically similar to the female uterus. Prostate cancer is the NUMBER ONE cancer in men. Prostate enlargement is a major cause of problems in elderly men. It appears we now have a simple, safe inexpensive solution to prevent and treat this problem.
Dr. Lee has a large number of anecdotal stories of complete reversals of metastatic prostatic cancers. The clinical research has just begun. Dr. Lee states that there are several studies that will be published in the peer reviewed literature very shortly confirming this observation in animal studies.
There is no need to wait for these studies as there is strong biochemical evidence to support this recommendation. The JAMA released an article on January 28th entitled, “To Die or Not to Die?” that declares that most cells in the body die through a more subtle, non-inflammatory, energy-dependent form of cell death called apoptosis.
Recent research into the molecular mechanisms of apoptosis has revealed that apoptosis is a genetically programmed process that can become deranged when the components of the cellular apoptotic machinery are mutated or present in inappropriate quantities.
Deregulation of apoptosis is associated with the cause of a wide array of diseases: cancer, neurodegeneration, autoimmunity, heart disease, and other disorders.
All cells, with the exception of brain and muscle cells, multiply continuously. The genes which regulate this cell growth are p53 and bcl2. If the gene bcl2 dominates it will push cells to cancer.
If gene p53 dominates, the opposite will occur. The article clearly shows that traditional chemotherapy using poisons to stop cell hyperplasia does not work as they kill normal cells easier than cancer cells. The new idea promoted by the review is to find agents that activate p53 and deactivate bc12. This is the hope for curing cancer.
Well folks, guess what the research shows? Estradiol turns on the cancer gene bc12 and progesterone turns on the anti-cancer gene p53! Breast cancer cells do not multiply when women are on progesterone. These hormones also worked for cancer of the ovary and uterus and small cell lung cancer which is normally a very difficult cancer to treat with a horribly dismal diagnosis.
This is MAJOR news and will provide a radical shift in my recommendations for hormonal replacement. I now believe that nearly all men should seriously consider natural progesterone replacement sometime in their 40s, or even earlier if they have a family history of prostate cancer. There is also a reasonable likelihood that this will decrease male balding. So, all the men who wish to retain what is left of their hair, I would start this immediately.
Dr. Lee has always recommended a low dose cream. Originally, I did not believe that the low dose cream was necessary and decided to reduce the patient cost by using a high dose 10% prescription cream. This made the cream very affordable but also significantly increased the risk of overdosing and causing complications.
Dr. Lee explained to me that when much higher doses are given, the excess progesterone is metabolized in the liver and some of the metabolites may have an anesthetic dose on the brain. I believe that many of the patients I have prescribed the higher dose 10% cream for have experienced some of these symptoms.
The other consideration has to do with the distribution of the dose. The progesterone cream enters from the skin into the fat. The progesterone is released from the fat into the blood stream in direct proportion to the concentration of the cream.
The danger of using a higher dose cream is that there will not be a smooth release of the hormone into the blood stream over the 12 hour period. Since progesterone has a relatively short half life of five minutes once it is in the blood, this will significantly limit its effectiveness and one will only receive partial benefits from the progesterone.
His arguments are very compelling and I am changing my recommendation to the lower dose cream. The higher dose cream was $3 per month. Shifting to the lower dose cream will increase the price to about $9 per month. However, I believe the benefits are significant enough to warrant the increase in cost.
There are many low dose non prescription natural progesterone creams on the market. A typical one would have about 900 mg per two ounces which is about 1.7%. Many are available in the health food store.
However, one needs to be very careful that the cream indeed has natural progesterone and in the 1.7% concentration. We will be offering one of the best low dose creams on the market, Natragest, which we obtain from Biotics Labs.
The dose of natural progesterone for men is 10 to 12 mg per day. Men do NOT need time off like women and can take the progesterone without taking any days off. The normal dose for women of natural progesterone should be about 20 mg per day from day 12 to 26.
These doses are split and taken twice a day. If one is using the Natragest cream the 6 mg male dose would be about 1/16 of a teaspoon twice a day. The dose for women would be about twice that 1/8 to 1/4 teaspoon twice a day from day 12-26.
It is VERY important to be a precise as possible when administering this dose. If you are a woman and have the older higher dose cream they can still be used but I would decrease the dose to 1/32 of a teaspoon immediately.
JAMA. January 28, 1998;279:300-307