Bio-Identical Hormone Optimization Therapy
Conventional medicine has always held the belief that aging is inevitable and that the progressive deterioration that occurs in our adult years cannot be altered. This is simply not true. We have also been lead to believe that the disease of aging, such as heart disease, stroke, cancer, and senility, are all part of the normal aging process. Fortunately, there is an exciting revolution in science and medicine that identifies bio-identical hormone optimization as preventative medicine. The downward spiral of physical and mental decline that we have come to accept as a natural part of growing older is becoming recognized as somewhat controllable and preventable. We are entering an era where mainstream medicine will focus on slowing down the aging process and thereby achieve prevention of both the illnesses of aging as well as the symptoms of aging. One of the most important and successful treatments is bio-identical hormone optimization.
As a man ages, his body naturally makes less testosterone. In fact, by the time a man is in his mid-forties, testosterone levels can be down by 40%. By the age of 70, most men’s testosterone levels are down by 70%. Lifestyle factors such as excessive stress, weight gain, hormone disruptors in some of the foods we eat and products we put on our skin, lack of exercise can lower levels even further which have a negative impact on stamina, sex drive, virility, bone strength, muscle atrophy and can potentially lead to chronic fatigue, erectile dysfunction, and even cardiovascular disease: heart attack and stroke. The same is true for women. By the time they are in their mid-forties, their testosterone levels can become non-existent resulting in multiple signs and symptoms negatively impacting their quality of life. On average, almost all women by age 52 are deficient in testosterone, estradiol, and progesterone.
Warning symptoms of low testosterone levels, aka “Low T” or andropause:
- Decreased energy, lack of motivation or self-confidence
- Low Libido (sex drive)
- Decreasing sexual performance and erectile dysfunction (ED)
- Poor concentration and memory
- Increases visceral and peripheral fat
- Reduced physical performance, muscle mass and obesity
- Loss of body hair
- Low sperm count, infertility
- Increased risk for cardiovascular disease and prostate cancer
Warning symptoms of diminishing testosterone, estradiol and progesterone levels, aka menopause, include:
- Irregular, heavy or absent periods
- Chronic fatigue
- Weight gain
- Low Libido (sex drive)
- Vaginal dryness, painful intercourse
- Anorgasmia (inability to have orgasms)
- Urinary incontinence
- Frequent urinary tract infections
- Increased skin laxity and wrinkles
- Loss of breast volume
- Thinning hair
- Muscle and bone aches and pains
- Migraine headaches
- Brain fog, decreased mental clarity, poor concentration
- Osteoporosis (thinning bones), fractures
AGING, HORMONES, AND BIO-IDENTICAL HORMONES
Over the past 50 years research in the fields of endocrinology and immunology has improved our knowledge as to how and why we age. The rate and incidence of disease formation as well as the rate of aging are partially controlled by our endocrine and immune systems. These two systems are responsible for adaptation and change of our body in relation to the aging process. The endocrine system regulates our body’s temperature, reproduction, growth, aging and immune system. Communication between the nervous system, the endocrine system, and the immune system makes it possible for us to adapt and survive in our environment. It is through hormones that these systems interact to accomplish this mission. Hormones are molecules that are released into the blood stream and exert biochemical effects on distant organs and cells. Hormones can affect every cell in the body by activating a receptor site on the cell and thereby causing an internal activation of protein synthesis and activity. The hormone’s effect is determined by a specific receptor site on the target cell. Hormones serve as messengers from the central nervous system telling our internal organs how to function. Hormones turn on the cellular machinery and therefore cause increased metabolism, increase in protein synthesis, increase in cellular repair, and increase in cell replication. A decrease in the production of hormones begins in middle age and continues to diminish in a linear fashion until old age.
Hormones are made in endocrine glands which include the pituitary gland, adrenal glands, the testes, ovaries, pancreas, thyroid, and pineal gland. When there is degeneration and aging of organs, the levels of hormones diminish. In addition, as we age, the specific receptor sites in the cells tend to change and become not as receptive to the hormones as they once were in our younger years. Whether the problem is low hormone production or hormone resistance, the solution is to optimize hormone replacement.
For many years, medicine has recognized the health benefits of replacing these waning hormones. For most physicians, synthetic hormones were the only option, however, now it is possible to produce natural, bio-identical hormones that in every way match those produced by the body. Bio-Identical means molecularly identical to the body’s natural hormones. Unlike conventional, synthetic hormones, bio-identical hormones are derived from natural plant sources like yams and soybeans. We have come to understand that synthetic hormones, which are chemically different than those naturally found in the body, can cause a whole host of side effects and even cancer. It does not make sense to replace with chemically different hormones when bio-identical hormones to which our bodies are accustomed are available.
All aspects of aging are influenced by hormones. As we age cellular receptor sites become less sensitive to stimulation by hormones, thus requiring an increased amount of hormone to affect a cellular change. This is precisely why people need optimal levels of all their hormones. Even though their levels might be considered normal, they still need more hormones in the body to improve and feel better. As we mention to all of our patients, “You don’t want to have normal hormone levels, you want to have optimal hormone levels.” Research has now proven that optimizing hormones is a valid means to improve and prolong quality of life, thus showing that deficiencies in hormones and endocrine dysfunction can contribute to signs and symptoms of getting old.
Although nothing can reverse the aging process, bio-identical hormone optimization can slow down the process and help us maintain our good health. Hormones decline in all people as they age. You are never as healthy as the day you turned 21, its pretty much all down hill from there unless you get proactive with your health and lifestyle choices. Many physicians assume this is the natural way it should be. If a younger person were to be diagnosed as having a hormone deficiency, it would be quickly corrected. However, the same low level in a middle aged or older individual is considered “within normal limits” for their age and not something we should treat. This is absurd! Normal is a relative term. No one wants the hormone levels of an 80-year-old, but labs report this low level as “normal” even though it might be only 20% of the level of a 30 year old. Researchers from around the world have shown that the hormone deficiency associated with age should be optimized to that of a younger person. When patients see and feel the improvement, they embrace this “life-changing” phenomenon wholeheartedly. It is not until one tries this new therapy and experiences the incredible vitality that one realizes the harm that is being caused by the lack of these hormones. In fact, bio-identical hormone optimization should really be called “preventative medicine”.
It has been shown that many changes seen in normal aging, including osteoporosis, weight gain, diabetes, cardiovascular disease,muscle atrophy, sleep disorders, male and female sexual dysfunction, and decreased sociability are partly caused by a decrease in hormone levels. Within six to twelve months of bio-identical hormone optimization, patients notice the reshaping of their bodies with decreasing visceral and peripheral fat, increased muscle tone, more energy, better sleep, improved sex and many other life-changing symptom relief. Patients report and improved sense of well-being and an improved outlook on life.
Unfortunately, the majority of the patients we see who are taking “natural hormones” from other physicians are on inadequate regimens. We know this because on the initial visit we perform a very comprehensive endocrine lab evaluation and check all hormone levels which are frequently sub-optimal. In order for hormones to be beneficial, the serum hormone levels must be kept within the optimal, upper limit of normal levels of a younger person. Most physicians are not trained to target optimal levels. They also might not be aware of the many options in the compounding of a natural hormone in order to provide a type that is absorbed and metabolized by the individual patient. It is not a “one pill fits all” and “see you next year” program. Patients must be monitored closely and their symptoms and labs evaluated frequently (at least every 3 months upon initiating therapy). The correct form of bio identical hormones must be utilized in order the get patient compliance to insure optimized levels. There are different forms of bio-identical hormones including pills, creams, injections, pellets, troches, and vaginal suppositories.
What are the hormones that need to be optimized?
We usually optimize testosterone, DHEA (dehydroepiandrosterone), Vitamin D in both men and women. Women also get estradiol, progesterone and thyroid hormone optimized.
What are the benefits of optimizing estradiol in women?
Estradiol optimization improves the quality of life for women by making them more youthful and energized. Women on estradiol have better muscle tone, fewer wrinkles, stronger bones, shinier hair, and more enjoyable and satisfying sex life after menopause. Estradiol users have half the risk of heart disease and stroke and an extremely low incidence of Alzheimer’s disease. It is not until women lose estrogen that they start to experience heart disease, bone loss, and deterioration. Estradiol uses do not experience vaginal dryness, urogenital atrophy and concomitant urinary tract infections. Estradiol has been shown to lower total blood cholesterol and raise HDL, the good cholesterol. Not only does estrogen protect blood vessels of the heart, it also protects vessels of the brain and protects against Alzheimer’s disease.
Why is it important to optimize testosterone and is used in women as well as men?
Testosterone is the ultimate “feelgood” hormone that is made by the ovaries, testis, and adrenal glands and is critical for restoring energy, vitality, libido, and enhancing quality and frequency of orgasms. It also helps men and women decrease both visceral and peripheral fat, improves attention, focus, and memory, prevents muscle and bone loss, and prevents thinning of skin and wrinkles. Testosterone gives both men and women an overall sense of well-being and a zest for life.
Why is it important to optimize thyroid hormone?
Most patients seem to know when their thyroid hormone levels are subpar but physicians refuse to acknowledge this. Decreasing energy levels, weight gain, thinning hair, dry skin, cold hands and feet, slowness of thinking, forgetfulness, and susceptibility to colds and infections are all symptoms of low thyroid hormones. Oftentimes, physicians will only check a TSH (thyroid stimulating hormone), which indirectly evaluates the thyroid gland. We routinely check and free T3 and free T4 blood levels which directly measure what the thyroid gland is actually making. By doing this, we can optimize exactly what the body is lacking, restore metabolism, and get resolution of the aforementioned symptoms.
Why is it important to optimize DHEA?
DHEA is the precursor to all of the hormones made in the body. Maintaining optimal DHEA levels are important to optimize health as it helps one to sleep better, gives you more energy, helps you handle stress better as well as boosts your immune system which protects your from getting infections, inflammation, atherosclerosis, and cancer.
Why is it important for women to optimize progesterone?
Natural or bio-identical progesterone (not synthetic progestins) are important for women as they protect you from endometrial, breast, and colon cancer. Progesterone also helps prevent osteoporosis, improves libido, prevents insomnia and promotes REM sleep and the production of HGH (human growth hormone). It also is cardio protective as decreases total cholesterol and raises HDL. Progesterone also helps alleviate PMS symptoms: headache, depression, anxiety, bloating, cramping, irritability and moodiness.
Why is it important to optimize Vitamin D?
Vitamin D not only protects you against bone loss, heart disease, dementia and osteoporosis, it also boosts the immune system and therefore protects you against most cancers and infections.
Are all hormones the same?
Absolutely NOT! Bio-identical hormones are not the same as synthetic. Premarin, Provera, and Prempro are synthetic hormones made from pregnant horses’ urine and are not bio-identical. The WHI (Women’s Health Initiative) Study in 2002 demonstrated that the combination of synthetic hormones resulted in the increase risk of breast cancer and heart disease. This is not true when you use bio-identical hormones. In fact, the opposite is true as there have been studies linking bio-identical hormones with decreased risk for heart disease and stroke. Bio-identical progesterone and testosterone decreases risk for breast cancer.
Are you ever too old to start bio-identical hormone optimization?
As men and women age they are at increased risk for cardiovascular disease, stroke, osteoporosis, dementia and cancer. Since bio-identical hormone optimization protects you from these diseases, it is never too late to start.
Does testosterone cause prostate cancer in men?
Absolutely not. In fact, there are studies suggesting that younger men with low testosterone are at higher risk of getting prostate cancer when they are older if they do not optimize their testosterone.