The In’s and Out’s of Replacement Therapy
By Katelyn Zachau, DO
ioidentical hormone therapy refers to hormone replacement with hormonal substances that are, on a molecular level, identical to what our own bodies make. This, as opposed to replacement with synthetic hormones, allows for several advan- tages. First, because the bioidentical hormones you receive are identical to your own, they have a complete action in the body. That is, they act exactly like your own hormones would. Synthetic hormones are molecularly similar, and will exert similar effects to your own hormones, but will not have complete action. This incomplete action often does not elicit a balanced hormone re- sponse in the body. In addition, because synthetics have a unique molecular structure, they have the potential to have effects on the body that your own hormones would not exert.
B Because of this “complete action” effect, using bioidentical
hormones allows doctors to use smaller doses than with synthet- ics. Bioidentical sources of hormones include both plants and animals, but most bioidentical hormones are sourced from plants. Further, when we replace deficient hormones with a bioidentical version, the replacement compounds are specifically tailored to the individual. Taking into consideration the symptoms as well as the objective levels found on testing, hormones are compounded in tailored doses and combinations for each patient.
Hormones include more than the well-known estrogen and
testosterone. For example, insulin is a hormone that helps regu- late growth and is responsible for shuttling glucose from food into cells for energy; your thyroid produces different hormones to help regulate metabolism; and your adrenal glands produce cortisol, known as “the stress hormone,” which, among other things, helps the body store energy from food.
What symptoms might I experience if I have a hormonal imbal- ance?
Hormones affect all systems of the body, so hormone imbal-
ance can have a wide array of effects. Everything from fatigue to weight gain to hair loss can be affected by hormones, in addition to better known effects of hormone shifts like hot flashes, night sweats, insomnia, and mood swings. Menopause in particular can cause any of the following symptoms, in addition to many oth- ers: depression, irritability, insomnia, mood swings, hot flashes, reduced sexual interest, painful intercourse, bloating, panic at- tacks, hair loss, urinary symptoms and even infections, headaches, “brain fog” or memory loss.
Who suffers from hormone imbalance? There is a generalization that hormones are only for women going through menopause. Menopause, also known as “ovar-
26 Natural Nutmeg -May/June 2017
ian failure,” is when the ovaries stop producing eggs, and levels of estrogen and progesterone fall. While menopause certainly brings significant changes to overall hormonal balance, women in this phase of life are not the only ones who may suffer from symptoms of imbalanced hormones. Men go through a parallel process to menopause, called andropause. Essentially this refers to age-related hormone changes in men, specifically, the decrease in testosterone. This, like menopause, is a natural part of aging and may cause unpleasant symptoms such as fatigue, reduced muscle mass, and depression. Unlike menopause, however, this decline is typically more gradual than the decline of estrogen and proges- terone in women during menopause. A typical rate of decline in testosterone is about 1% per year after age 30.
Adrenal insufficiency, often resulting from a prolonged period of stress be it emotional, mental, or physical, can cause a subse- quent decline in sex hormones in both men and women. DHEA is an androgen-like hormone that helps produce cortisol, the stress hormone released by the adrenals. DHEA also helps support testosterone production. When the adrenals require more DHEA, there is less to be utilized in testosterone production, and often men can experience faster rates of decline in their testosterone levels than what would be expected from aging alone. Many men are treated for testosterone deficiency with testosterone alone, but read on as this often does not completely address the problem. Adrenal support and prevention of testosterone conversion into es- trogen is a crucial part of treating testosterone deficiency in men.
How are hormones monitored? Your doctor may choose to monitor your hormones through
saliva or blood testing. Some hormones, such as pregnenolone, are best monitored by blood levels, while it is preferable to moni- tor cortisol and estrogen through saliva testing. The frequency of hormone testing will be determined by your doctor, but often hormones are tested three months after any changes are made to your hormone regimen.
What do hormones do? Each hormone has many functions and operates in harmony with the other hormones in your body. Here is a brief summary of some functions of each:
• Estrogen: increases metabolism, increases insulin sensitivity, improves sleep, regulates body temperature, maintains bone density, relaxes blood vessels, encourages blood vessel growth particularly in the uterine lining, supports production of neu- rotransmitters such as serotonin.
• Progesterone: Modulates the effects of estrogen, helps promote sleep and reduces hot flashes.
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