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Safer Hormone Replacement Therapy for Men and Women

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Wellness - Hormones for Males and Females

"Keep an open mind, but not so open that your brain falls out"  Groucho Marx
 
What is a hormone?
A hormone is a chemical messenger that circulates throughout your body telling your cells what to do. Should the body build new muscle, burn fat or go to sleep? Hormones are responsible for your physical and emotional health. Hormones work like an orchestra. If they are unbalanced, they can produce a whole range of unpleasant symptoms such as anxiety, depression, weight gain, decreased libido, excessive facial hair, acne and osteoporosis. Both men and women are affected, but constant ups and downs due to periods, yo-yo dieting, stress, pregnancy and menopause make woman much more susceptible. Progesterone, estrogen, and testosterone are three sex hormones whose names are known by most adults. They are involved in much more than sex and reproduction. Osteoporosis, heart disease, mood changes and memory decline are examples of side effects brought about by declining sex hormones.
 
Thyroid hormone, growth hormone, DHEA, and pregnelolone are examples of other hormones that also decline with age. Nearly all hormones decline with age. Let us repeat one more time: our hormones do not decline because we age; we age because our hormones decline. Many women and men will benefit at a certain age from bio-identical hormone replacement. The question is when and how. Here are the evidence based answers that we have today. Let us start with the most controversial topic: hormone replacement for women.

Hormone replacement for women. The Women's Health Initiative study published in 2002 covered some 60,000 nurses randomized in a trial of estrogen/progestin versus placebo in women aged 50-79. It was stopped early because the women on HRT were developing more cardiovascular disease and breast cancers than those on placebo. The message that some people got from the media was that HRT was killing women, but that wasn’t true. Over the thousands of patients followed for four years, women on estrogen plus progestin had seven more coronary events, eight more strokes, eight more pulmonary emboli, and eight more invasive breast cancers than women who didn’t take hormones; but they also had six fewer colorectal cancers and five fewer hip fractures, and the same number of deaths overall.
 
Instead of reporting the absolute risks, the media reported relative risks which sounded much worse. Furthermore, the statistics were for all women including those who smoke, have strong family histories of heart disease, are overweight, etc. It is clear that those with no other cardiac risk factors would be less likely to have heart attacks.
 
Most people equate "natural" with safe, and "chemical” or synthetic with unsafe. Marketers exploit the public’s misconception to sell them natural vitamins or plant hormones that may or may not be effective. Natural does not mean it is safer than synthetic. Snake poison, mercury or heroin plants are natural. Water, calcium and oxygen are chemicals. Insulin, a chemical hormone that is depleted in diabetics used to be extracted from pork but now is synthesized through recombinant DNA technology in the lab. Such hormones are called biologically identical or bio-identical for short, regardless of whether they are natural or synthetic. Frequently, synthetic is more effective, more standardized or more precise than natural or herbal.
 
The findings scared many women to the point of stopping their Hormone Replacement Therapy (or HRT), and opting instead to tolerate hot flashes, and night sweats, two of the more physical symptoms of hormonal decline.

The problem is that without estrogen, women experience a significant increase in memory problems, Alzheimer’s disease, mood swings, osteoporosis, increased lipid oxidation and heart attacks. Classic menopausal symptoms manifest themselves, e.g., hot flashes, increased vaginal dryness, urinary incontinence and bladder infections, and reduced libido to name just a few.

Without enough progesterone, a great many women suffer from anxiety, insomnia, depression and weight gain. They are quickly handed anti-depressants when in fact these symptoms may be cured or seriously minimized through natural bio-identical progesterone replacement.

The HRT drug used in the above mentioned study was called Prempro. It is short for a combination of drugs (Premarin and Provera). Premarin represents 51 different foreign conjugated estrogens that are prepared by horse liver as waste. “Pre” is short for pregnant and “mare” is a female horse. Premarin has very little resemblance and no receptors to the natural or bio-identical hormone that the body needs, also called bio-identical estrogen.

While they are effective in controlling hot flashes, these foreign estrogens actually increase breast cancer and elevate cholesterol and platelet stickiness thereby increasing strokes and heart attacks. Mounting but inconclusive evidence point to the likelihood that risks are much less with E3 or estriol and probably less with estradiol or E2. Estradiol should not be taken by mouth but should be used as a trans-dermal patch. Using any estrogen by mouth increases platelet stickiness and clots. Premarin has been banned in many countries in Europe and in the Middle East. Amazingly, Premarin is still available as an FDA approved drug in the USA! The other component of Prempro that was used in the WHI study is Provera. Provera is another foreign substance that is supposed to mimick progesterone. This substance is called progestin or Medroxy Acetate Progesterone (MPA). The body does not have receptors for progestins the result of which is that they linger in the body for much longer. Progesterone is a natural diuretic whereas progestins cause water retention. Natural micronized progesterone has fewer adverse reactions than progestins or MPA.

The only major problem attributed to the natural form is drowsiness. Drowsiness is good if the patient is having trouble sleeping which is often the case in females suffering with low progesterone. Patients then are happy to take their pill in the evening. Progesterone skin patches, currently available only in compounding pharmacies, do not cause drowsiness as they bypass the liver. Overdose may also cause fluid retention. Progesterone, a naturally occurring hormone in both men and women, participates in practically every physiological process in the human body. Its tremendous increase during pregnancy acts to stabilize both mother and child. At levels reached just before delivery, progesterone causes a natural anesthesia and contributes to tissue elasticity.

Bio-identical progesterone also help control the entire range of PMS or Peri-Menstrual Symptoms, which affects millions of women in their early forties prior to their monthly periods including migraine, acne, hot flashes, irritability, edema, and lethargy. Links between progesterone insufficiency and certain cancers have also been made. For instance, prolonged progesterone deficiency causes subtle changes in a normal uterus so that endometrial hyperplasia (an abnormal thickening of the uterine lining) may develop. This, in turn, if left untreated may eventually lead to uterine cancer.

Studies have concluded that progesterone has a positive impact on osteoporosis in postmenopausal women since progesterone helps build new bone tissue while estrogens maintain the newly formed bone.

Additional studies have shown that women taking estrogen are more likely to develop uterine cancer than those not taking this hormone. It should be noted that the vast majority of women studied were either using estrogen without balancing it with progesterone, or they were using the wrong kind of estrogen i.e. the conjugated form. It is important to note that many hormone specialists believe that some forms of estrogen are safer than others. All hormone replacement for women should be monitored by a gynecologist or a competent physician who is familiar with Bio-identical Hormone Replacement Therapy or BHRT, as the patient need regular retesting and adjustments about every six months.

Testosterone is known by most to be a "male hormone" that changes a boy into a man. While this is true, it is important to understand that women need testosterone for bone health, enhanced energy levels, an overall sense of well-being, and increased libido, especially if their partner maintains his ideal testosterone and sex drive.

Anti-Aging Medicine Practitioners are, in my opinion, correct in attacking conjugated foreign estrogens in favor of the synthetic estradiol that is bio-identical. However, disturbing ethical problems persist as Bio-identical Hormone Replacement Therapy or BHRT continues to be prescribed with lax regulation or inconsistent specialists’ oversight by some outlets. Although, misleading advertising can apply to other health products, particularly around diet and nutrition, hormone therapy is not a “supplement” but a necessary therapy that burdens all women in menopause and men in andropause. Patients are thus vulnerable victims seeking relief from debilitating symptoms and interested in preventing diseases associated with estrogen, progesterone and testosterone loss. They are confused, and even coerced, with misinformation and inaccurate patient literature that is meant to guide them in decision-making. This creates special obligations for health care providers who treat menopausal patients.

Special education sessions about the risks and benefits of various treatments, along with time for correcting misinformation, should be the standard of care for in-office visits. The doctrine of informed consent demands that patients have the genuine capacity to understand and appreciate the potential risks and benefits of their hormone replacement therapies, as well as, other available options. Barriers to informed consent include language and lack of time on the part of the harried physician who is not reimbursed by insurance providers to spend more than twelve minutes per consultation. It is not unusual for language and mental health problems, including depression and anxiety, problems that are not infrequent in the peri- and postmenopausal community, to interfere with patients’ ability to receive the information needed for a proper consent. The patient frequently caves in and signs a consent form without true informed consent.

While we are on the subject of informed consent, let us also talk a bit about hysterectomies, one reason for needing hormone replacement prematurely. Most of us would not knowingly choose to be castrated or choose an operation that triggers early menopause. We would not deliberately choose to accelerate aging, heart disease, osteoporosis and urinary incontinence. But that is what millions of women do every year when they schedule a hysterectomy.

One out of five women in the USA loses her uterus by age 55. 70% of hysterectomies not done for cancer are avoidable. Young girls who start taking birth control pills at age twelve or fifteen, and continue to use them into their adult life, do suffer from an increased incidence of early cervical cancer, which is usually picked up by the gynecologist. After years of observation and biopsies, a woman may have to undergo this life-altering operation. Only 15% of all hysterectomies are done to treat or prevent cancer. With the exception of cancer, there are in most cases many effective alternatives to hysterectomies. Make sure your doctor discusses alternatives with you before making an informed medical decision that can have far-reaching consequences.

The most difficult decision a woman may face at mid-life is the question of whether Hormone Replacement Therapy (HRT) is right for her.

When patients seek out information about BHRT on the internet, they encounter several prominent BHRT websites maintained by physicians in private practice. Studies surveying internet health-seeking behaviors support the hypothesis that most patients do not have the background to decipher credible sources from non-credible sources, and when they are looking for solutions to menopausal discomfort, the sites making false claims have convincing arguments for laypersons. They seem to forget that anyone can say anything on the internet.

Patients who self-educate about BHRT frequently start with non-technical books describing anecdotal examples of BHRT use that validate their experiences of estrogen loss. Susanne Somers' book is one example of a text that does this; it remained on the New York Times Bestseller's list throughout much of 2007, receiving wide coverage by CNN; and continues to be one of the best-selling books on Amazon under “Menopause”. What is most problematic is that this book makes unsubstantiated claims that BHRT prevents breast cancer. Regardless of formulations, hormone therapies using estrogen and progesterone are presumed to carry certain risks. They seem to think, if it is on the best seller list, it must be accurate.

Estrogen increases cell division thereby increasing the risk of certain cancers, whereas progesterone makes the cells differentiate into specific cells. Uncontrolled purposeless division without differentiation is what creates cancers. There is no evidence that micronized bio-identical progesterone replacement increases the risk of cancers, while there is some evidence that progesterone decreases cancers. As far as BHRT containing estrogen goes, estradiol may cause less cancers than other estrogen forms but this is still not proven beyond doubt. Estriol or E3 is the weakest and safest form and is used in Europe by some instead of Tamoxifen for breast cancer therapy. The worst case scenario is that BHRT is as bad as conjugated estrogens where the risk of breast cancer is relatively small in the properly selected patients, compared to the long list of BHRT benefits.

Progesterone secretion decreases with aging ovaries in the early forties. Progesterone stimulates the calming GABA neurotransmitters in the brain to balance the energizing or stimulating estrogen hormone. Frequently women continue to secrete unopposed estrogen even with weak ovaries as their fat stores secrete estrogens. This leads to increased anxiety and increased cancers.

The question of hormone replacement in women should be influenced by a number of factors, including:
1. The severity of the physical and emotional symptoms caused by declining hormonal levels.
2. Your hormone levels as measured by laboratory tests
3. Your individual risk for Alzheimer’s, osteoporosis and heart disease.
4. Your individual risk for cancers of the breast and reproductive systems should be discerned through family history or genetic liver testing.

A slim female with a male chest physique and a strong family history of osteoporosis and Alzheimer's presents to my office wanting hormone replacement. She would be a probable candidate for BHRT. Should she be a patient who is overweight with a family history of breast cancer and is suffering from anxiety and insomnia, I would recommend progesterone pills to balance her unopposed estrogen produced by the fat cells around her belly. Laboratory tests would be carried to confirm the clinical impression prior to BHRT.

The attempt to balance short- and long-term health concerns against HRT's potential risks has been a source of great uncertainty for many women. In fact, one survey found that one-third of the women who are given prescriptions for hormones don't bother to refill them. The discussion can get very technical. I have interpreted the data and summarized it to provide you with the most up to date, comprehensive, and scientifically proven information in relatively plain English. This subject is too critical for men or women to ignore. I hope to shed light on some of this uncertainty in the remaining few pages on this subject.

When should a woman consider BHRT?
Hormone therapy is helpful in most women after menopause and for many women in their early forties when their ovarian function starts declining.

Hormone therapy should be avoided if you:
1. Are pregnant
2. Have a family history of or have had uterine, or ovarian cancer
3. Have large fibroids or a breast cancer
4. Have a history of forming blood clots, although some studies claim that using the estriol- estradiol combination or BHRT form as a skin patch is safe

Progesterone Deficiencies Are Easily Treatable. A progesterone deficiency may manifest itself in younger women as "problem periods." During these times, women may have trouble conceiving or have extreme menstruations. Performing repeated surgeries (Dilatation and Curettage or D&C') will only stop the bleeding temporarily, whereas progesterone therapy can have long-lasting results. In some cases, after a few months of treatment, the body will bring its own progesterone production into the proper balance.

Premenstrual Syndrome (PMS) and menopause are classic examples of conditions treatable with progesterone. Usually, when a woman reaches her 40's, progesterone levels drop below normal. Also, quite commonly, there is a low progesterone/estrogen ratio. Both conditions produce symptoms including anxiety, cramps, irritability, depression, headache, dizziness, and bloating. Progesterone relieves these symptoms, enhances energy and sexual libido, and heightens feelings of well being. In treating osteoporosis, it is important to note that estrogen supplements delay bone mass loss, but do not reverse it. Thanks to its anabolic nature, progesterone, on the other hand, effectively treats this loss of bone mass by enhancing new bone formation and supporting bone calcification. Hence, a reversal in diminished bone density is possible in many cases.

Estrogen Deficiencies Are Also Easily Treatable. One complication of a woman's diminished estrogen levels is the increased risk of decreased HDL, the "good" cholesterol, and heart disease. The frequency of heart disease in women, which is low before age 50, rises dramatically after menopause and approaches that of men.

Taking estrogen alone increases HDL, which can actually result in a 25% reduction in the risk of heart disease. Estrogen combined with progesterone reduces heart disease risk also, but not as dramatically as estrogen alone. Unfortunately, a third of the women taking only estrogen developed endometrial changes, a precursor to uterine cancer. Estrogen beneficial cardiac effects are lost if estrogen is taken by mouth. As an easy-to-apply trans-dermal patch, estrogens are supplemented with progesterone by mouth to reduce the risk of heart disease with a lower risk of increasing breast cancers.

The Benefits of BHRT
BHRT is slowly replacing the old HRT because there appear to be clinically proven benefits: protection against osteoporosis and heart disease, and relief of menopausal symptoms with much less risk of developing uterine, ovarian or breast cancers. Another problem facing BHRT is the "individualized" approach. Doctors often prescribe BHRT as a compounded formulation. This means that pharmacists put in several ingredients to fill the prescription order. This practice may lead to variations in the amount of the active ingredients which could lead to overdosing or under-dosing when taken by the patient. In addition, the safety, efficacy, potency and purity of the formulation can also be affected. In the U.S., the FDA analyzed compounded BHRT formulations and discovered that 34% failed in one or more standard quality tests. We shall see in the future stricter quality controls on compounding pharmacies and a larger dose selection of standardized BHRT skin patches, to answer the need of the full range of patients. This selection shall sacrifice the ideal individualization delivered by compounding pharmacists for the safety of drug manufacturers.

 
The drug companies are now manufacturing synthetic BHRT in the form of estradiol skin patches and bio-identical progesterone pills with Prometrium in the USA and Utrogestan in Europe as the leading brands, to wrestle back the business lost to compounding pharmacies. The patient in my opinion gets the better of the two worlds: FDA approved standardized bio-identical hormones that are not foreign to the body.
 
Monitoring your BHRT program
Lab tests can give some guidance in terms of monitoring BHRT and especially to avoid overdose. Saliva tests are excellent tools to check the levels of the stress hormone cortisol and tissue levels of sex hormones. Blood tests are the gold standard for estrogen, progesterone and testosterone levels and urine tests for DHEA sulfate. When looking at lab values we need to be guided by ideal or optimal recommended levels. Keep in mind that hormone lab tests are tricky because hormones are secreted in spurts and are bound to different proteins making errors in interpretation very common. An experienced specialist relies mainly on patients’ symptoms and much less on lab tests.
 
An essential but underutilized test to conduct on all patients of both gender, whether on BHRT or not, is the Estronex test which calculates the ratio of the bad estrogens to the good ones. Early detection may prompt the monitoring physician to decrease the dose. Taking proper liver supplements such as DIM and curcumin pills help the liver re-route the body’s estrogens into favorable detoxification pathways, and assist in preventing prostate and breast cancers.
 
Relief of Menopausal Symptoms
 

Hot flashes. About 75 percent of women entering menopause experience hot flashes, a sudden flush or reddening of the skin on the upper body and face accompanied by feelings of intense heat and , in many, profuse perspiration. These frequent and unpredictable episodes may awaken you at night, causing sleep deprivation. In most women, hot flashes occur for a year or two after the onset of menopause; however, in 25 to 50 percent of all women, they continue for more than five years. Although the physiology of the hot flash is still not understood, its correlation with lower levels of estrogen following menopause has been clearly established. Most women find relief from hot flashes with hormone therapy.
 
Vaginal atrophy. Because low estrogen production brings a loss of elasticity in the skin, many postmenopausal women experience atrophic changes of the vagina exhibited through loss of muscle tone and strength in the vaginal wall. Vaginal dryness, which can result in burning, itching, and painful intercourse, can be remedied with post-menopausal hormone therapy. Recurrent urinary tract infections that result from abrasions due to vaginal dryness are also effectively prevented with hormone treatment.
 
Some women get significant relief in a month, but therapy can take six to 12 months, so don't be discouraged if you do not see immediate results. To maintain relief, you will most likely have to continue taking estrogen. To stop treatment “cold turkey” often invites an even worse recurrence of the problems that led, initially, to taking hormones.
 
Urinary incontinence. The postmenopausal loss of pelvic tone that causes urinary stress incontinence in some women can be improved with hormone therapy. However, Kegel exercises are a more effective way of restoring muscle tone, and you don't need a prescription. Most doctors recommend diligently performing these exercises rather than using HRT solely to cure incontinence.
 
Emotional distress. Women experience increased anxiety, depression and insomnia as their calming hormone –progesterone- decreases after age forty. Hormonal therapy can restore your sense of well-being by alleviating these symptoms. However, emotional distress that goes beyond the normal sadness that accompanies serious life events, such as the death of a loved one, is probably better treated by a psychiatrist than by hormonal treatment.
 
Other symptoms. Hormone therapy may improve short-term memory and slow overall body deterioration. It also improves skin collagen, bringing smoother and thicker skin, firmer breasts, and improved muscle tone.
 
Side-Effects of BHRT in women
Although most women respond well to hormone replacement therapy, you may notice one or more of the following side effects.
 
Vaginal Bleeding
Uterine bleeding is the most common reason for stopping hormone therapy. This menstrual-like bleeding is called withdrawal bleeding, because it occurs when progesterone levels drop. While bleeding diminishes and ceases within a year for about two-thirds of women on progesterone, some women will continue to bleed periodically as long as they continue the therapy. Breakthrough bleeding, which is spotting at other than the expected time, may also occur. Whether you are troubled with bleeding depends on the dose, regimen, hormone chosen and your individual response.
 
Other Side Effects
A two to three month adjustment period is often necessary for women beginning hormone replacement therapy. Other reported side effects include: nausea, cramping, headaches, fluid retention, vaginal discharge, depression, irritability, weight gain, and bloating. As with spot or break-through bleeding, sometimes slight changes in the dose or hormone chosen can minimize BHRT side effect, so it is important to tell your doctor if what you are experiencing troubles you. Routine follow up is essential.
 
Making the Decision
The decision to use or not to use BHRT ultimately belongs to you. It can be a tough decision informed by competing influences.
 
Trying to decide whether to take medication now to prevent disease that may occur in 20 years is a daunting prospect.
 
Most women base their decision on matters much closer to home. For example, a woman with a family history of breast cancer may resist taking hormones until she can no longer tolerate her severe menopausal symptoms. But after being on estrogen and progesterone, she may become reconciled to the therapy as it eliminates her hot flashes, restoring her normal sleep patterns and improving her mood. She worries about cancer, but believes with her doctor that she can monitor her situation through monthly self-exams, an annual checkup and routine mammograms. Though the risk of heart disease is greater than that of breast cancer, many women tend to be more worried about breast cancer because of the disease's physical and emotional toll. A woman may reason that there are other ways to prevent heart disease but no known ways to prevent breast cancer, and so resolve to eat a low-fat diet and exercise regularly instead of taking hormones.

Some physicians recommend testosterone supplements for women with diminished libido after menopause. In men, testosterone replacement, when indicated, is a sure guarantee for a better sex life. Women are different. While they need appropriate testosterone levels to be interested in sex, they are more complicated creatures than men, as psychological and emotional factors often play a major role.

To summarize, Bio-identical Hormone Replacement Therapies offer a method of correction that allows women of child-bearing age normal menstrual periods and increased opportunities for conception. In pre-menopausal woman, the scourge of PMS can be reduced, if not outright eliminated. Also, for postmenopausal women and andropausal men, the probabilities do exist for decreased risk of heart disease, and osteoporosis in conjunction with increased energy, improved memory and libido.

In the world of our ancestors, dramatic hormone loss, menopause, and rapid aging of women were perhaps nature’s plan. After all, why should the female stay around if she cannot reproduce? In today’s world, when millions of men and women are living longer than ever, Bio-identical Hormone Replacement can - and does when indicated – slow down this biological destiny, while improving quality of life for those well past their reproducing years.
 
Testosterone deficiencies in men and women There is a male menopause - sometimes called andropause – that is similar to the female menopause.
 
Andropause is more subtle than menopause because it happens more gradually and without the symptoms expected from menopause (hot flashes, night sweats, etc.). Unfortunately, the end result is about the same: loss of muscle mass, lack of energy, and decreased libido to name a few of the symptoms. Decreased sex drive is accompanied with decreased length of erection during intercourse, longer time needed before a second erection, loss of stiffness of the male organ during intercourse and loss of morning erections. These poor men wake up stiff all over except where it counts!
 
Depression in men is also a common result of lower testosterone. Depressed men do not go to psychologists and cry on their shoulders, instead, they get upset, grumpy and seem impossible to please.
 
The good news is that andropause responds very well to testosterone supplementation. But did you know that testosterone is a "love hormone" for women, too? It is true!
 
To treat andropause and or to increase libido in males and females, many physicians are now using testosterone-based patches. We can also use for men a convenient intramuscular shot given every 2-3 weeks, available in Europe but not yet in USA. Avoid using testosterone pills as they damage the liver and get transformed into harmful by-products. One side effect of taking testosterone is that it diminishes the size of the testicles by 20% and decreases the sperm count with each ejaculation thereby interfering with fertility. Individuals who are concerned about fertility should consider intermittent courses of the Human Chorionic-Gonadotropin or HCG, a hormone that indirectly stimulates the testicles to produce testosterone.
 
What about testosterone and the risk of prostate cancer?
It was always “felt” or “assumed” by urologists that testosterone therapy increased the risks of prostate cancer. Several studies in 2006, published by Dr. Morganteler, shed scientific light on these assumptions when they proved that Testosterone therapy does not increase prostate cancer. It is a challenge for a busy physician, even a specialist, to stay up to date. Make sure that your doctor is keeping up with the latest research. The body of medical knowledge in the fascinating field of anti-aging medicine alone is doubling every few years.
 
What about testosterone and heart disease?
It was also “felt” or “assumed” by cardiologists that testosterone increases the risk of atheroma or plaque formation which is responsible for blocking heart blood vessels. The assumption is based on the observation that women- who naturally have ten times less testosterone than men- have lower heart attacks. However, if you think of it men start getting heart attacks at the time their testosterone drops. Women have fewer heart attacks not because they have low testosterone but because they have the protective estradiol (E2). When estrogen levels drop in women after menopause, they catch up with men and get as much heart disease but occurring at a later age. Their testosterones also drop after menopause resulting in lower libido and higher lipids, abdominal obesity higher insulin and eventually heart disease.
 
There is absolutely no scientific evidence that testosterone replacement in humans increase atheroma formation, while there is abundant evidence in animals to suggest a potential improvement. A large four year study published in 2006 by the Sheffield Hospital team in England revealed that testosterone replacement did not increase atheroma formation in the carotid artery and did improve exercise tolerance tests and the time needed for ST segment changes and cardiac ischemia. Both estrogens and testosterone have been shown to have immune-modulating effects; testosterone in particular appears to suppress activation of pro-inflammatory cytokines. Men with low testosterone levels are at increased risk of coronary artery disease. We need to monitor the therapy with regular laboratory analysis every six months to avoid excessive dosing or aromatization, when testosterone is converted into bad estrogens, especially in men with large abdomens.
 
Testosterone may raise the blood pressure through its action on the kidney and adrenals and should be used with caution in people with established hypertension.
 
Unrecognized weak thyroid function. “I checked my thyroid hormones and I was told they are normal’’. While that may be true, if you are suffering from obesity and sluggishness you may want to take a closer look. There exists an epidemic of sub-clinical hypothyroidism affecting 10-15% of patients. In these cases, the thyroid hormone level may be within the normal range but is actually not in the ideal range. External stress leads to cortisol release and weakening of thyroid secretion. Internal stress such as a leaky gut, heavy metals, pesticides and other pollutants can severely interfere with thyroid function causing weight gain despite little caloric intake, depression, memory loss, chronic fatigue, depressed immunity and osteoporosis. Tissue swelling in the leg and in the wrist can lead to carpel tunnel symptoms such as pain and tingling in the hands at night.
 
To boost thyroid function I recommend a pill that contains a mixture of essential rare minerals such as selenium, iodine, zinc. If above thyroid boosters are not deemed strong enough, I start my patients on thyroid hormone replacement.
 
Growth Hormone Deficiency. Growth hormone is essential in adults to maintain proper posture, the immune system and brain function. Many anti-aging and hormone specialist saw great improvement in their older patients when they were placed on growth hormones. Unfortunately, resorting to growth hormone injections as an anti-aging remedy is illegal in the USA unless we document that you have growth hormone deficiency as growth hormone injections may cause joint pain due to temporary fluid retention and may be abused by individuals, such as athletes, whose growth hormone blood levels are normal. I have seen many physicians lecturing about the benefits of growth hormones walking around with large foreheads and large extremities (acromegaly) due to their abuse of that hormone.
 
The best way to maintain the body’s ability to produce its own natural growth hormone is through maintaining muscle mass by lifting weights, and by giving your brain the time to recharge its battery by avoiding alcohol and simple sugars. As growth hormone is mostly secreted by the brain in spurts during sleep, it is crucial to get deep and uninterrupted quality sleep.
 
Other Hormones. There are many hormones that need to be monitored as we age such as DHEA, pregnelolone, insulin, cortisol and the parathyroid hormone. An anti-aging specialist working as a team with an endocrinologist or hormone specialist may provide you with the best chance for optimizing your health. It is important to keep in mind that excessive stress, lack of sleep, sedentary lifestyle, environmental toxins and inflammatory diets rich in trans-fat and simple carbohydrates, negatively affect your entire hormonal symphony.
 
It would be much wiser to delay the need for hormone replacement by changing your habits, improving your body’s ability to detoxify and using selected, specific and effective vitamins and supplements. These supplements are the raw materials and hormone precursors that your challenged body need to grow its own hormones.

 

 


Last Updated on Sunday, 30 January 2011 11:15
 
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