What is HRT? HRT and Hormones Explained
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In this short video, Dr. Sophie Newton explains how menopausal HRT, sometimes called just MHT, is the use of exogenous (didn’t come from your body) to replace/supplement the endogenous hormones (made in your body) that aren’t being made in the quantities that would result in ideal health.
Bioidentical hormones are, as the name suggests, chemically identical to those made in the body; there is no difference, all the way down to the atomic structure.
People are understandably wary of “putting chemicals into the body”, but in fact, everything is a chemical and those chemicals are also found in your body, just not in the numbers that we might always like.
In the case of hormones, these chemical messengers are simply there to tell cells what to do, so having the correct amount of hormones ensures that all the cells that need to get a certain message, get it.
In the case of estrogen specifically, while it’s considered a sex hormone (and it is), it’s responsible for a lot more than just the reproductive system, which is why many people without correct estrogen levels (such as peri- or post-menopause, though incorrect levels can happen earlier in life for other reasons too) can severely feel their absence in a whole stack of ways.
What ways? More than we can list here, but some are discussed in the video:
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Want to know more?
You might like our previous main features:
- What Does “Balance Your Hormones” Even Mean?
- What You Should Have Been Told About The Menopause Beforehand
- Menopausal HRT: Bioidentical vs Animal
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A person in Texas caught bird flu after mixing with dairy cattle. Should we be worried?
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The United States’ Centers for Disease Control and Prevention (CDC) has issued a health alert after the first case of H5N1 avian influenza, or bird flu, seemingly spread from a cow to a human.
A farm worker in Texas contracted the virus amid an outbreak in dairy cattle. This is the second human case in the US; a poultry worker tested positive in Colorado in 2022.
The virus strain identified in the Texan farm worker is not readily transmissible between humans and therefore not a pandemic threat. But it’s a significant development nonetheless.
Some background on bird flu
There are two types of avian influenza: highly pathogenic or low pathogenic, based on the level of disease the strain causes in birds. H5N1 is a highly pathogenic avian influenza.
H5N1 first emerged in 1997 in Hong Kong and then China in 2003, spreading through wild bird migration and poultry trading. It has caused periodic epidemics in poultry farms, with occasional human cases.
Influenza A viruses such as H5N1 are further divided into variants, called clades. The unique variant causing the current epidemic is H5N1 clade 2.3.4.4b, which emerged in late 2020 and is now widespread globally, especially in the Americas.
In the past, outbreaks could be controlled by culling of infected birds, and H5N1 would die down for a while. But this has become increasingly difficult due to escalating outbreaks since 2021.
Wild animals are now in the mix
Waterfowl (ducks, swans and geese) are the main global spreaders of avian flu, as they migrate across the world via specific routes that bypass Australia. The main hub for waterfowl to migrate around the world is Quinghai lake in China.
But there’s been an increasing number of infected non-waterfowl birds, such as true thrushes and raptors, which use different flyways. Worryingly, the infection has spread to Antarctica too, which means Australia is now at risk from different bird species which fly here.
H5N1 has escalated in an unprecedented fashion since 2021, and an increasing number of mammals including sea lions, goats, red foxes, coyotes, even domestic dogs and cats have become infected around the world.
Wild animals like red foxes which live in peri-urban areas are a possible new route of spread to farms, domestic pets and humans.
Dairy cows and goats have now become infected with H5N1 in at least 17 farms across seven US states.
What are the symptoms?
Globally, there have been 14 cases of H5N1 clade 2.3.4.4b virus in humans, and 889 H5N1 human cases overall since 2003.
Previous human cases have presented with a severe respiratory illness, but H5N1 2.3.4.4b is causing illness affecting other organs too, like the brain, eyes and liver.
For example, more recent cases have developed neurological complications including seizures, organ failure and stroke. It’s been estimated that around half of people infected with H5N1 will die.
The case in the Texan farm worker appears to be mild. This person presented with conjunctivitis, which is unusual.
Food safety
Contact with sick poultry is a key risk factor for human infection. Likewise, the farm worker in Texas was likely in close contact with the infected cattle.
The CDC advises pasteurised milk and well cooked eggs are safe. However, handling of infected meat or eggs in the process of cooking, or drinking unpasteurised milk, may pose a risk.
Although there’s no H5N1 in Australian poultry or cattle, hygienic food practices are always a good idea, as raw milk or poorly cooked meat, eggs or poultry can be contaminated with microbes such as salmonella and E Coli.
If it’s not a pandemic, why are we worried?
Scientists have feared avian influenza may cause a pandemic since about 2005. Avian flu viruses don’t easily spread in humans. But if an avian virus mutates to spread in humans, it can cause a pandemic.
One concern is if birds were to infect an animal like a pig, this acts as a genetic mixing vessel. In areas where humans and livestock exist in close proximity, for example farms, markets or even in homes with backyard poultry, the probability of bird and human flu strains mixing and mutating to cause a new pandemic strain is higher.
There are a number of potential pathways to a pandemic caused by influenza. Author provided The cows infected in Texas were tested because farmers noticed they were producing less milk. If beef cattle are similarly affected, it may not be as easily identified, and the economic loss to farmers may be a disincentive to test or report infections.
How can we prevent a pandemic?
For now there is no spread of H5N1 between humans, so there’s no immediate risk of a pandemic.
However, we now have unprecedented and persistent infection with H5N1 clade 2.3.4.4b in farms, wild animals and a wider range of wild birds than ever before, creating more chances for H5N1 to mutate and cause a pandemic.
Unlike the previous epidemiology of avian flu, where hot spots were in Asia, the new hot spots (and likely sites of emergence of a pandemic) are in the Americas, Europe or in Africa.
Pandemics grow exponentially, so early warnings for animal and human outbreaks are crucial. We can monitor infections using surveillance tools such as our EPIWATCH platform.
The earlier epidemics can be detected, the better the chance of stamping them out and rapidly developing vaccines.
Although there is a vaccine for birds, it has been largely avoided until recently because it’s only partially effective and can mask outbreaks. But it’s no longer feasible to control an outbreak by culling infected birds, so some countries like France began vaccinating poultry in 2023.
For humans, seasonal flu vaccines may provide a small amount of cross-protection, but for the best protection, vaccines need to be matched exactly to the pandemic strain, and this takes time. The 2009 flu pandemic started in May in Australia, but the vaccines were available in September, after the pandemic peak.
To reduce the risk of a pandemic, we must identify how H5N1 is spreading to so many mammalian species, what new wild bird pathways pose a risk, and monitor for early signs of outbreaks and illness in animals, birds and humans. Economic compensation for farmers is also crucial to ensure we detect all outbreaks and avoid compromising the food supply.
C Raina MacIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney; Ashley Quigley, Senior Research Associate, Global Biosecurity, UNSW Sydney; Haley Stone, PhD Candidate, Biosecurity Program, Kirby Institute, UNSW Sydney; Matthew Scotch, Associate Dean of Research and Professor of Biomedical Informatics, College of Health Solutions, Arizona State University, and Rebecca Dawson, Research Associate, The Kirby Institute, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Beat Sugar Addiction Now! – by Dr. Jacob Teitelbaum & Chrystle Fiedler
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Sugar isn’t often thought of as an addiction in the same category as alcohol or nicotine, but it’s actually very similar in some ways…
A bold claim, but: in each case, it has to do with dopamine responses to something that has:
- an adverse effect on our health,
- a quickly developed tolerance to same,
- and unpleasant withdrawal symptoms when quitting.
However, not all sugar addictions are created equal, and Dr. Teitelbaum lays four different types of sugar addiction out for us:
- Most related to “I need to perform and I need to perform now”
- Most related to “I just need something to get me through one more stressful day, again, just like every day before it”
- Most related to “ate too much sugar because of the above, and now a gut overgrowth of C. albicans is at the wheel”
- Most related to “ate too much sugar because of the above, and now insulin resistance is a problem that perpetuates itself too”
Of course, these may overlap, and indeed, they tend to stack cumulatively as time goes by.
However, Dr. Teitelbaum notes that as readers we may recognize ourselves as being at a particular point in the above, and there are different advices for each of them.
You thought it was just going to be about going cold turkey? Nope!
Instead, a multi-vector approach is recommended, including adjustments to sleep, nutrition, immune health, hormonal health, and more.
In short: if you’ve been trying to to kick the “White Death” habit as Gloria Swanson called it (sugar, that is, not the WW2 Finnish sniper of the same name—we can’t help you with that one), then this book is really much more helpful than others that take the “well, just don’t eat it, then” approach!
Pick up your copy of Beat Sugar Addiction Now from Amazon, and start your journey!
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7 Days Of Celery Juice: What’s The Verdict?
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Laura “Try” tries many popular trends, and reports on the benefits (or problems, or both). In this case, it’s 7 days of celery juice… Not as a fast, though, i.e. she doesn’t just have celery juice for 7 days, but rather, it’s how she kicks off each morning, with half a liter (16oz) on an empty stomach.
What she found
First, she bought a masticating juicer and organic celery. So, those are expenses to consider, especially the one-off expense of the juicer, and the ongoing expense of organic celery—estimated $90/month).
In terms of taste, she was surprised it wasn’t as bitter as expected, but from the second day onwards, she did use the juicer’s filter to remove the frothy sludge, and she also switched to juicing only the stalks, not the leaves—which are more bitter.
10almonds note: the leaves are more bitter because that’s where the polyphenols are more densely concentrated. The leaves are better for you than the stalks. Enjoy the leaves. Really: if you chop them finely you can use them as herbs in your cooking, and if you’re making a salad, just chop them into that too.
The reason she picked the quantity of half a liter is because this is what she found recommended to coat the stomach lining—on the promise of increased stomach acid production, reduced bacteria overgrowth, as well as antiviral, antifungal, and anti-inflammatory properties. As she’s just one woman without a personal lab, she couldn’t test and thus verify any of these though—but she did still have benefits to report:
She did experience clearer skin, more energy, and better sleep after a few days.
Ultimately, she decided to continue to do it just at the weekends, due to its positive effects, despite the cost and time consumption.
For more personal insights, enjoy:
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Want to learn more?
You might also like to read:
Enjoy Bitter Foods For Your Heart & Brain
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The AFib Cure – by Dr. John Day & Dr. Jared Bunch
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The authors—cardiologists and AFib specialists—make the case that if you have atrial fibrillation, you do in fact have more options than “take these pills and suffer”.
To be clear: they’re not anti-medication per se and they also acknowledge that for some people the meds may still have their place (safety first, and all), but they do fall on the side of “it would be nice to not have to, if possible, so let’s see what we can do”.
Rather, they recommend lifestyle adjustments (no surprises there), and certain biomarker optimizations (this is where it gets more in-depth), which have a good record of reducing symptoms to the point of remission and freedom from medications.
The book is first a primer on the topic of AFib, and then a how-to manual of fixing the problems that you now understand, by biomarker monitoring, lifestyle optimization, and if those things don’t work, ablative therapy which they argue is safer, easier, and more successful than you might think.
The style is clear and easy to understand, with frequent scholarly citations throughout. On the downside, the tone can sometimes be a little on the pushy side for this reviewer’s tastes, but if one overlooks that, it doesn’t detract from the useful content.
Bottom line: if you or a loved one have AFib and would like more treatment/management options than have hitherto been presented, this book will give you that.
Click here to check out The AFib Cure, and look after your heart!
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It’s Not You, It’s Your Hormones – by Nicki Williams, DipION, mBANT, CNHC
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So, first a quick note: this book is very similar to the popular bestseller “The Galveston Diet”, not just in content, but all the way down to its formatting. Some Amazon reviewers have even gone so far as to suggest that “It’s Not You, It’s Your Hormones” (2017) brazenly plagiarized “The Galveston Diet” (2023). However, after carefully examining the publication dates, we feel quite confident that this book is not a copy of the one that came out six years after it. As such, we’ve opted for reviewing the original book.
Nicki Williams’ basic principle is that we can manage our hormonal fluctuations, by managing our diet. Specifically, in three main ways:
- Intermittent fasting
- Anti-inflammatory diet
- Eating more protein and healthy fats
Why should these things matter to our hormones? The answer is to remember that our hormones aren’t just the sex hormones. We have hormones for hunger and satedness, hormones for stress and relaxation, hormones for blood sugar regulation, hormones for sleep and wakefulness, and more. These many hormones make up our endocrine system, and affecting one part of it will affect the others.
Will these things magically undo the effects of the menopause? Well, some things yes, other things no. No diet can do the job of HRT. But by tweaking endocrine system inputs, we can tweak endocrine system outputs, and that’s what this book is for.
The style is very accessible and clear, and Williams walks us through the changes we may want to make, to avoid the changes we don’t want.
In the category of criticism, there is some extra support that’s paywalled, in the sense that she wants the reader to buy her personally-branded online plan, and it can feel a bit like she’s holding back in order to upsell to that.
Bottom line: this book is aimed at peri-menopausal and post-menopausal women. It could also definitely help a lot of people with PCOS too, and, when it comes down to it, pretty much anyone with an endocrine system. It’s a well-evidenced, well-established, healthy way of eating regardless of age, sex, or (most) physical conditions.
Click here to check out It’s Not You, It’s Your Hormones, and take control of yours!
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Syphilis Is Killing Babies. The U.S. Government Is Failing to Stop the Disease From Spreading.
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ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
Karmin Strohfus, the lead nurse at a South Dakota jail, punched numbers into a phone like lives depended on it. She had in her care a pregnant woman with syphilis, a highly contagious, potentially fatal infection that can pass into the womb. A treatment could cure the woman and protect her fetus, but she couldn’t find it in stock at any pharmacy she called — not in Hughes County, not even anywhere within an hour’s drive.
Most people held at the jail where Strohfus works are released within a few days. “What happens if she gets out before I’m able to treat her?” she worried. Exasperated, Strohfus reached out to the state health department, which came through with one dose. The treatment required three. Officials told Strohfus to contact the federal Centers for Disease Control and Prevention for help, she said. The risks of harm to a developing baby from syphilis are so high that experts urge not to delay treatment, even by a day.
Nearly three weeks passed from when Strohfus started calling pharmacies to when she had the full treatment in hand, she said, and it barely arrived in time. The woman was released just days after she got her last shot.
Last June, Pfizer, the lone U.S. manufacturer of the injections, notified the Food and Drug Administration of an “impending stock out” that it anticipated would last a year. The company blamed “an increase in syphilis infection rates as well as competitive shortages.”
Across the country, physicians, clinic staff and public health experts say that the shortage is preventing them from reining in a surge of syphilis and that the federal government is downplaying the crisis. State and local public health authorities, which by law are responsible for controlling the spread of infectious diseases, report delays getting medicine to pregnant people with syphilis. This emergency was predictable: There have been shortages of this drug in eight of the last 20 years.
Yet federal health authorities have not prevented the drug shortages in the past and aren’t doing much to prevent them in the future.
Syphilis, which is typically spread during sex, can be devastating if it goes untreated in pregnancy: About 40% of babies born to women with untreated syphilis can be stillborn or die as newborns, according to the CDC. Infants that survive can suffer from deformed bones, excruciating pain or brain damage, and some struggle to hear, see or breathe. Since this is entirely preventable, a baby born with syphilis is a shameful sign of a failing public health system.
In 2022, the most recent year for which the CDC has data available, more than 3,700 babies were infected with syphilis, including nearly 300 who were stillborn or died as infants. More than 50% of these cases occurred because, even though the pregnant parent was diagnosed with syphilis, they were never properly treated.
That year, there were 200,000 cases identified in the U.S., a 79% increase from five years before. Infection rates among pregnant people and babies increased by more than 250% in that time; South Dakota, where Strohfus works, had the highest rates — including a more than 400% increase among pregnant women. Statewide, the rate of babies born with the disease, a condition known as congenital syphilis, jumped more than 40-fold in just five years.
And that was before the current shortage of shots.
In Mississippi, the state with the second highest rate of syphilis in pregnant women, Dr. Caroline Weinberg started having trouble this summer finding treatments for her clinic’s patients, most of whom are uninsured, live in poverty or lack transportation. She began spending hours each month scouring medicine suppliers’ websites for available doses of the shots, a form of penicillin sold under the brand name Bicillin L-A.
“The way people do it for Taylor Swift, that’s how I’ve been with the Bicillin shortage,” Weinberg said. “Desperately checking the websites to see what I can snag.”
The shortage is driving up infection rates even further.
In a November survey by the National Coalition of STD Directors, 68% of health departments that responded said the drug shortage will cause syphilis rates in their area to increase, further crushing the nation’s most disadvantaged populations.
“This is the most basic medicine,” said Meghan O’Connell, chief public health officer for the Great Plains Tribal Leaders’ Health Board, which represents 18 tribal communities in South Dakota and three other states. “We allow ourselves to continue to not have enough, and it impacts so many people.”
ProPublica examined what the federal government has done to manage the crisis and the ways in which experts say it has fallen short.
The government could pressure Pfizer to be more transparent.
Twenty years ago, there were at least three manufacturers of the syphilis shot. Then Pfizer, one of the manufacturers, purchased the other two companies and became the lone U.S. supplier.
Pfizer’s supply has fallen short since then. In 2016, the company announced a shortage due to a manufacturing issue; it lasted two years. Even during times when Pfizer had not notified the FDA of an official shortage, clinics across the country told ProPublica, the shots were often hard to get.
Several health officials said they would like to see the government use its power as the largest purchaser of the drug to put pressure on Pfizer to produce adequate supplies and to be more transparent about how much of the drug they have on hand, when it will be widely available and how stable the supply will be going forward.
In response to questions, Pfizer said there are two reasons its supply is falling short. One, the company said, was a surge in use of the pediatric form of the drug after a shortage of a different antibiotic last winter. Pfizer also blamed a 70% increase in demand for the adult shots since last February, which it described as unexpected.
Public health experts say the increase in cases and subsequent rise in demand was easy to see coming. Officials have been raising the alarm about skyrocketing syphilis cases for years. “If Pfizer was truly caught completely off guard, it raises significant questions about the competency of the company to forecast obvious infectious disease trends,” a coalition of organizations wrote to the White House Drug Shortage Task Force in September.
Pfizer said it is consistently communicating with the CDC and FDA about its supply and that it has been transparent with public health groups and policymakers.
The FDA has a group dedicated to addressing drug shortages. But Valerie Jensen, associate director of that staff, said the FDA can’t force manufacturers to make more of a drug. “It is up to manufacturers to decide how to respond to that increased demand.” she said. “What we’re here to do is help with those plans.”
Pfizer said it had a target of increasing production by about 20% in 2023 but faced delays toward the end of the year. The company did not explain the reason for those delays.
The company said it has invested $38 million in the last five years in the Michigan facility where it makes the shots and that it is increasing production capacity. It also said it is adding evening shifts at the facility and actively recruiting and training new workers. Pfizer said it also reduced manufacturing time from 110 to 50 days. By the end of June, the company expects the supply to recover, which it described as having eight weeks of inventory based on its forecast demands with no disruptions in sight.
The government could manufacture the drug itself.
Having only one supplier for a drug, especially one of public health importance, makes the country vulnerable to shortages. With just one manufacturer, any disruption — contamination at a plant, a shortage of raw materials, a severe weather event or a flawed prediction of demand — can put lives at risk. What’s ultimately needed, public health experts say, is another manufacturer.
Congressional Democrats recently introduced a bill that would authorize the U.S. Department of Health and Human Services to manufacture generic drugs in exactly this scenario, when there are few manufacturers and regular shortages. Called the Affordable Drug Manufacturing Act, it would also establish an office of drug manufacturing.
This same bill was introduced in 2018, but it didn’t have bipartisan support and was never taken up for a vote. Sen. Elizabeth Warren, the Massachusetts Democrat who introduced the bill in the Senate, said she’s hopeful this time will be different. Lawmakers from both parties understand the risks created by drug shortages, and COVID-19 helped everyone understand the role the government can play to boost manufacturing.
Still, it’s unlikely to be passed with the current gridlock in Congress.
The government could reserve syphilis drugs for infected patients.
Responding to the shortage of shots to treat the disease, the CDC in July asked health care providers nationwide to preserve the scarce remaining doses for people who are pregnant. The shots are considered the gold standard treatment for anyone with syphilis, faster and with fewer side effects than an alternative pill regimen. And for people who are pregnant, the pills are not an option; the shots are the only safe treatment.
Despite that call, the military is giving shots to new recruits who don’t have syphilis, to prevent outbreaks of severe bacterial respiratory infections. The Army has long administered this treatment at boot camps held at Fort Leonard Wood, Fort Moore and Fort Sill. The Army has been unable to obtain the shots several times in the past few years, according to the U.S. Army Center for Initial Military Training. But the Defense Health Agency’s pharmacy operations center has been working with Pfizer to ensure military sites can get them, a spokesperson for the Defense Health Agency said.
“Until we think about public health the way we think about our military, we’re not going to see a difference,” said Dr. John Vanchiere, chief of pediatric infectious diseases at Louisiana State University Health Shreveport.
Some public health officials, including Alaska’s chief medical officer, Dr. Anne Zink, questioned whether the military should be using scarce shots for prevention.
“We should ask if that’s the best use,” she said.
Using antibiotics to prevent streptococcal outbreaks is a well-established, evidence-based public health practice that’s also used by other branches of the armed services, said Lt. Col. Randy Ready, a public affairs officer with the Army’s Initial Military Training center. “The Army continues to work with the CDC and the entire medical community in regards to public health while also taking into account the unique missions and training environments our Soldiers face,” including basic training, Ready said in a written statement.
The government isn’t stockpiling syphilis drugs.
In rare instances, the federal government has created stockpiles of drugs considered key to public health. In 2018, confronting shortages of various drugs to treat tuberculosis, the CDC created a small stockpile of them. And the federal Administration for Strategic Preparedness and Response keeps a national stockpile of supplies necessary for public health emergencies, including vaccines, medical supplies and antidotes needed in case of a chemical warfare attack.
In November, the Biden administration announced it was creating a new syphilis task force. When asked why the federal government doesn’t stockpile syphilis treatments, Adm. Rachel Levine, the HHS official who leads the task force, said officials don’t routinely stockpile drugs, because they have expiration dates.
In a written statement, an HHS spokesperson said that Bicillin has a shelf life of two years and that the Strategic National Stockpile “does not deploy products that are commercially available.” In general, the spokesperson wrote, stockpiles are most effective before a national shortage begins and can’t overcome the problems of limited suppliers or fragile supply chains. “There is also a risk that stockpiles can exacerbate shortages, particularly when supply is already low, by removing drugs from circulation that would have otherwise been available,” the spokesperson wrote.
Stephanie Pang, a senior director with the coalition of STD directors, said that given the critical role of this drug and the severe access concerns, she thinks a stockpile is necessary. “I don’t have another solution that actually gets drugs to patients,” Pang said.
The government could declare a federal emergency.
Some public health officials say the federal government needs to treat the syphilis crisis the way it did Ebola or monkeypox.
Declare a federal emergency, said Dr. Michael Dube, an infectious disease specialist for more than 30 years. That would free up money for more public health staff and fund more creative approaches that could lead to a long-term solution to the near-constant shortages, he said. “I’d hate to have to wait for some horrible anecdotes to get out there in order to get the public’s and the policymakers’ minds on it,” said Dube, who oversees medical care for AIDS Healthcare Foundation wellness clinics across the country.
Citing an alarming surge in syphilis cases, the Great Plains Tribes wrote to the HHS secretary last week asking that the agency declare a public health emergency in their areas. In the request, they asked HHS to work globally to find adequate syphilis treatment and send the needed medicine to the Great Plains region.
During the 2014 outbreak of Ebola in West Africa, Congress gave hundreds of millions of dollars to HHS to help develop new rapid tests and vaccines. Facing a global outbreak of monkeypox in 2022, a White House task force deployed more than a million vaccines, regularly briefed the public and sent extra resources to Pride parades and other places where people at risk were gathered.
Levine, leader of the federal syphilis task force, countered that declaring an emergency wouldn’t make much of a difference. The government, she said, already has a “dramatic and coordinated response” involving several agencies.
The FDA recently approved an emergency import of a similar syphilis treatment made by a French manufacturer that had plenty on hand. According to the company, Provepharm, the imported shots are enough to cover approximately one or two months of typical use by all people in the U.S. (The FDA would not say how many doses Provepharm sent, and the company said it was not allowed to reveal that number under the federal rules governing such emergency imports.)
Clinics applaud that development. But many of them can’t afford the imported shots.
The government could do more to rein in the cost.
Clinics and hospitals that primarily serve low-income patients often qualify for a federal program that allows them to purchase drugs at steeply discounted prices. Pharmaceutical companies that want Medicaid to cover their outpatient drugs must participate in the program.
One factor in determining the discount price is whether a pharmaceutical company has raised the price of a drug by more than the rate of inflation. Because Pfizer has hiked the price of its Bicillin shots significantly over the years, the government requires that it be sold to qualifying clinics for just pennies a dose. Otherwise, a single Pfizer shot can retail for upwards of $500. The French shots are comparable in retail price and not eligible for the discount program.
Several clinic directors also said they worried that drug distributors were reserving the limited supply of the Pfizer shot for organizations that could pay full price. For several days in January, for example, the website of Henry Schein, a medical supplier, showed doses of the shot available at full price, while doses at the penny pricing were out of stock, according to screenshots shared with ProPublica. When asked whether it was only selling shots at full price, a spokesperson for Henry Schein did not respond to the question.
Local health departments that qualify for the discount program told ProPublica they’ve had to pay full price at other distributors, because it was the only stock available.
The Health Resources and Services Administration, the federal agency that regulates the discount program, said that a drug manufacturer is ultimately responsible for ensuring that when supplies are available, they are available at the discounted price. When asked about this, Pfizer said that it has “one inventory that is distributed to our trade partners” and that hospitals and clinics that qualify for the discount program are “responsible for ensuring compliance with the program and orders through the wholesaler accordingly.” The company added, “Pfizer plays no part in this process.”
In October, on Weinberg’s regular search for shots for her Mississippi clinic, she found doses of Bicillin for sale at the discounted price and purchased 40. “The idea that we’re supposed to be hoarding treatment is a horrific compact,” she said. Word got out that the clinic, called Plan A, has some shots, and other clinics began sending pregnant patients there.
The clinic’s supply is dwindling. Weinberg is happy to get the shots to patients who need them. But she’s not sure how much longer her reserve will last — or if she’ll be able to find more when they’re gone.
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