Doctor Nice

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Friday, June 3, 8 a.m. Carol Costello is sitting in for Soledad O'Brien on CNN's American Morning. Today, there's hard-hitting stuff: Brooke Shields's postpartum depression.

Shields just professed in her book that she wasn't able to bond with her daughter in the weeks after her birth. When Tom Cruise publicly disapproved of her use of antidepressants, the story got hotter -- at least by American Morning standards. When you have actors of this caliber duking it out, you've got to call in a true medical expert to put a nation at ease. Someone who's trained in dealing with postpartum depression. Or, in CNN's case, you call in a Houston family practitioner in the midst of a whirlwind tour promoting his self-published book.

"Does Tom Cruise have a point about how women should treat postpartum depression?" Costello asks. "Dr. Steven Hotze is author of the book Hormones, Health and Happiness…Brooke Shields calls Tom Cruise's statements dangerous. What do you think?"


Steven Hotze

Hotze displays to the nation the slow-talking, warm-voiced, easygoing manner that thousands of patients from across the country pay thousands of dollars a pop to experience. At 55, Hotze is a nearly bald paternal figure blessed with down-home charm. In his slight, soothing drawl, he says that women experiencing PPD should seek natural progesterone replacement therapy. No one asks what his credentials are. His expertise is cited solely by the book, which he paid an Austin vanity press to publish and distribute.

"My daughter is getting ready to have a baby," he explains. "And she's going to take her progesterone to the hospital and take it as soon as she has her baby."

"Really?" asks an incredulous Costello. "Even though she may show no sign of postpartum depression?"

"Every woman has a dramatic drop in progesterone," Hotze says. "And that helps calm the water so they don't have those…postpartum blues."

"Thank you, doctor, for clarifying things for us," Costello says.

If CNN had allotted more time for Hotze, he might have had time to talk about the Hotze Health and Wellness centers in Katy and Houston. He might have had time to explain why his unconventional approaches to a variety of disorders are superior to mainstream medicine.

Costello could have asked why one of the country's leading proponents of "bioidentical" hormone replacement claims to be a board-certified ear, nose and throat doctor when no records of certification exist. She could have asked why leading experts in women's health issues say Hotze's methods are not supported by science and are potentially harmful. She could have asked why Steven Hotze runs an expensive one-stop shop for thyroid disorder, hormone replacement, yeast infections and allergies, when no medical records show Hotze has training in any of them.

Finally, she could have asked why Hotze tells his patients it's their fault if they don't get better.

Steven Hotze did not consent to an interview for this story, and it's easy to understand why. As a Christian fundamentalist who espouses antigay rhetoric, he's received his share of criticism. Hotze first popped up on the radar in 1982, when he supported a proposed Austin ordinance that would have made it legal for homosexuals to be denied housing based on their sexual orientation. Hotze's organization, Austin Citizens for Decency, proposed the measure to see if Austinites wanted to afford "special privileges to sodomites."

Because homosexual activity was illegal at the time, Hotze told the Associated Press, the groups he was fighting were "like thieves or murderers trying to gain political power," adding, "The public ought to be outraged."

Unfortunately for Hotze, the measure was defeated. But Hotze was not deterred. Three years later, he brought his fight to Houston. Here his group, Campaign for Houston, helped kill a proposal that would have made it illegal for the city to hire, fire or promote employees based on sexual orientation.

"There's one way we can avoid doing this again," The Washington Post quoted Hotze as saying. "And that's by electing godly, righteous people to office. We need a slate of candidates, from the mayor on down, so we can sleep well at night." Hotze's wish came true with the next Houston election, when his group assembled a sort of homophobe dream team called the Straight Slate -- eight City Council candidates who supported antigay legislation. Not one was elected.

Hotze was able to better articulate his views in 1986, when he was one of dozens of ministers, professionals and laypersons who signed the Coalition on Revival's Manifesto for the Christian Church. The coalition claims on its Web site to be a national network of religious leaders aligned in a mission "to help the Church rebuild civilization on the principles of the Bible so God's will may be done on earth as it is in heaven." They want all aspects of life -- government, science and education -- to adhere to fundamental biblical beliefs. These beliefs include the following:

A wife may work outside the home only with her husband's consent

"Biblical spanking" that results in "temporary or superficial bruises or welts" should not be considered a crime

No doctor shall provide medical service on the Sabbath

All disease and disability is caused by the sin of Adam and Eve

Medical problems are frequently caused by personal sin

"Increased longevity generally results from obedience to specific Biblical commands"

Treatment of the "physical body" is not a doctor's highest priority

Doctors have a priestly calling

People receiving medical treatment are not immune from divine intervention or demonic forces

Physicians should preach to their patients because salvation is the key to their health

"Christians need better health to have more energy, tolerate more stress, get depressed less often, and be more creative than our non-Christian counterparts for the advancement of God's Kingdom."

Three years after committing to the Coalition on Revival, Hotze opened his Health and Wellness Center on Braidwood Road in Katy. With money he earned in his private practice, as well as funds from an engineering company founded by his father, Hotze bankrolled a series of local conservative candidates. By the mid-'90s, he was a bona fide kingmaker. But soon his political clout deteriorated, and by 2000 the Texas Ethics Commission had fined his political action committee a record $5,000 for violating campaign finance laws.

With publicity focused on Hotze's political activities, his private practice never got any attention. But the Hotze Health and Wellness Center's claims are typical of those that get the attention of the Food and Drug Administration, the Federal Trade Commission, the Texas Department of Health, and mainstream and alternative practitioners.

Hotze graduated from the University of Texas Medical School in Houston and entered a mainstream family practice. But according to the story he shares in his literature, he turned to alternative medicine in the late '80s, when his father's heart disease failed to respond to conventional treatment.

Testifying before a congressional health care subcommittee last year, Hotze said, "My dad used to tell me -- and he wasn't a doctor -- 'beware of doctors, they will poison you to death with their drugs.' "

But at some point during Hotze's journey into alternative medicine, things got weird. Hotze, who had spent the last decade in family practice, switched his focus from his father's heart disease to a pathogenic smorgasbord of allergies, hypothyroidism and yeast infection. He reported to the Texas State Board of Medical Examiners that he was a board-certified otolaryngologist, but the American Board of Otolaryngology (located in Houston) and the American Board of Medical Specialties have no such records.

The Houston Press left numerous voice-mail messages with Hotze's assistant, asking her to provide proof of certification, but there was no response. However, state board spokesperson Jill Wiggins related in an e-mail that Hotze faxed her a request on June 20 to correct his profile. Hotze is no longer listed as being board-certified.

However, he claims to be at the forefront of identifying the relationship between a woman's allergies and her hormones. On his Web site he claims to have been led down this road in 1996, when a patient gave him an audio tape of Dr. John R. Lee, the pioneer of botanically derived "natural progesterone" for menopausal women and the originator of the dubious term "estrogen dominance." Hotze had found his calling.

According to an undated study posted on his Web site that reads more like ad copy, Hotze explains that natural, or "bioidentical," hormones are "derived from diosgenin, a plant molecule found in soybeans and wild yams. Diosgenin is extracted from these plants and converted into progesterone in the laboratory. Progesterone can then be converted into the three human estrogen hormones…Because the supplemented bio-identical hormones are exactly the same as those which we produce, they are identical in action."

In the same study, which does not appear to have been published outside his Web site, Hotze stated, "In the interest of all my female patients, I felt that I had a responsibility to offer them this new treatment opportunity." (Hotze's work does not exist in any recognized peer-reviewed journals. The only publications he lists on the Texas State Board of Medical Examiners' Web site are articles in Houston Lifestyle&Homes and Spirit, the in-flight magazine for Southwest Airlines.)

Armed with his newfound belief in natural hormone therapy, Hotze claimed in his literature and on his Web site that his brand of bioidentical hormones "protects against breast cancer and uterine cancer," for which he provides no scientific evidence. Hotze did not respond to questions about where he purchased the raw materials for his hormones, or in what laboratory they were converted into human estrogen.

But now Hotze had something to offer women who had had no luck with traditional medicine -- and that's quite a population.

A 1993 Commonwealth Fund survey found that women change physicians more often than men; the main reason being lack of communication. More women than men reported instances where their doctor talked down to them. Women also were more likely to report occasions where doctors said their problems were imaginary.

Clearly, many women were not getting the treatment they deserved. So Hotze created a warm, caring environment more like a spa than a doctor's office. Patients became "guests" who would never be treated like second-class citizens.

Hotze's literature describes the difference between his Health and Wellness Center and what his guests were used to: "It is intentionally designed to look and function differently than a typical doctor's office. Our office is filled with fresh flowers and attractive furnishings in addition to having a warm, friendly staff who consider it a privilege to serve our guests. Service is timely. Phone calls are returned promptly and every effort is made to accommodate you."

Flowers. Fancy furniture. Friendliness. Fortune.

According to his booklet for prospective patients, Hotze's intakes run from $2,000 to $3,900. Guests are prescribed drugs available only through his in-house pharmacy that cost about $300 a month. He also recommends a plethora of dietary supplements, also available in-house, which run $150 to $200 the first month. A ten-week supply of his experimental allergy drops is $288. He claims 1,500 new guests a year, with 35 percent coming from outside Texas.

Hotze admits that insurance companies generally do not recognize his treatments as "medically necessary." Most patients pay entirely out of pocket. And patients are told up front that if they don't get better, it's because they have a negative attitude. "When individuals do not believe they can get better, it can become a self-fulfilling prophecy," Hotze's literature states. Of course, the opposite also can be true. In medicine, it's called the placebo effect.

His literature is chock-full of bizarre, unsubstantiated claims wrapped in pseudo-scientific jargon. For example, birth control pills prevent "the production of women's biologically identical female hormones and pheromones, making them less attractive to men." This, despite the fact that no one has ever identified a human pheromone, and subjective claims of physical beauty are largely irrelevant to the field of medicine.

His weird claims don't apply to just women, as is evident in the statement that "When men lose their testicles to disease or injury, they have difficulty reading a map, performing math problems and making decisions."

In science, the gold standard for testing theories is the double-blind, randomized, placebo-controlled study, which adjusts for bias on the behalf of both the scientist and the subject. But Hotze eschews that methodology and relies on vague "in-house" studies, such as the one where his testosterone supplement increased his male patients' "mental sharpness, memory, abstract thinking, mathematical ability, goal-setting, initiative, assertiveness, decisiveness, sense of well-being, self-confidence, depressed moods, anxiety, irritability, muscle strength and romantic inclinations." Curiously, there was no mention of sharpened map-reading skills.

In addition to his natural hormones, he developed an interest in other conditions that exist only on the fringes of medicine, such as "yeast hypersensitivity syndrome." In his prospective patient booklet, Hotze states that an overgrowth of yeast in the colon "produces toxins which depress the immune system and make it more reactive to allergy." A person with yeast overgrowth "often becomes allergic to yeast, and therefore allergic to food products which contain yeast, such as beer, wine, breads, etc." Symptoms include lethargy, depression, gas, difficulty concentrating, athlete's foot, jock itch, joint and muscle pain, and hives. Hotze claims the condition can be remedied by purchasing megadophilus supplements from his in-house dietary supplement store.

In 1986 the American Academy of Allergy, Asthma and Immunology called this syndrome "speculative and unproven," adding that "the basic elements of the syndrome could apply to almost all sick patients at some time."

And his treatment of thyroid disorder is in keeping with similar "wellness centers" across the country: Instead of treating all problems associated with the thyroid, Hotze treats the one condition -- underactive thyroid -- where patients need to buy thyroid replacements. The only drug he prescribes for hypothyroidism is Armour Thyroid, made from desiccated pig or cow hormones. Endocrinologists at the nation's leading hospitals contacted for this story all described Armour Thyroid as an inferior, antiquated product. Hotze, however, prefers its "natural" qualities to those of synthetic thyroid replacements. (For some reason, Hotze argues that pig hormone originally provided by the Armour hot dog people is perfectly natural for humans, while Premarin, an estrogen replacement derived from mare's urine, is not.)

"That's like selling snake oil," says Dr. Carlos Hamilton Jr., a professor of medicine at the University of Texas Health Science Center-Houston. He is also a past president of the American Association of Clinical Endocrinologists.

"For one thing, when you give this, you're giving all the other things that sort of come up with ground-up pig thyroid, and you don't necessarily want those," says Dr. Susan Kirk of the University of Virginia Medical Center in Charlottesville.

In conventional medicine, hypothyroidism is best diagnosed by a blood test and a review of symptoms. While Hotze administers blood tests, he states in his booklet that a more important tool in determining hypothyroidism is the measure of a patient's basal body temperature. This method, discredited in conventional medicine, is a technique used to detect a dubious hypothyroid condition called Wilson's syndrome. The American Thyroid Association states that there is no scientific evidence proving the syndrome's existence, and that any diagnosis and treatment of the condition could be harmful.

From the thyroid association's Web site: "The 'Wilson's syndrome' website states that Dr. Wilson named this concept after himself 'because it had not been previously described.' In fact, for more than a century, the same set of symptoms has been given different names and attributed to a variety of causes by others, including the syndromes of neurasthenia, chronic fatigue, fibromyalgia, multiple chemical sensitivity, chronic Ebstein Barr disease, and chronic candidiasis," or yeast hypersensitivity syndrome.

According to Dr. Manuel Quinones of UCLA's David Geffen School of Medicine, "it would be malpractice, it would be unethical for somebody to diagnose somebody by a body temperature…In the medical community, we would say immediately, 'What's his or her gimmick?' "

Dr. Bill Ladenson of Johns Hopkins Hospital also is skeptical of using basal body temperatures to diagnose hypothyroidism.

"Part of this whole naturopathic gospel is [blood] tests don't detect, somehow, a group of patients with thyroid problems who can only be detected by basal body temperature," he says. "There's just no scientific evidence for this. If you want to check your basal body temperature tomorrow morning or for the next few mornings, I think that you would find you would readily fulfill this doctor's criteria for having an underactive thyroid gland…It's a good way of kind of assuring that 90 percent of your patients are going to want the treatment."

And Hotze's allergy drops, administered under the tongue, are considered experimental in the United States and are not endorsed by the American Academy of Allergy, Asthma and Immunology. In his booklet, Hotze claims that sublingual drops can "neutralize" a patient's allergic reaction to foods, but there is no scientific evidence supporting this claim.

Dr. David Weldon, vice chair of the AAAAI's immunotherapy committee, says that while European testing has shown that extremely high-dosage drops are effective for certain airborne allergies (but not food allergies), advocates in the United States of the drops often use diluted, ineffective doses to cut costs.

"Believe me, I wish that the sublingual stuff in Europe was a lot more practical and used in the United Sates," says the board-certified Weldon, who is also president of the Texas Allergy, Asthma and Immunology Society. "We have a great dilemma in the state of Texas regarding practitioners providing alternative care under the umbrella of allergy. And that alternative care, in the majority of instances…amounts to nothing more than a placebo effect. But it's a very expensive placebo effect."

He adds: "My colleagues who are board-certified or board-eligible have gone through the training in order to prove their worth and have been tested. What they do after that is up to them. But the vast majority of physicians that belong to the TAAIS practice allergy, and not the business of allergy."

In 1994 President Clinton signed the Dietary Supplement Health and Education Act, setting into non-motion one of the least effective pieces of legislation in recent memory.

The act broadened the definition of "dietary supplement" beyond essential nutrients and transferred safety monitoring from the FDA to the manufacturer. Today, most dietary supplements are not subject to premarket testing.

Under the act, providers of dietary supplements are not allowed to claim their products treat, prevent, cure or mitigate disease. Claiming your supplement cures whooping cough is illegal; claiming that the target ingredient aids in overall well-being is not. And, just so the consumer didn't miss the point, the act required manufacturers to print on the label, "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."

To get a sense of how effective the 1994 act is, type "colloidal silver" into your search engine and see everything it's claimed to cure. Colloidal silver is the quintessential snake oil, consisting of microscopic bits of silver -- a toxic heavy metal -- suspended in a gelatinous base. The online sale of colloidal silver to cure everything from jock itch to Ebola gives Internet porn a run for its money. In 1999 the FDA got so sick of colloidal silver salesmen that it issued a statement declaring that "all over-the-counter products containing colloidal silver or silver salts are not recognized as safe and effective and are misbranded."

One of the reasons they're not entirely safe is that they carry the risk of argyria, a severe buildup of silver particles in the tissue that can turn your skin blue. Permanently.

The National Center for Complementary and Alternative Medicine (part of the National Institutes of Health) echoed the FDA in 2004, adding that other potential side effects include seizures and kidney damage.

But that did not deter Hotze from making extravagant claims about the colloidal silver he sells through his dietary supplement store, Physicians Preference.

In early June, the Physicians Preference Web site described colloidal silver as a natural antibiotic that "can heal burns, cut[s], rashes and sunburns. It can also be used for toothaches, mouth sores, eye infections, and as a mouth gargle to fight bad breath and tooth decay." (The range of fake qualities of these phony cures is astounding; consumers who want the best bogus treatment should skip Physicians Preference and get their fake cures from Utopia Silver, whose Web site shows cool drawings of silver colloid particles battling E. coli and Ebola microbes.)

Without mentioning that the product can turn your skin blue, the Physicians Preference Web site suggested children between the ages of six and 12 take a teaspoon a day, and children under six take half a teaspoon.

A representative of Physicians Preference told the Houston Press that Hotze's company gets its colloidal silver from a group in Tennessee that had studies to support the claims. However, that company, Natural Path/Silver Wings, made no claims for colloidal silver on its Web site.

Company president Liz Smith explained to the Houston Press that she was well aware of laws regarding false claims, which is why none of their products claim to treat any disease.

After that discussion, the Press sent an e-mail to Physicians Preference, asking why the added claims were legitimate. No one from the company replied, but overnight Hotze's colloidal silver lost its ability to fight infection. The claims on the Web site were changed, and not just for colloidal silver.

Magnesium citrate, which on June 9 could be used in the treatment of congestive heart failure and high blood pressure, is now "primarily taken to support cardiovascular and muscular health." (Also new is the disclosure that magnesium "may cause a laxative effect.")

Also on June 9, Iodoral could treat fibrocystic breast disease, hemorrhoids, ovarian cysts, thyroid disorders and excess mucous production. Now it possesses the power of extreme vagueness: "Using Iodoral could yield maximum benefits."

In 2001, the FDA and the Federal Trade Commission issued a statement declaring their intent to crack down on "unscrupulous marketers who use the Internet to prey on the sickest and most vulnerable consumers." But for every shark-cartilage manufacturer penalized for making cancer-curing claims, someone else pops up with spit from worker bees that wards off aging.

Karen Tannert, chief pharmacist with the Texas Department of State Health Services, says the marketers of colloidal silver are among the worst violators of labeling laws.

"The product's basically fraudulent from the word go," she says. "However, because of the loopholes in the laws, it can be marketed still as a dietary supplement, and they take advantage of that."

Tannert says hucksters play with people's health by distracting them from treatment that might actually work.

"Who is being affected through omission?" she asks. "That's really one of the big problems with a lot of these fraudulent products, is that people want to take care of their own treatment, their own therapy, so they don't seek, you know, the truly effective stuff…How can you measure the harm because somebody postponed seeking chemotherapy for six months? How do you measure that?"

Hotze has gone to great lengths to sell his line of bioidentical hormones, which he trademarked under the name BellaFem. While Hotze's Web site doesn't directly list the sources of these hormones, the site repeatedly mentions soybeans and wild yams.

Bioidentical hormones for the most part are sold as dietary supplements. But Hotze prescribes them to his patients, who purchase them from his in-house pharmacy.

BellaFem's claims were criticized in a 2004 issue of The Women's Health Activist, the journal of the National Women's Health Network. Under a headline reading "BellaFem: Fulla False Claims," the brief article stated that "no hormone has been proven to be completely safe," adding that "All of the research done so far shows that natural hormones carry the same risks (including increased risk of breast and endometrial cancer) as synthetic hormones. Research has shown that natural hormones are beneficial only for the treatment of hot flashes and vaginal dryness." (The Washington, D.C.-based advocacy group does not receive funding from pharmaceutical companies.)

Under the 1997 FDA Modernization Act, compounded drugs were not subject to approval standards as long as pharmacists did not advertise them. But the U.S. Supreme Court overturned that part of the act in 2002, stating it violated pharmacists' First Amendment rights. In Texas, Senator Kyle Janek introduced a bill to reflect the court's ruling. With the green light to hawk BellaFem online, Hotze created an organization called the American Academy of Biologically Identical Hormone Therapy.

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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