HEALTH NOVEMBER 12, 2013
A couple weeks ago, Suzanne Somers made Twitter explode with her anti-Obamacare screed on the Wall Street Journal’s Experts blog. The article itself wasn’t remarkable—she used the usual trigger-phrases, like “socialist Ponzi scheme,” and “Canada”—but the corrections certainly were:
An earlier version of this post contained a quotation attributed to Lenin (“Socialized medicine is the keystone to the arch of the socialist state”) that has been widely disputed. And it included a quotation attributed to Churchill (“Control your citizens’ health care and you control your citizens“) that the Journal has been unable to confirm.
Also, the cover of a Maclean’s magazine issue in 2008 showed a picture of a dog on an examining table with the headline “Your Dog Can Get Better Health Care Than You.” An earlier version of this post incorrectly said the photo showed and headline referred to a horse.
Dog is to horse as Churchill is to Lenin—oh, whatever. Left uncorrected, though, was the mountain of misinformation and half-truths on which Ms. Somers has built her post-show-business career as a health guru. Since 2004, with the publication of The Sexy Years, she has been a relentless advocate of so-called “bioidentical” hormone replacement therapy for post-menopausal women. In her latest book, I’m Too Young For This!, published last month by Crown Books, she doubles down, pushing hormone therapy for women in their 40s and even 30s, who have not even undergone menopause yet.
Her message can be boiled down to this: Hormone replacement therapy makes life awesome! She's having Sex Twice A Day! Thanks to hormones, her skin is smooth, her hot flashes are gone, and as she claimed in 2006's Ageless, "I have substantially reversed the aging process in my body." She has riffed on this same basic theme in most of her 24 (!) books, from Ageless to Breakthrough to Bombshell to her current offering. And while some of her advice is basic Grandma stuff (eat fresh vegetables, get some exercise, sleep well and manage your stress), it all appears to hinge on these “bioidenticals,” which Somers swears by. In her notorious 2009 Oprah interview, she revealed that she injects hormones directly into her vagina. Every day. Plus a daily shot of human growth hormone.
A little history: Middle-aged women (and men) have been shooting themselves up with sex hormones since the 1940s, not long after estrogen and testosterone were first identified by scientists in Nazi Germany. They are, basically, steroids, and testosterone and its relatives soon became beloved by athletes of both sexes. Beginning in the 1960s, estrogen-replacement therapy was widely prescribed for menopausal American women, for "hormone management," until 2002, when the massive Women’s Health Initiative study was stopped because the drugs seemed to trigger an increased risk of cancer and blood clotting. Millions of women quit taking the drugs overnight, and were left without an alternative.
Then Somers came along and popularized so-called “bioidentical” hormones, which were supposedly natural, unlike the “synthetic,” evil pharma-company versions. It didn’t help that the most popular prescription drugs, Premarin and Prempro, were made using pregnant mare’s urine—hence Premarin. Creepy, right? Soon millions of women had switched to the bioidenticals, for which Somers evangelizes constantly, with seven books on the topic and counting.
But there’s only one problem: It’s bull.
“It’s a catchy phrase, ‘bioidentical,’ but it doesn’t really mean anything,” says Dr. Nanette Santoro, chair of the department of obstetrics and gynecology at the University of Colorado Medical School. “It’s a loaded word.” According to the respected blog Science-Based Medicine, “[Bioidentical] is a marketing term rather than a scientifically meaningful one.”
What bioidentical means, technically, is that the hormone molecules are chemically the same as those found in the human body. As used by Somers and her adherents, though, it also means that those hormones (not only estrogen, but progesterone and others) are prepared in a special mixture by a “compounding” pharmacy, which makes custom preparations of drugs and supplements, to a physician's prescription. Compounding pharmacies are basically unregulated, and hormones are technically considered dietary supplements, and are minimally controlled by the FDA. “Bioidenticals are a natural substance and cannot be patented,” she writes in Ageless. “Therefore, there is no money to be made from selling the best solution for menopausal women.”
Actually, not true: Otherwise the compounding pharmacies would not sell them. “The markup on this stuff is awesome,” says Santoro. “To get a crystalline steroid in bulk is very cheap, and to be able to sell it for $200 a month is really a good gig.”
It’s also a myth that “bioidenticals” can only be obtained from one of these unregulated compounding pharmacies; in fact, there are many FDA-approved hormone treatments using hormones identical to our own. “A better distinction could be made between products that are approved and regulated by the FDA, and those that are not,” wrote two noted menopause experts, Drs. Lynn Pattimakiel and Holly Thacker, in the Cleveland Clinic Journal of Medicine in December 2011. Also, the "bioidenticals" do not have the scary "black box" warning label the FDA requires on all approved hormone-replacement products.
FDA approved means it’s been tested for safety, efficacy, and dosing and absorption; the drug companies have researched, and patented, the various delivery methods (pills, creams, skin patches, even a nasal spray.) And doctors know how much of the hormone their patients are really getting. With compounding, not so much. Last year, contamination at a compounding pharmacy in Framingham, Mass. caused an outbreak of fungal meningitis that killed 48 people and sickened more than 700. An FDA study of compounded drugs found that the actual dosage varied by as much as 280 percent.
“I’ve had a patient bring in her hair in a baggie because a compounding pharmacy screwed up her testosterone prescription,” says Santoro.
Many experts object to the aggressive way in which Somers advocates using the hormones, cranking her estrogen (and testosterone!) levels up to those of a 30-year-old in her sexual prime. After Ageless came out in 2006, seven prominent OB-Gyns wrote her an open letter—including three of the doctors she had actually quoted in the book—criticizing her for pushing the “Wiley Protocol,” an intensive hormone regimen invented by a writer and actress whose medical credentials consisted of a bachelor’s degree in anthropology. “Is it healthy to be dosed like a 30-year-old when you’re 60?” asks Dr. Joann Pinkerton, Director of the Midlife Health Center at the University of Virginia Health System. “Show me the evidence.”
In fact, the evidence shows that hormone use is relatively safe only for short periods of three to five years, for women under age 60, says Pinkerton—and even then, only to treat symptoms. The risk of heart disease, stroke, and dementia all increase steeply after after age 70. Somers is 67, but has been using hormone therapy since her 40s, by her own account, including through an episode of breast cancer. And her latest book, of course, essentially advocates lifelong hormone therapy for women—beginning as early as their 30s. "Not all women actually need this in order to feel good and healthy and OK," Santoro points out.
Somers’ ideas have been thoroughly debunked in reputable medical publications: Try the Cleveland Clinic Journal of Medicine, Harvard Women’s Health Watch, and the well-respected Medical Letter, a newsletter for physicians, for starters. The American Society for Reproductive Medicine and the American College of Obstetricians & Gynecologists also think her “bioidentical” hormones are a bad idea. She’s had critical press, too: Newsweek took a pretty hard look at her and Oprah in 2009, and way back in 2001 Larry King (of all people) pretty much busted her for getting liposuction when she was still hawking the Thighmaster. And of course, there is the undeniable contrast between her highly-retouched author photo and her actual appearance. Is this someone you would trust for advice about aging? (And I haven’t even mentioned her wacky, dangerous ideas about cancer.)
But in America today, it doesn’t really matter that you are wrong, just so long as you are famous—and preferably blonde. For whatever reason, as a culture we've chosen to outsource our medical advice to very good-looking people on TV. So Jenny McCarthy is able to wage her successful anti-vaccine jihad, and Somers can continue to spread her cuckoo theories, because the media and the publishing industry give them a massive platform from which to do so. Somers' books have sold millions of copies, including three #1 New York Times bestsellers, and there are more to come: She’s partway through a three-book deal with Random House. For this latest book, she’s been on CBS’ "The Talk," "Good Morning America," and a passel of local affiliates, with minimal fact-checking pushback from actual medical experts (although Katie Couric tried, and CBS did run this rather tepid report). Inevitably, though, TV and print media set it up as a "debate," with the blonde hottie on one side, looking amazing, and some Debbie Downer "expert" (or worse, "critic") on the other.
“It’s really galling to be competing for scientific legitimacy with Chrissy from 'Three’s Company,'” says one well-respected menopause authority who has tangled with Somers. And perhaps not surprising, given her politics, she is a regular on Fox News, with at least six appearances in a one-week period at the end of September and early October, and nary a breath of criticism.
Oh well. At least she’s not on "The View."