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Doctor Nice

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For a $1,000 membership, "wellness" facilities get access to the BellaFem line and are allowed to use Hotze's ad copy on their Web sites. Shortly after the Houston Press called the Houston members of the Biologically Identical Hormone Therapy group, the academy's Web site was shut down. The only physician who replied, Susan Hardwick-Smith, stated in an e-mail that "we have no particular relationship with [Hotze's pharmacy], although we use them frequently." She also stated that natural hormone replacement is "an excellent way to treat menopausal and premenopausal symptoms for some women."

With more and more doctors prescribing the BellaFem line, Hotze would need more pharmacy technicians to prepare orders. More techs means more pharmacists, since Texas law requires a ratio of one pharmacist to three techs. Janek once again took care of that by pushing through legislation that changed the ratio to one-to-five in pharmacies that dispense no more than 20 different prescription drugs. Hotze's pharmacy appears to be the only one in the state affected by the law, according to Gay Dodson of the Texas Board of Pharmacy.

The risky nature of mainstream hormone replacement therapy has made it easier for some manufacturers to sell their bioidentical products. Although no studies exist to verify Hotze's claims that his products are safer, an infamous study by the Women's Health Initiative went a long way to show the substantial risks in mainstream therapy.

In 2002 the Women's Health Initiative terminated the study of a popular hormone replacement when incidence of breast cancer in the study group reached a preset safety limit. The 10,000 women taking an estrogen-progestin combination had higher incidences of breast cancer, stroke, coronary heart disease and blood clots than those taking a placebo.

Last year Hotze addressed a congressional subcommittee looking into bioidentical hormones.

"For gosh sakes, do not take the drugs that the drug companies are putting out, because they will kill you," he told them. "The women's health study has said that [and] I've been saying that for ten years."

Hotze believes that drug companies are interested only in patentable products that can make them a fortune, which is why they eschew bioidentical treatments.

He says that this bottom-line mentality, coupled with the frustration that many middle-aged women have with condescending physicians, is why his approach is so popular.

"They visit their physician and their physician runs a blood test and says, 'Everything is normal,' " Hotze said. "They'll put them on Prozac and Effexor and Zoloft and a whole host of them and completely ruin their lives."

Vickie Reynolds, one of Hotze's patients, illustrated the point. Since adolescence, she had experienced bouts of extreme pain, nausea and bleeding, but she said no doctor took her complaints to heart until she found Hotze. Reynolds declined a request for a phone interview, saying she had to ask Hotze's permission before she could consent.

"I went for my year examinations as I thought I was supposed to," Reynolds testified. "I would explain each time, and I would go through these symptoms. And either I got a shake of the head or I got 'Well, some women are just that way.' I thought, 'Well, okay, so some women are just that way.' "

After 40 years of suffering with traditional physicians, she found Hotze, and calls her experience "one of the most enjoyable, educational, mind- and body-healing events of my lifetime. I spent four and one-half hours talking about myself and my body…No doctor had ever listened to me for more than 15 minutes."

But Amy Allina, program director of the National Women's Health Network, says women should be skeptical of bioidentical hormones.

"There are a range of changes that can happen in the body around menopause that can be really difficult to manage," she says. "And those women right now are in a situation where mainstream medicine doesn't have a lot that's great to offer them…So you've got a group of women out there who are looking for an alternative, and that's where people like Dr. Hotze have stepped in and offered an alternative. Unfortunately for women, the alternative they're offering is completely unproven in terms of safety and efficacy."

The network's Web site states: "The cancer prevention claims for natural progesterone are perhaps the most dangerous. While oral progestins protect against estrogen-induced endometrial cancer, natural progesterone cream is not well enough absorbed to offer this protection. The effect of natural progesterone on the development of breast cancer is unknown, but the oral progestin in hormone therapy has been shown to increase breast cancer risk."

Dr. Adrian Fugh-Berman, medical adviser for the National Women's Health Network, testified at the same congressional subcommittee as Hotze. Fugh-Berman is an associate professor in Georgetown University's Complementary and Alternative Medicine Program. She was formerly medical director for two alternative health clinics and worked in the NIH's Office of Alternative Medicine (now called the National Center for Complementary and Alternative Medicine).

"Every claim made by these hucksters is misleading," she wrote in The Women's Health Activist last year. "Truth be told, compounding pharmacies purchase their hormones from major pharmaceutical companies, which use 'natural' hormones in their own products…Promoting [such] products as alternative therapies is like decanting supermarket jam into gingham-topped canning jars and passing them off as homemade at the county fair."

She told the Press: "This is not a respectable form of alternative medicine. It's pretending to be alternative medicine, when in fact it's using conventional therapies with all the risks of conventional therapies, and trying to pass them off as alternative medicine."

As for the FDA, it's not entirely sure what Hotze is selling. When asked if the BellaFem line was FDA-approved or legal as advertised, FDA spokeswoman Laura Alvey stated in an e-mail that compliance officers could not ascertain what was actually being marketed.

"These could be dietary supplements, [prescription] drugs, compounded drugs, dietary supplements making a drug claim…[it's] entirely unclear from looking at this Web site."

With a new wellness center near the Galleria, a new book and the appearance on CNN, Hotze's business appears to be more popular than ever.

Although his services are expensive, Hotze's claims -- if true -- are well worth it. His products can be used to mitigate adrenal fatigue, allergies, angina, asthma, breast cancer, bad breath, chronic hepatitis, cirrhosis, depression, diabetes, excess mucous production, hair loss, headaches, hemorrhoids, high blood pressure, impaired map-reading ability, jaundice, osteoporosis, ovarian cysts, PMS, prostate cancer, ugliness, thyroid disorders, yeast overgrowth and much more.

There are no nasty side effects. Forget what the National Institutes of Health, the National Women's Health Network and the FDA say: If you believe in Hotze's potions, they will work. Your health is the most important thing you have. And, as it says in Hotze's literature: "All wealth is founded on health."

Just whose wealth he's talking about isn't exactly clear.

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