Are Your Hormones Making You Sick? Making Sense Of All The Madness { by Elvis Torres, D.O.,FACOG
Hormones 101 Everything you wanted to forget from Biology class Hormones function as chemical messengers in your body. The base molecule for many hormones is Cholesterol. The sex steroids include: Estrogen, Progesterone, Testosterone. Other just as important hormones are TSH, Insulin, DHEA and Cortisol. 99% of hormones in the blood are protein bound and as such cannot be used by the cells. Approximately 1% of hormones are free and are active in the cells. Different factors can affect the amount of bound and unbound hormones.
Hormones 101 cont.
Functions of Estrogen Stimulate the endometrium (uterine lining) Maintain vaginal and bladder tissue health Stimulate growth of breast cells Development of female sex organs during puberty Decreases bone breakdown Effects mood, cognition and concentration Decreases thyroid function, which slows down metabolism Increases fat storage
Allergies Estrogen Dominance Decreased sex drive Fatigue Low blood sugar Headaches/ Migraines Memory loss Thyroid dysfunction Weight gain Breast pain/ cyst Depression PMS Fibroid growth Fluid retention Worsening of endometriosis Heavy periods Cramping Breast cancer Uterine cancer Irritability/ mood swings Increase hormone binding globulin
Estrogen Deficiency Vaginal dryness Decreased sex drive Disturbances in sleep Poor concentration Thinning of skin
Not All Estrogens Are Created Equal Three types of Estrogen made in the human body Estrone: A moderately strong estrogen made from Androsteinedione (a male hormone) in the adrenal glands and in women converted into estrogen in fat tissue. Estradiol: The strongest and longest lasting of the estrogens, estradiol is made in the ovaries. It is the primary estrogen found in birth control pills Estriol: The weakest estrogen. Peaks during pregnancy but in non-pregnant women it is made by conversion of Estradiol. May reduce risk of estrogen dependent cancers by blocking the receptor from Estradiol s effects.
Estrogens Continued Phytoestrogens: Plant derived estrogens that can bind to human receptors and act as weak estrogens. May reduce the risk of estrogen dependent cancers. Example is Soy. Premarin: Very strong and very long lasting estrogen derived from pregnant mare urine. By-products have been known carcinogenic for decades. The most widely prescribed estrogen for hormone replacement. Xenoestrogens: The most potent of the estrogens. Byproduct of commercial compounds. Usually found as isolates in small quantities. When combined, they potentiate each other. Examples include pesticides, cleaners, pollutants.
Progesterone Deficiency Promote and maintain pregnancy Diuretic: decreases water retention Increases thyroid function Anti-depressive and anti-anxiety properties Increases libido Decreases cramping Decreases estrogen receptors Promotes cell maturation Promotes natural cell death Decreases frequency of seizures Regulates menstrual cycles Promotes growth of new bones
Functions of Testosterone Increases libido Improves strength and balance Builds muscle and strengthens bones Keeps prostate growth under control Nourishes tissues of the urinary tract Increases red blood cell count Lowers cholesterol Improves cardiac circulation Increases energy Improves mental alertness
Functions of DHEA Lowers cholesterol Prevents blood clots Boost the immune system Strengthens bones Reduces body fat Low levels are associated with: Lupus, Alzheimer s, diabetes, breast and ovarian cancers, obesity and heart disease.
Feeling Overwhelmed?
Points to Remember The presence of estrogen, progesterone and testosterone in a proper ratio balance the body. There are many factors that can alter this perfect ratio. Restoring the proper ratio can have significant benefits to your health.
Why Get Tested? Would you take thyroid, blood pressure, cholesterol medication or insulin without first checking your levels? Would you add gas to your car or replace the brakes whenever you felt like your car needed it? Why maintain the car at all? It s just part of being an old car isn t it?
Testing Methods Serum Hormone levels: Disadvantages: Doesn t distinguish between bound (non-functional) and unbound (functional) hormones. Invasive. Normal ranges can vary from 30-500 milligrams. Advantages: usually covered by insurance. Salivary levels: Found in studies to more closely mimic true tissue levels. Reflects free (unbound) hormone levels.
Testing Methods Pg Cream (daily dose) 0 mg 0.34 mg 30 mg Plasma (ng/ml) 0.36 + 0.06 0.50 + 0.09 1.8 + 0.3 Saliva (ng/ml) 0.03 + 0.006 0.152 + 0.025 8.7 + 3.5 Direct Comparison of Plasma and Saliva Levels After Topical Progesterone Application Dollbaum CM, Duwe GF. Absorption of progesterone after topical application: plasma and saliva levels. Presented at the 7th Annual Meeting of the American Menopause Society, 1997 Bloom T, Ojanotko-Harri A, Laine M, Huhtaniemi I. Metabolism of progesterone and testosterone in human parotid and submandibular salivary glands in vitro. J Steroid Biochem Mol Biol Jan 1993; 44 (1): 69-76.
Salivary Hormone Levels Studies Painter-Brick C, Lotstein DS, Ellison PT. Seasonality of reproductive function and weight loss in rural Nepali women. Hum Reprod May 1993; 8 (5): 684-690. Ellison PT, Painter-Brick C, Lipson SF, O'Rourke MT. The ecological context of human ovarian function. Hum Reprod Dec 1993; 8 (12): 2248-2258. Ellison PT. Measurements of salivary progesterone. Ann NY Acad Sci Sept 20 1993; 694: 161-176. Campbell BC, Ellison PT. Menstrual variation in salivary testosterone among regularly cycling women. Horm Res 1992; 37 (4-5): 132-136. Lipson SF, Ellison PT. Reference values for luteal "progesterone" measured by salivary radioimmunoassay. Fertility and Sterility May 1994; 61 (3): 448-454. Bloom T, Ojanotko-Harri A, Laine M, Huhtaniemi I. Metabolism of progesterone and testosterone in human parotid and submandibular salivary glands in vitro. J Steroid Biochem Mol Biol Jan 1993; 44 (1): 69-76. Good Evidence Concerning the Absorption of Steroids Through Human Skin Johnson ME, et al. Permeation of steroids through human skin. J Pharmaceutical Sci 1995; 84: 1144-1146. The Evidence of Red Blood Cell Transport of Progesterone Devenuto F, et al. Human erythrocyte membrane: Uptake of progesterone and chemical alterations. Biochim Biophys Acta, 1969;193:36-47. Koefoed P, Brahm J. Permeability of human red cell membrane to steroid sex hormones. Biochim Biophys Acta 1994; 1195: 55-62.
Hormone Replacement Options Traditional Hormone Therapy: Premarin, Provera, Evista, Estratest, Climara, etc. Bio-identical Hormones: synthetic hormones made to be identical to human hormones
Natural vs Bio-identical Estrogen
Natural vs Synthetic Premarin
Natural vs Synthetic Progesterone (Progestin)
Myths and Misconceptions WHI looked at the effects of Premarin and Provera on health. Study stopped due to increased risk of Stroke 41%, breast cancer 26%, heart disease 29%, worsening of lipid profile 31% and pulmonary embolism 213%. No difference in risk with progesterone. PEPI Study looked at cardiovascular disease risk in apes using progesterone vs progestins. Decreased risk in progesterone group. Not one study to date has shown an increased risk of stroke, worsening heart disease, increased cancer, worsening lipid profile, pulmonary embolism or any other disease with the use of Bio-identical hormones to balance hormones when prescribed and used as directed.
So Why All The Confusion? Conspiracy theory? Pharmaceutical companies control nearly every venue of medical literature and support medical schools with grants and donations and would never allow any promotion or literature supportive of anything contrary to their business to be promoted. Pharmaceutical companies would lose billions of dollars/ annually if synthetic hormones were no longer used. Most doctors know very little about most of the medications they prescribe beyond that told to them by the drug representative. People (including doctors) tend to fear and mock what they do not understand. Very few studies have been done directly comparing Bio-identical hormones to their synthetic counterparts. Most medical literature group hormones together as if they were all the same. Not all fuels are good for the same vehicle.
Take Home Message You aren t just getting old. It may be your hormones that are making you sick. Hormone imbalance may be the problem or it may not. The only way to know is to check. When done right, hormone replacement therapy does not increase health risk but may significantly reduce your health risk.
Want more information? Contact Dr. Elvis Torres 414 Grand Parkway S. Ste 115 Katy, Texas 77494 281-392-3700