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When a famous person—a beautiful, sexy, and powerful famous person—gives an endorsement, people tend to listen. That's why corporations hire Maria Sharapova to endorse Canon or Michael Phelps to pitch for Kellogg's (at least until he took his famous bong hit). But what happens when stars weigh in on medical topics? Think of Tom Cruise and his sweeping condemnation of modern psychiatry. Celebrities may be perfectly qualified to evaluate sneakers, but that doesn't mean you want to learn biochemistry from them.
But stars are human, too, and often cannot resist speaking out when a health crisis has touched their lives, even if there's little evidence for their solution. Here's a look at three celebs who have swayed public opinion on three health issues and where they went wrong—or got it right.
Oprah Winfrey on hormones after menopause
Her take: Oprah says bio-identical hormones pulled her out of a major funk, restored her sense of vitality, and turned her life around. While she doesn't suggest they're right for all menopausal women, in January she devoted two shows to their advantages, giving a platform to the hormones' most enthusiastic proselytizers.
The science: Taking hormones after menopause is serious business, whether or not you use trendy bio-identical hormones, which precisely mimic the ones your body produces. Studies on hormone therapy (HT) show that using it for more than a few years can increase the risk of developing breast cancer; it may also raise the risk of heart attack.
That's not a blanket condemnation, however. Hormones are the most effective treatment for menopausal symptoms of the mind-bending, libido-sapping, shoot-me-now variety. If you have no personal history of breast, uterine, or ovarian cancer, the short-term relief may outweigh the risks. But don't assume you should take them indefinitely to restore youthful hormone levels, as actress Suzanne Somers suggested in her book Ageless and on the second of Oprah's shows.
"A 60-year-old should not have the same hormone levels as a 20-year-old," says Wulf Utian, MD, executive director of the North American Menopause Society. He calls Somers's ideas "dangerous and irresponsible."
If hormone therapy is right for you, then and only then does the issue of bio-identicals come into play. The problem is that the word bio-identical means different things to different people. Technically, it embraces any exact copy of a naturally occurring female hormone. That's in contrast to some traditional hormone products; for instance, Premarin, the leading estrogen product, is made from the urine of pregnant mares. ("It's bio-identical if you're a horse," says Christiane Northrup, MD, author of The Wisdom of Menopause.)
Many other big-pharma products actually are bio-identical. FDA-approved drugs that precisely mimic women's hormones include Estrace, Evamist, Vagifem, Estraderm, and Climara for estrogen and Prochieve, Prometrium, and Crinone for progesterone. Yet bio-identicals have become synonymous in many women's minds with a narrower set of products—those that are made to order in compounding pharmacies. These customized drugs have acquired a reputation as a "natural" alternative to hormone therapy. They are not: They're highly processed, potent medicines.
What really worries many doctors is the common perception that bio-identicals are safer. Some women do report that they're easier to tolerate, but in the absence of solid studies, Dr. Utian says, doctors have to assume that any kind of supplementary estrogen carries similar long-term risks—and others agree, including Andrew Weil, MD, a leading proponent of integrative medicine. The jury is still out on the safety of bio-identical progesterone as well.
Promoters of compounded bio-identicals often suggest that "they have all the benefits but none of the risks of pharmaceutical brands," said Dr. Utian on the first of Oprah's broadcasts. "If you believe in that, you believe in the tooth fairy."
Reader's Digest Version: If you need hormone therapy, take the lowest effective dose for the least amount of time possible (think one to three years). For bio-identicals, seek out FDA-approved brands.
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