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Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland: nationwide case-control study

BMJ 2019; 364 doi: (Published 06 March 2019) Cite this as: BMJ 2019;364:l665

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Menopausal hormone therapy and cognition

Rapid Response:

HRT and dementia Re: Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland: nationwide case-control study

The almost universal use of contraceptive “Pill” progestogens and oestrogens in young women causes biochemical perturbations and often medical complications. At the menopause falling levels of sex steroid hormones can unmask symptoms. although the menopause is a long-evolved normal event, menopausal symptoms made worse by previous contraceptive hormone exposures are “treated” with further progestogens and oestrogens. This has led to the rise of HRT.

The Finnish post menopausal case-control hormone therapy (HT) and Alzheimer’s disease study found use of both systemic combined and oestrogen only (estradiol) HT was associated with a 9 to17% increased risk of Alzheimer’s disease. The mean age at initiation of systemic HT was 52 years. In women aged < 60 years at HT initiation, the risk increases were associated with HT exposure over 10 years. The authors think that HT users should be informed of the risk of Alzheimer’s disease with prolonged use.1

“Women need to be informed about the dangers of Hormone Replacement Therapy” is one of our most accessed publications according to Research Gate. It was about the epidemic increases in breast and ovarian cancers and vascular diseases with HRT.2

The menopause in healthy women is physiological but menopausal symptoms are like a lighthouse which flashes signals of adverse reactions to foods and chemicals. In my experience undiagnosed essential nutrient deficiencies, infections or increases in toxic DNA adducts are common. Both hormonal contraceptives and HT can lower white cell zinc levels, red cell magnesium levels and raise serum copper levels which can reduce copper stores and impair superoxide dismutase function. Zinc is essential for brain function and necessary for hundreds of enzymes. Zinc and magnesium deficiencies can block omega-3 and omega-6 essential fatty acid pathways. Zinc and magnesium deficiencies also increase headaches, vasomotor symptoms like hot flushes, mood changes and osteoprosis.3-5 HT use can cause addiction with severe withdrawal symptoms when discontinued.6

HRT promoters concentrate on giving different types and doses of progestogenic and oestrogenic hormones rather than investigating common biochemical abnormalities.

1 Savolainen-Peltonen H, Rahkola-Soisalo P, Hoti F, Vattulainen P, Gissler M, Ylikorkala O, Mikkola TS. Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland: nationwide case-control study. BMJ 2019; 364 doi: (Published 06 March 2019) BMJ 2019;364:l665.
2 Price EH, Little HK, Grant ECG. Steel CM. Women need to be warned about dangers of hormone replacement therapy. BMJ Clinical Research 1997;314:376-77.
3 Grant ECG, Howard JM, Davies S, Chasty H, Hornsby B, Galbraith J. Zinc deficiency in children with dyslexia: concentrations of zinc and other minerals in sweat and hair. BMJ 1989;296:607-609.
4 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity, and mineral imbalance. J Nutr Environ Med 1998;8:105-116.
5 McLaren Howard J, Grant ECG, Davies S. Hormone replacement therapy and osteoporosis: bone enzymes and nutrient imbalances. J Nutr Environ Med 1998;8:129-138.
6 White M, Grant ECG. Addiction to oestrogen and progesterone. J Nutr Environ Med 1998;8 :117-120.

Competing interests: No competing interests

09 March 2019
Ellen C G Grant
Physician and medical gynaecologist
Kingston-upon-Thames, Surrey, UK