Letters to the Press: Why disallow hormone treatment?

As patients and the public learned about the new ruling regarding Bioidentical Hormone Replacement (BHR) and Natural Desiccated Thyroid (NDT) treatment some of them wrote to The Straits Times. There was no response from the Ministry of Health (MOH) to any of the letters.

Why disallow hormone treatment? 25 April 2014, Ms Debra Bray


The writer lives in Indonesia and has been visiting Singapore for treatment with bioidentical hormones and natural desiccated thyroid. Her letter was heavily edited before publication. She has allowed her original letter to be published here:

Medical Tourist seeks other destinations as Singapore Ministry of Health bans customized Bio-identical Hormones

Dear Editor,

Singapore is a world-class city, I have learned from visiting here 6 times in the past 3 years. I enjoy this futuristic city with a knowledge economy, clean water, good transportation, green initiatives, excellent education and health care and a quality of life most can only dream about. However, my impression is changing as I realize the Ministry of Health (MOH) is eliminating the prescription of customized or compounded bio-identical hormones by physicians and local pioneers in the international field of Pro-Aging Medicine. I wrote to the Ministry 3 months ago to ask officials why? I wondered if there had been a policy change? There has been no reply. This ban hurts both patients and doctors. It tarnishes the image of a world-class city. The main reason I have visited Singapore from Indonesia is to see my physician who has successfully relieved my symptoms of an underactive thyroid and menopause with natural thyroid medicine and customized bio-identical hormones. I have been using this medicine for the past 6 years. I am very thankful for both the professionalism and quality of the medicine I found in Singapore.

You may call me a “medical tourist” because I also spend money for hotels, dining and entertainment. And as a medical tourist – I’m free to go where I find the best health care; I left Bangkok 3 years ago for Singapore.

However, the term “medical tourist” doesn’t reflect my understanding and research that led me to a Singapore physician who could prescribe what I need to be healthy now, and prevent the risk of cancer, Alzheimer’s disease and bone-density problems in the future. My career – as a science teacher and part-time professor – flourished – along with my health.

Hormones for women are far more complex than for men, and I wonder if MOH officials are shortsighted, or if health care for women is a lower priority. I would like to understand why the Singapore MOH is eliminating the prescription of bio-identical hormones by local physicians; I wonder if this ban is related to the influence of some pharmaceutical companies.


Ms Debra Bray, BSc, BA, MPhil (University of Cambridge)

Testimonial – Natural Thyroid Treatment for Hashimoto’s

Ministry of Health

To Whom it May Concern,

It has come to my attention that there are concerns within the Singapore Ministry of Health (MOH) over the use of desiccated pig thyroid. I am writing to convey my despair and frustration that the MOH does not seem open to allowing a patient to determine their own health choices, especially when my doctor provides an invaluable, scientifically founded and results-driven service.

I came to know about my doctor after being diagnosed with an auto-immune condition, Hashimoto’s Thyroiditis. The specialist I was seeing upon my diagnosis could offer no explanation for my condition, nor offer any advice on how to improve my symptoms, other than by taking the prescribed T4 based medication. Out of frustration, I educated myself about my condition and looked for a doctor who would consider all my symptoms in a holistic way.

My doctor guided me on my learning journey to make sure I was in control of my own health choices. However, he would always recommend that I made changes slowly, determine what was working and what was not, as well as providing good reasons for not following a particular form of treatment. Through his guidance I have improved my knowledge of my condition and most importantly improved my symptoms and health markers.

Before making lifestyle changes I was taking Nexium for reflux related issues, T4 for Hashimoto’s and was well on the way to needing a statin because of increasing blood cholesterol levels. After adopting the paleo lifestyle and changing to desiccated pig thyroid I no longer need Nexium and my cholesterol continues to fall from very high levels. Not only am I taking less drugs, but my symptoms of itchy scalp, itchy shins, weight gain, light headiness and others have practically disappeared. This was most definitely not the case when taking conventional medication.

I believe strongly enough in the services my doctor provides to recommend him to two friends that I’ve met through an auto-immune support group. Both of whom have provided positive feedback on their interaction with my doctor as they begin to address their own health issues.

I wish to continue having my doctor’s services available in Singapore to monitor and guide my journey to a healthier life through the use of appropriate lifestyle changes and supplements required for complex, chronic conditions, such as mine. If the MOH sees fit to discontinue my doctor’s ability to provide the treatment that I require then I will have no other choice but to find another holistic/integrated medicine practitioner overseas.

I am happy to provide more detail on just how effective the changes that my doctor made to my treatment have impacted my health and upon request will be happy to release my medical records as proof of such treatment.

Yours faithfully,

Blair Layton.

Bioidentical Hormone Replacement Therapy Under Threat in Singapore

This Hormone Choice Singapore (HCS) Website has been set up by a group of concerned patients in response to a recent communication from the Singapore Ministry of Health (MOH) to Licensees/Managers of all clinics disallowing the provision of nonvidence based treatment in licensed healthcare institutions.

Letter 15 April 2014. Provision of non-evidence based treatment in licenced healthcare institutions

The letter calls attention to bioidentical hormone replacement therapy (BHRT), which we take to include natural desiccated thyroid (NDT) medication, but does not specify other forms of treatment that may be impacted by this decision.

This announcement and previous investigations by the MOH have created a great deal of uncertainty amongst doctors, patients and pharmacies about whether they can continue to use existing treatments that show considerable benefits for patients.

As a result of this uncertainty, a number of patients who could be impacted by any restriction in the use of BHRT and NDT treatment have come together to form HCS.  We aim to try to find out what MOH’s letter actually means and hopefully, by showing the support for and benefits of the treatment worldwide, to convince the MOH not to remove access to the bioidentical hormone and natural thyroid treatments that we know work for us and so many people around the world like us whose symptoms are not relieved by synthetic drugs or who do not want to take synthetic drugs to relieve their symptoms.

Since all the bioidentical and desiccated thyroid hormones in Singapore are prescribed based on rigorous testing both of patients’ blood hormone levels and of the products themselves and since the treatment is endorsed by many well-known experts in other countries, following various studies, we believe there is sufficient “evidence” for their continued use. We feel much of the information on this site is extremely convincing, as is our own experience taking bioidentical hormones or desiccated thyroid, or both.

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