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Bio-Identical Natural Hormone Therapy/Replacement
Bio-Identical Hormone Therapy
What is it? What conditions benefit? How is it tested and how is it administered?
There is much discussion these days about hormone therapy/replacement. Synthetic hormone replacement for women has been around since the 1930”s. women have been taking premarin for years. Premarin is a synthetic form of estrogen derived from horse urine. There are two major problems with premarin. One is the potency of horse estrogen is 300 times that of humans. This overexcites the receptor site, which causes inflammation, cyst formation, and potentially a cancer tumor. The second is that the estrogen molecule has to be altered from the natural form in order to be patented. You see drug manufacturers cannot patent a natural substance. Therefore, the natural estrogen hormone has to be altered to sell it as a drug.
Hormones work with cellular receptor sites in cells all over your body: Your brain, skin, muscles, bones , heart, lungs, blood vessels, digestive system, joints, macula, as well as breast, uterus, ovaries, prostate, and testicles. They are everywhere! Hormones work with the receptor site like a key works with a lock on your front door. There is an exact key shape made for your front door lock, just like there is a specific molecule shape to your natural hormone that fits all the receptor sites in your body. If you lost your key, you might be able to use a screwdriver to open your front door lock but if it doesn’t damage the lock the first time, repeated useage of the screwdriver certainly will. Likewise synthetic hormones are “extraterrestrial” molecules not designed for your body and it may fool your receptor site for awhile, but eventually the receptor will be damaged. Without proper functioning receptor sites, there can be no appropriate cellular function. Again, synthetic hormones like premarin over-excite the estrogen receptor site causing inflammation which cause cysts to form and can become a cancerous tumor over time. This is why the synthetic hormones increase a woman’s risk for breast, uterus, and ovarian cancer. Increased incidence of heart attack, stroke, and blood lots also occurs. The truth about the hazards of synthetic hormones came to light a few years ago when a pharmaceutical company conducted a five year double-blind study on women, half receiving synthetic hormones and half receiving placebo. The pharmaceutical company was convinced their drug would make people healthier. The study was stopped within two years because of the alarming rate of increased rates of cancer, heart attacks, strokes, blood clots, and fractures among the group receiving synthetic hormone! Once this study came to light, the volume of prescriptions for synthetic hormones obviously reduced due to doctor and patient awareness since this was made public. It will not be long before studies will show that these men using synthetic Testosterone will have increased cardiovascular and cancer rates. Mark my words!
Wow! You are probably thinking I don’t want any part of taking hormones. So, what is the difference between natural bio-identical hormone replacement and synthetic hormone replacement? There are several. The first is that natural bio-identical hormone replacement is just that: supplementing hormones exactly like your body makes. Bio-identical hormones such as testosterone, estrogen, progesterone, pregnenelone, and DHEA are derived from yams, and contain the exact molecule that your body produces! The second is that the doseage is in amounts that are consistant with levels that a healthy 25 year old would have. They are physiological doses, not supra-physiological doses. There are no negative side effects and increased cancer risks with using bio-identical in physiological doses. In fact, studies demonstrate all degenerative diseases including cancer and heart disease, stroke, and diabetes are decreased with hormone levels in the top 25%. Make sense?
Now that we have discussed the what, let’s discuss the why. let’s take the ladies first. If you, your daughter, your sister, your granddaughter, your friend had or have an irregular menstrual cycle, then a hormonal imbalance exists. What is a normal cycle? 28 days with 3-5 days of flow, without breakthrough bleeding, blot clots, severe cramping, fluid retention, water weight gain, and emotional instability. Generally, problems in the first 14 days indicates an estrogen deficiency and problems in the last 14 days are usually due to a progesterone deficiency. Progesterone levels should be 20 or more times than that of estradiol. Ratios under 20 increase breast, uterus, and ovarian cancer risks. The medical approach to placing these girls on birth control pills should be frowned on. These synthetic hormones increase breast, uterus, ovarian cancer and cardiovascular risks. There are better ways to handle this. Left untreated properly, these hormonal imbalances can become life threatening! As women reach their thirties, progesterone levels start to fall. Progesterone levels have to be adequate to maintain the pregnancy, this is why women have more problems carrying a pregnancy as they age into their forties. Sub-optimal levels will cause problems with conception or early spontaneous abortions. Post-partum depression occurs sometimes because progesterone and estriol elevels drop 1000% in a 24 hour period following the delivery of the baby. Progesterone has a calming, tranquilizing effect on the brain as well as has a diuretic effect. this hormone is necessary to balance the estrogen. progesterone deficencies can cause anxiety and depression! Once menopause occurs, estrogen levels drop dramatically, but progesterone levels can fall even more. This is why so many menopausal women are having anxiety and/or depression. These women are having a progesterone deficiency, not a prozak deficiency! Most women will manifest estrogen dominace at this point, even though they are estrogen deficient because of the greater drop of the counter- balancing progesterone levels. Giving a menopausal woman synthetic estrogen is double trouble because she lacks the antagonistic/balancing effect of the progesterone. Progesterone gives protection to the breast, uterus, and ovaries , encourages new bone growth, calms the brain, and has many other beneficial functions. It is the estrogen/progesterone balance that helps maintain healthy bone density. This is why some women can lose 30-40% of bone density in five years folowing menopause. Correcting this will do far more to preventing osteoporosis than taking calcium. As women age, their skin, hair, bones, mucous membranes are drying and shrinking. balanced bio-identical hormones will keep women’s hair, skin more youthful and moist, muscle mass and bone density maintained, and will reduce fat around the belly, hips, and upper thighs. There are estrogen receptor sites in the brain, skin, muscles, bones, digestive system, blood vessels, as well as the breast, uterus, and ovaries. The appropriate activation of these receptor sites is essential for optimal function in all organs. By maintaining balanced hormones at more youthful levels, there is a synergistic effect on all organ/body functions maintaining all organ functions at a younger level.
By the way, your excess fat is producing more estrogen. Interesting tidbits of fact:The average 55 year old man in America is producing more estrogen in his body than his 25 year old daughter! Conversely, the average 25 year old female is producing more testosterone than a 60 year old man..
Now that we have talked about the why, it is now time to discuss the how. There are three ways to analyze our hormone levels, through the blood, urine, or saliva. The most common way is through the blood. A man’s testosterone is highest in the morning hours, but levels can fluctuate 800% throughout the day. A woman’s estrogen can fluctuate 400% in a day. A blood draw is just a snapshot of a 24 hour movie. What conclusions could you draw from looking at a single picture from a motion picture? What is the beginning? What is the end? What is the plot? So, not only do blood tests not give the doctor much accurate information, they are expensive, $1000-$1500.
Urine testing of the hormones is accurate. Analysis of all hormone by-products are available, so accurate levels and balances of the hormones are obtained. The second method of analysis, urinalysis has the advantage of measuring mineral levels such as sodium, calcium, and phosphorus as well. The cost is fairly reasonable at about $300. The negative of this testing is that you must keep all your urine for a 24 hour period in a container, and keep it refrigerated, and have to take it back to the lab. This is not very convenient.
The third method of analysis is through the saliva, is the most accurate. It is recommended by the World Health Organization, and is what we use. Saliva testing shows only the un-bound, bio-available hormones. The bio-available hormones represent only 1-5% of the total hormone pool, but they are the only ones that are available to be used to activate the receptor sites in the cell membrane! The hormones present in the saliva are free because the sex hormone binding globulin molecule is too large to go through the saliva ducts. Testing is done multiple times throughout the day by simply spitting into a plastic tube, to get an accurate overview of the hormones through their cyclical phases. Most labs test 4x/day. We test 5x/day which is more accurate, over 90%.
The second part of the how is, how is it administered? The hormones can be injected, taken orally, surgically inserted in time released pellet form, or applied in a transdermal cream. Let’s discuss each method.
Injections can be problematic because supra-physiological levels occur within the bloodstream, stressing the liver to produce sex hormone binding globulin to bring levels down to physiological levels. The liver is very efficient, and many times it will overcompensate, and hormone levels will go lower than optimum. Not only will the hormone being injected drop, so will all other hormone levels.
Oral doses require taking doses 10-20 times what is needed because 90-95% will not make it to the blood stream after going through the digestive system. There is an 100%, or more ,variance in that doseage, depending on whether you are able to use 5% or 10%. Supra-physiological doses can occur , causing the liver to produce sex hormone binding globulin to bring to physiological levels.
Another method is the surgical insertion of time-released hormone pellets under the skin. Tthese pellets can be either synthetic, or natural, so beware. There are several negatives to this methodology in my mind. One is that the doseage cannot be changed for the 2-3 month period they are in. The other is that it is a surgical procedure requring anesthetic. The third is the cost. I can only assume that because this procedure may be covered by insurance that the procedure itself is lucrative to the practioner.
The other methodolgy involves the application of a transdermal cream (rubbing hormone into the skin). Transdermal doses are at least ten to thirty times more readily available than oral doses. Absorption is dependant upon the carrier cream. Physiological doses are used. the hormone is absorbed through the skin and taken to the receptor sites via the lymphatic sytem. The hormone is used up at the receptor site, and therefore blood levels don’t elevate, and the liver is not producing sex hormone binding globulin (SHBG). Nnon-prescriptive transdermals can be prepared in volume at specific strengths, and therefore, are less expensive. Doseage for a patient can be individualized by using one, two, three, or four pumps of transdermal cream. Doses can be quickly changed as needed. The best form of transdermal is using liposome technology. Liposome technology is the greatest breakthrough in nutrition of the decade, if not the century.We have known for years that certain nutrients were essential to normal function, and will improve health. The challenge has always been getting the nutrient into the cell. Liposome technology is when a vitamin, mineral, nutrient, herb, or hormone is encapsulated with phosphatydal choline. Phosphytidal choline is a naturally occuring lipid found in all our cell membranes. Because this is part of our natural cellular membrane, it is readily accepted into the cell. This technology is also availble in sublingual dosing, as with our vtamin B supplemention.
I want to leave you with just one more bit of information. When hormone levels are tested for testosterone, estrone, estradiol, estriol, progesterone, DHEA, and cortisol, you do not want to just be in normal “reference range” levels. You want your scores to be in the top 25% range. People with scores in the bottom 25% range are 300-400% more likely to get Diabetes, Cancer and Heart Disease. If you don’t get Diabetes, have Heart Disease, don’t have a heart attack or stroke, and don’t get cancer, you are far more likely than not, to have a very long, quality life. Optimum hormone levels are an invaluable asset, coupled with quality nutrition, clean water, daily exercise, quality sleep, deep breathing, and positive thinking, for increasing your odds to achieve optimum functional aging.
This service is provided through Hoffman Clinic for Optimal Health.If you would like to see if Bio-Identical Hormone Therapy could benefit you, call 813-985-1322.
Kelly Miller, DC NMD FASA FBAARM CFDMP*, is a physician for Hoffman Clinic for Optimal Health.
*There is currently no licensure for Naturopathic Physicians (NMD) in the state of Florida and the Florida Board of Chiropractic Medicine does not currently recognize the credentialing of the Fellowship from the Brazil-American Academy for Aging and Regenerative Medicine (FBAARM), or the Certification in Functional Diagnostic Medicine (CFDMP) from Functional Medicine University.