Kent Holtorf

Last updated
Kent Holtorf
Born (1964-06-23) June 23, 1964 (age 59)
NationalityAmerican
EducationPostgraduate
Alma materUniversity of California at Los Angeles, St. Louis University School of Medicine
OccupationMedical Doctor
Years active17
EmployerHoltorf Medical Group

Kent Holtorf (born 1964) is an American physician and entrepreneur practicing in Los Angeles, California. [1] [2] He is a board examiner of the American Board of Anti-Aging Medicine (ABAAM), which is not recognized by established medical organizations. He is the founder and medical director of Holtorf Medical Group, a practice with five centers that offer treatment for conditions including fibromyalgia, adrenal fatigue (a non-existent condition), complex endocrine dysfunction, hypothyroidism, age management, chronic fatigue syndrome, low libido, chronic Lyme disease, migraines, PMS, perimenopause and menopause. His practice focuses on alternative therapies that are not recognised as effective. [2] He has been criticized in the media for his controversial views on topics like bioidentical hormone replacement therapy and vaccines. [3]

Contents

Professional status and publications

Holtorf is a graduate of the University of California at Los Angeles. [4] He is also a graduate of the St. Louis University School of Medicine, where he received his doctorate of medicine then returned to UCLA for residency training. [1] [4] He has maintained a clinical practice since 1994 and is a former medical director of the Fibromyalgia and Fatigue Centers, Inc. (FFC). [1] Holtorf has published a number of endocrine reviews on complex topics in peer-reviewed journals on controversial diseases and treatments. [4] He is a guest editor and peer-reviewer for a number of medical journals including Endocrine , is the current AOL Health Expert in Endocrinology, [4] and is a diplomate and board examiner of the American Board of Anti-Aging Medicine (ABAAM). [5] He is a founding member of The Bioidentical Hormone Initiative (BHI), and a founder and director of the National Academy of Hypothyroidism (NAH). [4] In 2001, Holtorf established the Holtorf Medical Group. [4]

Controversy

Holtorf has been the subject of criticism online and in the media for several years for his promotion of controversial diagnostic methods. He has been an advocate of bioidentical hormones, which has been labeled as quackery. [6] He published an extensive review on the safety and efficacy of bioidentical hormones in the peer-reviewed journal Post Graduate Medicine. The review concluded, “Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. Further randomized controlled trials are needed to delineate these differences more clearly.” [7] The conclusions were contrary to mainstream opinions on the use of bioidentical hormones. [8] Additionally, many argue that the extensive use of compounded bioidentical hormones is risky because they can be inconsistent and unstable and are not always subject to FDA oversight. [9] [10] [11]

Holtorf has also taken an unpopular stance that children are over vaccinated and that vaccines may be associated with autism. Televised appearances and interviews have put Holtorf's views front and center and invited criticism and debate. Among them, his 2009 appearance on Fox News in regards to the H1N1 vaccine, in which Holtorf plainly states he "definitely would not" administer the controversial vaccine to his own children, is one of the most highly deliberated. [12] Holtorf likewise links high levels of vaccine adjuncts, such as mercury, to some cases of autism development in children during the interview and is questionably identified on the program as an infectious disease expert. [12] This view is contrary to the position statements of agencies such as the Center for Disease Control and the Institute of Medicine, and societies such as the American Academy of Pediatrics, who state that there is no credible evidence that vaccines have any link to autism. [13] [14]

Diagnosis and treatment of hypothyroidism

Holtorf states that the standard thyroid tests which are typically relied upon by primary care and specialist physicians to diagnosis hypothyroidism (low thyroid) and determine dosage are insufficient because they focus on TSH levels as an indicator of thyroid function and miss a large percentage of people with low thyroid. [9] This is discussed extensively on the website of his nonprofit organization the National Academy of Hypothyroidism. [15] Instead, Holtorf advocates labs and diagnostics which look at all thyroid hormone levels, with a particular emphasis on free T3, triodothyronine, the active hormone both produced by the thyroid and converted from T4, levothyroxine, and reverse T3, a metabolite of T4 conversion usually created during times of stress or trauma. [9] [16] This is contrary to position statements by societies such as the American Thyroid Association and American Association of Clinical Endocrinologist. [17] [18] Holtorf condones treating hypothyroidism with compounded combinations of bioidentical thyroid hormones. [9]

Diagnosis and treatment of CFS and fibromyalgia

Chronic fatigue syndrome (CFS) and fibromyalgia are two separate disorders that share many overlapping symptoms and are often cross-diagnosed. FDA approved therapies for the treatment of fibromyalgia include Cymbalta (duloxetine hydrochloride), Lyrica (pregabalin), and Savella (milnacipran HCL); while there are no FDA approved medications for the treatment of chronic fatigue syndrome. [19] [20] [21] Other medications that are commonly used include tryicylcic antidepressants, SSRI antidepressants, Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. [22] In contrast, Dr Holtorf advocates a controversial six step plan that involves the treatment of hormone imbalances, mitochondrial dysfunction, sleep disturbances, and chronic infections. [23]

Diagnosis and treatment of Lyme disease

The Infectious Disease Society of America states that Lyme disease is easily treated with a few weeks of antibiotics and that chronic Lyme disease does not exist. Their position is that standard blood tests are an accurate means of determining the presence of Lyme disease. [24]

Weight loss

Holtorf maintains a controversial stance that weight loss is not an issue of diet and exercise, citing causes for the inability to lose weight as leptin resistance, undiagnosed hypothyroidism, environmental toxins, hypometabolism and dysfunctional weight set-point. [25] [26]

Leptin resistance is described as a condition in which overweight individuals are unable to respond to the hormone’s signals appropriately, leading to a starvation response in the body as well as hypothyroid symptoms at the cellular level where they are more difficult to detect. Holtorf treats leptin resistance in patients with a class of medications that are typically reserved for controlling blood sugar levels in diabetics. [25] [26]

A suppressed or "wrecked" metabolism is another cause of obesity commonly cited by Holtorf. [26] Holtorf claims the metabolism, when subjected to repeated or overzealous dieting and exercise, will regulate itself by repressing thyroid hormone levels in the body, resulting in a hypothyroid state. [26] Even the return to normal intake of food or levels of exercise will not be substantial enough to return the metabolism to its previous state. According to his website, holtorfmed.com, this leads to a permanently or chronically suppressed metabolism and Holtorf issues metabolic testing for patients exhibiting metabolism suppression, as well as labs denoting thyroid and other hormone levels. [26]

Set-Point malfunction is another theory proposed and supported by Holtorf, which suggests that the body is programmed to return to a set weight and that this point can be altered by numerous medications, resulting in weight gain. [26] Holtorf prescribes naltrexone, an opioid receptor blocker, used most often to treat opiate addiction, and bupropion (Wellbutrin), a common antidepressant, to reduce the body's set-point. [26]

Related Research Articles

<span class="mw-page-title-main">Endocrinology</span> Branch of medicine dealing the endocrine system

Endocrinology is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth, and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones. Specializations include behavioral endocrinology and comparative endocrinology.

<span class="mw-page-title-main">Hyperthyroidism</span> Thyroid gland disease that involves an overproduction of thyroid hormone.

Hyperthyroidism is the condition that occurs due to excessive production of thyroid hormones by the thyroid gland. Thyrotoxicosis is the condition that occurs due to excessive thyroid hormone of any cause and therefore includes hyperthyroidism. Some, however, use the terms interchangeably. Signs and symptoms vary between people and may include irritability, muscle weakness, sleeping problems, a fast heartbeat, heat intolerance, diarrhea, enlargement of the thyroid, hand tremor, and weight loss. Symptoms are typically less severe in the elderly and during pregnancy. An uncommon but life-threatening complication is thyroid storm in which an event such as an infection results in worsening symptoms such as confusion and a high temperature; this often results in death. The opposite is hypothyroidism, when the thyroid gland does not make enough thyroid hormone.

<span class="mw-page-title-main">Graves' disease</span> Autoimmune endocrine disease

Graves' disease, also known as toxic diffuse goiter, is an autoimmune disease that affects the thyroid. It frequently results in and is the most common cause of hyperthyroidism. It also often results in an enlarged thyroid. Signs and symptoms of hyperthyroidism may include irritability, muscle weakness, sleeping problems, a fast heartbeat, poor tolerance of heat, diarrhea and unintentional weight loss. Other symptoms may include thickening of the skin on the shins, known as pretibial myxedema, and eye bulging, a condition caused by Graves' ophthalmopathy. About 25 to 30% of people with the condition develop eye problems.

<span class="mw-page-title-main">Hypothyroidism</span> Endocrine disease

Hypothyroidism is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as poor ability to tolerate cold, a feeling of tiredness, constipation, slow heart rate, depression, and weight gain. Occasionally there may be swelling of the front part of the neck due to goitre. Untreated cases of hypothyroidism during pregnancy can lead to delays in growth and intellectual development in the baby or congenital iodine deficiency syndrome.

<span class="mw-page-title-main">Fibromyalgia</span> Chronic pain of unknown cause

Fibromyalgia is a medical condition defined by the presence of chronic widespread pain, fatigue, waking unrefreshed, cognitive symptoms, lower abdominal pain or cramps, and depression. Other symptoms include insomnia and a general hypersensitivity.

Thyroid-stimulating hormone (also known as thyrotropin, thyrotropic hormone, or abbreviated TSH) is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T4), and then triiodothyronine (T3) which stimulates the metabolism of almost every tissue in the body. It is a glycoprotein hormone produced by thyrotrope cells in the anterior pituitary gland, which regulates the endocrine function of the thyroid.

<span class="mw-page-title-main">Hashimoto's thyroiditis</span> Autoimmune disease

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis and Hashimoto's disease, is an autoimmune disease in which the thyroid gland is gradually destroyed. Early on, symptoms may not be noticed. Over time, the thyroid may enlarge, forming a painless goiter. Some people eventually develop hypothyroidism with accompanying weight gain, fatigue, constipation, depression, hair loss, and general pains. After many years the thyroid typically shrinks in size. Potential complications include thyroid lymphoma. Furthermore, because it is common for untreated patients of Hashimoto's to develop hypothyroidism, further complications can include, but are not limited to, high cholesterol, heart disease, heart failure, high blood pressure, myxedema, and potential pregnancy problems.

Bioidentical hormone replacement therapy (BHRT), also known as bioidentical hormone therapy(BHT) or natural hormone therapy, is the use of hormones that are identical on a molecular level with endogenous hormones in hormone replacement therapy. It may also be combined with blood and saliva testing of hormone levels, and the use of pharmacy compounding to obtain hormones in an effort to reach a targeted level of hormones in the body. A number of claims by some proponents of BHT have not been confirmed through scientific testing. Specific hormones used in BHT include estrone, estradiol, progesterone, testosterone, dehydroepiandrosterone (DHEA), and estriol.

<span class="mw-page-title-main">Levothyroxine</span> Thyroid hormone

Levothyroxine, also known as L-thyroxine, is a synthetic form of the thyroid hormone thyroxine (T4). It is used to treat thyroid hormone deficiency (hypothyroidism), including a severe form known as myxedema coma. It may also be used to treat and prevent certain types of thyroid tumors. It is not indicated for weight loss. Levothyroxine is taken by mouth or given by intravenous injection. Maximum effect from a specific dose can take up to six weeks to occur.

<span class="mw-page-title-main">Thyroid disease</span> Medical condition

Thyroid disease is a medical condition that affects the function of the thyroid gland. The thyroid gland is located at the front of the neck and produces thyroid hormones that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development.

<span class="mw-page-title-main">Thyroiditis</span> Medical condition

Thyroiditis is the inflammation of the thyroid gland. The thyroid gland is located on the front of the neck below the laryngeal prominence, and makes hormones that control metabolism.

<span class="mw-page-title-main">Menstrual disorder</span> Medical condition affecting menstrual cycle

A menstrual disorder is characterized as any abnormal condition with regards to a person's menstrual cycle. There are many different types of menstrual disorders that vary with signs and symptoms, including pain during menstruation, heavy bleeding, or absence of menstruation. Normal variations can occur in menstrual patterns but generally menstrual disorders can also include periods that come sooner than 21 days apart, more than 3 months apart, or last more than 10 days in duration. Variations of the menstrual cycle are mainly caused by the immaturity of the hypothalamic-pituitary-ovarian (HPO) axis, and early detection and management is required in order to minimize the possibility of complications regarding future reproductive ability.

Desiccated thyroid, also known as thyroid extract, is thyroid gland that has been dried and powdered for medical use. It is used to treat hypothyroidism. It is less preferred than levothyroxine. It is taken by mouth. Maximal effects may take up to three weeks to occur.

<span class="mw-page-title-main">Endocrine disease</span> Medical condition

Endocrine diseases are disorders of the endocrine system. The branch of medicine associated with endocrine disorders is known as endocrinology.

Thyrotoxic myopathy (TM) is a neuromuscular disorder that develops due to the overproduction of the thyroid hormone thyroxine. Also known as hyperthyroid myopathy, TM is one of many myopathies that lead to muscle weakness and muscle tissue breakdown. Evidence indicates the onset may be caused by hyperthyroidism. There are two known causes of hyperthyroidism that lead to development thyrotoxic myopathy including a multinodular goiter and Graves' disease. Physical symptoms of TM may include muscle weakness, the breakdown of muscle tissue, fatigue, and heat intolerance. Physical acts such as lifting objects and climbing stairs may become increasingly difficult. If untreated, TM can be an extremely debilitating disorder that can, in extreme rare cases, lead to death. If diagnosed and treated properly the effects can be controlled and in most cases reversed leaving no lasting effects.

Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal atrophy, accelerated skin aging, vaginal dryness, decreased muscle mass, sexual dysfunction, and bone loss or osteoporosis. They are in large part related to the diminished levels of sex hormones that occur during menopause.

<span class="mw-page-title-main">Autoimmune thyroiditis</span> Medical condition

Autoimmune thyroiditis, also known as Hashimoto's disease and chronic lymphocytic thyroiditis, is a chronic disease occurring in the thyroid, the butterfly-shaped endocrine gland in the anterior neck. This disease occurs when the body interprets components of the thyroid glands as threats, therefore producing special antibodies that target the thyroid's cells or proteins, thereby destroying it. It most commonly presents as hypothyroidism with or without a goiter. It is the most common cause of hypothyroidism in iodine-sufficient areas of the world.

Hypothalamic disease is a disorder presenting primarily in the hypothalamus, which may be caused by damage resulting from malnutrition, including anorexia and bulimia eating disorders, genetic disorders, radiation, surgery, head trauma, lesion, tumour or other physical injury to the hypothalamus. The hypothalamus is the control center for several endocrine functions. Endocrine systems controlled by the hypothalamus are regulated by antidiuretic hormone (ADH), corticotropin-releasing hormone, gonadotropin-releasing hormone, growth hormone-releasing hormone, oxytocin, all of which are secreted by the hypothalamus. Damage to the hypothalamus may impact any of these hormones and the related endocrine systems. Many of these hypothalamic hormones act on the pituitary gland. Hypothalamic disease therefore affects the functioning of the pituitary and the target organs controlled by the pituitary, including the adrenal glands, ovaries and testes, and the thyroid gland.

Thyroid disease in pregnancy can affect the health of the mother as well as the child before and after delivery. Thyroid disorders are prevalent in women of child-bearing age and for this reason commonly present as a pre-existing disease in pregnancy, or after childbirth. Uncorrected thyroid dysfunction in pregnancy has adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Due to an increase in thyroxine binding globulin, an increase in placental type 3 deioidinase and the placental transfer of maternal thyroxine to the fetus, the demand for thyroid hormones is increased during pregnancy. The necessary increase in thyroid hormone production is facilitated by high human chorionic gonadotropin (hCG) concentrations, which bind the TSH receptor and stimulate the maternal thyroid to increase maternal thyroid hormone concentrations by roughly 50%. If the necessary increase in thyroid function cannot be met, this may cause a previously unnoticed (mild) thyroid disorder to worsen and become evident as gestational thyroid disease. Currently, there is not enough evidence to suggest that screening for thyroid dysfunction is beneficial, especially since treatment thyroid hormone supplementation may come with a risk of overtreatment. After women give birth, about 5% develop postpartum thyroiditis which can occur up to nine months afterwards. This is characterized by a short period of hyperthyroidism followed by a period of hypothyroidism; 20–40% remain permanently hypothyroid.

Chronic Lyme disease (CLD) is the name used by some people with "a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to Borrelia burgdorferi infection" to describe their condition and their beliefs about its cause. Both the label and the belief that these people's symptoms are caused by this particular infection are generally rejected by medical professionals. Some doctors view that the promotion of chronic Lyme disease as an example of health fraud. Chronic Lyme disease is distinct from genuine Lyme disease, a known medical disorder caused by infection with Borrelia burgdorferi, or with post-treatment Lyme disease syndrome, a set of lingering symptoms which may persist after successful treatment of infection with Lyme bacteria.

References

  1. 1 2 3 “Kent Holtorf.” The Huffington Post. Retrieved 2011-09-28.
  2. 1 2 Wilson, Lori (2008). "Dr. Kent Holtorf – Bringing Hope Where There Was None". Lastheplace.com. Retrieved 2011-11-26.
  3. ↑ Balas, E A. (2001). "Information Systems Can Prevent Errors and Improve Quality". Journal of the American Medical Informatics Association. 8 (4): 398–9. doi:10.1136/jamia.2001.0080398. PMC   130085 . PMID   11418547.
  4. 1 2 3 4 5 6 Schwartz, Erika T.; Holtorf, Kent (2008). "Hormones in Wellness and Disease Prevention: Common Practices, Current State of the Evidence, and Questions for the Future". Primary Care: Clinics in Office Practice. 35 (4): 669–705. doi:10.1016/j.pop.2008.07.015. PMID   18928825.
  5. ↑ "AgeMD Advisory Board | AgeMD Bioidentical Hormone Doctors". Agemd.org. Retrieved 2011-11-26.
  6. ↑ Robert W. Griffith, MD (2009-12-21). "Saturday Quack - Bio-Identical Hormone Therapy". Healthandage.com. Archived from the original on 2012-04-15. Retrieved 2011-11-26.
  7. ↑ Holtorf, K (2009). "The bioidentical hormone debate: Are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?". Postgraduate Medicine. 121 (1): 73–85. doi:10.3810/pgm.2009.01.1949. PMID   19179815.
  8. ↑ North American Menopause, Society (2010). "Estrogen and progestogen use in postmenopausal women: 2010 position statement of the North American Menopause Society". Menopause. 17 (2): 242–55. doi:10.1097/gme.0b013e3181d0f6b9. PMID   20154637.
  9. 1 2 3 4 “Diagnosis of hypothyroidism: Are we getting what we want from TSH testing?” The Non-Profit National Academy of Hypothyroidism. Nahypothyroidism.org. Retrieved 2011-10-25.
  10. ↑ Gardner, Amanda (2009-01-30). "The Truth About 'Bio-identical' Hormone Therapy". U.S. News & World Report. Retrieved 2011-11-26.
  11. ↑ "The Endocrine Society Position Statement (bio-identical hormones)" (PDF). The Endocrine Society. 2006. Retrieved 2011-11-26.
  12. 1 2 Ashford, Molika (2009-10-08). "FOX News Broadcasts Bad Advice From H1N1 Flu "Expert"". Stinkyjournalism.org. Archived from the original on 2011-02-12. Retrieved 2011-11-26.
  13. ↑ "Vaccine Safety | Immunization Facts For Parents | Immunization Safety - Mollen Immunization". Flushotsusa.com. 2008-03-03. Retrieved 2011-11-26.
  14. ↑ "MMR Vaccine and Autism - CDC. (Measles, Mumps, and Rubella). FACT SHEET" (PDF). www.in.gov. Retrieved 2011-11-26.
  15. ↑ “How Accurate is TSH Testing?” NAHypothyroidism.org. Retrieved 2011-10-02.
  16. ↑ "Optimal Treatment for Hypothyroidism - Dr. Kent Holtorf Shares Thoughts About The Best Way to Treat an Underactive Thyroid and Hypothyroidism". Thyroid.about.com. 2010-12-22. Archived from the original on 2011-12-05. Retrieved 2011-11-26.
  17. ↑ "Treatment Guidelines for Patients With Hyperthyroidism and Hypothyroidism | Thyroid Cancer Guidelines from the American Thyroid Association". Thyroidguidelines.net. Archived from the original on 2011-12-06. Retrieved 2011-11-26.
  18. ↑ Baskin, HJ; Cobin, RH; Duick, DS; Gharib, H; Guttler, RB; Kaplan, MM; Segal, RL; American Association of Clinical Endocrinologists (2002). "American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism". Endocrine Practice. 8 (6): 457–69. doi:10.4158/1934-2403-8.6.457. PMID   15260011.
  19. ↑ "Highlights of Prescribing Medication - Cymbalta" (PDF). pi.lilly.com. Retrieved 2011-11-26.
  20. ↑ "Highlights of Prescribing Medication - Lyrica". Dailymed.nlm.nih.gov. 2011-06-21. Retrieved 2011-11-26.
  21. ↑ "Highlights of Prescribing Medication - Savella" (PDF). Retrieved 2011-11-26.
  22. ↑ "Fibromyalgia Medications". Webmd.com. 2009-10-21. Retrieved 2011-11-26.
  23. ↑ Kent Holtorf, MD (2008-12-03). "A Confounding Condition on ADVANCE for Healthy Aging". Healthy-aging.advanceweb.com. Archived from the original on 2012-04-05. Retrieved 2011-11-26.
  24. ↑ Wormser, Gary P.; Dattwyler, Raymond J.; Shapiro, Eugene D.; Halperin, John J.; Steere, Allen C.; Klempner, Mark S.; Krause, Peter J.; Bakken, Johan S.; et al. (2006). "The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases. 43 (9): 1089–134. doi: 10.1086/508667 . PMID   17029130.
  25. 1 2 "Kent Holtorf: Long Term Weight Loss - More Than Will Power?". Huffingtonpost.com. Retrieved 2011-11-26.
  26. 1 2 3 4 5 6 7 "Weight Loss". Hormoneandlongevitycenter.com. 2005-09-20. Retrieved 2011-11-26.
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